Functional Medicine Clinical Pearls – Podcast #104


By Dr. Justin Marchegiani

Dr. Justin Marchegiani and Evan Brand get into this relaxed discussion about some digestive issues, quick and easy meal ideas, and they also touch upon some conscious competence in this episode. Get some cool knowledge bombs and brain candy when you listen to this podcast on Functional Medicine Clinical Pearls.

Listen and find out why it’s good to get multiple tests done even if you don’t have symptoms. Learn some tips on making meals easier so you have no excuse of choosing not to eat good food all the time. Heed the advice of getting habits dialed in first and then manage stress.

In this episode, topics include:

02:15 Chronic digestive issues

11:06 Cooking and meal prep

14:57  Conscious competence

17:37 Whey & pea protein

28:55 Get tested


Dr. Justin Marchegiani:  Evan Brand, it’s Dr. J! How’s your Friday going, man?

Evan Brand:  It’s going great! I’m happy to be with you!

Dr. Justin Marchegiani:  I’ve been in the zone. I had—I think 5 or 6 patients in a row. I get to go jump into a podcast here with you which always makes my week, getting information out there and it’s so nice knowing that when you’re sleeping that you’re not even with a patient that you’re still out there helping people because are listening to us thousands of times throughout the day. So it’s such a rewarding–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Thing knowing that you can help people even when you’re not doing it at that exact second.

Evan Brand:  The beauty of technology.

Dr. Justin Marchegiani:  Love it! So I’m hanging out with Butter here right now. She’s actually asleep in her bed. But she’s been my little trusty steed all week long. How are you doin’? How’s Summer doing and the kid?

Evan Brand:  She’s good. She’s–

Dr. Justin Marchegiani:  Good.

Evan Brand:  She was fussy earlier so we gave her something. It’s called Gripe Water. It’s like this organic fennel-ginger concoction that you give in a little—it’s like a little child tincture if you will.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  And it—it really helps.

Dr. Justin Marchegiani:  That’s awesome. And it was to help her tummy?

Evan Brand:  Yeah, just like stomach discomfort. I mean, you’ll feel the stomach get hard.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And you’ll feel it soften up once you give her that. I don’t know if it’s gas or—or what it is. But the fennel, the ginger, it’s all just–

Dr. Justin Marchegiani:  Oh, that’s great!

Evan Brand:  Very helpful.

Dr. Justin Marchegiani:  And you may even want to look to is a couple of, you know, good probiotics out there that are—that are higher in the infantis strain and the infantis is the one of the best ones when they’re less than 3. It’s more in the—in the infant so to speak, right? So it’s great for the kinda digestive issues in the—in little kiddos.

Evan Brand:  Yeah, I think the one we have, it’s like called Probonix. It’s like a very high infantis–

Dr. Justin Marchegiani:  Oh, yeah! We has this conversation a weeks ago.

Evan Brand:  It’s—it’s—I tasted it. It is gross, but it’s effective.

Dr. Justin Marchegiani:  Yeah, I mean what I like—what I’ve done with patients in the past is you just get the powdered infantis and you—the—the mom could put it on her nipple–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So then when the baby is feeding, then it’s just right there, and it just gets right into the normal flora just kinda naturally and it helps, because it’s going in the same time as the feeding is happening, so it can help with the breakdown of everything.

Evan Brand:  Yeah, this one’s a little dropper.

Dr. Justin Marchegiani:  Okay.

Evan Brand:  It looks like—it looks like colostrum. It’s like little yellow milk.

Dr. Justin Marchegiani:  Oh, nice.

Evan Brand:  Not tasty, but it works.

Dr. Justin Marchegiani:  Well, we will not gripe over Gripe Water.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Cool, man. Awesome, anything else?

Evan Brand:  That’s it for this week.

Dr. Justin Marchegiani:  Dude, let’s talk about some clinical pearls. Because me and you, we’re in the trenches, our sleeves are rolled up. We’re getting down and dirty, getting our patients who are, you know, having symptoms, having issues, having challenges better and overcoming them. We wanna share with some of the—because we have patients that listen to the show. We have patients—people that aren’t even patients that are just looking to get their health better. We wanna share some of those clinical pearls. So let’s talk about people that have chronic digestive issues. You know? What are some clinical pearls from the last week of some of some the patients that have come in to see you that you wanna share off the bat.

Evan Brand:  Yeah, so one girl in particular I was talking to you about, she had stomach pain for a really long time. It’s been at least 5 years that she’s had stomach pain and it comes in waves. So it could be an 8 or a 9 on a pain scale, 10 being the most, some days. Some days it was like a 2 or a 3. And so I just assume something had to be going on in the gut and we ran the Biohealth, the 401H, the 3-day panel and nothing showed up. And then we did the organics and some yeast problems showed up, a couple bacterial markers, and I was like, “Okay,” so we took care of those, but the pain–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Was still there. So we had spun wheels for quite some time and I said, “Okay, we’re gonna have to go deeper. We’re gonna have to get the genetic stool test.” So she was like, “Alright.” And so she ran it and then she comes up with Dientamoeba fragilis.

