Peptide & Hormone Therapies for Health, Performance & Longevity | Dr. Craig Koniver

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life I'm Andrew huberman and I'm a professor of neurobiology and Opthalmology at Stanford School of Medicine my guest today is Dr Craig conver Dr Craig conver is a medical doctor who did his training at Brown University and Thomas Jefferson University he is a world expert in what he refers to as performance medicine which involves the use of peptides and other therapies for improving mental health physical health and performance now many of you have perhaps heard of peptide therapies perhaps some of you have not a peptide is simply a small protein so insulin is a peptide we have many different thousands of peptides in our brain and body and they perform a variety of different roles Dr conover's expertise is in the use of exogenous that is peptides that one takes exogenous peptides for activating multiple Pathways in the brain and body to augment health now of course peptides such as insulin have been used for many years now to treat things like diabetes but today we talk about novel peptides including glp1 so these are glucagon likee peptide analoges things like OIC and monjaro which I realize are a bit controversial however today we talk about the micro doing of those peptides we talk about those peptides combined with other peptides as well as behavioral practices to offset the muscle loss associated with them and then we dive into some lesser known peptides but ones that are growing in in use for instance bpc157 or body protection compound 157 which is used to treat inflammation to accelerate wound healing and a variety of other things then we discuss the use of peptides specifically to increase growth hormone secretion during sleep as well as some peptides that can actually increase rapid eye movement sleep dramatically today we also discuss testosterone therapies Not Just For Men but for women these are growing increasingly popular as well as things like NAD as well as specific supplements Dr Conover as he will soon tell you is not a huge proponent of supplements but he does mention several that he feels are of particular use including things like co-enzyme Q10 and some of the methylated B vitamins and he explains why he takes that stance so today's discussion is really for anybody interested in mental health physical health and performance and the reason I say that is that even if you aren't considering taking peptides or already taking peptides peptides and some of these other compounds I've mentioned sit somewhere between doing nothing except diet and exercise supplements which I sort of see is the next step up the ladder in terms of augmenting your health approaches and then of course there are a number of prescription drugs including hormone therapies such as growth hormone therapies testosterone therapies and a number of other things that yes can modify those hormone Pathways they are in fact hormones but they actually can shut down one's natural production of those hormone Pathways peptide therapies sit somewhere between doing nothing and supplementation and those more advanced hormone therapies and that's why peptide therapies I believe are growing in popularity they can augment specific hormone Pathways they can augment specific in fact multiple processes within the brain and body to augment Health but they don't tend to operate in that negative feedback cycle by shutting down one's own endogenous production now that doesn't mean that they aren't without some safety concerns and today we of course discuss the potential side effects and safety concerns of peptides as well as the critical issue of sourcing clean peptides and working with a board-certified physician if one is going to pursue peptide use so by the end of today's discussion you will be right there on the Cutting Edge of what's happening and where things are going with peptides and in keeping with that you'll notice that during today's discussion we talk a fair amount about what the FDA currently allows in terms of prescription peptides what the FDA has recently removed from the market in terms of peptides and as a very recent update just prior to the release of this episode I learned that three peptides cjc-1295 epom morelan both of which are in the growth hormone secretagogue family meaning they promote the release of growth hormone as well as thymosin beta Alpha which is in the sort of anti-inflammatory and tissue repair pathway those three are now reallowed for prescription in the United States so at the time of recording this episode we discussed some of those as being recently banned by the FDA they are now approved again for use in humans by the FDA so there's a brief and very recent update so just to summarize this admittedly long introduction today you're going to learn about this incredible area of science called peptide biology and how it can augment mental health physical health and performance and you're going to do so from one of the world's leading clinical experts before you begin I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford it is however part of my desire and effort to bring zero cost to Consumer information about science and science related tools to the general public in keeping with that theme I'd like to thank the sponsors of today's podcast our first sponsor is ju ju makes medical grade red light therapy devices now if there's one thing that I have consistently emphasized on this podcast it is the incredible impact that light can have on our biology now in addition to sunlight red light and near infrared light sources have been shown to have positive effects on improving numerous aspects of Cellar and organ Health including faster Muscle Recovery improved skin health and wound healing improvements in acne reduced pain and inflammation even mitochondrial function and improving Vision itself what sets Tu lights apart and why they're my preferred red light therapy device is that they use clinically proven wavelengths meaning specific wavelengths of red light and near infrared light in combination to trigger the optimal seller adaptations personally I use the juv whole body panel about three to four times a week and I use the juv handheld light both at home and when I travel if you'd like to try juv you can go to ju spelled jv.com huberman juv is offering an exclusive discount to all hubman lab listeners with up to $400 off ju products again that's ju spelled jv.com huberman to get up to $400 off today's episode is also brought To Us by betterhelp betterhelp offers Professional Therapy with a licensed therapist carried out entirely online therapy is an extremely important component to overall health in fact I consider doing regular therapy just as important as getting regular exercise including cardiovascular exercise and resistance training exercise now there are essentially three things that great therapy 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betterhelp.com huberman to get 10% off your first month again that's betterhelp.com huberman and now for my discussion with Dr Craig conver Dr Craig Conover welcome thank you Andrew I appreciate the invitation to be here I'm thrilled that you're here we are going to launch ourselves into the space that is called pep tiddes yeah and it's a it's an interesting space for sure because I think um most people probably don't know what a pepti is they should feel no guilt or Shame about that I'm sure you'll you'll tell us but this area of medicine that people broadly refer to as peptides is picking up a lot of momentum even though it's been around for a long time and I find it particularly interesting because um there are many people using peptides for very specific purposes but most people haven't really heard of the various peptides that are out there right and and if anything we can be sure that in the years to come peptides are going to be increasingly popular and totally agree and there's of course the incredibly popular peptide of glp1 Agonist um for sure taking over so to drop into this um and make sure everyone's on the same page uh what is a peptide yeah I mean just from a very Elementary level peptides are just chains of amino acids so so amino acids all naturally occurring molecules we call it a peptide if it's 40 amino acids or less call it a protein if it's 41 amino acids or more the body makes I think last I read 300,000 peptides so it's a massive number uh we've probably therapeutically are using closer to 150 over the years which is obviously tiny compared to that so to your point this is blossoming we've been using peptides for about 8 years a long time um but still very early in in our understanding of how best to use peptides and how clinically we're going to get the most out of them so it's exciting maybe just to orient ourselves we should talk about glp1 first um not because it's necessarily the uh category of peptides that um I think uh people would want to consider for themselves um but because most people have probably heard of uh semaglutide and U monjaro and things like that sure so um how long ago was it that humans started injecting glp1 Agonist in order to lose weight I think the weight loss aspect has only been a couple years I mean it's been tremendous how it's accelerated to like literally becoming the number one prescribed in America uh you know semi Glu OIC was approved longer than that for four type 2 diabetics helping with you know glucose control and helping with glucose utilization uh and what they found you know as a side effect was that these people were losing weight and then that word caught on and you know what's interesting and I don't think most people understand this most of the medicines prescribed particularly in America are prescribed off label meaning they've never ever been approved for what they're used so is that right yeah the vast majority yeah are never approved so as a physician I'm allowed to prescribe any drug for any reason I want as long as it's been approved for something right as long as we're safe right we don't want to be cavaliere about this and Renegade and do all these things that are not that are out out of bounds but that is the truth so that seml is a great example being used for helping people diabetics type two diabetics lower their blood sugar and then it got to well now let's help diabetics lose weight right because diabetics struggle with weight the insulin resistance and then it became well even if you're not a diabetic could you benefit from losing weight well heck yeah right I mean look at the amount of obesity and people who are overweight and having trouble maintaining healthy weight it's exorbitant in this country and certainly worldwide so then it spread it did eventually get uh FDA approval specifically for weight loss but you know at first no it's been just for type two diabetics to help with glucose utilization and you know we've been using primarily tepati which is like semi glutide version 2.0 mostly for the past two years have learned a tremendous amount and my opinion's actually changed from working with people yeah what is your opinion my understanding is that um well there's sort of two camps on this it seems yeah at least two camps one Camp seems really bullish on this um they seem very excited about this drug the other Camp seems to point to the fact that one may be creating a drug dependency um that it's very expensive um and they point to the also potency of Lifestyle factors like exercise and caloric restriction um eating mostly non-processed Foods Etc as a quote unquote better alternative I'm not necessarily saying that I think that both have their place it's to me it seems very contextual but as a clinician I'm curious what you think yeah I I agree both have their place um My Philosophy is I want everyone have to have access to things that are number one safe that propel them to look feel and perform their best and if that means right if it was just about if I can exercise my way out of this eat my way out of this meaning lose weight change my body composition why do we have an epidemic you know of so many people who struggle with that because it's really hard right we don't totally understand it I'm not saying that yeah the processed food thing is a massive problem you I mean I know that's come to light recently with people pushing for us to take a look at food companies and the quality of our food which is amazing but if people aren't interested in doing better for themselves and you know this is may not make sense but I think it does the analogy I use is I like to help people win the race first which then helps them motivate to train for