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Blood Sugar, Insulin And Your Best Health with Dr. Justin Marchegiani
I am honored to have a fantastic guest, Dr. Justin Marchegiani from Just In Health. He’ll tell you all about his backstory and what he’s got going on. I’ve met with Justin on several occasions. Justin and I spoke together at Paleo f(x) a couple of years ago and he’s on point, on a mission. He is a Doctor of Chiropractic. The Doctor of Chiropractic totally have all my heart and affection because the chiropractic message and chiropractic lifestyle are what got me to where I am now. Dr. Justin, welcome to the Healthy Heart Show.
Dr. Jack, it is a pleasure to be here. I love all things functional medicine because we have the mindset and the framework of getting to the root cause. In chiropractic, there’s a vitalistic approach. We believe the body can heal itself. Our job is to go in and figure out what are the physical, chemical and emotional barriers that are holding our bodies back from healing and addressing them. Being a cardiologist like you, we’re trying to get to the root cause of inflammation. What’s driving that inflammation? As functional medicine people, we focus on the diet as a foundational Paleo template. We dig in deeper to get to the hidden source of inflammation, whether it’s hormonal, whether it’s gut, whether it’s toxicity, whether it’s a nutritional deficiency. It’s always exciting digging into the underlying deep issue. It’s like every patient is their own little CSI case where you have to uncover the clues to help get them better.
I especially love the fact that it’s like that chiropractic mantra about taking away what’s damaging the body and the body will heal itself. Above to below, inside and out. It is that whole philosophy about how the body is meant to heal when you cut yourself shaving. When you injure yourself, the body is meant to heal itself. If you take away the trauma, if you keep cutting yourself in the same area, the area’s not going to heal. If you remove the injurious method then the body will heal itself. I love that from a chiropractor. Tell me some of the backstories. What got you interested in chiropractic and functional medicine?
I love chiropractic because of its vitalistic approach where it assumes the body can heal itself and if there are some root causal issues that need to be addressed. In the chiropractic side, physical stress via the spine and the nervous system is what’s being looked at. I know and probably your wife as well that we’re not as well-fed as we were 100 years ago. We’d be more chiropractic. We know nutrition, the toxicity, the soil supply. There’s a nutritional component that wasn’t necessarily a big factor 100 years ago. There are a lot more toxins and a lot more stress that affects our digestive system and immune system so you can combine the chiropractic and then dig in deeper on the nutrition side with functional medicine. That’s big.
I worked in surgery for a bit. I wanted to be an orthopedic surgeon. I was that person in the OR that would hold the limbs of these diabetic patients that would come in as the surgeon would tie off the vasculature and amputate the limb. I’d be the person to wrap it up and bring it down to the morgue. I wanted to get ahead of this. We talk to these doctors and surgeons and say, “How can we get ahead of this? How can we prevent it?” There was a total disconnect because this guy will be outside smoking a butt or eating a donut. There were a total lifestyle and nutritional disconnect of how that patient got on their table. The things that they were doing were probably predisposing them to be on their own table at some point someday. I wanted to get ahead of that and look at what we can do to prevent that from happening. That’s where chiropractic nutrition and functional medicine I felt connected.
I know those doctors that you’re talking about. The medical doctors are the absolute worst to ask for advice when it comes to prevention. The medical doctors have nothing. When I give those presentations and speeches, I show that empty doctor bag as symbolic to what they have for prevention. Statin drugs and aspirin are not prevention. Tell me some of the things that you would say are your top three things for prevention, for anybody looking to prevent cardiovascular disease or any other disease for that matter.
The first thing is we start with inflammation. What are the big sources of inflammation at a foundational level? The diet has to be dialed in. What does that mean? I like a Paleo template. I don’t say Paleo diet because the template assumes the foods are going to be anti-inflammatory, nutrient-dense, and low in toxins. That’s number one. Number two is we adjust the macronutrients according to what that patient needs. Most people with accelerated cholesterol and inflammation, if it’s from excess carbohydrate or high amounts of insulin, we know we can make tons of cholesterol. Being a vegan, I’ve seen it many times because that enzyme that makes cholesterol, that HMG-CoA reductase enzyme gets stimulated by insulins. We want to make sure your diet has a good Paleo template and we dial in the macronutrients according to your metabolic needs.