Dr. Justin Marchegiani:  Is that the GI-MAP?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  The GI-MAP and she showed up with the Dientamoeba fragilis and I was like, “Wow,” and you read every symptom of this parasite and that’s her. I mean, it was textbook and I was like, “Wow!” You know, I assume something had to be there but we just had to find it. So I think the pearl, the take-away is it—the stuff is there in people—it’s just a matter of you finding it and she had been to conventional doctors for years and gone to all these prestigious hospitals and all of that in Los Angeles and they found nothing. So it makes you question, how many people out there are really going with this stuff undiagnosed? I think it’s a lot.

Dr. Justin Marchegiani:  I think it’s really important to do 2 different stool tests. I think that’s essential because you can really cast a bigger net to pull some or to catch some infections that may or may not have been there and when you have someone and it’s really hard, too, because, you know, it’s easy to get someone to do these tests when they know they have bloating, gas, constipation, diarrhea, right? All those things. It’s really easy. But then when you maybe not have some of those symptoms. Maybe it’s more mood stuff or fatigue or—or some other things regarding emotions or hormones. It’s hard to get people to connect that those symptoms even though they’re atypical, you know, they’re not the typical digestive symptoms to get these tests. So I always tell patients, anytime you affect the gut, right? It’s like shaking the branch on the tree. The le—all leaves move or it’s like throwing the rock in the water, you get the ripple effect. You affect all the nutrients. From the nutrients comes our hormones, comes our building blocks for hair, skin, nails, everything. Neurotransmitters for mood. So gut’s really important. I had a couple patients this week. We did one test that came back clean. Another one came back H. pylori.

Evan Brand:  Wow.

Dr. Justin Marchegiani:  The gentleman I’m treating right now has got a lot of like head, like stuffiness or like head, like almost like a head congestion where his head feels just lots of pressure and he came back with a Klebsiella overgrowth and H. pylori where he had seen lots of other clinicians and came back clean. Now this gentleman we’re trying a lot of different things like lower FODMAPs, like really keeping the diet like bland, very mono, one meat, one vegetable, crockpot in it, you know, kinda blending it up making it into a slurry so it’s super easy to digest so we’re trying all these things with this person and the next step is we’ll be going to an elemental diet, which is just really what it is. It’s elemental. Everything is broken down to its absolute, you know, finite form so it’s really easy to digest. We’re trying to get this person the foundation so we can start some killing real soon for the H. pylori and for this, more than likely a SIBO or a small intestinal bacterial overgrowth.

Evan Brand:  Yeah, and that—what I was gonna mention is for this female, she—she was not able to ever get the burn with hydrochloric acid. I didn’t tell her to do the—the test where you take a bunch of enzymes and HCl and all that until you feel the burn. She did that on her own and she was up to like 14 capsules of HCl and she still did not feel the burn and I believe she’s 27-28 years old. So that just shows how far these parasites can really damage the gut health and people have no clue why they are not digesting, why all of their amino acids are not working, their brain’s not working, and the conventional doctor’s gonna say, “What, oh, maybe this low mood is depression, here’s your Abilify.”

Dr. Justin Marchegiani:  Right, and how does the Abilify affect a mood issue if it’s a lipopolysaccharide overgrowth from the bacteria and which is causing a leaky gut and all those LPS compounds are getting to the brain and crossing the blood-brain barrier?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right?

Evan Brand:  That’s scary.

Dr. Justin Marchegiani:  If you’re on Google, type in LPS and mood issues or depression. There’s studies on this stuff. So yeah, gut issues can cause depression and also just a note to anyone listening here that’s doing HCl. I always recommend, once you hit, you know, 7-8 and you’re not having a digestive improvement, don’t go that high because you don’t wanna increase your chance of getting a peptic ulcer. Right Your food, all that chyme, that mixed up food in your stomach, once it passes into your small intestine, your pancreas has to make a whole bunch of bicarbonate to take that nice low pH back up to about neutral, about 7, and if you exhaust your bicarbonate stores, you’re gonna have a hard time neutralizing that hydrochloric acid. So even through it’s fine in your stomach, you may not be able to bring it back up to neutral once it hits the duodenum, the first part of your small intestine and you can get a peptic ulcer.

Evan Brand:  Yup, yeah.

Dr. Justin Marchegiani:  So I always just tell patients, anyone listening, you know, work your way up to 4 or 5, you know, maybe 3,000-4,000mg or 3-4g. Unless you’re seeing a noticeable difference and feeling an improvement as you go higher then I would stop at that 5 or 6 and if you’re not noticing an improvement from 2 or 3 let’s say, then keep it at 2 or 3 which is about anywhere between 2 to 2.5mg. If you wanna go up higher, make sure you’re working with a functional medicine clinician.

Evan Brand:  Yeah, that’s well-said. Yeah, and I told her, I was like, “That’s not a good idea. It’s unnecessary.” 14? That’s insane. Imagine how quick you’re gonna through a supplement bottle anyway.