the next race right and this kind of goes against the grain of conventional medicine which is you know if you want to train for the race you have to you know run a certain number of miles you have to sleep a certain way you have to eat a certain way you have to do all the things struggle to get there right and losing weight is a struggle and and the way I look at if I can help people lose weight first literally by using something like tepati semaglutide and I've seen this they're now excited I mean I met with a client yesterday here in Los Angeles and she literally looked at me and said you've changed my life she goes I am a super successful woman in my company with my family with my kids everything's great but now I love my life my workouts are better I look better my clothes fit better I am super excited about waking up every morning like she is there and that is what it's about right and so for people if you can help them achieve their goal first then they're going to be motivated the light bulb turns on they're going to be like wow I want more of this and that's the Ala moment that I love helping people with so at first I was like oh we got to be really cautious with this same thinking like I don't want people to lose too much weight like this is a problem are they going to be dependent I like the notion that you have to take something the rest of your life and I'm not saying it has to be the rest of your life but when something works and as far as I can tell it's very safe I think I think it's worth discussing and I I like people having those options at least yeah it sounds like from the uh story you just told us that it's not just about um an aesthetic change that motivates people to lean into other aspects of their health and life when they lose some weight that it's also just the the sheer literal weight and also that adapost tissue fat tissue you know produces a lot of hormones that we know impact the brain and um brain function which is not to say that there aren't people out there with a lot of adapost tissues who aren't extremely bright and motivated Etc but many people who are carrying excess body fat don't feel good they report brain fog Etc and I think now thanks to Chris Palmer and actually at Stanford there's also a program in metabolic Psychiatry we're starting to see um or understand and appreciate the link between adapost tissue and brain health or lack of brain health in most cases sure so in the um in the case of glp1 yeah um people have criticized it saying that a fair percentage of the weight uh that's lost is lean body mass muscle loss but it seems to me that can be remedied pretty easily if people just do some resistance training I I think part of that yeah resistance train the other think I would say is from what we've seen is when people are using the conventional dosages um they're losing weight too quickly and so what we do is we get uh both semaglutide mostly tepati compounded and that allows us to use basically micro dosages and start very low in terms of dosage and go slowly with people and what we found is as long as people are losing less 2 lounds or less a week they're not losing the muscle mass we certainly encourage adequate protein intake you know resistance training but that micro doing has been a GameChanger like literal Game Changer because then people don't feel like oh my and I've seen it where we when we started people were losing you know 15 pounds in three weeks goodness right and then they're like excited but then they're not cuz then they come off of it and they just gain it right back or they lose a lot of weight and they' lose that fat in their face they look like skeletons we've seen those called OIC faces we don't like the way that looks and that fat takes a while to come back so if we just go slowly with this and we can really dial it in and Nuance it that has had a tremendous impact and now beyond the weight loss you know we're seeing cognitive benefits we're seeing you know inflammation benefits a lot of people with autoimmune disease who their inflammation markers are coming down and that's the only thing we can think is working is that a direct effect of um OIC on the immune system and Pathways related to inflammation or is it indirect through the loss of adapost tissue body fat which then lowers uh lowers inflammation great question or or I could say is it the positive thoughts that come from looking yourself in the mirror and feeling good right which transcends to you feeling better about yourself and that feeds forward to the momentum that you put forth in the world all of those things I think it's all of the above you know I think that's going to be hard to dissect but it's real I mean I have a patient she's 50 she has Hashimoto thyroiditis meaning she attacks her thyroid she doesn't you know make enough thyroid hormones so she takes thyroid hormone well one of the challenges with that is they make a lot of thyroid antibodies this antibody called thyroid peroxidase antibody and when you have an elevated thyroid proxy andbody you don't feel good you feel inflamed your joints hurt you get rashes life is just not easy and it's a challenge to get that number down I mean certainly a challenge for me you know you traditionally use probiotics a lot of to help bolster the immune system well now we're starting to use the gp1s and we're seeing that those antibody levels come down and I I don't have a great way of explaining it but there's something going on that's very positive very interesting well I suppose moving from uh most widely known um peptides are still fairly unknown to most people even the concept but that's why you're here uh you're changing that right now um but moving from things like gp1 to what I would probably call the second most popular peptide the one that we're hearing more and more about all the time um and that's bpc 157 body protection compound 157 um which to my understanding they're are a lot of animal data very few if any clinical studies on humans but a lot of people now taking bpc in various forms yeah um what are some known uses for bpc let's just say within your clinic sure um and then we'll get around to the fact that bpc has let's hope temporarily been taken off Market y um and what some of the alternatives are but um what is bpc what instances where people have you found it useful for so many so I think with bpc for me kind of the most utilized peptide that we've used so we'd like to use bpc almost with every patient it is very anti-inflammatory right and so just from a very general perspective you know most people walking around who are adults you know they're stiff they're sore as they get older they work out we work with uh athletes of all levels there's that element of inflammation maybe they have some chronic disease diabetes heart disease autoimmune disease inflammation is Paramount we understand that and bpc I you know observed with so many patients we're talking thousands upon thousands of patients where their inflammation comes down so they feel better they're not as stiff they're not as store their knee doesn't hurt as much their shoulder improved so we've learned you know that we start with the dose you know based upon these like you said animal studies um which is conservative make sure it's safe and then we've seen over time that we can get to higher and higher dosages and have even more of an impact you know and I think so for people understanding using bpc we started with a dose of like 500 micrograms a day we got up to 5,000 micrograms a day you know U and we'd like a protocol 5 days on two days off and that's been very helpful for a variety of things from post viral you know with the pandemic had a lot of success with bpc to again you name it honestly almost everyone I could think of particular as people are engaging more Fitness related lives they're working out more I would argue that anyone who's working out on a regular basis bpc is going to benefit it's going to help you know improve the inflammatory status but also help with recovery and it doesn't seem to be one of these agents that's going to be detrimental like we we were talking earlier Rob and I for the starter like you know they found that people were working out hard taking antioxidants that there seems to be a negative consequence to that because you don't allow the body to kind of repair itself I don't think that's happening with bpc that's interesting because my understanding is also that um part of the specific and General Adaptation of exercise is triggered by inflammation yeah this is why indeed it is true that doing ice bath or really cold water immersion cold shower seems fine but cold water imers ver in the you know 4 to 8 hours after resistance training can limit some of the hypertrophy and strength gains from resistance training because what you're inducing when you actually go into the gym is the that leads to the hypertrophy and strength training is an inflammation response that triggers the compensation right or um or the hyper compensation so um it's interesting you're saying that bpc by the way I must say this because then uh forgive the editorial but that is not to say that cold plunges and cold immersion is bad it's just in the hours following resistance training specifically for hypertrophy and strength training if those are your goals probably best to do it outside of that window other times has some tremendous benefits be safe but there okay back to the topic at hand forgive me but this can set it can set off a a complicated um storm of sorts if if I'm not if I'm not Ultra clear about the details um bpc157 strongly anti-inflammatory yes my understanding is it also May upregulate growth hormone receptors it does right and so works well if you're you know we'll get into taking a growth hormone releasing peptide it pairs very well with that because then you're working both sides of the equation meaning if you're using a growth hormone releasing peptide like semelin or ellin ghrp6 whatever you're helping your pituitary put out more growth hormone well if you combine it with bpc which upregulates the growth hormone receptor you make the process of growth hormon binding more efficient so you get more out of it then you can use less of the growth hormon releasing peptide with the same result got it yeah BP c57 um comes in many different forms or it used to when it was allow when it was FDA uh not disallowed um so I could imagine how the oral forms would allow for a just general um anti-inflammatory response it's a gut peptide so we don't have to worry about it being destroyed by the gut most peptides that go into the gut are broken down and corre but this peptide when it's naturally occurring occurs in the gut so it survives in the gut so if somebody body is taking bpc157 orally through a capsule or tablet form right um my guess is that has a general anti-inflammation response I think it can what we've observed is it's more limited to the gut so people with any sort of you know gastrointestinal issue whether that's inflammatory bow disease like Crohn's or uler of colitis you know irritable bowel you name it leaky gut I think oral bpc is more effective there has it been shown to be effective for those conditions or have you observed that clinically Ober that clinically but interestingly I've observed a better clinical response when people inject it even for gastrointestinal related things so I think injecting and then so people injecting subq which is right under the skin we use the tiniest of needles like an insulin needle 30 or 31 gauge we're talking super small um and so I know a lot of people like I'm never injecting is less painful than a um than a Texas mosquito bite there you go super easy once you do it once or twice it's really easy and we we walk people how to do how to do that but interestingly I we started thinking okay if you've got something going on in your gut you should take oral PPC cuz it's going to Target it right then and I found now if we're injecting it actually works better than the oral and uh and then they came up what if I've got an elbow injury should I inject it in my elbow and we found actually don't it's going to work systemically you can inject it in your abdomen or your rear end you're still going to get benefit in your elbow but now you're going to get benefit in all your joints all over your body systemically how do you think that's working and my understanding is bpc157 can initiate fiberblast migration some of the cells that that make up the the various connective tissues that um when injured or sore other things can make us injured or sore of course but when injured or sore that they those need repair um so