How To

#215 Dr. Justin and Evan Discuss Their Functional Medicine Program Design

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Dr. Justin Marchegiani and Evan Brand discuss their effective functional medicine programs and how they create and follow protocols. This interview goes in-depth about the world of functional medicine practice. Find out why you shouldn’t wait for something to happen before doing anything about it health-wise. Discover the differences between Body System One and Two and how optimal health can be attained. Learn about the various tests you can take and the right tools that are available to further achieve better and more effective results with functional medicine.

In this episode, topics include:

01:26 Get help as early as possible

07:00 Body System One

10:19 Diet and lifestyle

17:16 Body System Two

38:22 Tests

Listen to it on iTunes. Stream by clicking here. Download as an MP3 by right-clicking here and choosing “save as.”

Dr. Justin Marchegiani: Hey, Evan, it’s Dr. J in the flesh. How we doin’ this Monday?

Evan Brand: Hey, man! I’m doing great. How are you?

Dr. Justin Marchegiani: I’m doing great. Can’t complain. It’s a little rainy Monday here in Austin. The grass is getting plenty of water which is great. I got the fireplace on behind me, so it’s got that wintery Christmas feel a little bit.

Evan Brand: Nice. Excellent.

Dr. Justin Marchegiani: Can’t complain. How about you?

Evan Brand: Doing well, man. Hey, we were trying to record this thing, and then we had choppy audio so I wanna repeat what my little rant was because I thought that was important. I’m always curious about what is the catalyst for someone to work with yourself or myself, and I had a lady this morning who had been listening to us for six months and she knew that she had problems. She had a lot of gut issues going on but she continued to just listen to try to fix herself, and then she got the diagnosis of alopecia and now she’s lost over half the hair on her head, and now she’s figured out that that’s the time to come and get help. And I just want that to be a fire under people’s butts listening that you shouldn’t wait until things are so bad that you’re at rock bottom before you get help and unfortunately, that’s the conventional system that we’ve all been brainwashed to do which is we wait until we’re really bad, we absolutely need a doctor or practitioner and then we go get help. And my advice, get help now. If you have symptoms and things are off, and this is something you’ve—you’ve trained me on so much. It’s like, “Evan, look, these issues are not gonna resolve themselves. You have to resolve issues now. They’re not just gonna magically disappear.” Did you wanna speak on that a little bit about people just waiting too long or people just not having enough reason so they think to get help?

Dr. Justin Marchegiani: Yeah, well, there was an interesting scenario just the recently. There was a plumber in my house a few months back and he was doing some work, and there was just like a leak on the faucet, and for some reason the leak went away the next day. So there were two plumbers there and he goes down and looks, and he couldn’t find the leak. And he goes, “Well, maybe it just went away,” and then his partner, the plumber next to him spoke up and said, “You know what? Leaks never go away on their own. If there’s a leak, it’s gonna get worse.” So he went down there and he looked, and he said, “Okay, well, we just need more flow and if you had more flow coming, it would start to leak.” And he looked a little deeper back and he found the leak and just the environment wasn’t quite right enough for the leak to be expressing itself but the whole idea was that these problems don’t ever tend to go away by themselves. So that was kind of the moral of the story and connecting it to your patient, let’s say if you have these symptoms, they’re gonna get worse and the question is, how long do you wanna wait until those symptoms, right? Pain, pay attention inside now—that’s what symptoms are—whether it’s aesthetic, whether it’s inflammatory, whether it’s mood or energy. How bad do they have to get before you start getting a—a fire under your butt so to speak.

Evan Brand: Right. Well, and my grandparents, their old house, you know, they had issues with their plumbing and they had to wait until their entire basement was flooded and thousands and thousands of dollars’ worth of carpet and furniture was ruined due to the flood before they came in and got the issue. So maybe they saved, you know, a couple hundred bucks in the beginning, but then it cost them likely $10,000 or more in the long run because they waited until things just hit an absolute worst-case scenario. So you know, I know there’s a lot of people out there listening that are trying to fix themselves and you and I certainly applaud that. I mean that’s what this is all about, right? Taking your health into your own hands and us teaching you how to fish, but at a certain level, you really just have to reach out and—and don’t be afraid to get better and—and don’t be afraid. You know, we’re real people. We don’t bite and we’re here for you. That’s what this is for. The show is to inspire you and to help you, but there’s nothing that’s gonna replace a one-on-one, you know, with one of us because there’s so many courses and online things, and things that you can look into, but it’s not specialized and I’m against specialization if you only look at one person. But you know, something we’re gonna talk about today is functional medicine is a specialty but we’re breaking that down. We’re—we’re looking at someone. We’re casting a net wide enough to look at every body system, so that we’re gonna figure out what in the world going on with somebody.

Dr. Justin Marchegiani: 100%. And so the template for how we treat patients is pretty unique for—for us as functional medicine clinicians, right? There a lot of nutritionists out there that will primarily just focus on the diet piece. There are a lot of medical doctors out there that I find that will a lot of time skip the diet, maybe focus on more of the hormones and ignore the gut. You have other people that will only work on infections, whether it’s Lyme or a gut doctor. They’re only focused on the infections. So the question is, how do we become the general or the ultimate general practitioner, where we can pull the key issues from the infections, from the hormones, from the diet, from the lifestyle, from the digestive system, and combine them together and mesh it? So we put it all together in a way that is holistic, that represents the underlying cause from each person, because that underlying cause percentage-wise may be different for each, meaning one person that may be 60% diet, 30% infections, and 10% hormones, and others it may be 30% diet, 50% hormones, 20% gut. So you gotta look at it from the perspective of what piece may be the bigger player, and it may not be the same for each person. So we may not know, but if we hit them all in the order that we consider to be the order of priority, that’s gonna give us the highest chance of hitting all of those key issues and not missing them.

Evan Brand: Right, and during the free calls, you and I block out just a few hours each month for free calls, which we’re always booked up for those and it’s a true honor to be able to offer that to people.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: A lot of people ask us, “Hey, Justin or hey, Evan, you know, can you just tell me right now what tests we’re gonna need to run.” And we can’t because that involves a case review, that involves looking at your history, looking at the fork in the road when did things get bad, how long have things gotten bad, what else was going on at that time in your life in terms of stress and travel and relationships and moving. You know, so there really is no one-size-fits-all program. Now there are similar tests that we run on nearly everyone, but at the end of the day, it’s so case-by-case and I know people wanna just get put into a box because it makes them feel comfortable. I mean, think of like Weight Watchers, right? You know, it’s a point system and you can buy their little hundred-calorie snack packs of pretzels. But that’s a horrible box to be in and you don’t wanna be confined there. So it—it’s a box of functional medicine but it’s a box without boundaries, too, because we never know what toolbox or toolkit we’re gonna need to reach into to pull something out specifically based on—on your symptoms.

Dr. Justin Marchegiani: 100%. So we wanted kinda get things dialed in, and we have like the pallet of our tests that we may choose from for body system one. That’s like the hormonal system and we break that up into ATF and ATM, adrenals, thyroid and female hormones for our female patients and then our ATM, adrenals, thyroid and male hormones. And depending on how deep we go is depending upon what kind of symptoms present themselves and how long the patient’s been sick. Typically, the longer someone’s been sick, it may be better to get more data so we can fine tune the plan better, more specific to what’s going on. If someone’s been maybe not feeling good for just a little bit of time, maybe only a few years or a few months, we may run less off the bat because we don’t need as much data. Typically, the low hanging fruit tend to work on people that aren’t as chronic. So that’s kind of a good rule of thumb. So our body system one test are gonna typically include high-quality adrenal tests. Well, and that depends. I know we’re going back and forth and testing, you know, the new Biohealth saliva test that’ll be out soon. We’ve been using the Dutch for a bit of time. We have been using the old Biohealth 201. I have lots of patients that come in with other subpar salivary hormone testing that—that come in. We also look at the DHEA sulfate, which is an adrenal marker of sex hormone precursors from the adrenals, DHEA sulfate. And then we’ll also add on female and male hormones to those tests, whether it’s female hormones, progesterone, estrogen, estrogen metabolites, the different kinds of estrogens, estradiol, estrone, estriol, whether we are looking at the DHEA metabolites like androstenedione or etiocholanolone. Those also get factored in, maybe even melatonin as well. So we’ll look at all these different metabolites on the hormone side and then depending on if they’re showing with thyroid symptoms, we may even run a thyroid blood test or we’re looking at all of the thyroid markers, TSH, T4 Free and Total, T3 Free and Total, reverse T3, T3 uptake, and thyroid antibodies. So those are kind of all of the hormonal tests that we may run. And we even have some different. We may even time it up on day 20 of a female cycle if they’re—if they’re menstruating to get a window into where their hormones are tapping out. We may even look at a full month long panel, testing hormones every other day for a full month, so we can get a window of ovulation and the ebb and flow of the hormones throughout the month, just to make sure it’s optimal for fertility.

Evan Brand: Yup, well said. So body system one. I mean, this is the foundation, you know. You talk about these people that just focus on the gut and we’ve dealt with that. I mean a lot of times and I know you hear this just as much as me if not more, “Oh, I’ve already been to 10 specialists or 20 specialists or 20 doctors. They all think I’m crazy or they said it was just the gut. They gave me antibiotics.” If you don’t get the hormones aligned and checked out, you’re kinda wasting your time really because if you have cortisol issues, you’re likely gonna have leaky gut issues which is gonna leave you susceptible to infections. So it’s like if we come in and just hit the gut, which we’ll talk about in a minute, body system two, it’s not really worth it, right? Because if you get the infection gone, but the leaky gut’s still there due to the cortisol issues, I mean, that’s kind of a bigger top of the food chain issue, right?

Dr. Justin Marchegiani: 100% and just backing up one bit, everything sits on a foundation. So the introductory foundation for everything is diet and lifestyle.

Evan Brand: Yup.

Dr. Justin Marchegiani: And we’ve talked about this before, but just to make sure we don’t miss it, the foundation is gonna be what you eat, when you eat, the quality of food that you eat, how you sleep, how you move, how you deal with stress, and hydration. So that’s gonna be a really important piece of the puzzle. Making sure we’re eating nutrient-dense, anti-inflammatory, low toxin foods. Making sure the diet is dialed in for you. Now what does that mean for you? Well, if you’re just a little bit sick, maybe you’re kinda in the middle, it’s not too bad, a Paleo template may be good to start with. Alright, no grains, no legumes, no dairy. If we’ve been sick for longer, maybe we have a history of autoimmunity in the family, or there may be known autoimmunity in yourself or known autoimmune symptoms, well, the next step may be an Autoimmune Paleo template where we go to the next step which is cutting out nuts, nightshades, and eggs. And then from there if there’s excessive gut issues, we may look at specific carbohydrate diet where we cut out salicylates and phenols and peel our vegetables and—and make sure everything’s well cooked and mash our foods. We may even look at a GAPS approach where we focus more on bone broth and soups and—and the same type SCD stuff, more in a liquid, palatable—a liquid, more palatable type of form. And we may even go to a low FODMAP diet where we cut out the fermentable carbohydrates–fermentable oligo-di-po—let’s see, fermentable oligo-di-mono and polysaccharides. So it’s your—your fermentable carbohydrates, your fermentable sugars. So we may add that piece onto it just to make sure that we’re taking as much stress off the body. We’re stabilizing blood sugar. We’re not adding toxins from the pesticides and chemicals and GMO and Roundup and—and the glyphosate and we’re stabilizing blood sugar. We’re not skipping meals and we’re making sure that we’re sleeping good at night and we’re hydrating appropriately in between meals or 10 minutes before, so we’re not diluting digestive enzymes and hydrochloric acid.

Evan Brand: Well said and there’s a ton of overlap in all of those, too. I mean–

Dr. Justin Marchegiani: A ton.

Evan Brand: You’re going to be omitting gluten. You’re gonna be omitting–

Dr. Justin Marchegiani: Yup.

Evan Brand: Many of the dairy components, the inflammatory component, then you’re going to stay away from pesticides and chemicals. I had a guy the other day. He asked me. He said, “Well, I’m not sensitive to gluten. So do I still have to avoid it?” I said, “Absolutely.” There’s no deficiency of gluten ever and just because you don’t think you’re sensitive to it, some of your skin rashes and all that is probably caused from some type of food intolerance. You know, you don’t have to be doubled over in pain from eating a bagel to—to necess—you know, to necessarily have to stay away from it, right? You don’t have to be falling over, needing a morphine shot due to the pain from gluten if you—if you have anything, any symptom, headaches. I mean I had a lady who had migraines for 20 years and it was amazing how simple it was just to get the diet and the gut cleaned up and the migraines went way. So I think people expect massive, massive symptom sometimes to be caused from gluten and otherwise, they don’t wanna get rid of it but you should just get rid of it.

Dr. Justin Marchegiani: Yeah, my thing with grains and gluten is if you’re gonna cheat and you’re gonna do grains, number one, the safest grain for most people tend to be white rice. So that’s tends to be an okay alternative if you’re gonna do a grain, if you’re gonna cheat. White rice tends to be okay. Even better, try doing the safer starch. You know, yucca, plantains, sweet potatoes, let’s see—I said plantains, yucca, sweet potatoes, squash—those type of safer starches tend to be a better alternative for most. Go ahead.

Evan Brand: Yeah, I was gonna say taro, too. Some people talk about that.

Dr. Justin Marchegiani: Taro, arrowroot, yeah, and then also if you’re gonna—like let’s say you’re like, “I’m gonna do bread.” Well, sourdough bread has actually shown to have less gluten because of the fermentation process that gliadin protein tend to be more dissolved in the fermentation process. So if you’re gonna go get all glutened out, take a look at the good, better, best side of it, right? Good or best would be abstaining and doing zero grains. Good may be doing like white rice or better—sorry, better maybe doing like white rice or something that’s fully gluten-free. And then third would be, alright, fine. You’re gonna do a gluten bread, well, it’s gonna at least be fermented, i.e. sourdough bread. It’s fermented, so the gluten and the compounds in there that may be more allergenic are decreased. But the other things–

Evan Brand: Right.

Dr. Justin Marchegiani: That Evan and I still wanna touch upon are the lectins, are the phytates and the oxalates, the mineral disruptors, the protein disruptors, and the high amount of pesticide and Roundup that are on some of these products. So you can at least reduce it by going organic and by going the sourdough method so it’s at least fermented and soaked, so the grains are gonna be more palatable and not have the mineral and enzyme disruptors. But again, better, right? Good, better, best. Best is gonna be at least keeping the grains out. Good or better part is gonna be in between, going like a rice protein and then like, you know, good would be doing the fermented sourdough bread option like I just mentioned.

Evan Brand: Yeah, and put it this way, it helps me sometimes to understand kind of the ancestral or the planetary perspective on this. These plants and these grains, they don’t want to get eaten–

Dr. Justin Marchegiani: Oh, yeah.

Evan Brand: And digested, right? I mean, they want to pass seed on through an animal and then it come out fully digest—or un—you know, undigested, fully undigested, so that that seed can go back into the ground and grow more grass or grain. I mean, that’s the goal with birds and humans, too, if it goes through and it’s not getting digested, the goal is for that seed to be intact enough to grow more plants, and they don’t wanna get eaten.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So that—that’s enough reason there that—that makes sense and really help me. But like, “Oh, man. Wow. Okay.”

Dr. Justin Marchegiani: And it’s pretty simple, right? You know, from evolution standpoints our role, I mean, it sounds crude is just to be able to pass on our—our seed to our offspring, right? That’s pretty much it. You know, be able to survive enough so you can procreate and pass on your DNA to your offspring. That’s pretty much it. Now there’s two ways of doing it. There’s having claws and weapons and tools and teeth, so you can prevent getting attacked on or preyed on, right? That’s like the wolf or the fox, or maybe us with our weapons as humans. And then there’s the, “Okay, I’m gonna get eaten, right?” Berries, grains, but there’s gonna be seeds and things that are gonna keep the seed and the DNA intact, so eventually maybe it will go back and be able to grow again and pass on its offspring so it can live again, right? So there’s two methods. It’s either you’re gonna fight now or you’re gonna basically submit but live the fight another day by passing itself back into the soil again so it can grow.

Evan Brand: Yup, yup. Should we move on to body system two?

Dr. Justin Marchegiani: Yeah, and then last piece that is the foundation with the diet, I’d say is also the emotions. So if there’s a lot of emotional stress, like there’s an active serious relationship issue. You know, not just like hey, you know, you had a fight here or there but you have active relationship problems. Maybe there’s an active divorce issue. Maybe you’re real problem with the child or a family member or maybe a death of a loved one or serious work stress, or stress at your church or where you go to—to have a spiritual connection, or you excessively exercise a ton, right? Those kind of things need to be looked at because they can provide a lot of stress underlying. So we wanna make sure there’s not an active emotional issue because it affects the timeline in which we expect healing to occur. If you’re actively going through a divorce or you’re having serious work issues, we may say hey, our goal is gonna be just to dig out feet in and prevent us from sliding downhill, and we may not be able to gain a whole bunch of ground going uphill.