Most people that have metabolic damage and insulin resistance do better with a lower carbohydrate Paleo template. Number two, making sure we can digest our foods. It’s because you’re eating a great diet, if we can’t digest, breakdown, assimilate, absorb, and utilize, it’s like going to Whole Foods buying a whole bunch of good perishable organic groceries and leaving it out on the counter for the week and not putting in the fridge. It rots. We have to make sure that we can digest and break down those foods. The next is going to be the sleep component, making sure you get into bed. You’re getting at least eight hours getting to bed on the other side of midnight and you’re able to sleep through the night because that activates the parasympathetic nervous system for rest, digest, and healing to start.
Sleep is important and I tell people that there are three main factors when it comes for our overall health and wellness. You can go on more and more but for me, sleep is probably number one. Sunshine is number two and food is number three. You can eat some of the worst diets yet if you’re getting the sleep and you’re getting the sunshine the body can get through that. Although we’re not going to recommend it, we’re going to say do all three. You can be on the best diet in the world but if you’re not getting the sleep and you’re not getting the sunshine, you’re done. Whether you believe in the story of creation or evolution or both or whatever it may be, in every story, the sun came first and sleep came to all life on Earth before there was ever any semblance of food. Tell us a little bit more as far as what you think about sleep and then tell me a little bit about your opinion on sunshine because for a long period of time you were living down in Texas. You were getting plenty of sunshine down there. Tell me about sleep and tell me about the sun.The body can heal itself. Click To Tweet
Sleep is important. We know the hours between 10:00 PM and 2:00 AM. We maximize and tap into our growth hormone, which is really important for stimulating and regeneration of our physical body. We know that 2:00 AM to 6:00 AM is where we turn over a lot of our brain chemicals, our neurotransmitters. Mood and focus and cognitive-wise, we can function. We want to tap into both. We want to heal our body but also heal our mind and emotions, which are all run off of neurotransmitters and hormones. Being a functional medicine hormone specialist like myself, sleep is important. That’s number one.
Number two, vitamin D is important. The reason why is because when you’re getting a lot of it from the sun, the sunlight stimulates that circadian rhythm. It jumpstarts that circadian rhythm. It initiates that cortisol response in the morning and that cortisol drops down and that melatonin goes up in an inverse correlation. The cortisol is important to have during the day because of the energy and the blood sugar stability, but it’s also highly anti-inflammatory. We want the Goldilocks, not too high, not too low. We want to tap into that melatonin at night. That good vitamin D and sunlight help initiate that circadian rhythm. The best thing you can do when you’re off your rhythm, especially if you’re traveling, ground in the morning first thing and watch that sunrise to get that hypothalamus, pituitary pineal access dialed in.
That was explained well. You can watch and you can listen to many different people and they can break down all of the hormones and the biochemistry of what happens when you get sunshine, when you get the appropriate sleep. I think it’s all fantastic that doctors like you understand that, but for the average person, maybe they have another occupation that’s outside of the health space, even if they’re in the health space. It’s a matter of going with Mother Nature. When I call myself the Paleo cardiologist, it’s not just about the Paleo nutrition. It’s about the Paleo lifestyle. It’s about living in concordance with Mother Nature. Waking up in the morning, walk, and stand barefoot outside, watching the sunrise because that’s infrared energy that’s coming at us. That’s the red-light energy that’s coming at us and that has a role. The noontime, UVA, and UVB has a role. The late afternoon sunshine has a role as well. That’s all super important. Somebody comes in and they have a high amount of inflammation. They come to you and they say, “I had my blood testing done. I’m concerned. I’ve got a family history of XYZ,” which you and I know means nothing because family history is bogus. Inflammation, where do you go from there?
What kind of inflammation are we talking about? We have our clinical indications of inflammation, achy joints. Number two symptom, people don’t think about it, brain fog and cognitive issues. It’s because when you have inflammation in the brain, it activates these immune cells called microglial cells. These are immune cells but when they’re activated, you can get brain fog and that’s important. If we have cognitive issues, memory recall, and those things, we literally feel we’re in the thought fog when we’re thinking and processing. That can be inflammation in the brain. Also, digestive issues, if we’re not able to digest and break down our food that’s probably stress and inflammation going on in the gut. Either number one because you have bacterial overgrowth or a fungal overgrowth or two, because of the food sitting, putrefying, rancidifying and fermenting in your gut. That’s messing up your motility. It’s messing up you being able to extract nutrition. It’s causing a dysbiosis, more bad bacteria than good bacteria.