it always was um perplexing to me why one could put bpc 157 in such a small volume Under the Skin you know just a few uh centimeters off the belly button and it would somehow um seek out the the injury site in an elbow or an Achilles and there all these wild anecdotes Tales of you know lore of let's just say uh there was this Olympic Athlete not this last Olympics but the previous Summer Olympics that had a torn Achilles who came back a few weeks later and everyone was and meddled people were talking about you know took Podium um uh that is and people were talking about bpc 157 there was kind of this you know and who knows that's just uh chatter and fog as they say but um kind of wild the idea that you could just inject something systemically put it into the systemic circulation into the bloodstream and it would faret out the location in which the injury took place and initiate a recovery response but we've seen it with not to get off top it we've seen it with with stem cells so they've taken stem cells they've tagged them radiographically so you can see them um in the study I read which I can find for you someone had a wrist broken wrist and they gave them intravenous stem cells and 24 hours later when they visualized radiographically those stem cells had AGG at at the sight of the fracture so there's a lot you know about our bodies obviously we don't know there's a kind of innate human like design and intelligence which I believe in um I see it because we we've done a lot of IV Therapy over the years and you you know it's interesting when you give some something intravenously you're getting in the bloodstream and you can feel some of these different compounds we're just talking about vitamins working within seconds and it shows you how quickly things circulate people don't understand like how quickly we move our circulation it's massively fast if one has ever gone into the hospital for a surgery and and got a a cold saline infusion yeah you realize how quickly it hits your your toes you know they're putting it in at your elbow almost instant yeah within a few seconds it also uh makes one appreciate how we're all generally a little bit dehydrated when you start getting a real proper saline infusion all of a sudden you feel yourself come to life in a way that oh this is what it feels like to have just the right amount of salt in my blam exactly so going back to bpc where I think it shines is in these ligaments and tendons right I think this is where most of these injuries happen is where muscle is connecting to the Bone um you know and there's you know people you know grow their muscle but we don't stretch the tendons and ligaments well and that's where we get pull sometimes strain and Sprain and tearing and I think that's where bpc shine that's certainly where it's been studied in animal studies and I know that because we can inject it directly into tendons which is unlike steroids we would never inject steroids into a tendon you damage the tendon bpc we mix with things like PRP prf which is play Rich fiber and a little bit different than PRP and you'll get healing within days like it's awesome wow super safe uh and it's amazing for people bpc is definitely shorthand for BBC 157 that is is certainly in widespread use I have been concerned just personally about um gray Market sources that um contain contaminants and the fact that um many people are obtaining bpc 157 not from a physician not from a compounded Pharmacy but just kind of on quote unquote on the internet sure uh you're a physician um I'm guessing that until the recent ban by the FDA you were able to prescribe clean bpc as it were what's the story with bpc now and maybe we could talk about gray Market sure versus um I think it's a great question you know versus prescribed and made it a compounding pharmacy versus uh pharmaceutical company uh pharmaceutical so um and then of course there's black market but let's just leave that out um you know there are people that are going to tell you know tell you hey this is bpc and sell it to you that's obviously bad and dangerous well we see that with the anabolic steroids right like so anabolic steroids are in the Black Market you can't really I mean there's one anabolic steroid which is nandrolone which is DECA which can be officially prescribed we use it you can combine it with testosterone all in the up and up Totally Above table the rest things like trend balone others you you can't get them from a physici in fact you very hard to get them from a reputable website in the United States so as long as we're we're here by understanding is deadin and uh testosterone cypionate are can be prescribed or testosterone and Nate things like that by by physicians that's that's because it's been FDA approved for the treatment of various things hypoc canatal syndromes corre uh testosterone replacement therapy in both men and women correct Etc so th those categories of testosterone um like compounds right um cypionate and anate Etc and deadin which is basically like is it similar to DHT is it uh a little bit yeah I mean it's uh the generic name is nandrolone yeah I mean it has the flavor of helping with joints I think uh it works synergistically with things like testosterone different you know whether it's testosterone cpen anate um and and I like it for people who particularly people who have been on testosterone men been on testosterone replacement for a long time which is many men um they tend to get less out of testosterone becomes less potent like anything right if you use something for a long time you're going to get less out of it over time anything you expose yourself to continually doesn't work as well um and so you know like to make this really real I had a patient who was a uh in the uh Marines and served a secret service for several uh white houses and he had a lot of you know osteoporosis osteopenia you know bone loss and you know this is where I learned about using something like nerone because we combine nerone with testosterone it changed his life you know this guy in his 80s who was had to use a cane who came back to life who started you know becoming super mobile and working out again and synergistically I think it works really well not to get too far off topic but it's interesting and I think uh another sort of brief editorial for me if I may um you mentioned this patient was in their 80s I think nowadays unfortunately a lot of younger males in in particular guys in their gosh even teens but 20s and 30s even early 40s think that they need to look to um synthetic testosterones in order to uh look a certain way um perform a certain way um in the gym libido Etc and I I'll go on record again and again and again saying that it's absolutely not necessary for most people of those ages provided that they um are taking good care to sleep well eat well take care now but I I realize that there are a growing number of use cases where people for whatever reason aren't able to recover from exercise they're struggling this a little bit like the OIC conversation right where that there are things that can help move the needle in the right direction pun intended um but here with testosterones syn synthetic testosterones in Deca there's a real concern about loss of fertility totally right I I think it brings up a larger point which is and obviously unbiased but I think it's super helpful for people to have a physician help them in this course particularly with testosterone it is just known that people get it from their trainers they're Bros from the gym right who were saying oh you got to use this I mean I have so many patients who were started using testosterone in their late teens early 20s goodness yeah that's I mean not goodness meaning Badness that does not seem like a good idea still very common like gracious still very common and you know one in particular this is probably 10 years ago came to see me he's 25 he got married and to your point he said I'm ready to have kids I have zero sperm left right and that's a real thing and so he had been using and I would say abusing both testosterone and growth hormone for years now what he told me was and I get it he was Superman he could wake up do a hard workout you know crush it wake up the next morning was not sore crush it again and just kept going kept going it was super fit super happy in that regard and how he looked how he felt how he performed but then he got to a point where he's a little bit wiser mature and he was like oh my goodness now there's a repercussion for this and I've seen that time and time again and the repercussion is Big you're not making any sperm or the sperm quality is super poor now what do you do well now you got to come off testost you got to rebuild your system which we can do you know we can use things like chopine en chopine HCG lots of different agents to help in that regard even certain peptides but I think it brings up the large Point even getting into peptides which is having a physician who's knowledgeable to me is super helpful the challenge for people is they don't know where to get the right information right and they're getting it from websites and they're getting it from people saying oh just try this peptide and I've had lots of people talking about the you know websites or whatever not to name any names who've had anaphylactic reactions to research type peptides which are not for human consumption and I'm not saying that there's bad companies or whatever you just got to be careful you got to be selective at least right well what brought us on to the uh conversation about testosterone was this black market issue there's also what I would call this um dark dark gray Market issue which is that there are a number of companies that will sell all sorts of things but peptides in particular sure and listed on their website it'll say not for human or animal consumption for research purposes only right and one of the major issues is that the um potency and cleanliness so to speak of Purity yes of those um compounds is not established um and many of them have LPS Lippy polysaccharide in them which is inflammatory and earlier before we started recording you mentioned um that you have heard of or interacted with not your patients but people who have come to you saying that they had like really serious life-threatening um consequences for using these black market certainly but um dark gray Market uh peptides yeah and so to to tell the story story further is back in October of 2023 the FDA uh put many peptides bpc and we can name them out on what's called a category 2 list meaning they are no longer allowed to be compounded right now that excludes then research companies who are not under the purview of the FDA but these compounding pharmacies it's been a huge blow because they've been told they cannot use these agents and the compounding pharmacies are distinct from these other um black and dark gray um sources um in that they actually can establish Purity they are designed to be injected into humans and they have a totally different standard right so they and I think it's confusing for people when they hear compounding pharmacy they thought friend they're not friende they're FDA regulator they're Board of Pharmacy regulated in every state they are monitored they are inspected all the time I've worked with compounding pharmacies my whole career which is going on you know close to 25 years now just like anything there's some amazing compounding pharmacies and there's some not so amazing compounding pharmacies which cut Corners the ones we work with don't cut any corners and I know that because they're inspected all the time right and it's a big deal to them and they want to do it right with Purity with processing and making sure that anything they make especially a sterile compound which is going to be anything injected you know eye drops things you inject in yourself whether it's IV subq or intramuscular they're considered sterile um they have to then be tested by an outside lab to make sure Purity make sure that there's no endotoxins things like that it's it's highly regulated and it's a big deal for them and it's a big deal for the Physicians who you know prescribe with them which I appreciate because the advantage of a compounding pharmacy is we can tweak the dosage we don't have to use a standard set dosage we can combine things synergistically to get you know 1 plus 1 doesn't equal two now it equals four and that to me is a huge Advantage just like we were talking about the gp1 semaglutide and tpdes we get those compounded so that you know we have a a the compounding pharmacy we're using now we're making a unique combination of tepati and saralin right