Evan Brand: Well said, yeah, and I’ll also mention the electromagnetic fields which I’ve done–

Dr. Justin Marchegiani: Oh, yes.

Evan Brand: Countless podcasts on. I had a lady the other day. She heard a podcast about EMF that—that was on the show and she bought a meter online and anything above 1 milligauss, a measure of magnetic field is bad, right? And this lady had 50 milligauss in her bedroom. And so she lives in San Francisco. She didn’t believe it. She called the power company as I told her to do and they came out and they measured, and sure enough, it was about 25 or 30 milligauss. So her meter was pretty inaccurate, but it was accurate enough to detect a problem that warranted further investigation. And even the power company was like, “Well, this is insanely high.” I mean, you’ll see some people that say anything above 3 milligauss of magnetic fields which comes from power lines is—is bad, but either way, 20, 50, that’s insane and so she’s moving immediately and she said she hadn’t slept well for months and kinda like my story that you and I chatted about when I had to move. I was measuring 7 milligauss in my office and I feel like I didn’t sleep. So I mean, that’s another cause of adrenal hormone issues that you and I are discussing and talking about with people because it’s—it’s an invisible smoke, right? If you had glasses that you could wear and see this stuff, everybody would freak out. But it’s invisible. And like my friend Eric Windheim says, “It’s like fighting a ghost.” So you have to measure this stuff and—and mitigate it, and there’s more. We won’t go into more detail today, but just check out EMF in the search bar on the website, and you’ll be able to find, you know, more episodes.

Dr. Justin Marchegiani: Absolutely. So we addressed the foundational pieces, diet, lifestyle, emotional stress, meal timing, nutrient density–

Evan Brand: Environmental.

Dr. Justin Marchegiani: Toxins from the chemical. Toxins are essentially—the electromagnetic toxins, right? That’s kinda in that toxin realm.

Evan Brand: Yup.

Dr. Justin Marchegiani: We hit that. We talked about the hormones, ATM, ATF. And then next step is gut function/gut infections. Now typically when we start out with the diet piece, depending on what’s happening symptomatically, if we see a lot of reflux, a lot of bloating, let’s say we have a history of vertical ridging in the nails or we see a lot of undigested food particulate or the stool looks grayer or the stool floats or we have poor hair quality or very dry skin, these are all symptoms that we’re not digesting our food optimally. So to support the diet piece, we may bring some of the digestive support up forward, and bring it into intro phase. What I mean is we may bring in some of the hydrochloric acid, some of the enzymes, some of the bitters, some of the digestive support to help stimulate digestion because we see that as supporting the intro phase. We’re working on digesting foods and making sure that piece is dialed in. So that may have to be brought up forward because it’s—it supports the foundation. That’s number one. Number two is we have to knock out the infections. So as we look at body system two, we really break it down into 5 steps. So number one is remove the bad foods. Number two is replace the enzymes and acids like I mentioned. So that’s the digestive support to make the intro diet piece work better. Number three is repair and repair means repairing the adrenals because we have to make sure that piece is there. because we don’t wanna work on really healing the gut, until we have the hormonal environment dialed in to help reduce inflammation and help heal the gut lining and help improve IgA levels, which is the localized immune system in the digestive tract. We also wanna make sure healing nutrients are present for people that have extra gut inflammation or extra gut irritation. Things like L-glutamine and the healing nutrients, the licorice root, deglycerized licorice root, maybe slippery elm, maybe cat’s claw, maybe some gentle amino acids like L-glutamine, and Jerusalem artichoke, etc. These are healing nutrients that help that gut lining. Number four is the removing of the infections and we’re able to remove the infections most adequately because of the 3 phases before it. Because of the removing the foods, the replacing the enzymes and acids, the repair in the gut lining and the adrenals, now we can come in and we can start working on removing the infections, and the infections are gonna be specific to the stool test we recommend to pick up the infection. So the H. pylori comes back or fungus comes back or various multiple parasites come back, those all need to be specifically addressed with unique protocols for each. And then number five is going to be the re-inoculation with robotics, really receding all of the good seeds after the weeding’s been done. And then number six is gonna be the retesting to make sure one, infections are cleared and two, there are no new infections as last podcast talked about, making sure there are no resistant infections that were burrowed in deeper that are showing their ugly head, and the only exception will be adding probiotics in the repair phase. Because sometimes probiotics can have an anti-inflammatory effect, and depending on how bad the gut is, we may add some probiotics in the ref—the repair phase as well as the reinoculation phase to help support gut healing and inflammation.

Evan Brand: Well said. I wanna speak just for a minute and see if you wanna add anything to it about the topic of antibiotic use and infections. There’s a lot of hate on the Internet about herbal remedies for infections, you know, whether it’s an M.D. or a naturopath or someone. You know, getting in an argument about saying, “Oh, herbs don’t work. You have to use triple therapy or this antibiotic or this antifungal prescription.” And there’s very, very, very, very few cases where it takes us more than one or two rounds to get rid of an infection using just herbs, no prescription. So could you add something to that conversation, too? I would 95% of patients can address their gut function and their got infections with herbs alone. 5% of the time we may have resistant bugs that we’ve treated, re-test, still there. Treated, retest, still there. Treated, retest, still there. And it’s 2-3 times and we’re not able to knock it out. But I’ve had people go and on the third time, we knock it out. So the antibiotics may be an option for some people. The conventional antibiotics that are typically run like the metronidazole, the Flagyl, which are the most commonly prescribed ones for these infections tend to miss the infection about two-thirds of the time. And then a lot of times the antibiotics prescribed for your typical triple therapy for H. pylori like clarithromycin, amoxicillin, and/or omeprazole like Prilosec, acid-blocking medications, tend to do the same kind of thing. They’ll miss the infections a third half the time.

Evan Brand: Well, what about this, too? What about creating more resistant strains due to the antibiotics that have been so overused? Which then makes our job a little bit tougher because people have gone through rounds and rounds of this crap and it’s done nothing.

Dr. Justin Marchegiani: Exactly. That’s the problem is you run the risk of having these antibiotics not work in the time where maybe you really need them, like you get in a car accident or you step on a—a rusty nail or some, some kind of infection that’s more acute and more severe based on the exposure of the microbes. So I’m always about conservative to invasive, right? What’s the most conservative type of care off the bat? It’s always gonna be diet. It’s always gonna be lifestyle. It’s always gonna be using antimicrobial herbal medicines that have been around for literally thousands of years to have a strong safety profile, to have the ability to use them long-term without resistance–

Evan Brand: Yup.

Dr. Justin Marchegiani: And also aren’t gonna wipe out a—as many other microbes, any other beneficial microbes the may be present that are helpful for your gut. We won’t wipe those out and create more problems. I can’t tell you how many patients I’ve seen that have been on antibiotics and had devastating side effects, and now we’re treating them from the damage caused by the antibiotics in the beginning. I’ve seen it so many times. Don’t see it with herbs though.

Evan Brand: I know.

Dr. Justin Marchegiani: But I see all the time with antibiotics so I’m always very conservative and we go up in—in gradations on what step one is. Herbs. Step two. Herbs. Step three. Maybe herbs. And then if we’re still having issues, then we go and we lean towards the antibiotics, typically on step three most of the time.

Evan Brand: Yup, yup. Well said. And just the fact that this has been used, the herbs that we’re talking about. They’re been used for thousands of years before antibiotics were invented. To me that says something about the success rate and the safety. So when people read concerns about herbs. A lot of times the concerns are unwarranted unless you’re talking about mixing herbs with pharmaceuticals, like you know, 5HTP and SSRIs and stuff like that. Yeah, you can get into trouble. But generally, there’s really nothing to be concerned about compared to the tens and if not hundreds of thousands of people dying due to medical error. That’s now the third leading cause of death. Did you know that? Medical error.

Dr. Justin Marchegiani: Wow.

Evan Brand: So—so this—this is real. This isn’t something were just saying on our—on our high horse. You know, this is for real. Look at CDC death or medical top causes of death. You’ll see medical error and this is from the proper, you know, or this is the prescribed rather is what I meant to say, the prescribed dose of a medication is still causing third leading cause of death, is medical error.

Dr. Justin Marchegiani: Yeah, I know. I know Barbara Starfield has her prized article in the Journal of the American Medical Association 2000, all on how much medications and surgical procedures done correctly, right? Hey, the surgery was a success but the patient died. Hey, the prescription was—was perfect according to what the patient’s symptomatology was, but the patient had an ulcer and died, right? Just like that happens with ibuprofen 19,000 times a year according to the New England Journal of Medicine. So we know there’s a risk with conventional treatments. So we wanna be as conservative as possible, so we don’t have to go to those type of higher risk procedures.

Evan Brand: Agreed, agreed. Well said. So yeah, the infections are huge. I mean, Justin and I, we have more podcasts on that talking about our own history with infections. So not only are we in the trenches helping others remove them, but we’re doing it on ourselves, too. So this is—this is a huge piece and has been instrumental for me to get my—my weight back when I’ve lost, you know, 20 pounds of muscle from infections. So this is a real big deal in something that has to be addressed.

Dr. Justin Marchegiani: Correct, and I think the key thing, too, is we’re not anti-medication.

Evan Brand: Right.

Dr. Justin Marchegiani: We’re all about using the correct tool at the right time, but also weighing the pros and cons. Like if we’re, you know, we got our tool bag on or our toolbelt on, right? And we have all these different tools in our tool bag, alright? And we look at this screw and it’s the flathead groove in it, so we know I gotta pull my Phillips head out, right? I’m not gonna look at that screw and be like, “Screw this, my dog must not gonna allow me to use this flathead, throw it away and then try to pull it—the Phillips in there and try to work it.” So let’s say it’s a—a flathead groove, I’m not gonna look at flathead screwdriver and throw it away, and say, “I’m gonna try using a Phillips, right?” I’m gonna go and say, “Well, this is the right tool for it. So I’m gonna put it in and I’m gonna use the correct tool based on what’s presenting itself.” That’s like if you get in a car accident, we’re not gonna look at the patient and say, “Great! Let’s just throw you on some turmeric right now and call it a day.”

Evan Brand: Right.

Dr. Justin Marchegiani: No. We’re gonna say, “Go to the ER. Get the correct test to make sure there are no fractures, no bleeds, no hemorrhaging.” You may even want to be on some higher dose pain meds. You may want to avoid the opiate ones, right? Because of the addiction, but maybe some higher those pain meds acutely just because you’re in severe trauma and pain. And then we’ll get you stabilized and then we’ll get you on a really good routine after. So we look at the right routine. If we see that flathead groove, we’re reaching for the flathead screwdriver. We’re not reaching for the Phillips.

Evan Brand: Yeah, absolutely. And if you break your arm, yeah, you don’t go take a dose of turmeric and fish oil. I mean, you need to get that checked out and make sure there’s no internal bleeding, etc., etc. So there’s no trophy for—for trying to be a hero and dismissing the acute, incredible trauma medicine that—that is offered. You know, it’s just the things we’re dealing with, their 1, 5, 10, 20, 30-year chronic issues and that’s where functional medicine tends to have far superior success rates. You know, 90+ percent success rates that you and I both have.

Dr. Justin Marchegiani: Exactly, and some of the things that are talked about regarding antibiotics, and I’ll put some of the research in the show notes, but antibiotics can create oxidative stress and mitochondrial dysfunction. That’s a big issue, so the mitochondria is gonna be the powerhouse of the cell which is gonna help generate ATP which is like the fuel currency for energy, and also creates oxidative stress which is just a way of breaking down your body, right? Oxidation, you leave a rusty nail in the rain, it gets all rust or you leave a nail out in the rain, it gets rusty because of that oxidation process. We have internal rusting. Doesn’t quite show itself like that, a brownish rust, but it happens—it happens internally and that creates a depletion of a lot of your antioxidant reserves. So your body has to use up more vitamin C, use up more vitamin E, use up more nutrients that would typically be used for other healthy functions. So oxidative stress and mitochondrial dysfunction are a side effect of some of these antibiotics use. So we really want to make sure if we’re using them—excuse my frog on my throat—we wanna make sure they are used appropriately for the right situation.

Evan Brand: Well said. Yeah, and I’ll briefly mention, typically for body system two, we’re gonna be looking at comprehensive stool testing. We’ve discussed that. So whether PCR-based testing or otherwise, and then also the organic acids testing. So you hear us talking, maybe it sounds fancy, mitochondrial issues, amino acid metabolite problems, etc. but we can see and I see it all the time. Vitamin C levels, very, very, very low across the board most time on organic acids which is a urine test that you do at home and then you send that back to the lab and then we go over the results and then stool testing, you’re gonna be able to find infections. You’re gonna go through the protocol and then you’re gonna retest and the infections are gonna be gone. So that’s—that’s it for body system two. Let’s go on to body system three, Justin. So detox, methylation, making sure that people are able to actually do things at the end of the line. Once everything has happened, once a good digestion has happened, you’ve absorbed your minerals, your colon’s helping to produce vitamins for energy, your probiotics are doing the things they should be doing, now it’s time to get the stuff out of the body. We’re hoping the liver is gonna be able to do what it can do. We’re hoping you’re pooping, right? I mean, people buy all these fancy detox powders and teas, but it’s like if you’re not pooping but once a week, that’s a huge issue. That’s a great way to detox, poop and pee. How simple and revolutionary is that?

Dr. Justin Marchegiani: 100%. Poop, pee, breathing, and sweating. It’s like un—unreal. So looking at a lot of the detox things, certain nutrients are required to detox. So you can see why number three, why detox is put number three. Let’s just break that down so everyone can get the—understand the concept. Again in this show, we’re really committed to being able to teach concepts because if you get the concept, there’s zero memorization involved in it. Once you get the concept, it’s like riding a bike. You get back on—Boom! You never have to go to that learning curve of falling. So what’s the concept? So number one, if we’re poor foods and eating toxic foods, and foods that are nutritionally poor, what happens to detox? Automatically impaired.

Evan Brand: Yup.

Dr. Justin Marchegiani: Right? So why are we gonna work on detox off the bat? Because if we just get that first phase done, we’re starting to work on detox even though we’re not working on it directly, because it’s body system three, we already worked on it in the intro phase. Number one. Number two, we actually start breaking down the foods. That means we start breaking down the proteins into their smaller amino acid constituents and we know how important the sulfur based amino acids for operating phase 2 detoxification. Phase 2 is like the n-acetylation, hydroxylation, the glutathione production, the methylation, and we need methionine and we need cysteine and glutamine and glycine and taurine, and all these really important sulfur aminos, and if we can’t break down our protein constituents into those smaller products, you know? Ripping off the pearl necklace and pulling off the individual pearls, that’s what it’s akin to. If we can’t do that, we’re not gonna be able to run phase 2 and then frankly we need lots of antioxidants and B vitamins to run phase 1. So if we have SIBO or dysbiosis, well, our probiotic production internally from our gut bacteria is automatically forwarded or downregulated because we know good bacteria in our gut produces a lot of those nutrients for us, right? Good bacteria eats poop and poops nutrition, B vitamins, antioxidants, nutrients. Bad bacteria eats nutrition and poops poop. Bad bacteria makes you more toxic. So what is the more toxicity from the bad bacteria due to body system three? It decreases its function. So you can see how we lead up to diet and lifestyle. We lead up to digesting food. We lead up to healthy gut bacteria, knocking out infection, addressing the flora, because all of that sets the stage for body system three, so we can come in there and really support the nutrients that are missing, the pathways that aren’t working properly, and we can potentially even knockout specific heavy metals if we see heavy metals are in there with other types of chelators and compounds that pull the metals out. And some of the test we do—well, I’ll take a breath there, Evan. Any comments?

Evan Brand: Yeah, I mean, well said. I wanted to mention this comes at the end because we want to make sure that everything else has been addressed upstream. I mean we’re not going to go straight to detox if we know that you have infections and we know that you’re still getting, let’s say artificial sweeteners in your diet which can be placing a burden on the liver, right? So we want to see the liver and your detoxification abilities, methylation, this includes anybody with like MTHFR genetic defects. This includes you, too. All that other stuff’s gotta be taken care of first because we want to see what the actual baseline is. Not the baseline when you are doing so much sugar and alcohol and bad fats and artificial sweeteners and all of that that’s got the burden on the liver. So once we get all that stuff out of the way, then we take a look at body system three. It’s the, “Oh, okay, so this is the true baseline,” and then yeah we can look for heavy metals, from dental fillings, amalgams, you know, bad food, bad water, too much tuna fish, other environmental exposures, and then we can start helping to get the detox system working better because if you’re not pooping well and you have an overburdened liver, you’re just gonna be recirculating all these toxins. So then you’re gonna get the joint pain and the allergies and the asthma, and the skin problems, the headaches, the brain fog, alcohol intolerance, I mean, we could go on and on but you gotta get all that other stuff taken care first, so if you go straight to detox or somebody tries to sell you on some detox protocol first when you don’t even know if you have leaky gut or not, I would be cautious and maybe you have more to say about that, but I don’t like the idea of pushing stuff out of people’s body if they don’t even have enough trash men to come gather all of the trash at the end of the road.