Dr. Justin Marchegiani:  I know.

Evan Brand:  But—but yeah.

Dr. Justin Marchegiani:  Hope you’re buying in stock in that supplement company.

Evan Brand:  Seriously.

Dr. Justin Marchegiani:  And I also—one more thing, too. I had a patient come in this week. He was just like, “Oh, yeah, I can’t handle the HCl, like you know, one capsule is causing burning.” I’m just like, “Alright, one. That means your gut lining is very, very thin.“

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Stress hormones, cortisol, inflammation in the gut—and she had H. pylori. She came back with H. pylori, so very thin gut lining. I’m like, “Yeah, that H. pylori really ate away at your gut lining.” Now that means something because that means that essentially your gut lining is weakened. So that’s gonna be our indicator to go back to as we heal. And having seen this dozens of times before, we can cut out the foods. You know, throw them to the 5 or 6R program and start adding in hydrochloric acid on our own in the middle of a meal at very small levels, maybe a quarter of a capsule and working it up can help. Because a lot of times, it’s the low acid that causes the food to rot. The foods rots and then it putrefies and organic acids rise up and then inability for that food to break down actually creates more irritation in the gut lining. So it’s kinda weird by giving small amounts of acid and breaking down the foods and doing anti-inflammatory foods, we can actually create less gut irritation but sometimes we gotta taper really low and slow and go back up like cooking a frog if you will.

Evan Brand:  Yeah, what about like adding in like a little bit of lemon, apple cider vinegar in the early stages if you can’t even do HCl?

Dr. Justin Marchegiani:  Yeah, if they can’t even do HCl at a half or a quarter or a capsule, we just go with a very small amount of apple cider vinegar, a teaspoon working up to a tablespoon. Choose either lemon, organic lemon or apple cider vinegar and work your way up and take in the middle of your meal, right? Imagine it’s like the Oreo cookie. You got the—you got the two outside cookie parts. You got the cream filling. We want that HCl or enzyme or acid kinda sandwiched in there right in the middle of the Oreo cookie, not up against the gut, not at the top up against the potential esophagus.

Evan Brand:  Right, that’s well said.

Dr. Justin Marchegiani:  Yeah, so that’s a really important kinda clinical pearl that we see a lot that helps and then even just starting, too, with enzymes. Just starting with enzymes first can help because they’re less abrasive.

Evan Brand:  Yeah, with no HCl you’re saying.

Dr. Justin Marchegiani:  Yeah, with no HCl can be–

Evan Brand:  Okay.

Dr. Justin Marchegiani:  A great starting point, too.

Evan Brand:  Yeah. Excellent.

Dr. Justin Marchegiani:  And then kinda also to note there, too, is you know we made all the good food changes, we’re doing also those really, really good things with food to make things easier, but just making sure the food’s—you’re chewing your food up, I mean, and if you can’t chew it up or you know you’re not sure you can get it enough, blending it or doing in a soup can be super helpful to make sure that surface area is there. Because chewing, what it does is it increases surface area which allows the enzymes and acids to work better and break it down.

Evan Brand:  You know what’s on my wish list?

Dr. Justin Marchegiani:  What’s that?

Evan Brand:  An Instant Pot. Do you have one?

Dr. Justin Marchegiani:  What is that exactly?

Evan Brand:  It’s a pressure cooker. It’s–

Dr. Justin Marchegiani:  Oh?

Evan Brand:  So basically, I went over to—actually she’s a patient of mine—I went over to her house. She had this little, I guess you would call it like a little functional medicine party, she wanted me to talk to all of her—her female friends about their issues.

Dr. Justin Marchegiani:  Oh, nice.

Evan Brand:  It—it was a fun time.

Dr. Justin Marchegiani:  That’s cool.

Evan Brand:  Yeah, and she had an Instant Pot, and she’s like, “Evan, you got—you gotta get one of these.” So she cooked an entire roast in 90 minutes where a crockpot would have been what, 6 hours, 8 hours? So–

Dr. Justin Marchegiani:  That fast?

Evan Brand:  Yes, man. 90 minutes.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  So she’s cooking everything with it. So I’m gonna have to get one. I’m gonna have to get an Instant Pot.

Dr. Justin Marchegiani:  So-

Evan Brand:  They’re on Amazon.

Dr. Justin Marchegiani:  So it’s just like it’s higher pressure? So what does it do? Is it—is it water in there and steam and it’s pressing it in?

Evan Brand:  I’m not sure exactly how it works but it’s just a modern pressure cooker. Supposedly back in the day and I asked my grandma about it pop­—pressure cookers were amazing and everybody used them until the microwave came along and then people got scared of pressure cookers because I guess they were less safe and they would explode if you were an idiot. I don’t know.

Dr. Justin Marchegiani:  Yeah, yeah, yeah.

Evan Brand:  And now they’re extremely safe. They’re not gonna blow up and they cook your food 8 times faster. So–

Dr. Justin Marchegiani:  Holy smokes.