which will address some of this muscle loss that people are getting so we can combine to stimulate growth hormone release offset some of the muscle loss from exactly toeside yeah yeah and and so you can do things like that with a compounding pharmacy but again just to make sure people understand compounding pharmacies are highly regulated highly regulated um again there's always going to be bad apples but uh you know Physicians who know how to work with compounding pharmacies I think provide access to things that these conventional both Pharmaceuticals and conventional pharmacies can't I'd like to take a quick break and acknowledge our sponsor ag1 ag1 is a vitamin mineral probiotic drink that also includes prebiotics and adaptogens ag1 is designed to cover all of your foundational nutritional needs and it tastes great now I've been drinking ag1 since 2012 and I started doing that at a time when my budget for supplements was really Limited in fact I only had enough money back then to purchase one supplement and I'm so glad that I made that supplement ag1 the reason for that is even though I strive to eat most of my foods from Whole Foods and minimally processed foods it's very difficult for me to get enough fruits vegetables vitamins and minerals micronutrients and adaptogens from food alone and I need to do that in order to ensure that I have enough energy throughout the day I sleep well at night and keep my immune system strong but when I take ag1 daily I find that all aspects of my health my physical health my mental health and my performance both cognitive and physical are better I know that because I've had lapses when I didn't take ag1 and I certainly felt the difference I also notice and this makes perfect sense given the relationship between the gut microbiome and the brain that when I regularly take ag1 which for me means a serving in the morning or midm morning and again later in the afternoon or evening that I have more mental Clarity and more mental energy if you'd like to try ag1 you can go to drink a1.com huberman to claim a special offer right now they're giving away five free travel packs and a year supply of vitamin D3 K2 again that's drink a1.com huberman to claim that special offer so is it fair to say that if one is interested in exploring the use of peptides for what you refer to as performance medicine um mental physical health and performance yes um Falls underneath that to essentially only put peptides into their body um maybe even on their body surface that they're obtaining from a physician who's obtained the peptides from a compounding pharmacy yeah and who's developing a relationship so we for any peptide that we use we meet with the patient we make sure they're a good fit we make sure that there's no contraindications we also can recommend and specifically dial it up or down whatever it is come up with this is what we think you should use based upon your life experience the medicines you're taking are not taking the conditions you're treating or not treating right I think that's really important again I'm biased being a physician my whole goal is to get to know patients that's why I'm here is to kind of walk that walk and help people in that regard and you know if someone's out there on the internet doing it themselves they're they're walking in you know kind of you know on their own and so you know not to make it like everything bad is going to happen but when you're when you have the help of someone who has experience that goes a long way I think particularly with something like this yeah I agree and um and it worries me very much that people are buying PPC from um gray Mark dark gray Market or uh uh Black Market sources I mean anything that says on it not for animal or human use for research purposes only you can pretty much guarantee the endotoxin the lipip polysaccharide at least has not been removed and that could be really atic especially since my understanding is that that can be cumulative over time it's not that one injection causes somebody to go into anaphylactic shock it's that some of this LPS can build up an inflammatory response over time and then you don't know where the Tipping Point is and then somebody can have a really terrible reaction well and then taking a step further you know getting away from just peptides but any I remember this was I don't know 15 years ago someone was taking advice from a very famous doctor on TV about taking an oral compound to lose weight and they called me up and they said H I'm having terrible headaches terrible headaches for days they came in their blood pressure was through the roof you know like I don't remember the specific numbers but let's just say 220 over 140 and normally it's 120 over 80 well did you take anything different yeah this doctor recommended I take this weight loss compound right so the problem is people have access to all this information but if they're not under the guidance of a doctor to help clean up the mess and we clean up the mess not that there's always mess but this is what we enjoy doing you know is as a physician like we've seen the darkest of dark you know we're able to help people when things don't go perfectly planned and uh I think that's a big deal you know particularly when there's lots of these tools and they're exciting tools and they're great tools and um fortunately for me I've been in this space longer than most that I've just you know built up a large repertoire of experience of observing people and working with people and seeing we got to tweak this we got to Nuance this or sometimes we don't ever want to use this again yeah this is not for most people so given that bpc 157 has been effectively removed from the um legitimate Market uh what are people's Alternatives again uh working with the the uh caveat that um people should work with a physician yeah um where can Physicians get something similar enough to bpc 157 so there's a new compound newer uh peptide called uh the shortened for PDA pentad DEA arginate it's basically the same molecular structure as bpc except they've swapped out an acetate for arginate one amino acid substitution corre one amino acid substitution um and so we're using that and having really good results um I certainly it's early in the game of using PDA but it seems very close to bpc in the clinical responses we're getting from our patients who are reporting back decrease in inflammation all these wonderful things that we used to see with BP C so and I and I think uh I surmise that this is going how it's going to be with all of these peptides right because again peptides are just chains of amino acids you know certainly a lot of people smarter than me trying to figure out how do we then create other types of amino acid combinations you know I.E peptides that do similar actions to bpc to thymus and Alpha to epimone to tb500 on and on and on so I'm hopeful in that regard um and I and I also you know some of my patients work at the very highest level of the US government they are well aware of this and who have assured me they're going to look at this that this is serious you know because they're they've been using peptides and they're concerned that oh my goodness the FDA came in and changed the game very it's been a huge setback for all of us I definitely want to Circle back as to what the motivation was by the FDA for doing that um at some point I think um in the meantime however I think um there's a lot of interest in BBC 157 a lot of use of bpc157 the sources of bpc157 are now drying up Y and that's why I'm personally concerned that people are going to start going to the dark gray market and black market I'm excited about the uh pentad DEA arginate yes um so let's put that on people's um ear map um brain map pentad DEA arginate may be a good uh physici prescribed substitution for people that can benefit from bpc157 and a good starting dose so to make it really clear for people helpful 250 micrograms to 500 micrograms we're using 500 micrograms injected daily again we like Monday through Friday take the weekends off that's a good dosing schedule we'll we'll see how that goes we probably can use larger dosages that's conservative um but that's a good starting point for people and thus far you haven't mentioned any side effects of bpc 157 or pentad dea arginate it's that's kind of remarkable it's been tremendous yeah and we were using bpc intravenously as well you know patients would come in and you know oh tweaked my knee tore my ACL tore my you know meniscus whatever um you can give them bpc essentially as a bolus intravenously my goodness that made a difference now that using something intravenously from the pharmacokinetic standpoint it's not going to last in the system very more it's more of a spark whereas if you use an agent subcutaneously you're going to get more of a long lasting you know again not terribly long-lasting with peptides but longer than using something intravenously kind of The Sweet Spot was C certainly using both we could use something as a spark to initiate that anti-inflammatory Cascade then follow up with a subcutaneous dose yeah and even though earlier we were talking a little bit about um some hormone replacement therapies um before that off microphone um you mentioned that you prefer peptides to direct hormone manipulations in most cases so I think um while peptides can be hormones there are things like uh um uh oxytocin is sometimes called a peptide in people think about hormone therapies thinking testosterone estrogen prone uh you know thyroid Etc it it sounds to me like much of your practice is built up around the the notion that there are things that one can use peptides to kind of um push and pull on these various systems without getting into them directly my understanding is the advantage of that is you don't get the negative feedback you don't gain the shutting down of natural production yeah you know and testosterone is a great example um um because like we were saying I don't ever want to manipulate hormones you know growth hormon is another example I don't ever want to manipulate that meaning you know providing it to people more than they would get in nature this is why I actually don't a little bit off topic like when people use testosterone pellets or any sort of pellet therapy because you're exposing people to a concentration of hormones we would never ever see in nature I would prefer people inject it where you're going to get some variation in dose on a day-to-day basis which we're humans so we do get some day day to-day variation or topically or under the tongue or something um peptid same thing I don't want to manipulate the hormones right I want to just stick within kind of the the highways or the lanes swim lanes for how they should operate and and then take advantage of that and that's been a safe way to do it as opposed to and I've seen it you know talking about another peptide which is eper marelin a growth hormon releasing peptide uh eper marelin you inject Under the Skin travels up to the pituitary the posterior pituitary in the brain which is respons we're putting out growth hormone that growth hormone then leaves the pituitary enters the bloodstream travels to the liver where we make insulin like growth factor one which then enters the circulation is very anabolic meaning growth healing mending you know as we get older we make less growth hormone as we get older we wear down obviously we get you know degenerative conditions part of that uh I don't know what part it for everyone's a little bit different is because of our hormonal Decline and so when you can give something like epin and we can talk about others you're actually helping not only push out a little bit of growth hormone for people but you're directing when you push it out right we we think so why it's important for people to be asleep by 10 p.m. between 10: p.m. and 2: a.m. because you think that's the B largest pulse of growth hormone during the 24-hour period is that right it so I've um long wondered whether or not the um the tale I was told when I was growing up which is that every hour before midnight is worth two hours of sleep post midnight um that feels true to me um then again feels true as as often misleading but feels true to me um but it makes perfect sense if the the largest pulse and growth hormone is occurring in the in the couple of hours before midnight yeah I mean that's that's how I learned it um I agree with you it feels true to me as well um but taking advantage then of you know injecting something like I morelan at bedtime then you're going to you know within a few minutes and with I morelan it's interesting because people will get a little