Good bacteria are designed to eat poop and poop nutrition, bad bacteria is designed to eat your nutrition and poops poop. Bad bacteria make you more toxic, steals your nutrition. Good bacteria adds nutritional value to your gut. Having a good bacterial balance, having the brain cognitive stuff under control, and then also making sure clinical things like the achiness and the pain. We can assess this C-reactive protein systemically, ESR, Erythrocyte Sedimentation Rate. We can look at homocysteine. We can look at inflammation in the gut via calprotectin as well. You can look at also leaky gut markers as well, Zonulin and Occludin, LPS markers, fibrinogen. These are all some good markers to assess inflammation, but we’ve got to look at the clinical. That’s why doctors like you and me, we look at the clinical indicators too.
What do you think is going on with the digestion? Why aren’t people digesting? Is this a deficiency in stomach, hydrochloric acid? Are they missing pancreatic enzymes, emulsifiers from the liver? Is it like that axis or the trio of the stomach, the liver, and the pancreas? I say this because when I was first going holistic back in 2005, one of the first books my wife ever gave to me was by Jonathan Wright, Why Stomach Acid Is Good For You. I spent several years in medical training and those few years in medical schools we learned about stomach acid and the role of stomach acid. Somewhere along the way, it was lost. All we started talking about was there was too much stomach acid, which is never true. We all need to be on these, first of all, TUMS and Rolaids and antacids. Then it was the H2 blockers like Tagamet, Pepcidine and stuff like that. It went on from there to become the proton-pump inhibitors. All of a sudden, my future wife hands me this book, Why Stomach Acid Is Good For You, and it was like a bomb was dropped on me. I couldn’t believe it.
If you draw a line, this line will separate functional medicine, holistic doctors like yourself from a conventional-minded allopathic physician. When you go see an allopath, what is the major thing that they’re recommending? They’re recommending things that are essentially blocking or inhibiting function or physiology in the body. You mentioned it, proton-pump inhibitors, beta blockers, ACE inhibitors, H2 blockers. They’re all inhibiting or blocking physiology with the end goal of controlling a symptom. We draw that line and the other side of the fence we’re looking at what are the roadblocks in physiology? Why that physiology is not expressing itself optimally? Is it a nutrient issue? Is there a digestive compound that’s missing from breaking those things down? Are we activating our fight or flight sympathetic nervous system too much?
We’re looking at the root cause. I call it the SSS Approach. We have symptoms at the bottom, back pain, mood issues, and digestive issues. Most allopaths write a prescription, “Here’s a prescription for each one of those.” We go upstream to the underlying systems that may not be working. That could be cardiovascular, it could be the digestive, it could be the hormone, and it could be the detoxification system. We address these systematically and we go upstream to the underlying stressors, physical, chemical and emotional. We would maybe look at these things individually, maybe do tasks, maybe you do food logs, and dive in deeper to address the whole triad. The underlying stressors, the systems that are now out of balance and also at the symptom level below. We’ve got to address the whole thing holistically. It’s that sympathetic nervous system overload that is affecting the digestive aspect. It’s affecting the ability to rest, digest and secrete all the compounds. When we’re fight or flight, we’re consumed with taking everything away from the core and bringing it to the muscles to fight, flee, and punch and we want to bring it back inside by activating the parasympathetic nervous system response.