Dr. Justin Marchegiani: Yeah, 100%. So we have everything lead up to it and I think you emphasized the whole leaky gut part right because the leaky gut as you mentioned is really the consequence of all of the inflammation, the inability to break down food, the compromised immune system, and then the infections. All of that will lead to leaky gut. So leaky gut isn’t necessarily a result. It’s more of an effect of all of the inflammation and the damage.

Evan Brand: Yup.

Dr. Justin Marchegiani: Right? The gluten, the bad foods, all of the inflammation. So that’s kind of the end product that you get there is leaky gut. So looking at everything that you mentioned. How do we quantify it? Because you put some really good points out there. How do we actually know what’s going on from the detoxification side? Well, we’ll look at an organic acid test. Typically as a good starting point because we’ll get a window into various detoxification pathways, whether it’s pyroglutamate or other types of organic acids, sulfate—these are organic acids that will give us a window into how those sulfur aminos are doing. If the demand for them is higher or if they’re depleted. And we’ll also get a window into B vitamin status. We’ll get a window into methylation and we’ll also get a window into oxidative stress by looking at the 8-hydroxy 2-deoxyguanosine for instance. Again, these are all like jeopardy words but these are organic acids that give us a window into all these systems, whether it’s simply xanthorrhoea for B6, whether it’s the amino acids for the brain with vanilmandelate or homovanilate or 5-hydroxyindoleacetate or whether it’s markers for gut bacteria like hippurate or benzoate. So these—these markers give us a big window into what’s happening and the organics can really help tell us what’s happening there from some of those detox nutrients, and we may even look at like a SpectraCell or a NutrEval as well. Again, I lean more towards the organics because that’s my baby.

Evan Brand: Yup.

Dr. Justin Marchegiani: The NutrEval combines the organics with another blood test for nutrients, too. So that’s a—another side option which at least does contain the organics and that gives us a good window into what’s happening but we always go back to intro, body system one, hormones, ATF, ATM; body system two, the ability to digest, removing food allergens, healing the leaky gut, repairing the gut lining, removing infections, adding in probiotics, and retesting because we gotta make sure new infections aren’t there and the old ones are gone. Number—body system three is gonna be detox nutrients and that’s typically where we follow suit, and we reserve the right to kinda move some things in. Like if I know someone has a ton of oxidative stress, I may throw some extra vitamin C that we may discover on an organics test, I may throw it in with the adrenal protocol. So we do things and we mix-and-match outside of that box a bit, so if any patients are listening, they may think, “Well, Dr. J gave me some detox support in body system one,” and that’s gonna be dependent upon how that person’s presenting, how sensitive they are, and how bad their detox is. We may add some small things in with body system one, because maybe the adrenal support is too much for their liver, and we need to give their liver just a little bit of support so they don’t have a lot of those hormone side effects.

Evan Brand: Totally, well said. I’m gonna mention two things and then we can wrap it up.

Dr. Justin Marchegiani: Cool.

Evan Brand: One for me on the organics, which I just love is the quinolinic 5-HIAA ratio–

Dr. Justin Marchegiani: Yup.

Evan Brand: Looking at inflammation because you could go on and on and sound fancy, but when someone sees inflammation and you’re like, “Look, here it is.” It’s like, “Oh, crap.” Because inflammation, you know, even a conventional physician is gonna talk about inflammation as a cause of disease, right? And so when we can actually prove that to a client or a patient, it’s incredible and it’s very profound to be able to do that and then whether it’s 3, 4, 6 months later when the retest comes, and you can see that that number’s gone down, it’s very, very rewarding for both of us, and lastly, the toxin piece, too, something that Justin and I have been talking about a lot and—and I’m running on—I’m running this test on nearly everyone I possibly can–

Dr. Justin Marchegiani: Yup.

Evan Brand: Including myself is the GPL-TOX so I can look at the toxic load because I bought a sauna based on my toxic load of insecticides, and this is not a challenge or a push test so even the sickest people, we don’t have to worry about doing any type of chelation which may push some stuff out. You just urinate in—in the morning in a cup and you send it off. And the cool thing is you can run it side-by-side with the organics, so it’s literally the same urine sample. All you have to do is spend a little bit extra investment to get both test run organics and GPL-TOX at the same time, and I had insecticide levels in my body that are known carcinogens that were higher than they should be. And so for me, this is a huge, huge, huge new realm of opening up this. Look, we know there’s detox problems. Let’s fix it, but what are we actually fixing. You know, that had always been the question, right? Ooh, there’s detox problems. Man, you got headaches. You got chemical sensitivity. You can’t handle perfumes, gas fumes. Look, here’s why. And oh, man, is there anything more fun in the world than this? I mean, I—I don’t think so.

Dr. Justin Marchegiani: Yeah, I agree. I mean, it’s like we’re CSI detectives without all the—the murder and blood, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: We’re trying to put together the—the puzzle piece that’s really getting people’s quality of life back. So just summarizing those tests. We run the organics test. We run maybe the OAT, which is the—the Great Plains Lab organics. We run the GPL-TOX. We may run the NutrEval, the SpectraCell and then we have the heavy metal challenge test where we challenge, with a chelation compound, like DMPS or DMSA or EDTA to get a window into the toxic burden of metals because metals don’t want to stay in systemic circulation. They don’t wanna stay in the blood. They only go on the blood acutely in that first 24 to 48 hours, then they go into the tissue.

Evan Brand: Yup.

Dr. Justin Marchegiani: Whether it’s the brain or the individual tissues or even bones when it comes to lead. So we gotta get a window into it so we have to do a challenge, a provocation agent that can go in into the tissues and really kinda pull things out. It’s like, “Hey, you go outside. You look for bees. There may not bees swarming around, but if there’s a beehive there, well provocation agent’s throw rock into the beehive, right?” You know those bees are in that beehive when those—when that rock hits it and those bees come out, that’s the provocation agents. So we use that same kind of methodology with the heavy metal test. The rock is like the chelation compound that we use to see what’s coming out in the urine and a lot of times we see aluminum, we see arsenic, we see cadmium, and we see a whole bunch of mercury and lead, and it’s different for each person.

Evan Brand: Yup, absolutely, and then you got blood metals, too. Quicksilver’s Blood Metals is cool.

Dr. Justin Marchegiani: Yup.

Evan Brand: There’s the Mercury Tri Test, too, for hair, blood, urine. There’s so many different things out there. A lot of them are good. A couple of them are bad, but you know, we’ll help you to make the distinction what is right for you and this is case-by-case. Some people they may not need to investigate metals. Other people they’ll come to us and they’ll say, “Evan or Justin, man, I got metal problems.” And they just have a gut feeling and in those cases, I say, “Okay, cool. Let’s get you checked out.“ It’s not gonna hurt. It can only help you to investigate. So if you have a gut feeling and that gut feeling can be disrupted obviously if you have got problems, right? Because the inflammation in the gut, you might be getting mixed signals, but if you have a gut feeling, ask us, and let us help you to investigative. If it’s something we didn’t bring up yet or maybe it’s early in the game and we wanted to do it later, just bring it up because you never know. You could be onto something that we just haven’t got to yet and that may save us, you know, a month or two of—of time.

Dr. Justin Marchegiani: Absolutely. And again, we’ll the show notes for everything, the full transcription, again in my new Thyroid Book that will be coming out very soon, just putting the finishing touches on it, we’re gonna have a chapter in the book all on this type of discussion, putting it all together because I feel like this is probably one of the key pieces that most functional medicine practitioners and doctors really, it—it’s very esoteric. It’s kind of in the ether. Like how does it all look?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Like what does the whole plan look like? And it just kinda like, you feel like almost like they’re making it up as they go and I think is really important if you’re gonna hou—you know, you’re gonna hike Mt. Everest so to speak, I wanna see that map. I want to know how we’re gonna go up there. I wanna know how we’re navigate that crevice and—and get across that—that ledge or that cliff. I wanna kinda feel like it makes sense when we get directions. So I think that’s a really important piece that we’re adding, is that clarity and that, you know, what’s our fu—future pacing vision? How are we getting to the top?

Evan Brand: Yup, amen.

Dr. Justin Marchegiani: Anything you wanna add there, Evan?

Evan Brand: I don’t think so. I think this was great and fun as always, real honor. If people want to schedule, go to justinhealth, J-U-S-T-I-N, Justinhealth.com to schedule with Justin. If you want to schedule with myself, go to notjustpaleo.com and like I said, we both block out a few hours, so you know, if there’s a spot available, you wanna grab it for the 15-minute free call. See if we’re a good fit, you know, discuss your options together. Justin and I are happy to do that and we look forward to helping you all out. You know, listening to this is one thing. Getting in the trenches with us is another, and I mean without functional medicine, I would likely still be dealing with depression and irritable bowel syndrome and skin issues and fatigue and insomnia and adrenal problems. I mean, every aspect, everything that could’ve gone wrong was wrong in my body systems and just one by one, plucking these things off the list, and there’s never a finish line, right? I mean it’s always a continual journey. So you’re just always pushing to the next step ahead and this is your time. You know, you don’t have to suffer.

Dr. Justin Marchegiani: Love it. I appreciate the hope and the inspiration, Evan.

Evan Brand: Yes, sir.

Dr. Justin Marchegiani: Great chat. Great chat. Look forward to chatting with you very soon.

Evan Brand: You, too. Take care.

Dr. Justin Marchegiani: Have an awesome day!

Evan Brand: You, too. Bye.

Dr. Justin Marchegiani: Bye.

How To Start a Blog

If you're here, I assume that you love talking about health, listening to podcasts and scouring the web for the latest info.

You have so many ideas about how you can contribute and have thought about the idea of starting your own health blog or even a podcast. Maybe you need a website for your health coaching business.

Today is your best day to start a health blog.

Spend the next 15 minutes with me and let's you up and running.

The three steps to blogging:

  1. Domain Name and Hosting
  2. Installing Wordpress
  3. Design and Graphics

1) Domain name and hosting

This part is important!

What do you want your domain name to be?

For example, mine is notjustpaleo.com. Try to use simple words and not use strange spellings for normal words. This will only confuse your future potential website visitors and searchers. They won't find your site.

After navigating to Bluehost, enter your ideal website name and click next.

Starting-a-Food-Blog-Picking-Your-Domain-Name
Starting-a-Food-Blog-Picking-Your-Domain-Name

Next you will pick your plan level which you should select the Starter Plan which is paid in one lump sum. It's much cheaper in the long term to do it this way.

Bluehost_Plan_Options
Bluehost_Plan_Options

After securing your domain, you'll need to add hosting  the domain. Hosting is how your website actually gets broadcasted to the world. Bluehost has great rates and gives your domain name for free if you decide to host with them.

I highly recommend using WHO IS privacy which is an option you check on the second page. This keeps your personal address and other information private.

2) Installing Wordpress

Once you've completed your registration process through Bluehost, you'll need to install Wordpress.

Wordpress is a free online software that allows you to create your blog. It's simple but powerful for all your needs. Not Just Paleo runs on Wordpress. It's the only software worth using in my opinion.

Login to Bluehost and look for this section pictured below. Click on the Wordpress "W".

On the next page click the "Install" button in the "Do it yourself (Free)" section.

Click the "Check Domain" button:

Check the terms and conditions box and click "Install Now" button!

You will get an "Installation Complete" message where you will see your Login URL, Username and Password you'll need to login with. You can change them later, but take a picture or screenshot of this page.

Go to your web browser and type in your Login URL. You'll see the Wordpress Logo and login page. Enter your login information from the last page.

wordpress
wordpress

You're in! Woohoo!

3) Making It Look Good

You now have your own blog! Congrats! You may be on the verge of changing the entire planet, I'd say you definitely are.

Now, you're only a few minutes away from publishing your first blog post, recipe or other spectacular content that you've had locked inside of your brain for the last how ever many years.

However, the basic Wordpress themes are quite boring and not pretty at all. It really makes a difference in if people delve deeper into your website or not. If it looks boring and basic from first glance, they may not stick around. Wordpress offers many alternative themes for free that you can view here. If you want to get a premium theme like Not Just Paleo runs on, you have a few options:

  1. The Thesis Theme -- This theme has been highly successful for many of my fellow blogging friends. It's highly attractive and simple to use.
  2. The Genesis Framework -- This is the current framework that Not Just Paleo runs on. Think of it as the higher end vehicle to deliver your content as opposed to using Wordpress by itself.. It's made my life and blogging experience much more professional while minimizing difficulty.
  3. Studiopress Themes -- This is the company I currently use for themes. These themes are built for the genesis framework. They are beautiful, functional, responsive and great for mobile users. The future of the internet depends on how well your site runs on mobile. These are your best bet.

3b) Get 1-on-1 Business Coaching

When first starting out, it's a daunting task to think and research about the various social media tools, recording software, editing programs and more. So I've conveniently offer 1-on-1 business coaching as part of my mentorship offering.

Learn more about my mentorship and apply here.

#207 Dr. J and Evan Discuss How to Stay Healthy While Traveling

Airplane_01.jpg

Dr. Justin Marchegiani and Evan Brand talk about travel and what you can do if you’re on the go. Listen to this podcast and pick up helpful strategies so you can stay healthy and continue living a chemical-free, organic lifestyle. It’s all about making better, if not the best choices. Discover a whole bunch of tips and tricks that you can practice the next time you fly or travel out of the country. Learn why choosing what you eat or drink could really help you avoid getting any sickness during a trip. Find out what supplements you can take to arm yourself and to prevent any infections and how to combat that dreadful jetlag.

In this episode, topics include:

01:05 Travel and food tips and tricks

07:15 Grounding and the pesticides in the environment

23:16 Supplements

25:14 Resetting circadian rhythms and boosting the immune system

37:29 Swimming, therapeutic massages, and exercises

Not Just Paleo Podcast
Not Just Paleo Podcast
Subscribe on YouTube
Subscribe on YouTube

Dr. Justin Marchegiani:  Evan, it’s Dr. J, man. It’s Tuesday. What’s going on?

Evan Brand:  Hey, not too much. How ya doin’?

Dr. Justin Marchegiani:  Doin’ great. We don’t normally do these things on Tuesday but here we are.

Evan Brand:  Yes, sir. And you’re—you’re headed out of the country and so this is a timely time and your dedication is impressive to this podcast. We wanted to talk about travel and even if you’re not going internationally like you, what can you do if you’re on the go? If you’re a busy mom, you have a one-hour commute, you’re out, you’re in the car, you don’t wanna have to stop and pick up something that is maybe not the best choice, how do you still live a healthy, chemical-free, organic lifestyle if you’re on the go? So that’s hopefully what we can address today.

Dr. Justin Marchegiani:  Yeah, great questions. Again, we’ll do anything for our listener, so again, I’m leaving, jumping on a plane here to go to Prague and then heading over to Croatia, right after that for a week or so, so looking forward to just reading some books, getting some R&R and repairing my adrenals as much as possible.

Evan Brand:  Absolutely.

Dr. Justin Marchegiani:  So off the bat, you know, what are some simple strategies? Well, number one, if you’re traveling and it’s long flights and you don’t have good food options, obviously fasting can be a great option. Right? A little bit of intermittent fasting can be helpful, even if you’re like—may have blood sugar issues or adrenal issues, you could always bring a nice snack onboard. I actually got about 4 really good like smoked salmon packages at Whole Foods, like the 4-6oz packages—the Wild Cod Alaskan Sockeye. So I got 4 of those. I got some grass-fed beef jerky. I got some packages of nuts and things, and I also have a couple of different bars, like some of the KIND bars, the Nuts & Spices brand that has the—the 5g of—the 5 to 4g of sugar or less and the 10g of protein. Those are good and I’m also gonna bring some collagen, too, and be able to just mix it with some water and be able to down it. So there’s a lot of good strategies. Fasting is number one. Number two is good, clean water. That’s always helpful. The solution to pollution is dilution. And then easy, simple snacks that you can either get nutrition from and/or stabilize blood sugar.

Evan Brand:  Yeah, water’s the tough one for me. It’s always the most frustrating aspect of flying because due to all the security regulations, you have to pour out your water, so like when I went to Chico back in the spring, I had like a—like a gallon of spring water that I was still trying to chug because they wouldn’t let me bring it through security. And then they’ll resell it to you for 4 or 5 bucks a bottle on the other side. So if you are doing that, you just have to do your best. What’s actually pretty cool and maybe next time I travel I would do this, Berkey actually has a portable system now. I have the at-home Berkey but they have a Berkey—I think it’s called the Berkey Go or the Berkey Travel. Very small Berkey but it’s got the same filter and you could literally shove that in your backpack or your suitcase and you could go to a water fountain and filter on the go. I think that’d be amazing, and you’re not paying 5 bucks for a bottle of water that’s still in a plastic bottle.