Evan Brand:  But it’s not a microwave.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I mean, it’s just pressure cooking. So you’re still gonna preserve all the nutrients and you can do, you know, anything you want in it. So I’m—I’m looking to make some stews. She used just a—I think it was like a pastured pork that she used and then I think she put like a couple of cloves of garlic in there/

Dr. Justin Marchegiani:  It’s a—it’s an instant c—instant cooker?

Evan Brand:  It’s called Instant Pot.

Dr. Justin Marchegiani:  Insta—okay, we’ll put an Amazon affiliate link up there so you guys wanna support the show, feel free and click on our Amazon link to get the Instant Pot.

Evan Brand:  Yeah, but I’m just thinking here, talking about how we can really take the load off people’s gut, you know, that’s one way.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And it’s so simple because–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You know, I find many people and you, too, were working with, you know, different people that are executives and all sorts of–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Busy moms and all that, and the barrier into cooking and preparing meals, that’s the—that’s the—the point where people can’t take their health in their own hands, like we talk about all this clinical stuff but at the end of the day, if people are too busy and they’re not actually going to do the diet that we’re recommending because they don’t have the time or they don’t think they have the time, if you have an Instant Pot, you come home, you throw four ingredients in there, you have a full complete, almost pre-digested roast ready in an hour or 90 minutes–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I mean, that’s gonna save you–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So much headache.

Dr. Justin Marchegiani:  Yeah, you set the timer, play with the kids, go take a shower, get cleaned up, dinner time’s here, the food’s ready.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Makes so much sense.

Evan Brand:  So I think we’re gonna start implementing it. Just because you can cook—I mean she had pounds of roast that she could use–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And that would last you a whole week if you needed it to, so I really wanna try to help people understand it, it’s really not that hard. Like everything we talk about, it might be a little—it might get complicated sometimes with the minutia of the details that we have to—to bring across but in reality, it’s simple. You wake up with the sun. You get your good nutrition. You don’t skip meals. You get your sunlight. You get your movement and you make sure you’re free of infections. You get your gut healthy. You get your hormones healthy. Obviously, there’s a lot more, you know, step by steps that we’re taking people through behind the scenes but in reality, it doesn’t have to be so complicated that it overwhelms you and stresses you out.

Dr. Justin Marchegiani:  I think we need to do some videos of us just like making some simple meals.

Evan Brand:  I think the behind the scenes stuff, I mean like a vlog.

Dr. Justin Marchegiani:  That may be cool.

Evan Brand:  I told you like a vlog style.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That’s what—that’s what’s hip on YouTube now.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Is people showing you everything, even themselves wiping their butts.

Dr. Justin Marchegiani:  Huh.

Evan Brand:  Actually I haven’t seen that. But you know, people go too far with the  reality TV a little bit, so I’m not gonna show that part of my life, but I think really just showing people that this is attainable. How many times have you heard that as a barrier where people are like, “I just can’t logistically make it happen with the food; I’m eating out twice a week,” or something like that?

Dr. Justin Marchegiani:  Yeah, and the reason why is, right? It’s how you learn. There’s the conscious competence, right? That’s like—that’ the hardest part because you gotta think and it’s really hard but you can do it but it’s—it’s all the thinking, right? And most people, you know, they get sick. They’re in that unconconscious incompetence. They don’t even know what the heck they’re doing that’s making them sick, right? So we try to get people into, alright, they’re already seeing us. They know—they’re conscious that something’s wrong. So they’re—they’re consciously competent because they know something’s wrong. Now they’re kinda getting these habits dialed in. They’re consciously competent but it’s like, you know, it’s like driving a standard for the first time. It’s like, whoa, you can’t even like, you’re looking down, you’re shifting, you got the clutch on, you’re trying to look at people crossing the road, like imagine having a conversation when you’re driving a—a standard for the first time? Forget about it, right? It’s like, “Everyone, quiet!” And that’s kinda what it’s like with people getting these new health habits down. It’s like driving standard and having a conversation for the first time. So the key is, make sure you’re working with people that own what they heck they’re doing. I consider us, we’re in the unconscious competence. We just go. Like I wake up, like I can literally listen to a podcast and breakfast is ready—breakfast is made, breakfast is ready, you know, owning all the right things because it’s easy, it’s effortless, it’s built-in and I preach it and practice it, so that when I go to my patient that’s automatic.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  It takes so little bandwidth to get these things across because I own it. Now what I recommend for patients is really simple, is get your 2-3 meals. Like figure your 2-3 breakfast, your 2-3 lunch and you’re 2-3 dinner that you own. Simple. And then make at least 2 out of 3, like 5 to10-minute meals. Like you can make it in 5-10 minutes. Because that way, it’s super easy. Like if you’re at home and you wanna go out and get some food, well, it’s way faster to do your 5 or 10-minute meal than go out, right? So then you never have an excuse to—to eat bad food, right? So have your 5 or 10-minute meal. So for me, in the morning I invested in one of these—it was actually a gift from my—my mother-in-law and my wife, which is this awesome old-school type—you know, kind of type of an egg cooker. And it’s all like stainless steel and stuff, and it like poaches, and like cooks up eggs, 8 minutes. So I’ll get up. I like throw some like coffee on, like feed the dog, feed the cats, put that in, 10 minutes later after I shower I’m downstairs, boom! My eggs are done. So I have some Bulletproof coffee, some eggs, or I’ll go throw in some of my, you know, pre-cooked sausages. I’ll heat ‘em up with some coconut oil, I’ll cut them up and I’ll have some sauerkraut. And then number 3, is I’ll have a nice clean prosh—protein shake. I’ll have maybe some collagen with maybe some pea protein or some whey or beef. I’ll mix it up with some coconut milk. Done.