flushing tingling at times um and what I've seen with the point of making is uh there are some Physicians and some pharmacies which you know the the dosage of velin and most of these growth home releasing peptides should be 100 micrograms that's the max dose uh for to bind the receptor and you know what I've seen is with eelin rare but some people do get Anil axis and it's happened and I think that happens when people are pushing it and giving more than they should and I've heard of that they're giving 200 300 400 micrograms at a time which is a big dose now what they're getting is the client the patient is like oh my gosh I feel this amazing flushing it must be working but then you could spiral into oh my goodness I don't feel good so good in your you know circulation system collapsing so yeah using side effects as a as a uh indicator of whether or not something's working just seems like a terrible idea but um it's very common you know um I tend to be very conservative about these things and by the way um I've tried various peptides for short periods of time because I like to experiment um very safely um and some things like surel and we'll talk about other growth hormones secretagogues uh for me uh for whatever reason you know gave me great sleep but only in the first part of the night it nuked my rapid eye movement sleep in the second half of the night it um spiked my prostate specific antigen it was a very consistent effect I came off it and it went back down and it went back on it it went back up and so I just found I couldn't take it and it didn't take me very long to figure that out but I know that there are some people who love Sur morelan and don't see any of the same issues so it seems like it can be very idual I agree with that I agree with that and that's why I think it's again helpful to work with a physician who has experience who can kind of you know I think of these peptides as having flavors particularly the growth hormone releasing peptides iiron very clean you know as long as you stay within 100 micrograms or less people are going to lean out a little bit sleep a little bit better there's no no real side effects they take it pre- sleep pre- sleep at bedtime without carbohydrates ingested in the previous two hours correct yeah or 45 minutes technically yeah but that's right and then there's saying like growth hormone releasing peptide 6 ghrp6 which is also going to bind so I think of iin being the most specific for the growth hormone receptor but the weakest so when you inject it you will get growth hormone to come out an only growth hormone but it's not going to be a big burst of growth hormone you inject ghrp6 now you may bind some prolactin now you may bind some ACT which is going to have your adrenals put out cortisol now you're going to get a hunger response right and maybe even have trouble sleeping if you're getting may have trouble sleeping but where where that's beneficial before is if you're looking to put on mass or get strong ghrp6 is your go-to right because you will increase your appetite and if you're smart you'll eat a lot more protein you know and and the building of muscle is not necessarily complicated right it's resistance training sufficient protein which is where I think most people fall off and then having some anabolic kind of hormone in the background like growth hormone or testosterone are both helps that process that's where ghrp6 can shine I mean within weeks people will get big and strong increase their press whatever stuff flat out works but you got to know how to use it and and understand the flavor so the point of making is these different peptides have different flavors and to your point there's individual responses that's that can be a good thing I think for most of our audience um the interest in growth hormon SEC creogs probably relates to the better sleep and the overall feelings of Vitality and probably uh most people are seeking to not Spike their appetite or put on muscle really these days we're hearing more and more from people both and women who want to be strong without being big yeah and they prefer to be lean as opposed to not lean which I think is a great goal frankly that's my goal at this stage of life I just turned 49 yesterday and I oh thank you thank you yeah thanks for coming out to the the birthday oh yeah that was a lot of fun mini bash the other day that was a lot of fun um you know I I yeah I want to be strong and capable I also want to be able to run and have cardiovascular fitness but I don't want to be large I don't want to take up a lot of space I'm not interested in taking up a lot oface space um and I think most people fall into that category so if ghrp6 can Spike appetite which for a subset of people might be useful um but probably most people will want to avoid it epom morelan I've always been calling it ipamorelin but epom morelan at 100 micrograms um dosage or less perite sounds like it's an interesting tool what are some of the other growth hormone secretagogues and I should just brief I'll I'll take the liberty of defining the these are peptides that stimulate the release of your own endogenous growth hormone this is not taking growth hormone right yeah yeah um two other main ones that we use one would be tesalan U which is similar to saralin and that it also is going to work on the growth hormone releasing hormone aspect a little bit higher up in the you know chain of how these hormones are released so both searon and tesone um you you don't necessarily need to add anything else to it classically with ion hexone ghrp6 we would add this other compound cjc-1295 which is going to work on the ghrh which allows the peptide and then the growth hormone to stay in your system a little bit longer the growth hormone releasing hormon correct yeah but we can almost set aside CJC now because CJC 129 the FDA just came in and uh one let's just say one acronym took out another there go the FDA took out CJC okay nbpc nbpc um people are probably getting a little dizzy with these acronyms but I think we're were uh doing a good job of guiding people uh uh along so cellin um and tesamorelin are similar enough similar in that regard testelin again talking about flavors testelin works on visceral fat reduction so fat around the organs and it's been FDA approved for that purpose yeah with HIV patients having this lipodystrophy which is you know you know abnormal accumulation of fat in particular visceral fat around organs so testelin works well for that my observation from using it for with lots and lots of people seems to work better in females than males or does it get lead to this um feeling of enhanced sleep as well yeah so I think any of the growth hormone releasing peptides anytime you're going to make growth hormone more active in your world that's how I think about it better sleep better skin tone texture right you're more resilient I think growth hormone is a resiliency hormone durability you know people find that oh I do a hard workout but it takes me days to recover I sprain my ankle takes me a week to recover I cut my skin takes me forever to heal they've got a durability issue and that's how I think about where growth hormone can shine not that you got to go all the way to growth hormone but these peptides can be a really nice push and this is taken before sleep no food within 45 minutes of the of the injection and then what and then the kind of the magic and what we do is you know when we first started about 8 years ago we'd use one peptide at a time and then what we learned is let's combine these peptides let's stack peptides and that's how we do it add lower dosages sometimes lower dosages um but for example we had a great combination BP PC epin and testelin all together um taking at bedtime and you're going to get subcutaneous fat reduction from the EP maralin visceral fat reduction from the test maralin uppr regulation of the growth hormone receptor from the bpc it was a wonderful peptide we we kind of labeled it as a fat loss peptide but people would put on lean muscle mass they'd sleep better their skin would be better they'd be more durable their thought process would be better awesome stuff and and that's where I think that's where we enjoy it is stacking these peptides together so it's not again just one peptide at a time but able to do it and that's why again working with a compounding pharmacy we can put these together so you're only doing one shot a day you may be doing three to seven peptides but it's still one shot got it and um if one is combining A tes morelan or Sur morelan uh epom morelan and well not bpc anymore but Penta arginate instead because you can't get bpc 157 compounded um is that done every night 5 days a week three days a week what's the rationale of this 5 days on two days off five days on two days off I came up with because of how we would dose growth hormone so the traditional growth hormone dosing cycle would be 5 days on two days off taking at bedtime yeah and that's where it came up and then I I personally with patients and myself I like to take breaks so even with supplements I won't take them on the weekends right because I think you we you know again anything you expose yourself to on a regular basis is going to decrease the potency we see that with exercise we see that with food if you're eating the same food every day it seems to become less valuable for you right like change it up like we we have to you know throw on the crazy switch every now and then but change it up and so then you're going to make it more potent for you I do the same thing with supplements so that you know just resonates with me with people to take a break from stuff I'd like to take a quick break and thank one of our sponsors function I recently became a function member after searching for the most comprehensive approach to lab testing while I've long been a fan of blood testing I really wanted to find a more in-depth program for analyzing blood urine and saliva to get a full picture of my heart health my hormone status my immune system regulation my metabolic function my vitamin and mineral status and other critical areas of my overall health and vitality function not only provides testing of over 100 biomarkers key to physical and mental health but it also analyzes these results and provides insights from Top Doctors on your results for example in one of my first tests with function I learned that had two high levels of mercury in my blood this was totally surprising to me I had no idea prior to taking the test function not only helped me detect this but offered medical doctor informed insights on how to best reduce those mercury levels which included limiting my tuna consumption because I'd been eating a lot of tuna while also making an effort to eat more leafy greens and supplementing with Knack and acetal cysteine both of which can support glutathione production and detoxification and worked to reduce my mercury levels comprehensive lab testing like this is so important for health and while I've been doing it for years I've always found it to be overly complicated and expensive I've been so impressed by function both at the level of ease of use that is getting the tests done as well as how comprehensive and how actionable the tests are that I recently joined their Advisory Board and I'm thrilled that they're sponsoring the podcast if you'd like to try function go to function health.com huberman function currently has a weight list of over 250,000 people but they're offering Early Access to hubman lab listeners again that's function health.com huberman to get early access to function today's episode is also brought To Us by eight sleep eight sleep makes Smart mattress covers with cooling Heating and sleep tracking capacity now I've spoken many times 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ultra has improved cooling and heating capacity higher Fidelity sleep tracking technology and even has snoring detection that will automatically lift your head a few degrees to improve your air flow and stop your snoring if you'd like to try an eights Sleep mattress cover go to 8sleep.com huberman to save up to $350 off their pod 4 ultra eight sleep currently ships in the USA Canada UK select countries in the EU and Australia again that's 8sleep.com huberman before we start recording uh you mentioned that you're actually not a huge fan of taking massive amounts of supplements that you are a big fan of taking CoQ10 coin Q10 200 milligrams per day in the morning I also take CoQ10 um I think I I started taking it for uh quote unquote General mitochondrial health I don't know that I thought very carefully about exactly what I was trying to