The question is why aren’t people producing enough stomach acid? Contrary to what we believe we see on the television, we don’t have too much stomach acid, we have too little. The average person has no idea of that. In the commercials, they never make that claim that there’s too much stomach acid. They’d never say that because they know that’s not true. They make the average consumer think that because they show the fire raging up into their esophagus. They show all the acid going in the wrong way. The problem is not too much stomach acid. It’s too little stomach acid. There’s a rare situation called Zollinger-Ellison syndrome where people have a tumor of their stomach gastrinoma where they’re secreting too much stomach acid as nobody has. I’ve never seen a case out of that. It’s a one in five million diagnoses, it’s so rare.The Paleo lifestyle is about living in concordance with Mother Nature. Click To Tweet
Most people are right. They do feel this extra acid thing that’s happening and they’re like, “That makes sense. We’ve got to block that.” Why is that acid event occurring? It’s occurring because the food is rotting, putrefying, and fermenting and then these organic acids rise up and that’s the burning you feel. That food is only rotting because it wasn’t completely digested, to begin with. That’s why the acid could actually help because it prevents that food from rotting later and then producing secondary acids after the fact. It’s the sympathetic nervous system response to stress, the inflammatory foods, not chewing your food up enough, drinking too much water with that meal, being on the go, poor diet. All of those things are what’s driving that incomplete digestion. The acid comes after the fact.
Personally, in your program and when you work with patients, I want people to know where they can find out more about you because this is phenomenal information. Do we always start with putting people on a digestive enzyme product, some kind of Betaine HCL with the pancreatic enzymes and gastric enzymes in there, as we continue to work with them on balancing out their autonomic nervous system? It’s making sure that they’re getting sleep, getting the sunshine. The power of the sun coming into the stomach, the liver and the pancreas help to energize those structures for better function. How do you see it? Does everybody need stomach enzymes right off the bat?
The first low-hanging fruit is this. Make sure, the underlying sympathetic nervous system stress is addressed whatever that is. Are you eating on the way to work? Are you eating at your table while you get in a fight with your family at the same time? Are you drinking a ton of water while you’re eating? Water’s got a pH of seven. Your stomach needs a pH of two. You’re raising that pH up. Is there an H. pylori infection? Are you not masticating enough? You have 32 teeth, so you’re going to chew 32 times. Ideally, it should be an oatmeal-like consistency. We’ve got to make sure the foundation, the chewing, and the not hydrating significantly. A little bit of water here, sipping some wine, swallowing some water for some pills, not a big deal. Making sure the underlying diet and lifestyle things are good because I’ve seen food allergens cause acid reflux and acid burning, so gluten, dairy, potentially those things. Any refined sugar and those compounds as well.
Make sure the food allergies are addressed. Make sure the underlying diet and lifestyle hygiene is good. The next thing would be taking the enzymes and the acids because that’s the low-hanging fruit. Most people’s money for their health should be invested in their food. If we can’t access all of it, it’s like depositing your paycheck and someone’s saying, “You only can pull out 20% of it.” I’m getting robbed 80%. If I can take that enzyme and that acid, I can access more of it and I’m giving my digestive system a crutch. The nice thing is hydrochloric acid does not disrupt the feedback loop to gastrin, so it’s not like taking testosterone and your testicles shrink. Your feedback loop with gastrin will not decrease by taking HCL or enzymes, so we’re not going to be disrupting anything in the brain.
I would assume that your goal is that the person would not be on digestive enzymes for life. This is going to benefit you. It’s not going to hurt you in the long run. There are no long-term side effects whatsoever. The end game is that once we tune up your lifestyle, once we improve your eating habits, once you’re eating the right foods as well. We’ll be able to wean you off of the digestive supplements just like we’d be able to get you off of pharmaceuticals.
My goal was always, one of the best things you can keep in your medicine cabinet is HCL and enzymes. If you’re eating a bigger meal than normal, you’re going out to eat, you’re having a special meal for that week or you’re having dinner and your kid is stressing you out. You’re at work and you got off in between patients and you’re a little bit too stressed. That’s where it’s good to take these things. Once you’re stable and your physiology is at homeostasis for acute stress responses, questionable foods and/or too much, that’s where it’s good to tie those in. It’s nice to have that plan B. In general, doing all the things we’re talking about can help. Even things like bitters like ginger or ginseng, if you do a little ginger tea before you eat, that can really help your digestion as well.
I was talking with Josh Axe and he’s a huge fan of the bitters as well. He loves that as part of the digestive approach. Historically, people that are overweight, they have always been told to drink a lot of water with their meals and to fill up their stomach. I was guilty of that as well, telling people to do that like, “Blast yourself full of water,” and all that’s doing is causing so much trouble and problems. You mentioned the wine and I agree with you, little sips of red wine during a meal. I’m not a big alcohol guy. I know you’re not either but doing little sips as opposed to most people when they say they drink wine, they’re drinking a bottle at night. If you’re having two glasses of wine with your meal, you’re in trouble.