Evan Brand:  I wanted to ask you this, now that you mentioned pea, and I’m gonna tell you about my lunch because it co—it took like 8 minutes and it was amazing.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  Autoimmunity and peas, is that an issue?

Dr. Justin Marchegiani:  Again there’s a lot of supplement companies that are doing a lot of pea protein stuff for people as a nutrient repletion for autoimmune patients.

Evan Brand:  See, because this—this girl I was talking, because there was a lot of people with Hashimoto’s and I was like well—you may—maybe whey’s not gonna be your friend but maybe you can go for pea, and she’s like, “Oh, pea, no, that’s not–that’s not allowed.” And I was like, “You know what, I don’t think there’s a really a—I don’t think—I think for some of this stuff what people try to do is they create these diet lists, right? This is on the No list. I think there’s gotta be a spectrum with that.’

Dr. Justin Marchegiani:  Well, a lot of the problems with peas actually come in, you know, it fits in that legume category–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Are the carbohydrate portion of that. So the whole idea with the pea is that a lot of that carbohydrate’s gone and you just have the protein portion of it which tends to be the not-so-bad portion. Remember a lot of legumes are 2/3 starch, so if you extract the 2/3 starch and you’re only getting the 1/3 protein, it can be a pretty good alternative for a lot of people, especially–

Evan Brand:  I thought it was a good—it was a good recommendation. I mean, if you had to take somebody autoimmune and you would go with the protein, would you choose whey? Or would you go pea?

Dr. Justin Marchegiani:  Well, I typically do—my true pea protein has no flavoring. Why? Because we don’t want any Xylitol or any—even Stevia. Even through Stevia is a good a lot of times, we want nothing in it, and see how we do.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And then typically if that doesn’t work, we just go right to the true collagen which is collagen peptides, already broken down, super, super hypoallergenic. And sometimes we’ll do a combo of the two, because we’ll get extra free-form peptides from the collagen, mix it in with the pea and if people can’t handle the pea, then we’ll just do the collagen, but I’d say I’m—a lot of my autoimmune patients, I would say 80% do not have a problem with the pea, I say 20% do.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And we can typically get them on the true collagen next, but even that, there’s still a small percent that can’t handle that because they, you know, convert that glutamine into glutamate and they have some kind of inflammatory response, too.

Evan Brand:  Right, yeah. And I—I told her the same thing. I said, “90% people are not having issues with pea.” I’ve had a couple of people say, “Oh, I don’t feel—I feel weird. My skin changes when I do pea.” Okay, cool. Cut it out. But you would not go—you would not go whey basically even with autoimmune. You would just skip over to collagen or some type of—would you do beef? You ever do beef with autoimmune?

Dr. Justin Marchegiani:  You could—yeah, I do—do beef as well. My beef protein has a little bit of like cacao or a little bit of vanilla and Stevia so I’ll hold off on that–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  First, just because there’s some extra flavorings and I wanna decrease, you know, all of the potential allergens there. So I’ll do the pea–

Evan Brand:  But no whey?

Dr. Justin Marchegiani:  A lot of times. No whey on the way. Okay? No whey. Now whey’s a great one. Once you’ve kinda gone through it and you have everything under control. It’s phenomenal. I love how it mixes. I love a little bit of mouth feel, the creaminess of it, and then also the sulfur amino acids spectrum in whey is phenomenal. So I like that. So pea protein first. People are like, “What about lectin or glutens? All these different things?” Yeah, that’s gonna be mainly in the carbohydrate portion. And—and a good pea protein’s gonna extract a lot of the out. Yeah, there’s a potential chance there’s some in there lingering, right? But you’ll at least have the majority of what’s causing the problem extracted out, and if that doesn’t work, we can go to a collagen next.

Evan Brand:  And how much issue do you really have with whey? If—if you’re autoimmune. I mean, how much is really left that’s gonna cause issues?

Dr. Justin Marchegiani:  There’s a potential less than 1%, you know, chance of casein in there.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  And a less than 1% of lactose.

Evan Brand:  So you—because you have Hashimoto’s, so you’ll still do whey and you’re fine.