accomplish with it um but what what is the rationale of taking CoQ10 so if I can break it down try to keep it simple if we people are familiar with the mitochondria it's the battery of the cell these little organel inside each cell um and they're responsible for you know doing many things but primarily making ATP chemical energy and so how do we make energy well there's three main ways the body uses it right or makes it first is glycolysis we take glucose which is a six carbon molecule we break it in half to make two pyruvates right that when we do that we make a little bit of ATP that pyruvate then is converted to something called a cetal COA we run that through the kreb cycle where we're also making ATP but we then we're making these intermediate products one of those intermediate products and the main one is something called nadh that nadh is then shuttled to the mitochondrial membrane for you know this is the magic where we make the most ATP and there's five different hubs or we call cytochromes right and this is how I think about it because I just like to simplify cytochrome one is where we use NAD and um what the what the different hubs are doing is we're exchanging electrons for protons and that's a kind of an electrical process we're exchanging electrons for protons going down an assembly line to eventually turn this wheel the ATP wheel to make ATP the way I understand it is the five different hubs different nutrients hit them so cytochrome 1 is NAD cytochrome 2 is ribo flave and vitamin B2 and succinic acid cytochrome 3 is CoQ10 vitamin K2 cytochrome 4 is methylene blue which we can talk about and then cytochrome 5 are things like magnesium vitamin A and copper so if you're thinking about mitochondrial Health if you include any or better all of those you're going to maximize how your mitochondria can work and make energy it's the strongest way to do it and it's again not necessarily complicated so when I think of cq1 and again we use a lot of NAD which we can talk about where I think most people the the traffic congestion happens on cyto Chrome one right and so when we give people upregulate their NAD production it's essentially we're allowing for more electron flow at cytochrome 1 which has a downstream effect on the other cytochromes so the traffic jam opens up and now you can move electrons to exchange for protons and make way more ATP and if you're and but that's not true for everyone and so some people it could be at cytochrom 3 with CoQ10 it could be at cytochrome 2 a lot of people at cytochrome 4 which is again cytochrome we call it cytochrom C oxidase which where methylene blue binds but that's just a simplistic view we just people we run into traffic jams right these electron flow gets stuck we're just trying to open up the traffic jam so 200 milligrams a day of co-enzyme Q10 can be um Can facilitate some of that Cy for sure and cyan's been studied very safe up to 2400 milligrams a day no harmful yep no harmful effects sometimes I'll take more like I was telling you earlier it's been dramatic for me with migraine headaches and you basically reducing them to zero you know as people are hearing this they're probably thinking okay well these are just you know this is what I call anic data or whatever I I you know I don't have to remind people that you're a board certified physician I think that what was what still ringing in the back of my mind this entire conversation even though I'm paying very careful attention is that most of the drugs that are prescribed in this country are off label I think that just like I I don't think I've ever heard that stated out loud yeah it's wild yeah yeah right so the idea that people would take something that wasn't um shown in a uh clinical trial to be effective for purpose a um that they would but it gets that it gets approved for purpose a but then can be prescribed by doctors for purpose B C D or E I mean you're not telling me this is common place you're telling me this is the majority of prescription drug but it makes sense if you think about it right so if you took an antibiotic right like we can just an antibiotic is going to be very specific what it gets approved for in terms of like working against a specific bacteria but then through clinical use and just experience you know we learn that oh I can use doxycycl or zpac aiyin or whatever it is for a variety of bacterial infections that extend well beyond just with a proof for well that makes sense and and does that ever cycle back to the uh clinical trials or no this just becomes physician understanding and lower like hey yeah you know I've got patients that you know they get on on aiyin and their their acne clears up by the way I'm not saying that folks I'm not a physician but um but for instance exactly what happened with semaglutide and OIC right approved for helping glucose utilization or lowering you know blood glucose in patients with type 2 diabetes and they found through use only people were losing weight and now it's become Blockbuster and it's and we see it with you know things like you know repurposing drugs for cancer right there's there's there's a lot of that going on a lot of the repurposing so you know doxy cycl is a very common one that's used in cancer therapies I think by sophisticated oncologists I don't treat cancer but by sophisticated oncologists to use things like doxycyclin metformin mendol which is an antiparasitic drug right um to help with cancer that's amazing so interesting it is amazing I think also um you know I'm I'm reminded that um you know medicine as beautiful a uh field as it is I have tremendous respect for it um of course uh is a field of of Fairly siloed training um and I love the idea that now thanks to public education efforts like this one um that you're providing us that Physicians learn from each other in a much broader way and can potentially hear about what drugs can be useful for this or that the other thing um and this is not editorial this is this is a real uh uh observation pharmaceutical companies are very interested in the other uses of already approved drugs sure the research and development process for a drug the safety uh evaluation is incredibly expensive so they want nothing more than to take a drug that's already been approved for one purpose and to take that already safety approved drug and find other use say how are they not circling back to the off label uh use and understanding of these compounds and um and then essentially marketing them for these other purposes or I guess with OIC that's exactly what happened that's what happened with OIC I mean it's again I I write prescriptions and I think there's a time in place I think it's challenging for me though right and I think for a lot of Physicians it's become challenging operating in a paradigm um when we talk about chronic disease which is essentially failing I mean and we all know this statistically we're not making huge dents in heart disease cancer autoimmune disease neurod degener we're not at all but we're spending exorbitant amounts of money right um and this is you know something that I had to learn over time and and I don't know how I got into it but when I started my practice back in 2006 I started it was a traditional Family Medicine practice but I started using these nutritional IVs and this is before hangover IVs this before was popular this is you know 20 years ago and what I learned was that these nutritional IBS help people feel better quickly and I developed this model for my patients which I think is a better model which is I want to help people feel better first like we were talking about earlier in this podcast because if I can get people to feel better what what we learned through Co and honestly what I want to say to you Andrew which is really true your podcast and what you do has been so successful at a time during the pandemic when people lost so much trust in people like me right people lost that trust of what do I do you know my how this is a scary time I don't know what's going on and you guys come along you in particular providing this very stable vetted information that people can trust and have a starting point be like this is what I want to do because Health one of the gifts of Co was it put our health on the Forefront of most people's mind and life and and so what you're doing is tremendous work and I can tell you personally no literally like as a physician I am just it's it's such an honor to be here and to to talk to you because every day every day my patients come to me and said I heard this on the huberman Lab podcast what do you think of it and and I am not joking and I love that I think it is awesome because people one taking their health seriously but two they have a stable resource that they can trust the problem with Physicians and and I'll tie this back in is Physicians are hard to trust right and it's this paternalistic model which is and that's how I I was trained which is you know you're going to do this because I'm going to tell you to do it right and I remember being in medical school which was in the 99s and I can't remember the exact specifics of the study but they would go they did a study where they colle collected the trash outside of Physicians offices found that greater than 30% of prescriptions written that day were run away greater than 30% wow and what and I remember learning that and I was like what is going on by the patients correct like you came to the doctor because you wanted a prescription right no you came to the doctor because you weren't feeling good you came to the doctor because you wanted to be listened to you came to the doctor because you wanted to be validated and most of the time and this still happens to today the vast majority of doctors will just write you a prescription or they'll write you two prescriptions and that's not what most people want sometimes it is and I do it and sometimes it is but there are so many other tools that we can use and so when I help people feel better first what i' why I've been successful and I work with you know the the peak you know people on this planet whether the athletes the best athletes celebrities the royal family you name it I'm so privileged it's because they trust me and that trust is really important I take that really seriously you know what I mean and so you know tying it back in is we've lost a lot of that with the pandemic it's actually come to the Forefront and so that's why I want to help people feel better first you know the traditional model of medicine is is get a diagnosis write a prescription if that prescription doesn't work write another prescription and so yes there there's a time in place for that but there's also a time in place for just helping people it only works when people value themselves enough like we're talking I can tie this back to weight loss right why do people have such trouble losing weight I would argue that most people don't value themselves enough to actually care enough to make the hard disciplinary choices in their life to get away from emotionally eating you know what I mean to do the right things that they actually it's going to be a struggle to get the right food for themselves get away from processed foods to be disciplined to go to the gym on a regular basis they don't have the right people that they trust this is where you've been such a gift tremendous gift well thank you for the kind words I mean the the um the birth of the podcast did take place during the pandemic and um in large part because I saw everybody getting very anxious their circadian rhythms disrupted and um those were focuses of my laboratory and and frankly when I was a postto and graduate student but especially as I got a little older uh in my years um I couldn't believe that you know I was reading these papers about how important it morning sunlight is and all these things but then my colleagues were all getting sick and dying around me or getting what we call the tenur look where they show up you know start their job and 5 years later they look like they've aged 25 years yeah and I realized that I I wanted to avoid that so I've always just enjoyed learning and sharing science and health tools and uh so thank you for the the kind words I've I've certainly um been um kind of both astonished and positively amazed in the ways that the pandemic and the post-pandemic years I I like to think we're in the post-pandemic years I I think we can safely say that now um how they've drawn people's attention to this idea that they need to take agency into their own healthare that that no one no one no pill potion injection Etc can replace good behaviors um pills potions and injections uh can