If you are going to be doing some alcohol, throw some activated charcoal in there, throw a little bit of vitamin C. You’re going to do that once or twice a week. There are some ways that we can use nutraceuticals that help buffer out some of those side effects. Also, H. pylori produce a compound called urease that takes the urea from protein, it spits out ammonia. Ammonia’s got a pH of eleven. We need a nice two for a pH in that stomach and we throw some eleven in there, now we’re raising our pH back up to more neutral. Physiology 101 for the audience, we need that nice low pH 1.5 and 2.5. That acid environment activates pepsinogen to pepsin. That’s a proteolytic enzyme that starts digesting protein. All of this stuff gets slurred into a swirl called chyme that gets released into the small intestine. That’s the second step. That nice acidity causes a release of a hormone called CCK, cholecystokinin, which triggers the gallbladder to release all that good bile salt, which spends concentrating. It causes the enzymes from the pancreas, that’s fat-digesting enzymes and proteolytic, protein-digesting enzymes. We have now all the enzymes being released and bile salts being released. We make a whole bunch of bicarbonate to bring that pH back up because we don’t want a low pH in the small intestine, that’s how you get an ulcer. That’s how that digestive cascade works. The first thing that starts it off is good acid levels.
You explained it well, easy for everybody to understand. I certainly appreciate that. You diagnosed somebody with H. pylori. What’s your protocol?One of the best things you can keep in your medicine cabinet is HCL and enzymes. Click To Tweet
With H. pylori, number one, we want to make sure there’s enough acidity. If we don’t digest the food, people that have H. pylori typically have a bacterial overgrowth too and they’re not digesting food well. Number two, we want to cut out the inflammation in their diet. They’re dying because they already have a lot of inflammation in their gut. H. pylori are associated with extra inflammation. We want to cut the inflammation out. Number three, we want to make sure there are no other co-infections, H. pylori and Blastocystis hominis are common as well as fungal overgrowth. We want to address the blasto and fungal overgrowth. We want to make sure we use specific herbs that can be helpful. A higher dose oil of oregano, a higher dose of mastic gum, clove, a higher dose of berberine, these are all effective. You want to work with a functional medicine doctor. You don’t want to just say, “Dr. J said these herbs,” because you want to plug this into a bigger overall program.
With me, it’s the six R’s. Remove the bad foods. Replace the enzymes, acids, and bile salts. Repair the gut lining and the hormones. The fourth R is removing the infections. Most people are trained because of antibiotics, “I have a sore throat, Amoxicillin. I have a gut infection,” they go right to that fourth R and you have to work on the first three R’s first. That’s the diet, the stress management, the sleep, the digestive support, the gut healing, the inflammation reduction, the adrenal support, and then we go to the fourth R. A lot of times that’s a couple of months into a program because we’re laying the foundation. You don’t go and get your house built and have your contractor starting the third floor. They’re on that foundational level building it nice and strong first.
I’m sure you feel strongly about this as well that when it comes to the autonomic nervous system that is an expertise of the Doctor of Chiropractic. When you’re talking about balancing off the sympathetic overdrive with parasympathetic under-drive, the brain through the spinal cord innervates all of the organs as well. If there’s dysfunction there because you’ve got a vertebral subluxation in your spine, that has to be addressed by the DC.
We have stress in our nervous system. We can also have what’s called a viscerosomatic reflex. That organ is on the same two-lane sensory highway as the muscles in the area around it. That can easily cause the spine to not move properly and we need movement. Movement allows us to feel where we’re at in space and time. It’s like walking into a dark room and you can’t use your hands to feel around, you’re bumping in. Your spine needs that movement. That movement activates a specific part of the nervous system called the IML, which dampens the sympathetic response. If we dampen that sympathetic response, we increase the parasympathetic response. The parasympathetic response is resting and digesting and that plugs back into the digestive section we were on. Having that movement is important and we need to make sure that there’s good alignment in there, movement and not that fixation. Our inflammation and our organs can also cause our spines to not work properly. A good holistic chiropractor is going to move the spine accordingly via a specific adjustment, but also ask you about food things and give other support that helps reduce inflammation in the body too.