Dr. Justin Marchegiani:  Yeah, I think that’s definitely great. That’s a really good option. Typically, you know, if I’m traveling a lot of time, you know, I—I’ll spend the 5 or 6 bucks and get the Evian or the Fiji just because it’s the high quality water with the minerals in there. The minerals are nice. You may lose that with the Berkey and such, so the minerals are really good. And then two, I’ll get the—like I fly Southwest a lot, big Southwest fan. I got a buddy pass with them so my wife and I go back and forth. Typically one of us fly free which is nice and what we’ll do is I’ll ask for like the—the Seagrams and I’ll get the sparkling water.

Evan Brand:  Yeah, that is good.

Dr. Justin Marchegiani:  And I typically tell them, so sparkling water and then I tell them, “Give me the can, no ice.” Because the ice is made out of water that’s, you know, probably junky water. I doubt it’s filtered or has any purification to it so I’m like, “No water. Just give me the straw and I’ll drink out of the can.” And they just—they can’t help it because every—they give ice to everyone, right? It’s like an automatic kind of thing. So I do that a lot. That’s a really good option is the sparkling water in the can, no ice, for—for the free side of the fence, or just spend the 5 or 6 bucks and get a good high-quality water before you get on the plane.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  I like Evian because of the minerals and I like Fiji.

Evan Brand:  Yeah, I was gonna say I think Southwest they—they’ll give you Deja Blue water. That’s their water that you can get for free as the can. That’s what I’ll ask for.

Dr. Justin Marchegiani:  Oh, yeah. You can get that, too.

Evan Brand:  I think it’s a good—I think it’s reverse osmosis water.

Dr. Justin Marchegiani:  Yeah, I mean, even if it is–

Evan Brand:  It’s not—I know it’s not distilled. It’s something—it’s something purification.

Dr. Justin Marchegiani:  Yeah, and people—people knock reverse osmosis water but I mean, frankly I’d rather have a water that mineral devoid and clean than mineral devoid, or let’s say mineral rich if it—if it is even that, right? We’ll give it the benefit of the doubt and say it’s mineral rich but then full of crap.

Evan Brand: Yeah.

Dr. Justin Marchegiani:  Right?

Evan Brand:  Pesticides.

Dr. Justin Marchegiani:  Pesticides, chemicals–

Evan Brand:  Pharmaceutical drugs, there’s average of over a dozen if you look at Environmental Working Group, over a dozen chemicals in tap water.

Dr. Justin Marchegiani:  Ton of things.

Evan Brand:  They’re not—they’re not trained I mean, that’s the thing. These municipal tap water companies, they’re only trained to remove condoms and poop out of the water that you flush.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  They’re not trained to remove chemicals and pharmaceuticals and pesticide residue and run off and somebody who threw their whole bottle of Xanax down the toilet. They’re not trained for that and they’re not filtering that.

Dr. Justin Marchegiani:  Yeah, and also pre-show we were just talking about toxicity. We were reviewing one of the labs that we used, the toxicity profile they do, and we were seeing a whole bunch of Roundup or glyphosate in some of the—the children patients that you’re treating, and that’s just–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  An epidemic because Roundup is being used everywhere. My neighbor just got a whole new lawn put in and then they—they did glyphosate or Roundup on everything. Now I’m getting a lawn put in as well, brand-new one and I said, “No Roundup”. Absolutely no chemicals, I’m just—they’re gonna do it the hard way, and just kinda scrape it really well, and then we’re using natural pesticides. We do like the probiotics-based pesticides and then some of the more natural-based fertilizers and then we use like some of the—like they put like some protozoa and some natural like nematodes and things that kinda help keep the environment in check that’s chemical-free.

Evan Brand:  That is so cool. Yeah, I mean, people have to realize there is a natural alternative or there was a natural alternative which was the only thing available until chemical industry came into play in the last 100 years or so.

Dr. Justin Marchegiani:  And don’t get me wrong. Chemicals are more convenient in a lot of times, but the question is–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  They also can contribute to disease and disease is not more convenient. Right?

Evan Brand:  Definitely not.

Dr. Justin Marchegiani:  So that’s–

Evan Brand:  Definitely not.

Dr. Justin Marchegiani:  That’s the issue that you fight and it’s just convenient, right? Farmers and a lot of these people that are doing this line of work.  They’ve been sold that pesticides are easy. They’re cheaper. You have multibillion companies that operate in magnitudes of—of volume and scale that can sell these things pretty darn cheap. But also here in Austin, I called a couple different companies that do organic lawn care because I’m looking at getting some lawn care for my home and I wanna do it in a way that is natural and not providing pesticides for my animals. I mean, I have cats. I have dogs. Hopefully, a kiddo soon and I want them to be able to interact with the grass and the environment and not have to worry about chemicals and–

Evan Brand:  Yeah, and if you’re going barefoot and grounding yourself on your glyphosate yard, that’s not very–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That’s not very good.

Dr. Justin Marchegiani:  And I–

Evan Brand:  I guess that’s a—that’s another tip, too. If we have people–

Dr. Justin Marchegiani:  Boom!

Evan Brand:  Like how did we get on this topic. If you’re traveling which I think Justin will probably do. If he’s not, this is my recommendation to Justin, and is to get grounded when you travel especially if you’re doing time zones because my dad when he went over to China, he was working over there for a while, I told him to go to a park as soon as he got there. I mean, you’re talking what—12 time zones to China from US?  And he went to a park there right next to his hotel and went barefoot on the grass for like an hour and he said that he slept really good. Probably he was just exhausted but I think—I’d like to think that—that part of the grounding and reduction of inflammation and stuff like that helped as well.

Dr. Justin Marchegiani:  Yeah, he just placed a lot of those negative ions that you accumulate.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  So and—and then flying at night which it sucks because you would destroy your circadian rhythm if you’re doing a red eye, but in terms of radiation—Mercola has written a lot about this. Your reduction of radiation’s basically 99% if you’re flying at night because the sun is not up and the sun is not beaming through the airplane.

Dr. Justin Marchegiani:  100%. 100%. So like the big thing—I just, I kinda got off topic just to touch—but the whole thing with the pesticides–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Calling these companies up, they were telling me it’s a huge demand. That lots and lots of people are demanding the natural alternative versus the toxic pesticides and this company was actually talking about moving away from—because they offered the organic option but they also have the regular option, talking about moving away from the conventional option and going more to the natural option exclusively because the demand is there. People are–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  People are understanding the fact that a lot of the chemicals are carcinogenic. There’s been studies looking at people that get actual lawn care like pesticides and chemicals put on their lawn, you know, shoot little flags, little sticks–

Evan Brand:  Oh, yeah.

Dr. Justin Marchegiani:  They put on their lawns saying, “Hey, beware!” That there’s a correlation with those people and cancer. So it’s like, alright–

Evan Brand:  My neighbor has one.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  My next door neighbor. He—and you know what he does? I’m so glad I asked because I was paranoid about it. I saw the—the truck come and do several applications of glyphosate on his yard and he always has the little stick with the sign there.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And I asked him. I said, “Tim, how often are you getting this yard sprayed?” I said, “This flag is always there.” He goes, “Oh, I just keep it to keep the kids off because the kids will walk through the neighborhood. I just keep it there to keep the kids off the yard.” It’s like, “Okay, well, thank gosh, because I thought you were getting it sprayed every week.” Apparently, he’s getting it sprayed like every 6 weeks which is still too much but hopefully now that the seasons are changing and grass is not gonna be growing, hopefully he’s not getting winter application. I mean, surely not.

Dr. Justin Marchegiani:  Right, exactly. So again the market’s demanding that because people are observe—even though conventional medicine doesn’t wanna talk about how things in our environment are causing cancer and they wanna just sell you drugs to actually treat the cancer and not fix the root cause of the cancer, right?

Evan Brand:  Or prevent it, yeah?

Dr. Justin Marchegiani:  That’s whole different podcast. Right. It’s a whole different podcast. So the toxicity part is important. So the solution to pollution is dilution. I think we got on that thread because we talked about toxicity in the water.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So clean water I think is really important. Next is figure out your snacks. Now some of my patients are on the autoimmune diet. I know some of yours are as well where they may have to be more strict with eggs or nuts or seeds or maybe some more of these snacky things like the—some of the bars that are maybe have some nuts in them. So I would say, number one, dried salmon’s excellent alternative. Good Omega 3s. Good fat, really good—very, very satiating, right? Number two, I would say after that would be jerky. There’s lots of good gluten-free jerkies out there that are just good dried beef.

Evan Brand:  I got a bag right here on my desk.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  This is Whole Foods and where’d it go? It’s under here and they use—let’s see—they’re using tamari. So they’re using the gluten-free soy sauce and it’s water and soybeans. Spices, now it does say spices but still I’m not concerned that there’s MSG in there. There could be some cumin or maybe some other spices.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That are not AIP but I don’t think you’re gonna fall apart.

Dr. Justin Marchegiani:  So I’m gonna give you one Paleo demerit right now because of–

Evan Brand:  What?

Dr. Justin Marchegiani:  The soy.

Evan Brand:  Oh, come on.

Dr. Justin Marchegiani:  I’m gonna give you one Paleo demerit, okay? Now with good behavior, you may be able to earn it back by the end of the show.

Evan Brand:  Yeah, right.

Dr. Justin Marchegiani:  But yeah, at least it’s tamari though. It could be the soy with the MSG and the gluten in it.

Evan Brand:  Exactly.

Dr. Justin Marchegiani:  So like on the scale of like good, better, best. If you’re like I’m going into the store and I gotta buy some jerky because I got his flight and I really wanna make sure I’m not starving. That’s definitely a better option than all the other crap that are there, because tons have the conventional soy. They have added sugar and they have the MSG. So on that scale of good, better, best, it’s definitely better.

Evan Brand:  Well, not to even mention, this is grass-fed beef jerky.

Dr. Justin Marchegiani:  Oh, so good quality there, too.

Evan Brand:  Yeah. I mean it’s not—think about your Jack Link’s or some type of jerky like that.

Dr. Justin Marchegiani:  Oh, it’s crap.

Evan Brand:  That is factory-farmed beef without a doubt. Yeah, this is actually the teriyaki one which I reluctantly got because they don’t have the original.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  They’ve had original there which is literally just like beef, salt, and a couple of spices and that’s it. But they’ve—I don’t know, they’ve not stocked it at our local one, but check it out. Look right by the cash register if you do go to your Whole Foods and you should see it. I found it nowhere else in the groceries. It’s just a small little Ziploc bag and it’s like made in-house jerky. So it’s–

Dr. Justin Marchegiani:  Got it.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That’s good. My next one is the KIND bars. Again, not all KIND bars are created equal. So you gotta look at the family. They have like fruit, nut, and then there’s like nuts & spice. If you’ll look at it, you’ll see what family it is you want. The Nuts & Spice. And they have about 4 or 5 flavors that have 5g of sugar or less, which is actually pretty good for a bar. So I like the dark chocolate and sea salt, the mocha, there’s a caramel one, and then there’s a Madagascar vanilla and a mint one. So there’s 5 that have 4-5g of sugar or less. The Madagascar vanilla has the least amount of sugar, 4g of to about 9-10g of protein and then some good fat in there as well. So not a bad deal.

Evan Brand:  Now those are not organic, correct?

Dr. Justin Marchegiani:  Correct. I don’t think those are like 100% organic.

Evan Brand:  So Love Crunch, it’s by I think the brand is QIA or maybe, no, it’s—it’s Nature’s Path Organics, I believe. I think they’ve discontinued all of them. Maybe you can find them online but for a while I was using the Love Crunch bars.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  They’re so delicious, 100% organic, almonds, cashews. I believe they did have a small amount of peanuts added to their nut blend so maybe a little demerit there but otherwise, your nuts in that bar were organic and it was organic dark chocolate. So that was a delicious bar and also, I’ve got a free box of Mark Sisson’s bars.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  His primal kitchen bars. It’s a grass-fed collagen dark chocolate bar. Those are really, really, really good.

Dr. Justin Marchegiani:  I tried those. I wasn’t a big fan of them.

Evan Brand:  No? Well–

Dr. Justin Marchegiani:  Whose bars I like the best right now is Dave Asprey’s bar.

Evan Brand:  His are good but I ate 2 of his bars when I went to—where’d I go? When I went to Los Angeles for the conference that he had last year and I got–

Dr. Justin Marchegiani:  Yeah, Bulletproof.

Evan Brand:  A box of those bars. I had 2 of those bars that morning on the flight–

Dr. Justin Marchegiani:  Gave you the runs?

Evan Brand:  No, but I was in severe stomach pain like a sharp pain.

Dr. Justin Marchegiani:  MCT.

Evan Brand:  Yeah, the MCT got me.

Dr. Justin Marchegiani:  Yeah, the MCT I think there may be a little bit of–

Evan Brand:  Or the ex—I think he had—

Dr. Justin Marchegiani:  Xylitol.

Evan Brand:  I think he had that XCT oil which is supposedly even stronger in there.

Dr. Justin Marchegiani:  Yeah, I think just the C6, or no, the—yeah, that the XCT I think is more C6. So more of the—the octanoic acid in there.

Evan Brand:  I didn’t poop my pants.

Dr. Justin Marchegiani:  Oh, man. That’s a tough one. I’m so—I like those because it’s got a little bit of MCT in there and then it’s got a little bit of the vanilla. His—his are pretty good. Again, let’s see what else do I have in bag? I’m ready to go. I gotta go finish packing after this podcast. Hard boiled eggs are good. Hard boil–

Evan Brand:  You’re not gonna bring those with you, are you?

Dr. Justin Marchegiani:  I—I have—I’ve been known to in the past.

Evan Brand:  What do you do? You just make them before and put them in a Ziploc?

Dr. Justin Marchegiani:  Yeah, I got one of those little hardboiled egg makers and I just throw them on there, 6 minutes, let it cool off and then just throw it in a Ziploc bag. Put it like in my, you know, on my personal, on my backpack, on my carry-on. Not in my suitcase.

Evan Brand:  Oh, I believe the brand is called Artisana. I don’t—Justin’s is okay but they have a lot of sugar. Sorry.

Dr. Justin Marchegiani:  Yeah, yeah, they do.

Evan Brand:  Sorry. Sorry, Justin.

Dr. Justin Marchegiani:  Yeah, I used to post them on my Facebook for a—for a while. I like their dark chocolate with the peanut butter even though that’s a Paleo demerit, I know. It’s a—it’s a good one, for like a cheap, for a treat. I used to post it so much. A lot of my patients thought that I—that was my company.

Evan Brand:  Oh, that’s awesome.

Dr. Justin Marchegiani:  I know, that’d be nice.

Evan Brand:  There’s another—so Justin’s is okay. They’re not organic with any of their nuts so that’s an issue because almonds are–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Heavily sprayed. However, I believe the brand is called Artisana. It’s in the same area as the little nut butter packet and they have a raw and organic walnut, almond and pecan packets that you can buy. I believe it’s 2 bucks for a little packet of some raw nuts, raw nut butter. There’s another brand, too. I can’t think of what it’s called. I’m gonna have to look it up for you but I’ve sampled it. They gave me and it was all organic pecans and walnuts and cinnamon. I think it was called like Crazy Nut Butter or something. I’ll have to look it up for you.

Dr. Justin Marchegiani:  There’s one called NuttZo that’s really good. NuttZo’s excellent but it’s like $18 a jar.

Evan Brand:  I know, it’s not the NuttZo. That’s a good one, too.

Dr. Justin Marchegiani:  It’s good. It’s like that stuff’s like pure manna. It’s like literally gold.

Evan Brand:  I know, yeah. Oh, it’s called—it’s called Cracked. So here’s a shout out for Chris.

Dr. Justin Marchegiani:  Crack? Are you doing—are you doing crack now?

Evan Brand:  Yeah, Cracked Nut Butter. It’s over—Chris over at Cracked Nut Butter—they found me online and they sent me a little sample kit and I ate their entire sample kit very quickly.

Dr. Justin Marchegiani:  Now that explains why you’re so energetic today.

Evan Brand:  Exactly.

Dr. Justin Marchegiani:  I just thought it was the adrenal support.

Evan Brand:  No, it was the—it was Cracked Nut Butter which I haven’t had—I haven’t had for like 6 months but they have a—it is a—it was, let’s—let me tell you. I’m gonna tell you right now. Hold on. Alright, here’s the ingredient list.

Dr. Justin Marchegiani:  What do you got?