Dr. Justin Marchegiani:  I still do whey. I don’t see a problem with it because once you every—once you have everything under control; like if you have an autoimmune condition when you’re symptomatic, it’s like a wildfire.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right? It’s just like—you know, it’s just goin’ on from one, you know, one tree to the next. You can’t control it. The firefighters are in. You know, everyone’s running from it. We’re trying to get that fire down to like a smoldering kinda thing and that’s where most people are. They just keep their—you know, their autoimmune conditions smoldering. And the reason why I say it’s smoldering is because if they start not managing stress and start eating a whole bunch of bad foods and/or they get some infections, that can flare it back up. So the goal of taking an autoimmune condition that’s like a flaring fire which is like symptomatic, right? That’s the symptomatic equivalent. Bringing it down to the smoldering one, so then you know because then when something happens if that fire revs up, you know, you feel achy the next day, your brain foggy, and if you’re using good quality whey like the ones that we use, you know, grass-fed, organic, no pesticides, no chemicals and we don’t have any, you know, crappy additives in either, so that tends to be the—the big thing that helps to make it, you know, more tolerable.

Evan Brand:  Yeah, well-said. Good, I’m glad for—thank you and grateful for clearing that up because so many ask about the wheys and the peas and–

Dr. Justin Marchegiani:  Lectins and the carbs and the carbs are–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Primarily extracted, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  It’s not pea, sugar or pea carbohydrate, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  It’s pea protein.

Evan Brand:  Yup, yup. So I was gonna go back to my lunch. This is my simple–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  6 to 8-minute lunch. It was a bison steak. It’s called—it’s a farm about 30 minutes out. They have about 60 head of bison. Big old bison top sirloin. It was amazing. I use some of the Primal Palates seasonings. It was delicious.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  And it took like 8 minutes, and then—did I do anything else? Maybe I did a handful of blueberries.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  But that was it and it amazing but it was so simple. It’s such a go-to thing, so it’s—I don’t know, I just feel like it’s a—it can be so simple.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  But there’s so much noise out there that people come to us and they’re frustrated and they’re sick of hearing XYZ person focus on methylation or MTHFR defects and it’s like the come in the door thinking, “This is my problem. This is why I can’t get better.” But in reality, so much emphasis is put on little tiny pieces of this puzzle that if you just stick to the stuff we’re talking about, you go through these 3 body systems, you check in with them, typically we’re gonna be able to remove the vast majority of your roadblocks. So I think maybe my take-away for this is try to think simply. Look at the big picture. You gotta be holistic and wholistic, you know, W-H—wholistic but also you can’t focus too much on the minutia. I mean, it’s like I’m trying to say both things at the same time. Maybe you can help me to bring across what I’m saying better.

Dr. Justin Marchegiani:  Yeah, so, get your—get your habits dialed in, right? You really become what your habits are. If you have a habit of eating good food, thinking good thoughts, surrounding yourself around good people and have it working hard and working smart, you’re gonna have a pretty darn good life.  So same thing with food, right? If we’re building on the food part, it’s getting the habits of really good meals together and managing stress, that’s gonna be essential and that’s the first thing we work on with our patients. So you went over your meal, I think that’s great. I did a little chicken contessa. It’ll be on my new book, the—the Thyroid Reset Diet whenever I get around to getting that final draft done. I got a rough draft here in my hands now. But we’re gonna have 30 easy recipes that I do myself, but we did a chicken contessa and I did some chicken thighs and what I did was, I took some ze—lemon zest. I did about a half a  cup of olive oil. We did some ginger. We did—I’m sorry, we did some garlic. We did some thyme. We did some oregano oil. We did some sea salt. I took 2 whole lemons and I zested the outside. I—I took all the—the coating off with a little grinder kinda thing and put that in there and mixed it all up, some garlic, heated it up and then I took the—the chicken thighs and I mixed them all up like coated both sides of it, put it in like a nice little Pyrex, a long Pyrex rectangle type of bowl and then I put all the coating on top of it, put it on the oven, 350°, 45 minutes and it’s phenomenal. Took me like 5-8 minutes to—to make it, 45 minutes to cook while I was, you know, relaxing, watching some Netflix, had an awesome meal, had it for lunch today as well. So I may even do like–

Evan Brand:  That sounds good.

Dr. Justin Marchegiani:  I may even do like a YouTube stream, just go out of the—out of the loop and share people how I did it just to keep it super simple and easy and different but easy things, batch cook. I got lunch today. I cooked it last night. My lunch will take me no time to get it prepped.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  It is.

Evan Brand:  I think you could do–

Dr. Justin Marchegiani:  Now those are cool things.

Evan Brand:  I think you could a couple cooking episodes on YouTube. I think people will like that—to see that from you.

Dr. Justin Marchegiani:  I think that’d be awesome, man.

Evan Brand:  I enjoyed your Kombucha video.

Dr. Justin Marchegiani:  Oh, great.

Evan Brand:  If—if they haven’t checked that out, like the—what is it? Like the healthy—what’d you call it?

Dr. Justin Marchegiani:  Oh, it’s that the—is that the Dr J’s Moscow Mule?

Evan Brand:  Yeah, yeah, yeah.