Who has a better barbecue, Kansas City or Austin, Texas?
In Texas, they have moist brisket and regular brisket. They delineate between the fatty brisket and the non-fatty. In Kansas City, they have something called burnt ends and that’s pretty cool too. It’s a little bit different, but I would say Austin wins on the ribs. Kansas City wins on some of the briskets.
What about Thanksgiving? Would you rather have ham or turkey? What’s the Marchegiani’s going to have?
We’ve got a sixteen-pound organic, free-range, pasture-fed turkey. A lot of the conventional turkeys are accumulating lots of salmonellae. Big reports are coming up so highest quality pasture-fed as possible. Six different servings. We will have a little bit of organic GMO-free potatoes. We’re going to have gluten-free stuffing that’s going to be celery and carrot-based. We’re going to have homemade cranberry sauce, sweetened with a tiny bit of honey. We’ll have green beans. We’ll have some sweet potato as well and then my apple cake, which will be a little bit of arrowroot powder in there and coconut flour, very low amounts of organic coconut palm cane. We got it online and ready to go. My wife and I are going over the menu. I’m like, “I want these six sides and I want the highest quality, pasture-fed, organic turkey as possible because of the pesticide residue.” If you’re not getting organic, you’re getting a turkey and a whole bunch of roundup, probably grains and corn.
As far as the potatoes, they would be organic because if they’re not organic they’re likely genetically modified potatoes. A lot of people don’t know that. They know that corn is GMO and soy is GMO. A lot of times they’ve never heard the fact that potatoes are as well, and that’s a major problem. Where are people going to find Dr. J? What do they get when they get there?Movement allows us to feel where we're at in space and time. Click To Tweet
You can head over to JustInHealth.com. I have a podcast, a YouTube channel. I speak to hundreds of thousands a month via my various mediums. You can subscribe there. I see patients all over the world as well. I’m in the trenches with patients 60 hours a week. Doctor is Latin for teacher so I’ve got to teach. I think of lots of metaphors and analogies to bridge complex information to make it easy, so you can extract the actual action items. People don’t care what it means. They want to know, “How can I utilize it?” That’s what I want people to walk away from this podcast. How can I use the information here to get myself better? If you want to reach out to me there, you can do so. There’s a little link there. I look forward to chatting with anyone that’s available.
You heard it from Dr. Justin Marchegiani and he gave us some great information. Dr. Justin, I appreciate you so much for being on the show. It’s always a pleasure to talk to you. Bring it to yourself. The answers are right here whether it’s I, Dr. Justin or all the other people that Dr. Justin interviews and I interview. We’ve got the answers for you. All you have to do is pay attention, listen, and follow the information and lead your best life.
I want to highlight one last thing too. When someone does a podcast and they’re a clinician like you, there are deeper questions. There are a lot of people out there doing podcasts that aren’t clinicians. When you listen to a podcast done by a clinician like yourself, you’re able to extract more actionable information. I hope everyone’s subscribing and appreciates the great clinical questions you asked. I appreciate it.
We will see you next time.
- Just In Health
- Paleo f(x)
- Why Stomach Acid Is Good For You
- Josh Axe
- Just In Health Podcast
- Just In Health on YouTube
About Dr. Justin Marchegiani
Dr. Justin Marchegiani started off his career in the health field working in a surgical center as he prepared for medical school while at the University of Massachusetts. Working in the surgical field gave him a first-hand, up-close perspective into the health care system. He was able to see where it shined, especially in the area of treating acute injuries and trauma. He also saw its shortcomings, which are most evident in the areas of chronic disease like diabetes, heart disease, and obesity which are still a problem today! This experience shifted his focus from conventional medicine to a more holistic or natural approach to healing; where the underlying cause of his patient’s health issues are addressed and not just medicated and surgically removed.
Dr. Justin Marchegiani is a graduate of the University of Massachusetts at Amherst with a degree in Kinesiology and Pre-medical studies. Dr. Justin has completed his Doctorate degree in Chiropractic from Life West University and is a licensed doctor of chiropractic in the state of Texas. He has completed postgraduate study in the area of clinical nutrition, rehabilitative exercise, and functional medicine so he can offer the most cutting-edge techniques to help address his patient’s growing health care needs.