Evan Brand:  Pecans—pecans and I believe this is all organic but I’m not 100% sure here. But it’s pecans, almonds, grass-fed whey protein, digestive enzymes such amylase, lipase, cellulase, protease, lactase.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  Organic ghee, organic coconut, and cinnamon and it comes in a little—I’m gonna have to buy these. They were too good. It comes in a little pouch and you just unscrew the lid and you just squeeze the pouch and you could make 2 or 3 servings out of 1 pouch. I think it was like 4 or 5 bucks a pouch but it was unreal how delicious it is. I’m gonna have to hit them up.

Dr. Justin Marchegiani:  And what’s that called again?

Evan Brand:  That is called CrackedNutButter.com. I may even have a coupon code. Let me see if I have my email for this guy.

Dr. Justin Marchegiani:  That’s excellent. We can always put it on after the fact, but that’s good.

Evan Brand:  Yeah, you put it in the show notes if I find it.

Dr. Justin Marchegiani:  I gotta get that. Cracked?

Evan Brand:  CrackedNutButter.com

Dr. Justin Marchegiani:  That’s great. Cracked Nut Butter. That’s awesome. We’ll have to get some crack here. Love it.

Evan Brand:  Oh, I do—I do have a secret VIP coupon code for you but we can’t give it to the listeners. I was instructed that it’s highly, highly top secret.

Dr. Justin Marchegiani:  Got it. Oh, I’ve seen it before.

Evan Brand:  But I will give it. Yeah.

Dr. Justin Marchegiani:  Awesome, that’d be great. So outside of that. One more that I like. Epic bars. I like Epic bars.

Evan Brand:  Yeah, they’re good.

Dr. Justin Marchegiani:  They’re pretty decent. I mean, for some of my autoimmune patients, there’s a couple of bars that do not have any nuts in it, which is great.

Evan Brand:  Little bit too many cranberries.

Dr. Justin Marchegiani:  Yeah, I mean–

Evan Brand:  Little bit on the sugar side.

Dr. Justin Marchegiani:  You’d have to look at the sugar.

Evan Brand:  Little bit too many sweet.

Dr. Justin Marchegiani:  I’d have to look at them but they have a couple that are—are decent that don’t have any of the nuts in them. So people that are just wanting like a really good clean, little bit of fruit, little bit of protein and fat, it could be a good bar that’s still autoimmune friendly. So I like that piece of it. Some have some of the almonds in it. Some don’t. So you just gotta look at the 4 or 5 that are out there.

Evan Brand:  Yup. I’m gonna send you the—I’ll send you the link to the store here because it’s—they advertised these little packets as TSA friendly.

Dr. Justin Marchegiani:  Oh, nice!

Evan Brand:  So I’ll send it to you and you can—and you can check them out.

Dr. Justin Marchegiani:  That’s great.

Evan Brand:  Yeah, the Epic, they have a chicken bar, too. I just saw. I haven’t tried it, but that’s another option. I believe, don’t they have a—an organ meat bar, too?

Dr. Justin Marchegiani:  They do. I think they do with some liver in there.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Which is excellent.

Evan Brand:  So the op—the options are out there and I mean, if people who are listening, they’re like, “Well, I’m not flying. I don’t fly.” Well, what if you go camping or what if you–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Are just out and you’re running errands all day in the city? I mean, even for my wife and I, we’ll take some snacks with us if we’re gonna be running out all day for hours, going around the city, going downtown, going to the river, etc. We’ll bring some of that with us. Also another brand I believe it’s called Wellshire Farms–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And I found this at Whole Foods. They have—now I can’t say whether it’s pasture-raised meats or not but it’s at least no antibiotics, no hormones. They have some beef sticks. They also have some I wanna say it’s pepperoni or some other type of stick but it’s completely antibiotic, hormone-free. So in a pinch, that’s a much better option than you going to Subway which is not fresh at all or going to, I mean maybe Chipotle could be okay.

Dr. Justin Marchegiani:  Yeah, Chipotle is not bad.

Evan Brand:  But they’re had a lot of—they’ve had a lot of issues.

Dr. Justin Marchegiani:  They’ve had some but I think I’ve seen some reviews where they do have the highest quality meat out there out of all the fast—fast food type of stores.

Evan Brand:  Yeah, I think maybe some of it’s blown out of proportion because they’re trying so hard to go natural and grass-fed and all that. Maybe the media is against that, who knows?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Could be food industry.

Dr. Justin Marchegiani:  Yeah, it’s very possible. I mean, anytime people are trying to show the value add and the quality of food, you know, well, how do you beat these multinational corporations that have absolute terrible quality, right? They just—they just can’t compete at that level.

Evan Brand:  Right, and just like we’ve seen anti-Tesla news after one guy got killed in the electric car, and now they’re trying to say all Teslas and electric cars are bad. Who knows if those media stories are getting co-opted by oil companies, you know? So if you see something anti this or anti that, like the anti-Chipotle media, maybe there is some sort of media bias. It’s hard to say.

Dr. Justin Marchegiani:  Yeah, you just gotta take it all with a grain of salt. That’s all.

Evan Brand:  Yup, absolutely.

Dr. Justin Marchegiani:  But I would say also one of the things I do—not the best for going on planes because you gotta have it, it’s gotta be mixed in water and technically you can’t get a lot of the water through the TSA, right? But a good protein like shake or cup that you can just throw in some collagen, some grass-fed collagen, mix it with some water or coconut milk. Shake it up and I’ll—if I go out and run some errands to do something or go to the gym, I’ll have it with me. That’s a real easy one and you can kinda figure out exactly what you want in there, whether it’s just protein or you wanna mix up some low glycemic fruit or maybe add some MCT or something. You can make that pretty nutrient-dense and it’s darn convenient.

Evan Brand:  That’s a great idea and if you really needed to not use water and you wanted the coconut milk, if you couldn’t get away with brining a can, you could bring one of those dry, cardboard containers of the organic coconut milk or–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  Almond milk. That’d easy.

Dr. Justin Marchegiani:  Yup, those are good. Also avocados are decent because they’re kinda self-contained. If you can get like a plastic spoon and a knife on the plane then you could just—you know, plastic knife, plastic spoon kinda gig, you could just scoop it out. That’s pretty good because it’s self-contained and you can just throw it in your bag and you’re good to go and I like things that are high in nutrient density like also satiating, because I mean after 1 or 2 avocados, your appetite’s pretty curbed.

Evan Brand:  Absolutely. I—I was thinking, I don’t know where you would get these. I saw Jimmy Moore. He posted like on online—I don’t know—3 or 4 years ago. He might have been in another country. There were miniature Kerrigolds.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  Like the little baby–

Dr. Justin Marchegiani:  Saw that once.

Evan Brand:  The little baby butters.

Dr. Justin Marchegiani:  I saw that once and I saw that at a Starbucks in North Star when I was skiing a couple years ago up in Lake Tahoe. I saw it once over there.

Evan Brand:  Ah, okay.

Dr. Justin Marchegiani:  But I’ve seen Dave Asprey post it online, too. So wherever those were at, if I could just buy those, that would be absolutely amazing.

Evan Brand:  That would be so perfect. Just—I mean all you would need is a tablespoon of butter and you would be satiated likely.

Dr. Justin Marchegiani:  Yup, I 100% agree. So we talked about some of the food things. Do you feel like we hit everything on the food side?

Evan Brand:  I feel like the food is over hit, for sure.

Dr. Justin Marchegiani:  Alright, let’s talk about supplements.

Evan Brand:  Sure.

Dr. Justin Marchegiani:  Alright, so number one, I’m going on vacation. I’m going on holiday, so does that mean I’m probably gonna get a couple of Paleo demerits thrown at me by you when I get back? Probably, right? So I may cheat a little bit. Will I have gluten? Definitely not. That’s gonna be my no-no. I have a history of Hashimoto’s. Not worth it and I also gotta practice what I preach for my patients. So what am I gonna do? Well, maybe a gluten-free option is totally fine. I’m gonna bring activated charcoal. That’s gonna be a go-to because that will help bind up any toxins in the food that I’m eating. If it’s–

Evan Brand:  Let me ask you this.

Dr. Justin Marchegiani:  Go ahead.

Evan Brand:  Are you gonna take that every meal? Are you gonna take it when the meal’s just questionable? How are you gonna dose that?

Dr. Justin Marchegiani:  Only questionable and—and alcohol.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Questionable food and alcohol. I’m also gonna be bringing, with those questionable foods, also a bunch of extra enzymes and hydrochloric acid.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Just to make sure–

Evan Brand:  And that will–

Dr. Justin Marchegiani:  I’m breaking that down well.

Evan Brand:  Will that will be with every meal because you think your gut? Because I’m thinking there might be like a circadian rhythm to your digestive system even.

Dr. Justin Marchegiani:  Yeah, we can talk about that next with the circadian rhythm part but definitely getting the hydrochloric acid there just to make sure I’m breaking down the foods. Two, I mean, who doesn’t eat a little bit more on vacation, right? So if you’re eating a little bit more, it’s a little bit more taxation on your gut, so I wanna make sure my gut has the ability to break things down. Also hydrochloric acid does kinda have like a sterilization effect. So if I’m eating some food that may be a little bit questionable, I don’t wanna get sick.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  I’ve gotten sick on vacations before. It can wreck a vacation and when you’re spending a lot of money on a vacation, me has spent an extra 30 or 50 bucks on some hydrochloric acid enzymes is a worthwhile insurance policy. Plus–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  I feel better and lighter after a meal.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So that piece—that piece is really nice to keep one, keep my gut kinda cleaned out from things getting in there and then number two, making sure I can break down that food and feel good afterwards.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Charcoal, with anything questionable and with alcohol. And then number three, off the bat, for the circadian rhythm part, I’m gonna—I got a nice bottle of melatonin I’m brining with me and I’ll hit that up as soon as it’s time for me to go to bed. I will use that kinda reset my rhythm, that’s number one. And number two, what’s great to kinda get your cycle back on track when you can is watch the sunrise while grounding and having some nice coffee. Because you get like the HPA axis because you’re kinda grounding. You get the negative ions being dispersed. You got—I’m sorry, I think it’s the positive—is it positive or negative with the grounding? It’s positive ions.

Evan Brand:  You’re getting—yup. Positive ions.

Dr. Justin Marchegiani:  You’re dispersing–

Evan Brand:  No. it—no, It is negative.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  It is negative ions. It’s the same thing–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You’d get at the beach. Yeah. Negative ions, you’re thinking of positive electrons. The—the extra electrons you’re getting. There’s two different things going on.

Dr. Justin Marchegiani:  So you’re dispersing the negative ions and you’re receiving a whole bunch of positive ions.

Evan Brand:  I believe you’re getting both.

Dr. Justin Marchegiani:  Getting both.

Evan Brand:  You’re—yeah, you’re receiving negative ions, like an ion generator for example.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  It’s like the ocean and then you’re also receiving the free electrons from the earth. The earth is like a giant electron generator so you’re getting both electrons and ions.

Dr. Justin Marchegiani:  Great. So we’re dispersing a whole bunch of negative ions there, right? We are using the melatonin to kinda reset our rhythm so we’re saying this is our new bedtime and then we’re also getting a little bit of stimulation at that same time while we’re consuming a little bit of clean caffeine and also optically triggering the pineal gland, which is where melatonin’s made that, “Hey, light’s coming in.” It’s hitting that optic chiasm that—that cranial nerve 2, that optic nerve. It—it’s hitting that and that is going to the brain and telling the hypothalamus, “Hey, this is our new circadian rhythm.”

Evan Brand:  Now people are gonna wanna know what dosage are you gonna do with melatonin.

Dr. Justin Marchegiani:  I always try going lower than high. So most people are more liberal on that. Typically up to 3mg. I keep it al 500mcg to 1mg.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Again 1000mg—I’m sorry, 1000mcg per mg. So 1—1mg is 1000mcg. So 500mcg to a 1000mcg or 0.5mg to 1mg.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  I get like the 1mg sublingual tablets and I just–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Kinda nibble off a little bit.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  I don’t need much so my body is very sensitive to melatonin so I like to keep that—those receptor sites more sensitive.

Evan Brand:  Yup, absolutely. What—what about other vitamins, you mentioned adaptogens?

Dr. Justin Marchegiani:  Yeah, so definitely adaptogens. I’m bringing some pure ashwagandha on this trip so that will just help with the circadian rhythm. It will also help modulate the immune system. People forget when you’re on a plane, that air is getting recycled. You’re getting a whole bunch of nasty air coming in and it’s not like we have a whole bunch of healthy people like me and you on the plane. Most people are probably unhealthy because–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Number one, they’re traveling a lot on average. Most of them travel a lot. And two, if you travel a lot, you tend to you know, get poor sleep and also eat more you know, junky food on average, right? Could be off. Just go to the airport and sit and people watch and you can make up your own conclusion on that. I do that a lot.

Evan Brand:  Absolutely.

Dr. Justin Marchegiani:  Yeah and I was doing more physical medicine. You could just walk and just see, “Oh, that person so asses off, this person’s ain’t­.” You know, you just see so much and learn about people’s walks and you could just diagnose by walking and movement pattern. That’s also a—a fun time in the airport but in general, the circadian rhythm piece is really important and the immune system because of all the people in the plane that are coughing or hacking up a lung. You wanna make sure you’re immune system is strong so you can deal with any viruses or bacteria that’s flowing through the air.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And also if you get that air vent on you, turn it off. I know it doesn’t help if the person next to you has it on, I get it. But at least it’s not blowing right in your face.

Evan Brand:  Why are you saying that? Because you’re gonna be—let’s say if that air’s recycled, bacteria you’re shoving that right into your–

Dr. Justin Marchegiani:  Yeah and you–

Evan Brand:  Right into your face?

Dr. Justin Marchegiani:  You know again, these infectious debris viruses, they’re gonna work more on proximity, right? If you get something going–

Evan Brand:  Makes sense.

Dr. Justin Marchegiani:  Right into your face, they can get right into your nasal orifice or your—your ear orifice. That’s a big area supposedly where viruses come inter—interact with the bodies, the ear as well.

Evan Brand:  That’s true.

Dr. Justin Marchegiani:  That’s why the old wives’ tale of putting hydrogen peroxide in your ear as being of good antiviral or good natural remedy for the flu. I think it’s because the viruses can come in contact with your—your orifices.

Evan Brand:  Yeah, when I actually met—I don’t know if I told you this or not—when I met with one of the reps at Designs For Health, the—he came into town. He flew in from Boston.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  He said that every single flight, he takes the silver and sprays it into his nose and his ears.

Dr. Justin Marchegiani:  Yes, exactly.

Evan Brand:  Every flight.

Dr. Justin Marchegiani:  Because he’s probably trying to kill bacteria and viruses.

Evan Brand:  And this guy flew like 200—200 days a year. So I take that recommendation–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  With great grace.

Dr. Justin Marchegiani:  Huge fan of that and you can actually cut the—the silver with hydrogen peroxide as well and put that intransally or inter—inter—I think it’s, what do you call it? Oh, I think you call it the—your earhole. Or your—your auditory canal.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  You put it right there.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  So—yeah maybe in the future, airplanes will use HEPA air purifiers–

Dr. Justin Marchegiani:  Right.

Evan Brand:  And things like that, but for now, they’re not.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So the problem is though and this has happened to me. If I get a middle seat and I’m sandwiched between two heavy set people, they create a lot of body heat so it gets kinda stuffy. So what do you then? You just fan yourself? I mean how do you—you know, you want that air flow. You want that little vent. I mean, I guess you—I don’t know. I mean some—I don’t know. It—it’s a tough call. It’s like do you burn up and then you sweat the whole time or do you—or do you put air in your face that’s maybe contaminated?

Dr. Justin Marchegiani:  Well, my—my trick is I’ll tell people here hopefully it won’t come back to bite me, but if my wife and I are flying somewhere and we’re not flying Southwest so you know, Southwest has the open seating kinda gig.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So you get on there and you choose. But if you’re flying on a flight where you have assigned seating, you know, we’ll always choose the aisle and the window because most people don’t wanna choose in the middle, right?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So then if the flight’s not full there’s a good chance that middle seat’s open.

Evan Brand:  That’s true.

Dr. Justin Marchegiani:  I mean, that’s just kind of an old wives’ tale trick that works very well. I’ve done it. And it’s worked for me dozens of times over the years. So that’s what we’re doing today and I think we got an open middle seat. Fingers crossed.

Evan Brand:  Cool.

Dr. Justin Marchegiani:  Fingers crossed. So that’s what I do for that. So melatonin to get the rhythm res—kinda reset. The ashwagandha or the adaptogenic herbal blend, whether it’s Eleuthero, rhodiola, ginseng, ashwagandha, holy basil, I mean you could just roll down your list. You know, your cordyceps are kinda adaptogenic, too.

Evan Brand:  Reishi, you could do.