potentially augment those good behaviors um and get people going down the right path which is what we're talking about today but that it's a it's really a personal responsibility I mean no no one can give us a calmer mind no one can give us a healthier body um no no one can do that right you can in it's interesting that some of the wealthiest people in the world um the new thing isn't for people to boast about their their Yachts or their properties it's about their health it's about their Vitality their longevity because that's the thing that I suppose in some sense money can start to buy but it doesn't require a ton of funds to take great care of one's one's body and mind it doesn't and and what I've learned and I've had to learn this over time and I think the wisdom is is and this is why it's it's even more challenging because I think people you know go on social media and they listen to podcasts and they listen to influencers and and a lot of the messages is additive right if you're not doing a high-intensity workout every day and then doing sauna for x amount of time and then coal plunge and all this kind of dieting you're not doing it well I know that that is cumul that that stress of that is cumulative to people right and so what I've learned and I have a really good friend probably the most you know affluent successful but also the most generous and smartest person I know who lives on the big island and he says to me which is worth repeating here I look for every opportunity to surrender and it is that surrender to people who you can trust to guide you right so you don't have to be the quarterback of everything right and that takes off the pressure and I think finding it's not always about adding it's it's actually creating space for us to just be in that flow right like it's to be in like and I know you've talked about this a lot that kind of active rest place where it's not about being super focused it's not about just going to sleep but almost the best parts of our day is when we're in that flow state where things just click and to me helping people with those you know types of times and figuring that out is the most valuable and and I don't think people talk about that enough so I appreciate that you do a lot yeah well and I appreciate that you're um bringing up this notion that you know just stacking more and more behaviors like you got to crush a workout and do sauna and that is not the message you know sometimes um we get teased and there's some good comedy uh takes on me um uh that make me chuckle now and again um about that but that's not the the approach these These are tools that people can can uh it's a buffet um and I think most everyone agrees that sleep is key um most everyone agrees that exercise is key nutrition is key great social connection is key when it comes to um because I want to make sure that we um Circle back to this when it comes to the peptides it seems that one of your approaches if I may is to kind of raise the hide so that the you know the boat can get you know get out can get out to see and we were talking about these growth hormone secret toogs we covered um uh uh GH rp6 which is the one that stimulates appetite that's probably going to be a niche case condition that people would want to use that ellin tesalan saralin I get a lot of questions about is it mk677 what in the world is mk677 it sounds like a weapon it does it's yeah it's it's just I think it's just like ghrp6 however it's it's absorbed well orally so it's basically the same I see it working this very similarly to G to ghrp6 so stimulates appetite it does can stimulate cortisol prolactin it sounds like a not good situation for most people not for most people although you know let me give you an example where it is I have a client very successful Guy and um he's been on testosterone he's doing all the things right he's in his early 60s he's he's working out well he's he eats well super well all these things he can't put on muscle mass well right and and actually as people get older that does become an issue for a lot of people is maintaining healthy muscle mass mk677 before it was taken off uh the compound list by the FDA it's another one that was included oh another acronym take it out by the FDA acon but you can take it orally which again removes the stigma or burden of having to do a shot and you will increase your appetite and that actually is a very useful agent you know metabolically for people as they get older um and I know this you know my kind of approach with this and both personally and professionally is I try everything I can and I remember mk677 I took it bedtime and it was an hour later I was in a dead sleep and I woke up and I had to go eat this it sounds like puberty it was I was like what is going on cuz I didn't totally understand I was like what oh I took that c oh my gosh I should never have taken it right before bed and I had to go up and eat and destroyed my sleep that night but I learned and I always learn and I'm grateful for it but don't take that one at bedtime um but it absolutely will stimulate your appetite which sure the growth hormone secretagogues that um your more typical patients who don't want to stimulate appetite um both male and female patients uh prefer what what are you compounding for them I I test some realin I I don't see any appetite stimulation from that hexarelin we haven't talked about that I don't really see talks about hexel yeah hexarelin hexarelin yeah sure arellin I think of is more again if we talk about the flavor of these peptides how I kind of look at it in my head is more of the energy endurance growth horm releasing peptid I like it for people to use it in the morning they get a nice burst of energy they feel it's a clean energy it's not a caffeinated energy or jittery or anything like that um and it's good for more endurance type you know Athletics are working out so people in that you know field of competition or whatever um I think hexon is a great choice does not Spike appetite I have not seen that is taken first thing in the morning you get an additional growth hormone release yes you do yeah you do uh in the early mornings when you're waking up and and you used to compound it with CJC 1295 to get the other Pathways involved that can help but now CJC has been taken out by the FDA right but hexarelin still exists that can be compounded what's the dosage on hexarelin that you typically prescribe 100 micrograms it's the same as these other like ion ghrp6 uh 100 micr the the two that are different would be teston uh ideal dose is 2 milligrams per dose um which is 2,000 micrograms so quite different and then semonin has a actually very broad dosing range anywhere from 200 micrograms uh I've used it up to 3,000 micrograms depending on you know your goals we were talking about coenzyme Q10 and the um kreb cycle yeah um and I forgot to close the hatch on supplements more broadly yeah um again doesn't sound like you're a big fan of taking lots of pills and capsules I think some people will take that as a relief I think a lot of people get tired of taking a lot of pills some people don't like to do that um what are some of the other things that um you do take besides coenzyme Q10 um earlier we were talking about methylated vitamins of meated B vitamins yeah this is becoming increasingly popular we're starting to hear more about methylation and methylated compounds um could you educate us on methylated B vitamins yeah and I think people are familiar with it um you know some people are talking on podcasts about the MTHFR snip we've not talked about that in this podcast so it' be nice sure so so a snip is a single nucleotide polymorphism meaning that genetically things don't flow as easily again that's an oversimplification um and you know you could be homozygous for that meaning you have both genes making you you know influencing you more you could be heterozygous meaning it's just one gene meaning one copy from one parent or homozygous copy from each parent you say it way better and so um what that means is and where we see that reflected homosysteine is a is a marker we use a lab marker we use it's an emerging marker for looking at one's cardiovascular risk profile and so if one's got an elevated homosysteine um and elevated by some Labs is can be greater than seven by most Labs greater than nine um means you're at an increased risk of what that is I don't remember but you're an increased risk of having a cardiovascular event which would mean a heart attack or stroke and so we want to lower that number and the best way to lower that number is taking ample methylated B vitamins methylated means you're adding a methyl group um so methyl B12 methyl folate trimethyl glycine methionine these are all methylation donors which just metabolically and through your detoxification Pathways in your liver is going to help you lower that homocystine um I'm sure it's more complicated than that but that's most people if you're going to take a B vitamin take a methylated B vitamin because then you overcome even you again I don't we've done a lot of MTHFR testing I don't think it's as profound as some people make it out to be like it's going to change their life I've never seen that can it help you sure but you're going to overcome it by taking sufficient methyl B vitamins anywhere and again those methylated B vitamins are methylated B12 B12 folate uh there's a methylated B6 there's uh and then trimethyl glycine um TMG is is a good compound methine is a good methyl donor is an amino acid are these taken in the morning or in the afternoon I like taking them in the morning although I think you know for people to play around with cuz I've certainly seen it you know people get that 3 P.M kind of Slumber um as opposed to reaching for the coffee or the dut take some more methyl B vitamins and see what happens or just the coffee no sorry you're not supposed to drink caffeine too late in the day lately what I find I don't know this is wrong to bring up on this podcast but I can't help myself I love y bate in the morning and afternoon okay coffee in the morning now makes me feel nauseous I don't know if I'm pregnant or something but it makes me feel nauseous but I love the taste of coffee in the afternoon this is like a a midlife thing I don't know what it is um so I now in the afternoon like around 1 or 2 p.m. even just the smallest amount of coffee is like it's like the most delicious thing I've ever tasted yeah I love coffee um it can mess with your sleep too late in the day but um that's a perfect segue to talk about sleep sure um because one thing that I know you've done a lot of work on and with are these peptides that can improve sleep not just by virtue of enhancing growth hormone release but um you know I'll just be very direct I um for the last gosh like four to six months I've had the opportunity to try pineline um and uh injectable pineline um combined with glycine yes um goodness gracious in the positive sense of the goodness gracious you're from the south so I don't know where where people how they never before have I found something that can improve the amount of rapid eye movement sleep that I get yeah besides rapid eye movement sleep deprivation you know sleep deprivation the next night you'll get a compensatory effect that's not the way to increase your Rim sleep folks you know there are a lot of things like um high-intensity exercise that improve my slow wave deep sleep um cold plunge early in the day improve slow deep sleep there been a few other things but with pinin I'm and by the way I'm not doing this every night I do this occasionally by Rand a little experiment and I track my sleep using the sleep tracker that's in eight sleep um and it's doubling the amount of rapid eye movement sleep that I'm getting doubling yeah which is so like from an hour to two hours or from an hour and 30 near near nearly 3 hours you know even um I posted a picture of a sleep score with some rapid eye movement sleep it's not something I typically do but um even the uh the the most competitive of biohackers uh Brian Johnson was like oh nice sleep score you know um now he touts a sleep score that's perfect every night for you know um for for every night but um and I'm kind of poking at Brian because we like to poke back and forth we're friendly with one another um so the point being that pinealon is a remarkable way to increase rapid ey movement sleep I have very little knowledge about it except that I my understanding is that it might stimulate some um regeneration or stimulation of the Pineo sites so the pineal that's exactly it mhm you've nailed it yeah I remember when you messaged me after starting