Dr. Justin Marchegiani:  I got a secret. I’ll share it with everyone that was a—that’s on the show here, but when I did that episode, you know the little SCOBY–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  In the Kombucha? It didn’t quite come out and it just hanged on my—up my chin and like it was like so long, it was like a big, you know, you know what coming out your nose and it was so gross, I had to cut that out.  That—that’s our little between us and the—and the peeps here, so–

Evan Brand:  That’s hilarious.

Dr. Justin Marchegiani:  Yeah, that was a good one. But you gotta love the SCOBY man. That’s where all the good probiotics are. I’m not gonna let that go, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So what did I do? You know, I did like a—a little, little slurp action, get it right back up there.

Evan Brand:  You should have put that in the blooper.

Dr. Justin Marchegiani:  I know right?

Evan Brand:  The blooper reel.

Dr. Justin Marchegiani:  That would be good.

Evan Brand:  Anyway if people are like, what are we talking about? Justin made a video of a healthy alcoholic beverage if you’re gonna enjoy one and show the behind the scenes of how you do that where you’re not gonna destroy yourself, and I think he gave some tips, too, about supplements–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Like your activated charcoal and some other stuff.

Dr. Justin Marchegiani:  Vitamin C, NAC.

Evan Brand:  If you are gonna drink—yeah, don’t be silly. Take your supps.

Dr. Justin Marchegiani:  Yeah, and that’s a—my little Dr J’s Moscow Mule, my awesome version of a regular Moscow Mule which is like–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Which is like ginger beer which—ginger beers tend to have a ton of sugar in it. So watch out, healthy, you know, clean, clean vodka and then some lime juice as well. So I did my version. Take a look at it. We’ll try to put that in the show notes, too. But go over to Google, Dr J’s Moscow Mule and it’ll pop up.

Evan Brand:  Yup, cool.

Dr. Justin Marchegiani:  Well, any other clinic peals today? We talked about some digestive stuff, some meal stuff, kinda get into that unconscious competence, and just know like if you’re starting out in this journey and you’re like, “Man, this is hard. I can’t do it.” Don’t worry, like we’ve been with a couple thousand different people. Everyone goes through this. Just get the habits down. Pick your like 3 to n—you know, 3 recipes or 3 easy things per meal, you know, 6-9 total or so. Have your go-tos. Work on getting your go-tos, and you know, get a good shake in the morning. Shakes are so easy. I mean, who can—who can’t do a shake?

Evan Brand:  Yup. I agree. Yeah, and save the last thing is just—I had it—I’m trying to think of who it was. Someone asked me, “Do I really need to get tested? Do I really need–

Dr. Justin Marchegiani:  yeah.

Evan Brand:  Need to get my gut tested? I don’t have symptoms.” Truth is, a female patient I spoke with this—what was it? This afternoon. She’s 60 and she has zero gut symptoms. She’s just tired. So I will consider that a gut symptoms but most people don’t consider that a gut symptoms, you know, bloating, belching, gas, etc. So just fatigue and she had H. pylori and also Citrobacter together. So–

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Get tested because even if you don’t feel it, who knows—like you use the analogy which I love of Dingdong Ditch.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  If you’re body has been trying to hit that button, hey, something’s wrong, it can only do that for so—so long before the body’s not gonna answer the door. So you really may have some things that have been in there for 20 years that are dormant or not dormant but they’re just—they’re not sending that signal that something’s wrong. So you have to get tested to rule these things—rules these things in, rule ‘em out, and yeah, you just—you never know. You never know and I sound like a broken record at this point but you have to do it. You have to do—you have to get the piece of paper with your results that says, “Yes, you’re fine. No, you’re not fine. You have stuff to get rid off.”

Dr. Justin Marchegiani:  Yeah, everyone has the right in my opinion to be infection-free.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Yup, that’s cool. Well, any last thoughts? I have one more thing I wanted to share, but I’ll let you–

Evan Brand:  No, please do.

Dr. Justin Marchegiani:  Anything else you wanna go ahead? So a lot of people come to me and they’re just like, “Alright, Dr. J like this is so boring. You know, come on. Like I am so bored.” And we go, “Okay, alright, great. You know, it sounds like you have the—the fine taste of a world traveler, let’s go take a look at your old food diary and just see how many different foods you were consuming.” We go look at it and it’s like, “Yeah, you’re kinda consuming the same crap all the time.”

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So where’s this, you know, variety that you’re screaming for, right? You know, with this world-class kind of taste, right? And a lot of people they only consume about 15 different foods they’re whole life. That’s it.

Evan Brand:  Definitely.

Dr. Justin Marchegiani:  And most people what they really are saying is, “Oh my God. I’m craving sugar. I’m craving—I’m craving things, whether it’s from my gut because of my upbringing–

Evan Brand:  Chocolate.