Dr. Justin Marchegiani:  Reishi mushroom.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Reishi to help modulate the immune system. Oh, really, really great tactics. Next, I would say even just extra immune support on top of that. I’m gonna bring some immunosupporting herbs as well, just to give my immune system a little bit of bump. Also higher dose vitamin D is excellent. Higher dose vitamin C is great. These are all just good things to have so if you get sick, you’re not gonna, you know, waste your time being inside and—and not being—not enjoying your vacation essentially.

Evan Brand:  Right, right.

Dr. Justin Marchegiani:  So I have all those things packed up and I would say also this is a game changer but gut-killing herbs. Gut-killing herbs are gonna be really important whether it’s oil of oregano, silver, or blend of berberine, antiparasitic herbs are very helpful. I have lost 1-2 vacations where I’ve gotten sick and just literally had to be like right next to a toilet. That’s not fun when you’re spending a lot of money on a vacation. So having, you know, 2 bottles of some good oil or oregano or some broad space antiparasitics can be awesome.

Evan Brand:  So what would you–

Dr. Justin Marchegiani:  Because if you get. Go ahead.

Evan Brand:  What would you be taking? Are you gonna take that or is that just something you could do if you were concerned about where you were going maybe?

Dr. Justin Marchegiani:  Well, I’m in a middle of an antiparasitic program and I timed this way so I’m gonna be on the gut-killing herbs anyway because I rather just prevent than have to respond.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  You know what I mean? I’d rather be on the front side of it than on the back side of it. So I’m gonna be doing my GI Clear 1, 5, and 6 right now. Going through a nice parasite killing program which we gotta schedule a podcast to talk about some of our results that have come back.

Evan Brand:  I know. I know. For sure it’s gonna be fun.

Dr. Justin Marchegiani:  That will be exciting. So that piece is really important because I don’t wanna get sick, especially if you’re in sketchier countries where like the food may not be like up to like what you’re used to in the United States and doesn’t mean the country’s bad, it just means that what’s in that food from a flora perspective just may be different.

Evan Brand:  Yeah, let’s go through some of those countries just—just to help. India is one.

Dr. Justin Marchegiani:  Of course.

Evan Brand:  I’ve had a handful at this point especially with Blasto where a woman–

Dr. Justin Marchegiani:  Huge.

Evan Brand:  She’s in Dallas.

Dr. Justin Marchegiani:  Giardia, too.

Evan Brand:  She was clear. We tested her. She went to India, came back tons of symptoms, re-tested her. She had Blasto. So India I would say was one. We–

Dr. Justin Marchegiani:  I’ve seen Mexico and I’ve seen any of that Latin American countries have been an issue.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  I’ve been sick in Mexico twice. So I can speak–

Evan Brand:  Did you get specific infections that you tested or just?

Dr. Justin Marchegiani:  I treated right away and knocked it out right away but I got really sick like just you know, couldn’t hold anything down and I had brought herbs with me and literally knocked it out, like everything was just liquid for like couple of hours and then I got back to my hotel room and then started my herbs and then everything solidified like right away.

Evan Brand:  Wow, that’s an excellent–

Dr. Justin Marchegiani:  And it would have been not good and the trip before that, I forgot to bring it and 5-6 days it lasted. I got back home, got to my office, pulled some stuff off the shelf, started, fixed right away. So–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So all my trips I treat myself preventatively.

Evan Brand:  Yeah, and I was gonna say if people are listening and they think they’re off the hook because they’re not traveling internationally, you’re not necessarily because I’ve never traveled internationally myself as of right now and I’ve had 2 parasite infections, and I’ve not gone anywhere out of the country. So if you’re going to somewhere and you’re drinking some new tap water or even think about it this far, what if you’re going to a restaurant where—and tell me if I’m wrong here—but what if you’re going to a restaurant and you’re getting some conventional rice, and that rice was soaked in water that was contaminated? Couldn’t you technically, theoretically get a parasite infection that way as well?

Dr. Justin Marchegiani:  100%, 100%. And that’s why when I travel, I bring at least 1 antimicrobial, 1 digestive support, charcoal, and 1 bottle of probiotics on average.

Evan Brand:  So if you’re doing just a little bit of charcoal, what are you gonna do like 500mg is like a standard capsule?

Dr. Justin Marchegiani:  Yeah, so typically 500mg to a gram per meal.

Evan Brand:  Is your poop gonna turn black from one dosage?

Dr. Justin Marchegiani:  Yeah, it should. Absolutely. Kinda like–

Evan Brand:  It should, okay.

Dr. Justin Marchegiani:  Yeah, to me, obviously the more caps you do, the more drastic that will be but you’ll start to see a tinge of going more black just like you will with beets and it going more red.

Evan Brand:  Okay, I was gonna ask you, what, like so say you’re traveling and then you’re doing like a spa experience, like let’s say you’re going to do an infrared sauna, would you wanna be taking your charcoal before the sauna or after or during or something like that? Is that gonna help you?

Dr. Justin Marchegiani:  Not really sure about that. But I would say that obviously you’re gonna sweat certain things out with the sauna, that’s the whole goal.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And the charcoal’s gonna kinda sequester all the—the stuff in the gut that it’s come in contact with. It’s putting straitjackets on a lot of the—the critters that it will be moving out the intestinal tract. So again, once it’s kinda sequestered in the intestines, you’re probably not gonna get too much of that to come out of the skin, so I think it’d actually make it—make the experience with the sauna more efficient because there’d be less stuff that it have to pull out through the skin. It will grab it all in the intestines and pull it out that way. And again, if you got crap in your—well, that doesn’t sound right—if you got crap in your intestines, of course. If you have toxins or bad debris in your intestines, it makes sense you want the charcoal to meet and interact with it right where it’s located, right? It’s much harder pulling toxins out when you have to use your skin because there’s a lot of different processes it has to go through and filters to make its way out through the skin, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  Not saying it’s not good, but if you have stuff that’s in your intestinal tract that’s toxic. You wanna meet it with something in the intestinal tract that can bind it up and allow it to go right into the toilet. So typically a good charcoal is good and/or a good bentonite clay. You can choose one or the other. Some people get backed up by it so you just gotta figure out how much you can handle. Start low and work your way up. If you don’t get backed up by it, then you can always go a little bit higher.

Evan Brand:  Sure, so maybe we’ll spend the last minute here. We talked about a couple of free things like grounding, looking at the sunrise, looking at the sunset which hopefully you’re doing if you’re on vacation. That’s a big part of it. Other things could be free. I mean, what about just swimming for example. If you’re going to an ocean place, that’s incredibly restorative. And that’d be a good jetlag reducer. I always try to jump in a body of water if I’m traveling to one.

Dr. Justin Marchegiani:  Yeah, that’s excellent. Also just a really good cold shower in the morning. That stimulates the hypothalamus-pituitary axis so it talks to all the organs better. It gets things revved up. So cortisol’s higher in the morning, within the half hour to an hour of waking. So get that good stimulation, maybe after you watch the sunrise and you have some coffee and you let your feet kinda ground on the concrete or on the grass, you go jump in a cool bath or just go draw a cold shower if you can.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  That’s a good. I’m gonna be practicing and doing all of these things on my trip because we all practice what we preach but that’s a good first step right there.

Evan Brand:  What about a massage? I guess that wouldn’t be free if you’re paying someone for one but I feel like that could be a good grounding type exercise, too. Really boost up your oxytocin a little bit. I mean it can’t hurt.

Dr. Justin Marchegiani:  Oh, I get a massage. I get at least one therapeutic massage a week. I’m a huge fan of massage and soft tissue and/or physical medicine techniques like chiropractic. I feel like it really helps keep your body in balance and it keeps the lymphatic system moving. Some of your toxins—well, the lymphs—the interplay between the blood and the tissue. So the more you can keep toxins going from the tissue into the blood and out your body via kidneys and/or stool, that’s gonna help you be more healthy. So I think that’s a great thing.

Evan Brand:  Because there’s what, 2 or 3 times more lymph fluid than actual blood in the body?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I mean, it’s amazing. So-

Dr. Justin Marchegiani:  Cleaning the blood out.

Evan Brand:  Movement I guess, movement would be the last one that would be free. Exercise or some type of routine while you’re—while you’re traveling as well. I haven’t traveled any more than 3 time zones but I’ve always tried to implement some exercise. You know, hit the hotel gym or the resort gym or whatever and—and get some exercises that way. That’s been a huge mood booster for me and really kinda hit the reset button on jetlag.

Dr. Justin Marchegiani:  Yeah, if I have a lot of free time and I’m just sitting and reading and relaxing, I try to exercise every single day.

Evan Brand:  What do you do? Are you gonna do like some weights or?

Dr. Justin Marchegiani:  Yeah, it’s gonna be weights to me even at any kind of gym, I can at least do pull-ups, push-ups, dips. I can at least one-legged squats. I mean, all these things I can do without any weight.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And then I may if I have enough room in my suitcase I may bring my TRX which is like the rope suspension pulleys that you can hook up behind a doorjamb or put over like even like a tree limb or whatever and then you can do pull-ups and—and do different things with that, too.

Evan Brand:  Excellent.

Dr. Justin Marchegiani:  So I like that, those are great.

Evan Brand:  That’s good coverage. I think—I think we should wrap this thing up.

Dr. Justin Marchegiani:  Yeah, I mean, we’re like giving everyone a ridiculous amount of knowledge like—like through—how, what’s the expression? You’re given a whole bunch of water through a firehose, right? You just can’t get all of it in.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So listen to this twice. Share it with friends, family, neighbors, and if you’re fine on this information, and tell us it’s useful, please give us a 5-star review on iTunes. We’ll put the link below. We’d love hearing what people think and just giving some great information to help improve people’s health and live the better.

Evan Brand:  Absolutely. This should be on a postcard that’s given out at the airport. Travel tips but I don’t think these tips would be—these tips would be controversial. A low fat diet would be—would be the approach. Eat a banana and good luck. That would be the approach.

Dr. Justin Marchegiani:  That’s it, 100%, man. But hopefully we’ve dispelled some of those myths today and I will be back in 2 weeks. I think we got some material in the—in the can, in the hopper here so there won’t be any lag time for all of our loyal listeners but look forward to coming back, recharged and talking about some awesome other health, nutrition, and functional medicine topics.

Evan Brand:  Awesome. Well, take good care and safe travels.

Dr. Justin Marchegiani:  Thanks, Evan. We’ll talk soon, man.

Evan Brand:  K, man. Bye!

Dr. Justin Marchegiani:  Bye!

Podcast #182 Dr. Justin Marchegiani and Evan discuss the 3 Body System Approach To Functional Medicine

Winding-Road.jpg

Dr. Justin Marchegiani and Evan Brand talk about their sequence of care in today’s podcast. Find out why they do things in the order in which they do them and discover the specific reasons why. What is the underlying philosophy behind it and why is it important to do them that way?  Once again they put an emphasis on getting diet right to begin with, followed by sleep and lifestyle. They also discuss in depth about how body systems work. Dr. Justin also describes his 5R approach in this interview. Listen and get some valuable insights on how detox programs really work and why some people may have undesirable experiences.

In this episode, topics include:

01:02 Functional medicine practitioners

03:20 Emphasis on the diet piece

07:33 Body system one

16:16 Body system two

21:32 Body system three

Dr. Justin Marchegiani:Evan Brand, it’s a beautiful day in Austin, Texas. How is it out in Louisville?

Evan Brand:  It’s great today. Mywife’s like, “We have to get outside. All the dandelions are popping up. It’s like 65 and blue skies,” so for this time of year, I can’t complain.

Dr. Justin Marchegiani:  That’s great. I was over in Lake Austin yesterday, water skiing for about 3 hours and I’m really sore today. Water skiing is like the ultimate full body support—or—full body support. I was in a wet suit yesterday, but I just was thinking back because I was out there in January without a wet suit.

Evan Brand:  Geez.

Dr. Justin Marchegiani:  Talk about cold thermogenesis. I mean, amazing though. It feels so good.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  Well, what do you wanna talk about today? I think we—we have a couple ideas here, but one of the things that our patients have been asking about and we used to kind of talk about it as well is the sequence of care. Why we do things in the order in which we do them and why—like what’s the underlying philosophy behind it and why is it important to do it that way?

Evan Brand:  Exactly, yeah. So a lot of different practitioners. There’s so many these days. The holistic health field is growing, which makes you and I happy because we know that more people are gonna get helped. But at the same time on top of that, people are coming in with these different treatment modalities and they may all be great, you know, like acupuncture’s great, acupressure’s great, you know, homeopathy may be awesome for you, you know, who knows? But a lot of times, we’re sharing people that are going to these different practitioners and they’re just getting some type of approach that may not work and there’s many reasons why it may not work. Maybe it’s not backed around as much science as some like the salivary testing where there’s like 12,000 studies on that you and I use, or maybe they’re getting the treatments in the wrong order which is something that you and I wanted to talk about today. I think you and I already discussed this story before but what kinda led us in to having this discussion today is a female patient of mine who’s 24 years old. She went to a naturopath for her stomach issues. She had already been the conventional route with the gastroenterologist, and no help. They did the endoscopy and everything, no help. So she went to a—a naturopath and she got thrown on a probiotic and her symptoms got worse. So her stomach was even more distended and her bloating was worse. Her abdominal pain and cramping was worse and she got thrown on this probiotic and she just continued to—to fall apart. And so I asked, “Well, was there any type of lab work done? Was there any investigative tools used on? You didn’t check for SIBO or other sorts of issues?” No, nothing. And so we run a couple of tests and finds out she’s got some major overgrowth in the gut and so we pulled out the probiotic and then start with the treatment and then she’s better and then we’re gonna revisit the probiotic but it’s gotta be in the right order and she’s feeling much better and she’s been struggling for 7 years. And you tell me this all the time, there’s people—we’re basically the end of the rope, for most people. We’re the end of the line.

Dr. Justin Marchegiani:  Absolutely. Most people don’t realize that there needs to be a certain order in which we do things. And one of the things that I think separates us from most functional medicine providers, especially the medical functional medicine, like the medical—MD functional medicine doctors is that we have a really strong background in nutrition and lifestyle. So one of the things we emphasize is get your diet right. And that’s gotta be the first thing. Now most people that I think comes, yes, because you’re the Not Just Paleo guy is you got a lot of people that have already gone Paleo which is great. That means they’ve enhanced they’re macronutrient ratios. They’re increased their macronutrient quality, meaning they’re buying higher quality protein, grass-fed meat, organic. They’re eating, you know, low mycotoxin foods. They’re avoiding the grains and the refine sugar. So we have that piece dialed in which is great and then we also have some of the lifestyle principles which you did a couple of books on. You did your—your REM Rehab book and then your Stress Solution all on these diet and lifestyle things, like the—the forest bathing, like the sleep hygiene, like all these really important things that need to be there to help everything work, because they have a really great effect on reducing inflammation. So if we get the inflammation reducer button hit on the lifestyle piece and we get the inflammation button hit on the diet piece, that sets us up to how we deal with the patient in the functional medicine realm. So why don’t we just touch upon the diet and lifestyle piece before we go into the functional medicine and our—the body system approach?

Evan Brand:  Sure. So that’s always gonna be the first step and like you alluded to already. Most people that are coming to—to you or I, they already have some type of diet in place, so whether it’s Paleo, whether it’s—maybe it’s because of us, I don’t know—Autoimmune Paleo is–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  Very common. A lot of people are already on that diet, but yet they’re still struggling. So I would say about 95% of people that I work with are people that already have been on a Paleo or some type of whole foods diet, Bulletproof diet, something similar for a period of time, you know, some people 6 months, some people 6 days, some people 6 years, and they’re still struggling. So that’s why I look at it and it’s important to have that in place. You gotta have the nutrients. You gotta have your good fatty acid balance, your minerals, your hydration’s key, making sure you’re getting your Omegas, all of that, and that can all be counteracted by a bad lifestyle though.

Dr. Justin Marchegiani:  Right.

Evan Brand:  So if you’re eating Paleo but you sit in Los Angeles traffic for 4 hours a day and you just—you white knuckle it every time you’re on the highway–

Dr. Justin Marchegiani:  Right.

Evan Brand:  That’s gonna counteract it. So for me, the diet I look at it, and to me, I don’t really—I know this sounds weird—I don’t really get that excited when I see someone has the perfect diet anymore, because a lot of people have what I will consider a really good diet, but they’re still struggling. So it’s like, “Okay, good. That’s there, but you’re still not healthy. You’re still not—something’s not right.”

Dr. Justin Marchegiani:  And I think one of the things that’s helped me out in my practice and I think you would agree is doing the podcasts and doing the blog post and the YouTube videos, we’re kind of educating patients by osmosis to begin with. So they have this foundation that’s so deep and the bigger their foundation, it’s like, you know, versus giving them a shot glass to pour information in versus this big bucket. So now they have this bucket so we can start dumping information whether it’s lab test or supplements, we’re going deeper into special kinds of diets where most patients they come in to your regular run-of-the-mill natural practitioner, they got a shot glass, they’re still eating the standard American diet and you just talked to them about cutting out sugar a little bit and it’s like, their cup is already, you know, overflowing if you will.