Dr. Justin Marchegiani:  Because of my blood sugar.” So you know, get the things that you can mix up your meals with. One of the things—I gotta give my props to my wife Shelly. She did a great thing a couple of weeks ago. We were at Whole Foods, and she got one of those big like buckets, you know, when you’re at the like the—at the salad bar and she just grabbed like a whole bunch of different toppings for the salad. It’s like a whole bunch. Like all these different things like we never even try and we just put them in like different containers she brought at home and we had like a big thing of lettuce. So every day we go in, grab like your 2 handfuls of lettuce, then you go into the toppings, and you could grab all these different toppings, get your salad, you know, ready to go by just grabbing it. You don’t have to cut it up. You don’t have to prep it, store—it’s all ready to go. And I could have a different salad every day. I could mix different things in there. They are nuts, cranberries, you know, all these things I never even have on my salad and every day was like this new salad with new different taste on my palate coming in.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  So that was super easy. We spent like $15 for different toppings but we had like 10 or 12 different salads that week with all these different flavors.

Evan Brand:  Yeah, even that, you could throw in the arugula or the other types of greens–

Dr. Justin Marchegiani:  yeah.

Evan Brand:  Get some bitter taste in there.

Dr. Justin Marchegiani:  Yeah, totally.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So I was huge a fan of that and I’ll tell you right now, a secret, I’m gonna go have, it’s this thing it’s called like bockwurst. It’s a combination of like pork and veal and it’s just like amazing. It’s almost like a white meat but it’s like so tender, it almost melts on your mouth. So I’m gonna do some bockwurst and I’m gonna do some of that salad contraption I just mentioned, and I may even have like a nice green apple with some cinnamon on it for dessert. So nice–

Evan Brand:  That does sound good.

Dr. Justin Marchegiani:  Yeah, so I think I’m gonna go bounce over to that and get my blood sugar stabilized and see a couple more patients and maybe get a little—little lift on at the gym today.

Evan Brand:  Nice. Here–

Dr. Justin Marchegiani:  How about you?

Evan Brand:  Here—here’s my last thoughts.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  We’ll probably go to the park. It looks like the storm’s clearing out.

Dr. Justin Marchegiani:  Nice.

Evan Brand:  So we’ll probably take the baby to the park. We went last night and I went to this spray ground. It’s at this—this new park, the last section of the park that opened, and it was like 85° and sunny. I just—I did some cold water immersion in the fountains that they had there. It was extremely cold but it was so fun. Anyhow, what I’m realizing is we do kind of like the super geeky clinical episodes and then today was like super relaxed. I think people are gonna enjoy this. Go hit us up on Twitter. I know Justin and I, we don’t—we’re not extreme Twitter fanatics but I think it you have a Twitter account, if you don’t maybe you can check us on Facebook, either way, I think Twitter’s an easy one. Reach out to us and let us know what you think about shows like this because this is just off the cuff sort of a chill out episode and I think it’s just a really good way not only for you and I to decompress and share the clinical pearls of the week with patients but also just connect with us on a different level where you don’t feel like you’re being lectured. You’re just kinda hanging out with us and—and I really enjoy it. So I hope all the listeners you all enjoy this as much we do.

Dr. Justin Marchegiani:  Yeah, goal’s a little bit of entertainment, a lot of, you know, knowledge and brain candy or at least practical info so you can go be healthier and—and kick butt in your life and with your families and then just you know, just continue to make yourself a little bit better every time.

Evan Brand:  The thing I’ve learned after over 5,000,000 of our podcast now is you’re not typically gonna hear any goods things. You’re only gonna hear bad things so if you hear nothing, then that means people like it.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  If you hear something bad, then we’re like, “Okay, you have to change.” So if you don’t hear anything, then we just have to assume that people like it and look at the download numbers which keep rising, and then we’re like, “People enjoy it.”

Dr. Justin Marchegiani:  Yeah, and if you want more of it, people listening, if you want more of it? Let us know because that pumps us up and lights a fire under our you know whats, and help us provide better and more quality info to you.

Evan Brand:  Absolutely. So finishing out, if you like to schedule a free consult with Justin, go to My website, NotJustPaleo.,com. We’re available. We’ll chat with you. See if we’re a good fit. We don’t accept everyone because we’re looking for people that are motivated. Luckily, we have the luxury to work with people that are super passionate and they wanna get better as much as we want them to get better. Not just people that are like, “Yeah, I’d like a little bit more energy.” No, we want people like, “I’m ready!” And–

Dr. Justin Marchegiani:  Rockstar status.

Evan Brand:  Yes. So–

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  Go—go check us out. JustinHealth and NotJustPaleo and you can go schedule those consults with us.

Dr. Justin Marchegiani:  Love it. Love it. Love it. Well, it’s Friday, man. I’m gonna take it off maybe an hour early. I’m gonna get off at 5 today from patients and head to the gym, so I’m stoked. Two days off here, gonna get recharged and then we’ll chat again and get some more high quality info out to our peeps here next week.

Evan Brand:  Sounds great.

Dr. Justin Marchegiani:  Evan, have a good weekend, man.

Evan Brand:  You, too. Take care.

Dr. Justin Marchegiani:  Thanks, bye!

Evan Brand:  Bye!

The post Functional Medicine Clinical Pearls – Podcast #104 appeared first on Austin Texas Functional Medicine and Nutrition.

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