Evan Brand:  Yeah, that’s a great point. I didn’t think about that. A lot of people do say—I’m sure you get this every week, too—yeah, I heard the latest podcast on this, and it’s like, that’s so exciting. In between consults, we’re already working on you but you’re still wanting to dig deeper, you’re still wanting to gather more information, and maybe it is information overload at a certain level, but either way, I’d rather you have too much information than not enough because that’s gonna prevent you from struggling.

Dr. Justin Marchegiani:  Right, so we kinda already touched upon the diet piece. A good Paleo template, where we’re cutting out the pesti—the pesticides, the GMOs, we’re avoiding the grains, the refined sugar, and the common food allergens like what you see in an autoimmune Paleo ultimately start, right? The grains, the conventional dairy, the soy, the legumes, maybe even the nuts and the seeds and the nightshade veggies and the eggs for certain people, and then we kinda introduce them back in. That’s kinda there and then we have the sleep piece where getting to bed before 11 to 10:30, getting good quality sleep and if you want more on the sleep hygiene, you can see previous podcast or checkout Evan’s book, REM Rehab.

Evan Brand:  Yup, thank you for that.

Dr. Justin Marchegiani:  Little plug there for you.

Evan Brand:  Thank you, sir.

Dr. Justin Marchegiani:  Let’s transition into the body systems now—now, one of our mentors is Dr. Dan Kalish, great guy, amazing clinician. Most people out there that talk about functional medicine, it’s sad to say that they aren’t actually in the trenches seeing patients. Got a great relationship with Dr. Dan and he has been seeing patient for 20-25 years, over 10,000 patients so he has a perspective that is very unique. It’s not theoretical—it’s a theoretical with a clinical application of hey, does it work or does it not? So we like that, and I know you’ve—you’re creeping up over a thousand patients in your lifetime, I’m over—I’m into a couple thousands so far so we have a lot of patient experience which is great. Now we find that one of the most important things, once the diet and the lifestyle piece is there, what’s the next piece? And we find the hormone—the hormone system tends to be best. Now that’s ATM, not the place where you get your money, but adrenals, thyroid, male hormones for the men. And then ATF, not alcohol, tobacco, and firearms, but adrenals, thyroid, and female hormones for the women. So that’s kind of our body system one approach. Now some people the thyroid and the female hormones are more important than the adrenals and vice-versa on the adrenals for the others, that’s where the functional medicine testing is amazing because we can line them up side by side, and see, “Hey, where’s your thyroid at? Do we have low body temp? Is your Free T3 below 3? Is your T3 total below 100? Or do you have low DHEA below 2? And with a cortisol sum low beneath 23? Or does your progesterone around 18-21 go below 200 pg/ml?” Right? So we can look at all these things and hold them up side by side and compare them. Any comments on that?

Evan Brand:  Yeah, well, it’s just amazing to me, this—this not that complex really. Once it’s dialed in and once we’ve created this system to it, it’s really not that complex but it’s so often ignored and the adrenal test for example, just looking at these hormones, it’s such a revolutionary thing because you and I both speak with people who’ve been to every specialist doctor in the country but yet they’ve never had an adrenal profile run for example. And then it blows my mind because then they get put on these different drugs or hormone creams or different therapies, but if they just looked at the body system and saw that they needed to be put on an adrenal program, they could have avoided all the side-effects and symptoms and things that now we’re trying to clean up the mess from.

Dr. Justin Marchegiani:  And it goes that way with the gut, too, just like you connected with the adrenals. I just did a YouTube video last Friday on a patient that just came in—all kinds of gut issues, ran just a conventional blood test, but we saw a whole bunch of immune markers off. To me, interpreting it from a functional medicine perspective, we’re like, “Hey, there’s some infections here.” Doctor said, “Nope.” You’re fine. We run our test and she hid the Three Amigos which is my slang term for Blastocystis hominis, Giardia and H. pylori.

Evan Brand:  Oh, man.

Dr. Justin Marchegiani:  Three major infections and there was a subclinical anemia as well because of malabsorption and because of excessive bleeding around menstruation. So go figure, but in the conventional medical world, she was fine and what we see when patients come down that path, it’s once they’re told their fine, it’s just a little bit while longer before they tell you it’s all in your head and they either recommend an anti-depressant or they put you on a birth control pill and/or an acid-blocking medication to stop the symptoms. I mean, that’s typically how it is. Me and you have seen it with hundreds of different patients and they get that same kind of response.

Evan Brand:  Oh, yeah. And that was actually the discussion I have with a male in his 50s this morning. Just turned out he has Klebsiella as well as H. pylori, but yet he’d been seeing this psychiatrist for—I don’t know—5, 10 years and he was diagnosed with depression, but he says, “Evan, I can track it to when I went to China and I got food poisoning.”

Dr. Justin Marchegiani:  Bingo.

Evan Brand:  And I was sick for multiple weeks. I lost 20 lbs from all the diarrhea and he just like brought that up and I was like, “Oh, my God.” I said, “We need to get a stool test run on. I can’t believe that we haven’t got there yet.” You know, and so there’s the answer. It’s just—if that’s ignored, you’re gonna get a drug and it’s not gonna fix—I mean the depression is not gonna be fixed with, I don’t even know, what do they use? Lexapro? I can’t even think of the names of them now.

Dr. Justin Marchegiani:  Yeah, it would be like an SSRI.

Evan Brand:  Like a Paxil.

Dr. Justin Marchegiani:  Yeah, or an SNRE or it would be like an old tricyclic anti-depressant. Those are the typical mechanisms. Basically what they do in a nutshell is they allow the serotonin or dopamine to accumulate between the pre and post synaptic neuron, between where the neurons meet, because it’s the neurotransmitters that act like the bridge that connect the action-potential neural impulse from pre to post, and it just allows it to accumulate more between that synapse. The problem is, the more it accumulates, the more the enzymes are upregulated to break it down, thus creating a deficiency in the long run, and guess what happens to that dosage of those medic—medicines over the long term?

Evan Brand:  Yeah, they got–

Dr. Justin Marchegiani:  Do they go up or down?

Evan Brand:  Gotta keep going up.

Dr. Justin Marchegiani:  They gotta keep going up and when the medications go up, what do you think happens to side-effects?

Evan Brand:  Definitely increases.

Dr. Justin Marchegiani:  That’s—that’s why the world needs functional medicine.

Evan Brand:  I agree. It’s scary. It really is when you think about that, because you look at the timeline here and the dosages do go up. You know, it’s whether a 5 to 10 to 10 to 20 and you’re just chasing the dragon there for a bigger hit and it doesn’t work. So now thank the Lord we found this.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And now we’re gonna fix it, and he’s gonna feel better. I told him, you know, I legally can’t say that you can stop these anti-depressants but if it becomes a side-effect that you’re just so healthy that your brain works again, you know, that’s a conversation to have with the psychiatrist that you’re feeling better, so–

Dr. Justin Marchegiani:  And when we fix these things, we’re always working in conjunction with the prescribing physician, either letting them know that the patient’s gonna be reducing and the patient has to make that call themselves and/or with the doctor and we just let them know what’s going on and the doctors working with the patient, we never wanna do it without the prescribing physician knowing. We just wanna mitigate the side-effects. We wanna make sure there’s a support system present so if we have a side-effect—boom—the doctor who’s prescribing it, who knows that drug the best or the most can curtail the dosage to make it last, because when we have side-effects, it’s typically because the person’s getting healthier, there’s more substrate in the brain to relocate, right? Because if we have more building blocks that can be told where to go, then we could hit that saturation point and have side-effects. So typically those side-effects are just mitigated by tapering down the dose, and that’s where it’s great to have a good prescribing physician in your corner so they can take responsibility of that piece and dial it down.

Evan Brand:  Right, and that’s a good distinction to make. It’s not that we come across this, you know, anti-MD. You know, neither of us are MDs, but we do still respect and use them for when we need them, but they’re just not the ones that are gonna help get to the root cause. They’re just there to help kinda keep an eye on the situation and monitor things, and a lot of times, it’s sort of well, I don’t know what you’re doing with those crazy silly amino acids, but keep doing what you’re doing because it’s working, you know?

Dr. Justin Marchegiani:  Exactly, exactly. So we kinda outline what we’re doing with body system one, which is ATF or ATM. The diet’s already lined up. The lifestyle’s already lined up. Now we talked about some of the gut stuff, so the gut’s the next piece because we know if there’s a leaky gut, our immune system’s gonna be in—in overdrive, that’s number one. Because undigested food and/or bacteria or biotoxin particles from the infection will get into the blood stream and that can cause molecular mimicry where your immune systems are attacking other tissues that look similar, number one. Number two, it’s gonna create immune stress. It’s gonna make your liver have to work harder to filter out these antigens. Antigens meaning foreign proteins or foreign compounds in the body, and then number three, we’re gonna have malabsorption, right? Because we’re not gonna be able to break down and ionize our minerals, our iron, our calcium, our magnesium, our selenium, our zinc, these important compounds that help our mood and digestion and hormones. And then eventually we’re gonna have macronutrient issues where we’re not gonna be able to absorb protein and fats and then there goes being able to make healthy hormones to help reconstitute our lipid bilayers and which is—lines every single cell, help raw material for our brain health, and then we create inflammation and then inflammation drives brain fog and mood issues and more hormone issues, so you understand now, the sequence is the body system one, the hormones, then the gut second. And now we can deviate from time to time, and I don’t think it’s worth going into the exact reasons why we deviate because it maybe is we call like a one-percenter or five-percenter, so 90-95 to 99% are gonna follow into that 1, 2 to 3 approach just because of how people predictively break down as they get sick and inflamed.

Evan Brand:  Yup, so are we still on body system two?

Dr. Justin Marchegiani:  Yeah, two.

Evan Brand:  Ok—okay. So it finally made sense for—for myself and this guy after he heard our podcast with my—about my parasites, he looked at his fingernails and he sent me an email with a picture of his fingernails. He had super intense vertical ridging across his nails and so we knew there was some type of dysbiosis going on there. So, you know, in his case, you know, it was caused from these bacteria but you all listening, too, you know, it could be yeast, too. It could be some candida stuff. It could be parasites. All of these things are going to tie into the same body system. So just because you hear that and you think, well, I don’t have a bacterial infection, that’s okay. There could be a parasitic infection. There could be a yeast overgrowth, too. You could have blood sugar issues on top of that, meaning that you’re basically going to have cortisol spikes and crashes, which are gonna further contribute to leaky gut, and so it doesn’t really matter what your struggling with generally this net that we’re casting for body system two is gonna be able to catch whatever type of dysfunction is there and how that actually manifests, there’s a lot of things that can go wrong but generally they’re gonna show up all in the same place as we investigate number—body system number two.

Dr. Justin Marchegiani:  Right, and one of the things that I say that really irritates some of my patients is they come in, they go, “I think that it’s the yeast that’s causing the problem” or “I think it’s adrenal fatigue,” and I say, “You know, Sir or Ma’am, you have the right to have more than one problem.” So a lot of times it can just be one issue that we resolve that one issue and it’s like—boom—you know, life breaks on marble head if you will, or it’s 10% here, 20% there, 15% there, or maybe 30% there. The gluten, the sleep, oh, there’s infection, there’s dysbiosis, there’s yeast, there’s detox issue, there’s nutrient issue. And then it’s like, boom, they all combine up and then it’s like, you know, we say have this great clinical outcome where the patient gets better over a 3, 6, 9, 12 or even maybe a—a 2-year type of sequence depending on how sick and how long they were sick to begin with.

Evan Brand:  Yup, that’s a great way to put it. There’s never one—the way I always say it is there’s never one thing that’s gonna make you or break you. It’s gonna be a combination of about a thousand different factors. So if you think, “Oh, it’s this one cookie.” That one cookie is maybe not gonna kill you, if it’s a gluten-free cookie, but if you’re eating those every night, that’s gonna take 5% away from your energy because your blood sugar’s gonna crash while you’re sleeping, and then the 5% of you doing too much coffee and skipping breakfast, because you know, everything is factored in. So every bite or every decision is sort of going to swing the pendulum or swing the teeter-totter or however you wanna look at it.

Dr. Justin Marchegiani:  Right, right. So we kinda talked about the gut stuff, right? And all the different elements, the leaky gut, the food allergens, the extra toxicity stress, the immune stress, also 70-80% of your immune system’s in the gut. So as soon as we start having immune stress, well, it’s really close to home, right? So where there’s fire—you know, where there’s smoke, there’s fire and where there’s stress close to home, it’s going to affect your immune system.

Evan Brand: Yup, so the whole microbiome in there you’re referring to is very common for people to talk about it now. It’s very common for people to just jump on probiotics or jump on other sort—some sort of bacterial support, but there is an order to the—to the method.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And if you just jump on it because you heard on some podcast that it’s good to take something, you may wanna make sure you’re doing it the right order.

Dr. Justin Marchegiani:  Yeah, and our—our sequence that we use for gut infections, something that I—I kinda tweaked over my—my tenure here, but it’s the 5R approach and we’ve talked about it in my other podcasts but one, first R is remove the bad foods. Second R is replace enzymes, acids and bile salts so we can break down the food. Three is help repair which is healing nutrients, adrenal support, and/or potentially probiotics because probiotics can have an anti-inflammatory healing, repairing effect. We don’t do it all the time in the repair phase, but sometimes we do. The fourth R is remove the infections, that’s the second remove. Notice why it’s not the first. Most doctors do it in the first, big, you know, clinical mistake there, well—we’ll give you a Paleo demerit on that one. And then the fifth R is the reinoculate, but again like we said, we may do some of that in the repair phase but 90% of the time, it’s gonna be in the reinoculation—reinoculation phase. So remove, replace, repair, remove #2, reinoculate.

Evan Brand:  I just wanna hit and repeat on what you said because that’s really profound. Most people, they’re going to find something. So let’s say you do go to someone that does run similar testing and they do find an infection, what Justin is saying is, we’re not necessarily going to come after that right out of the gate because you may not be ready for it. You may—you may not be strong or stable enough, so he’s saying let’s get you healthy first. Let’s remove all the things that are making you sick in the first place. Now that you’re ready and you’re toughen up and your defenses are prepared and you know, you’re flexing your muscles and you’re strong, now we’ll come in and address it. But if it’s in the wrong order there, that’s why you may be ridden with symptoms and so we try to keep the side-effects to a non-existent or extremely low level and that’s the way to do it, is just do it in the right order, make sure you’re ready for it.

Dr. Justin Marchegiani:  Exactly. And then that kinda transitions to body system three, where that’s our—our detox and/or nutrient type of programs, our detox and—and our brain programs tend to happen there. We also may add in probiotics there, too, because typically once we hit the fifth R, we’re done with a lot of the gut killing and then we graduate the patient as long as you’re doing good to that body system three where we use a lot of detox support and a lot of time it’s geared based on the Organix test that we run. A lot of time we’re adding in extra nutrients that we may find on the Organix test. We may add in extra nutrients with the adrenals or with the gut, and we kind of add them in as a means to support the adrenals and to support the energy systems in body system one, but there may be some nutrients we wait and we hold off, and add it in in body system three to help support detox, to help support reinoculation, to help support the brain and/or neurotransmitters. So we kind of—this is where the clinical art comes in where we have these body systems one, two and three that are very linear, but then you know, what stuff do we wait and hold off on, and what stuff do we add in to support one or support system two or we wait til the end to support three, but the nice thing is we have the date for each system and then we can look at the clinical outcomes of you know, the thousands of patients we’ve seen in the past and then we can interject it, what will be best for the patient and then we can outline options of hey, how fast do you wanna get better or how slow do you wanna get better? And then we can hit the gas pedal of success accordingly.

Evan Brand:  Yup, so body system three, once again, not selling a broken record but this is where most people start. They’ll put you on some detox tea or a detox shake, or a detox program and you’re just coming from maybe a conventional diet, maybe not, maybe you have everything dialed in, and you just skip over hormones, you skip over adrenals, you skip over the whole GI system, and now you’re on some detox cleanse and you’re feeling awful. You feel like you have the flu and you have no clue why. Well, here’s your answer. We haven’t revved up the other systems to make you able to do this so you know, if you’ve had bad digestion for such a long time and you’re filling up your body with free radicals, you got a toxic load in there and you’re not ready to just dump all a whole bunch of supplements in to help you detox because you can’t handle it. So maybe somebody, you lived in a toxic house, you can’t just go straight into detox, you gotta check everything else, too, because there’s an order. So–

Dr. Justin Marchegiani:  There is. Now it’s one of the other pieces we gotta be very careful of is the heavy metals because a lot of doctors wanna jump on heavy metal programs right off the gecko and this is a big, big mistake. Even when we do detox programs, we’re typically doing either in conjunction with detox program or doing it after a, you know, our chemical-based phase 1 or phase 2 detox because one of the main mechanisms of detoxifications is the gut, the hepatobiliary system. That’s the liver shooting out toxicity and bile salts to the gallbladder and then spitting it out into the gut an then having good transit time to eliminate that stool. So if we don’t—if we have any gut issues still lingering and they haven’t been dialed and addressed yet, we’re screwed because now we’re gonna have what’s called autointoxication where we reabsorb a lot of these compounds. So we gotta make sure the gut is so dialed in, the diet’s dialed in and this is—I would say at least 99% of the time. There may be a scenario where you get some type of acute environmental toxicity, you break a thermometer crap, you know, or you know, mercury one, or you get exposed to something really bad environmentally. You see your kid chewing on some lead paint or something, then you may wanna go in and start doing a chemical detox right away because it’s acute. But most people, it’s a chronic issue, so for the chronic issue, you really wanna lay out the 1, 2, 3 approach and then wait deeper into the body system three phase before we bring out some of the—the more powerful chelators to help pull down some of those toxic metal loads.

Evan Brand:  That’s a great point. So I’m gonna paint a little picture or a story and correct me along the way if I’m wrong.

Dr. Justin Marchegiani:  I just wanna—I just wanna make you’re not eating that paint.

Evan Brand:  No, I’m not eating the paint.

Dr. Justin Marchegiani:  It’s gonna be lead paint that you’re painting.

Evan Brand:  No, it’s gonna be zero VOC paint.

Dr. Justin Marchegiani:  Just checking.

Evan Brand:  Alright, so let’s bring—we’ll Sally into the picture. She’s 45. She’s busy working. She’s looking towards retirement but she’s got all these symptoms so she knows she’s gotta keep working away and make the money and buy all our good food and all of this. So she’s stressed out so she’s dumping magnesium from her body. She’s burning through it like jet fuel, so now she’s dependent on a couple cups of coffee per day and she just doesn’t feel right. She’s got this fatigue. Four o’clock hits, her brain’s not working. She’s tired. She’s exhausted. She’s got some excess belly fat she wants to get rid off. So she’s gone through all these programs out there, here’s the detox stuff, here’s et cetera, et cetera, but we look at the next system. She’s constipated, you know, she’s not even going poop once a day, not even that often which is not good, and then she goes and she does the detox shake and she feels awful, like you mentioned, if you have all these little chinks in the armor across the systems, your—your results are gonna be limited. So if she’s constipated, like you mentioned, you’re not gonna be able to flush out those toxins. So here you are releasing toxins. You’re opening up these pathways, right? In the liver, but yet there’s nowhere for them to go, so you get worse. But let’s say we look at her adrenals, get them dialed in, adjust the rhythm as needed, get her pooping normally so she can get the toxins out, heal up the leaky gut, get rid of the parasites, get rid of the infections if they’re there, then move into detox and getting the brain turned back on, making sure the neurotransmitters are working the way they should and that she’s methylating and she’s getting all of her B vitamins and her antioxidants and all of that.

Dr. Justin Marchegiani:  Bingo.

Evan Brand:  So–

Dr. Justin Marchegiani:  Bingo and I wanna say one more thing, too, with that is that when we talk about detox program or detox support, I wanna just make sure people aren’t under the—the misnomer that you aren’t doc—you aren’t detoxifying outside of the program. You’re always detoxifying. It’s just the question to what degree are you detoxifying and then we know that stress burns through nutrients and a lot of the nutrients needed to detoxify are gonna be sulfur-based amino acids, antioxidants, B vitamins and a lot of nutrients and these things get burnt up under stress and they get burnt up with malabsorption and gut stress and dysbiosis. So we’re talking about enhancing detoxification naturally via indirection mechanisms by style, sleep, diet, digestion, gut and then in body system three when we talk about detox, we’re talking more about a punctuated upregulation of these pathways via specific supplements to upregulate the antioxidants, the sulfur aminos, the extra Bs, the methylation like you talked about, Evan, and all the extra nutrients that may be missing you will know on lab test.

Evan Brand:  I love that, yeah. It just doesn’t sound as sexy as like a skinny tea–

Dr. Justin Marchegiani:  Right.

Evan Brand:  That you’ll see promoted online. But our skinny tea, detox tea, no. An upregulation, I mean, you’re detoxing every day. Hopefully, you and I are slightly detoxing right now from our breakfast or lunch today, you know, that’s the goal.

Dr. Justin Marchegiani:  The best thing you can do to detoxify is eat protein, alright, make sure you’re digesting that protein—high quality protein, right? Grass-fed meat, if you can handle whey protein, that’s an amazing source of sulfur amino acids, if not pea protein; if not, other high quality grass-fed or pasture-fed meat. Drinking enough water. My friend and colleague Dr. Robert Rakowski, the solution to pollution is dilution, say that ten times fast, and then get sleep. These are simple things. Now after that, this is where we kinda like, you know, we’d roll up our sleeves and we get all functional medicine fancy on you and we break out some of these more specific programs but foundation first, because no matter—the higher you wanna build meaning the more intricate you wanna get, the deeper that foundation has to be. Just like building a hotel. They go so deep down for the foundation so we wanna have that foundation so deep, so we can pile right high on top of it.

Evan Brand:  I think of a tree rather than a hotel, big root system. I was in the woods yesterday. This tree had fallen over I guess from all the storms that we’ve had.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Its root system was literally, I mean, so the tree was on its side and the roots and the dirt were all popping up, it had to be 12-foot tall. That, I mean, I was—I was reached all the way up and I could not touch the top of the root ball and it was a massive tree. And so you think, “Man, that’s what it takes to hold something that big up.” So–

Dr. Justin Marchegiani:  I love that, and let’s just stay on that analogy with the tree, because this is one of the things that I hit my patients over is the tree analogy, is that most people, they’re in the leaves, right? The leaves are all the different symptoms, okay?

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Where it’s pain or fatigue or mood, and then a lot of conventional or I should say, not so good nutritionists or not so good functional medicine doctors, they’re in the leaves treating the leaf. “Oh, well, this is a zinc issue, or we’re—we’re gonna do this herb for that and we’re gonna give this for that,” which is okay, as long as we have the right perspective that it’s palliative, not root cause. So as long as we can differentiate that’s fine, but then now where the—the really good nutritionists and functional medicine doctors go is they trace the leaves back to the branch. Great, we start making sure that branch is being addressed and then the even better ones go to the limb and the limbs being all the things that we mentioned—the systems, the diet, the lifestyle, and then we go right back to the tree trunk, the base, that’s where the core things that we’ve already mentioned in our foundation analogy have to be there. So we have the trunk, we have the limbs, then the limbs branch out into branches and then the branches branch out into leaves. Hope that makes sense.

Evan Brand:  Yeah, it does. So I’m gonna read just a little piece of the definition of palliative care just because I didn’t fully understand the full definition, so it focuses on providing patients with relief from the symptoms, pain, and physical stress and mental stress, whatever the diagnosis. So basically, it’s “Oh, you’re back hurts? Here’s 800mg of ibuprofen,” which is what I got prescribed when I hurt my back when I used to work at UPS to pay for my college. I never got told, “Hey, dude, maybe you shouldn’t lift 125-lb packages by yourself and work third shift and you’re up at 3AM. Maybe that’s your issue and your—your body can’t regulate your hormones properly so you’re not rebuilding and you’re in a catabolic state, you know.

Dr. Justin Marchegiani:  Right.

Evan Brand:  So–

Dr. Justin Marchegiani:  Right.

Evan Brand:  There we go.

Dr. Justin Marchegiani:  Now we’re kinda like just digging into that analogy, it’s gonna be always better for the natural doctor to go in and say, “Okay, well, here’s some fish oil and some curcumin and maybe some Boswellia for the—the pain in the back.” That’s great because at least we know it’s not gonna cause the ulcer or the liver stress, because we know according to the Journal of Medicine 1998, et al. 19,000 people die a year taking ibuprofen properly, so we automatically know you’re in a better place just doing that. Now the better doctor who’s practicing functional medicine, root cause medicine would say, “Okay, great, let’s send you to a really good applied kinesiology chiropractor. Let’s start adding some specific exercises from foundation training or some functional movement patterns and then let’s make sure your diet’s better so you have the nutrients for the back and the ligament. Let’s add in some collagen. Let’s make sure the sleep’s dialed in.” Like that’s how we go deeper. So I’m not saying adding palliative support is bad, it’s gonna great especially if it’s natural without the side-effects, okay? And then as long as we add in the other pieces, then we set a really good foundation to build on.

Evan Brand:  Yeah, you and I both like fixing symptoms so people can feel better and stay motivated for the program but as we’re removing the symptoms kind of side-effect, maybe supplement in our case, we’re still trying to work backwards to get rid of what’s causing it in the first place so maybe one day you won’t need that Boswellia or et cetera.

Dr. Justin Marchegiani:  We deal with a lot of executives that have a really stressful job that frankly, they may not be able to curtail as much of their stress at work but we can at least add in B vitamins and adaptogens and nutrient and glandular support and adrenal support that will help while we can cohorts them into getting a little more sleep, taking 5 or 10 minutes out to mediate or go walk in the woods and get some fresh air, or do some forest bathing, things like that. So we try to interject little pieces there and what I say is we help them we’re they’re at, you know.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  If—if they’re at this place, if we can just take one step forward that’s better, but for someone else, that may be too much. So we wanna help them where they’re at.

Evan Brand:  Yup, my lawyer clients and entrepreneur or business guys or businesswomen, they’re always the ones that have the most need for what you’re talking about, some of the adrenal support. Do you have any particular patient that comes to mind in terms of profession, in in terms of the typically having the lowest adrenal function or the worse adrenal function?

Dr. Justin Marchegiani:  Yeah, anyone with a type A personality and that could be—a lot of times that’s gonna be your lawyer, it’s gonna be your entrepreneur a lot of times. They’re—they’re burning the candle at both ends, and you know, I definitely fall into that category sometimes so I make I take my adaptogens. I make sure I get the right sleep. I make sure I try to get the mediation in or a—a walking kinda gratitude session in during the day and get the vitamin D. So I try to practice what I preach 100% and I need to because it keeps me real for my patients, you know, we’re just—we’re—we’re busy here keeping it real, Evan, right?

Evan Brand:  Yeah, we have to. I mean, that’s the only way to do it.

Dr. Justin Marchegiani:  That’s it. Well, anything else that you wanna touch upon that you think is important that you want your listeners and your patients to hear?

Evan Brand:  Not really. Just make sure that you’re playing an active role in this, too. So I just had a female client of mine email me this morning and she said, “I think I figured it out.” She said, “I need to change the timing of the vitamin C.” And she goes, “It makes me feel a little bit weird if I take it too early. So I’m gonna try later in the day or I may just try cutting it out for a few days.” I’m like, “Okay, awesome.” So we may not know every single little piece of the puzzle that’s going on, you know, in your household with your stress level with trying to get your kids to work in the morning and trying to check up on your emails and all that, so we fit everything in in terms of like your program according to the best timing that we can give you based on what we see, but if there’s other stuff behind the scenes that we don’t see like you’re running around crazy like a madman or a madwoman in the morning, then maybe they—taking those morning supplements dosage, maybe that won’t work. Maybe you have to shift it a little bit later. So always play the proactive approach and don’t just kind of like put your hands out and want everything to fall back into place without you having to do the work. It’s still work but it’s fun work and it’s very rewarding for you to play a proactive role in your health.

Dr. Justin Marchegiani:  I agree. And then one thing I just want to kind of leave here, to kind of echo for everyone is if you’re having an issue where you’re not getting that 5-10% improvement going through body system one to two, et cetera, there’s probably something deeper. It could be a deeper infection, number one. It could be your mitochondria’s really burnt out and you need additional mitochondrial support during the process or number three, there could be some serious detox impediments and we may need some extra detox support to help kind of help your body process everything because if we give these supplements it may even be too much stress on the body to handle. We may have to really kind of backtrack it to the detox and do body system three first and give enough time for three to work before we even go to one or two.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So–

Evan Brand:  Yeah, the last thing—the last thing I was gonna say, the guy I was talking about earlier with the malabsorption issues and the Klebsiella and the H. pylori, you know we always frame it around, “Well, how quickly do you wanna get better?” And he was like, “Well, I wanna have more energy, better sleep ASAP.” So we just started investigating body system one and we were treating based on, you know, stage 3 adrenal fatigue but we hadn’t made it to body system two yet. Just because we were so caught up in working there, so if you have an incomplete picture, now if you’re listened to this, you’re gonna know whether your picture’s complete. If it’s not complete, make sure you do start to complete it, because now we’re starting to complete the puzzle for this guy and we’re only going to accelerate the results because now we found two infections that we didn’t know about for the last 3 or 4 months.

Dr. Justin Marchegiani:  That’s it. And I think if something does go wrong, if doesn’t go as planned I should say, that’s probably a better phrase—something that doesn’t go as planned, it means something. Write it down and then meet with your functional medicine practitioner and have a solu—have a solution-based mindset, not a “Hey, this is where I’m at. I’m mad. I’m sad,” and you know, just throw a tantrum. Say, hey, back up, what does this mean and how can we then move forward with a solution-based approach to fix it? Because again, 90-95% of the patients get better with these proven approaches, so if you’re not in that 90-95%, and you’re in that 5-10%, I know it stinks. I empathize, it doesn’t feel fun or right, but then the question is how do we switch gears into that solution mode and get to the root issue that needs to be tweaked for you to help kinda unleash your success potential?

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  Awesome, Evan, anything else?

Evan Brand:  That’s it.

Dr. Justin Marchegiani:  Hey, great talk today as always. You enjoy this great Monday!

Evan Brand:  You, too.

Dr. Justin Marchegiani:  Take care, bye!

Evan Brand:  Bye!

Podcast #181 Dr. Alan Christianson on Types of Testing For Adrenal Fatigue

Dr Alan Christianson
Dr Alan Christianson

Alan Christianson is a New York Times Bestselling Author and a Phoenix, Arizona-based Naturopathic Medical Doctor (NMD) who specializes in natural endocrinology with a focus on thyroid disorders. He is the author of The Adrenal Reset Diet, The Complete Idiot’s Guide to Thyroid Disease, and Healing Hashimoto’s – A Savvy Patient’s Guide.

As a child raised in rural Minnesota, Dr. Christianson was an avid reader. He loved spending time with his family’s encyclopedias and medical textbooks. His health, however, was a struggle. Cerebral palsy left him with seizures, poor coordination, and obesity.

In 7th grade, he was compelled to change after a classmate made a cutting comment in gym class. He became determined to reset his health and his life. Over the next few weeks he devoured dozens of books on nutrition, fitness, and health and created his own recovery plan.

At age 12 he gave up sugar and processed foods and created an exercise plan that was easy enough for him to start on. He stuck with it and built on it. With no prior sports experience, he became a varsity football player and his classes’ best endurance runner by 9th grade. This experience taught him that being healthy transformed both how you feel and how others treat you. He also learned that the tickets to health were knowledge and persistence.

Dr. Christianson was a member of the premier class of Southwest College of Naturopathic Medicine (SCNM) graduating in 1996. He  is the founding president of the SCNM alumni organization and continues to be an active board member. He is also the founder and acting president of the Endocrine Association of Naturopathic Physicians.

He frequently appears on national TV shows like Dr. Oz, CNN, The Doctors and The Today Show as well as print media like Women’s World, USA Today, Newsweek, and Shape Magazine. When he’s not maintaining a busy practice, his favorite hobbies include mountain unicycling, technical rock climbing, and watching the stars.

Dr. Christianson resides in Scottsdale, Arizona, with his wife Kirin, and their two children.

Today we discuss:

  • The various types of lab testing for adrenal fatigue and cortisol
  • Urine testing and the lack of research
  • How saliva tests rank in importance for adrenal cortisol rhythm
  • How blood tests factor in for thyroid and other hormonal health

Podcast #155 Six Steps to Take Control of Your Life

Take Control of Your Life PodcastToday is an episode with just you and I. I needed some alone time with you to talk about some things that I have been seeing people struggle with in the clinic. There is an overwhelming sense that people do not feel in control of their lives. This could be on an emotional, physical, spiritual or other level. Just a lack of control.

Do you feel that you are constantly "out of time"? Do you feel rushed and that there are never enough hours in the day? This episode is dedicated to you.

I struggled for a long time to feel like I was staying above water with my life, it was like quicksand was everywhere I went and time and productivity would just disappear.

It wasn't until I put systems in place and used these strategies to take control of my rhythm that I was able to be more productive and accomplish the things that I needed to focus on.

If you're someone wanting to achieve success, which is everyone, these simple strategies that involve lifestyle, nutrition and mindset will give you the confidence you need to take control of your calendar again.

Enjoy!