it and you were like this is amazing it's amazing yeah that you were saying amazing I hope the FDA doesn't nuke it as a consequence of this conversation I hope so too no but I mean your response is what wece with our other patients who are who are loving and I think that combination with glycine I'm a big fan of glycine and injecting it seems to work really well um but back to your question about pinealon yeah I mean it's a bit one of the smallest peptides uh but I think it's one of the most profound we used to combine it with epitalon the the Russian peptide that was used for circadian rhythm and for my understanding um epitalon also um it's involved in DNA repair and might has been explored in animal studies for um trying to offset vision loss in some retinal degenerative conditions yeah again put on the do not compound list um with all the others that's gone um but panon stays and remains and yeah your response to it and experien with has been very commonplace from working with patients and seeing that it's I I think there's a circadian rhythm aspect with it as well you know and helping with melatonin production obviously that comes from the pineal gland um I this is just I'm postulating I think there's more to the pineal gland than we understand oh yeah um yeah it makes things other than melatonin that's for sure yeah and I think it's kind of elusive but I think there's something to it and I say that having used a lot of panon with people over the years and having very similar respons mon es um which is awesome like everyone knows like you said when you sleep better your entire day is better when you sleep better your life is better like exponentially better I think of the millions of people that suffer from lack of rap and eye movement sleep the lack of neuroplasticity that can be the consequence of that the lack of um healthy removal of uh emotional labels on previous day memories that is the consequence of REM deprivation the enormous um impact on depression rates the enormous impact on pretty much every mental health issue is made worse by by lack of REM sleep so I I say or I raise this conversation about pinealon with um a little bit of trepidation because I do worry that on the one hand people will see it as a miracle drug that's not what we're talking about it has this effect but at the same time I okay I'll just say that you know there's another drug that was released recently um uh this is a FDA approved drug um in the category of sleep drugs called the Doras so it works a little differently it doesn't um push on the sleepiness system so to speak it um it suppresses the wakefulness system and the idea is that it's supposed to increase REM sleep okay was by name quic and things like that um I tried it it was a total disaster for me I fell asleep woke up 3 hours later couldn't fall back asleep I tried it with lower dosage it's extremely expensive as well so I'm going to piss off whoever makes cor Vivic I forget who makes it it was a complete disaster for me yeah um um pinealon has been incredible and here's what's really interesting about it to me is that it seems to improve my sleep on the nights when I don't take it which makes total sense if it indeed is providing some regeneration of the pine pinealocytes that make melatonin and other sense to me yeah so here we're talking about something that one could potentially pulse with now and again and get Improvement in sleep every night yes yeah wild yeah and it's I mean I think it's worth noting that you you also take care of your health on many other aspects and that's probably why you were sensitive to it but it worked really well for you right and some other people it's going to take longer you know if if they're you know having to work on their diet and having to work on their exercise and having to work on their thought patterns right we don't talk that about that enough having positive thoughts um but yeah it's and it's so safe we've never ever seen I mean I never ever have seen a side effect or negative side effect from pinealon it's and and your response has been uniform you know it people don't always get there as quickly but people get there with their sleep love it and so and you compound it with glycine yeah what's the rationale there I really like glycine as an inhibitory neurotransmitter um it's coming to the nervous system uh over the years I tend to start with that when people are having trouble settling down at night not that it's going to sedate people um but just transitioning from you know being active you know 8:00 p.m. 9:00 p.m. wanting to settle down glycine in pretty large dosages at least most people think they're starting with 3,000 or 5,000 milligrams orally um kind of TS down the nervous system people relax a little bit and then they tend to sleep better from it and then you can dial it up I mean I've used very large dosages for the other advantage of glycine is it works on Phase 2 liver detoxification uh which is amino acid conjugation so you're helping your liver work better um and in a world where we're being exposed with all these toxic things from glyphosate to heavy metals we all need to do some sort of you know liver mitigation strategies glycine is one of the best wow interesting uh we haven't done an episode of this podcast yet on heavy metals but we're um I'm very interested in in this because many people write to me asking about Metal toxicity and about mold toxicity molds become super big yeah big um yeah I mean it's it's very prevalent and it seems the more we talk about it I mean we've seen it for years and years and years it makes sense right like if you think about the amount of airplanes flying above us every day pouring down heavy metals I mean it's massive it's in the air it's in the water it's in the soil talk about glyphosate or round up same exact thing so many chemicals and it's challenging for us as humans the way I break it down not to get too far off topic is you know we're water soluble organisms living in a fat soluble world it's the job of our liver essentially to take the fat soluble stuff make it water soluble so we can excrete it right and that takes place in the liver in two phases phase one we're using the p450 enzymes it's like taking the trash putting the trash and the trash can putting it out the side of the road you have phase two amino acid conjugation the trash truck comes and picks up the trash very few things in nature induce phase two independent of phase one meaning most of us have trash piled up on the side of our road those things are the polyphenols right and so things like the blues the Reds the pigments that's why it's important to eat a wide variety of colors in your diet matcha tea you know has a very strong inducing effect on Phase 2 liver activity right y I need to develop a taste for matcha yeah I feel like it's kind of grainy it is and it's bitter you know but bitter things tend to be you know again helping that phase two um glutathione helps phase two uh you we do a lot of that intervenous and then glycine is a wonderful agent for inducing phase two independent of phase one and the trouble is I don't think people realize you know people are told well you know most Pharmaceuticals induce a450 enzyme and a misconception is well if I'm just inducing one I'm good if you induce one you induce them all so if you take any pharmaceutical you're inducing your entire p450 system you're speeding it up meaning you're putting more trash out on the side of the road and if you look at the amount of things we're being exposed to outside of pharmaceuticals it's mounting say on the side of the road you mean in the liver yeah that's what I'm I'm just using that as a metaphor yeah yeah yeah like you're not about screeing it in the um you're talking about um building up of of debris Cellar debris with it or uh excuse me metabolic debris within your body right that the the trash again very oversimplification you need to speed up phase two to get the trash trucks come to pick up the trash so that you can then take that compound and excrete it in your stool and your urine your sweat your breath right I mean that's the only way it works it's not complicated per se but I think there's a lot of misconceptions about it so when people take a peptide that's injectable pineal and glycine the gain glycine obviously but for let's say somebody doesn't have access to to you or to for whatever reason there's a barrier um to getting a hold of those peptides um Can people take glycine orally they can yeah glycine's absorbed well orally has a really sweet taste it's actually the smallest amino acid huge fan of it we've been using it a long time and you can take big dosages of it very again I my starting dose is usually three to five grams at bedtime wow and then I tell what my the way I do this recommended is try that for a few nights in a row not noticing a thing double the dose go to 10 gram literally most people at 10 grams of glycine will notice it again it's not going to necessarily make you drowsy you're not going to be sedated but your n nervous system is going to be tone down a little bit it's going to help you fall asleep a little bit better and then while you sleep where a lot of this detoxification process starts working you're going to be more efficient in how your liver Works everything ties together right I'm still still a big fan of things like magnesium 3 and8 um appenine which is a chemom mile derivative um and I'll try glycine I think a few years back I was was using a little bit of glycine but it was more like um a th000 milligrams but now that it's in the injectable peptide yeah pineline I I don't take it um is there an oral form of pineline that works that there's these bio regular bioregulator peptides um which were developed by this Russian scientist uh last name cornon I think done a lot of research actually there's published research about it I think pinealon is one of the ones uh that they say will survive the stomach acid and get through the gut and be absorbed um so I I think that's true we've always used as injectable and um I tend to like injectable things for the bioavailability so um yeah but to your point I think people can those are going to be harder and harder to find actually it's probably easier to find an injectable pinealon than an oral one yeah and I as we're talking about this I'm realizing what unfortunately just the way the internet works that people are going to start selling likely as a consequence of this conversation will start selling pinin but you need to know that you're actually getting pinin I mean it's very easy for somebody to just pop something up on Amazon and sell it and uh totally maybe they just throw some melatonin in there and call it pinin like there there's a lot of like BS stuff out there so T this is why the compounding pharmacy component and working with a physician uh and researching right making sure that what you're taking is is legit lot of illegitimacy out there do you think the pharmaceutical companies are going to move into these other peptides I mean certainly uh uh epom morelan for the reduction in a viseral body fat that's an FDA approved drug um so is cellin FDA approved drug um uh The glp1 Agonist FDA approved drug so those are the FDA is unlikely to pull those but they're Blockbuster um especially gp1 I mean they're making a a not even a small fortune but a large forun big money the the concerning part about the gp1s is uh to me is what we're starting to they've been able to be compounded because there was a uh shortage and the way it works with compounding pharmacy is because those are brand named drugs and they're not patented for the peptide right they're patented for the delivery system which is the pen um which most people don't realize and they've been able to be compounded and then way more affordable because they're compounded um and there is rumors that the pharmaceutical companies now have Supply back they'll come back and they will you know remove the ability to to allow these peptides to be compounded which means we'll have to stick to traditional dosages and people will lose access because they're going to be way more expensive I mean they are if if insurance doesn't cover it 1,500 a month for for most people very expensive that's a lot more yeah for a lot of people that's rent and more so yeah uh I'm hopeful that doesn't happen um but that's that's in the works that's in the works and and that would be a huge shame and again I'm not a a pessimist by any means I'm a Perpetual optimist so we'll just we'll just make sure it stays this way but you know again if it does happen we'll get creative and and go other routes as well um earlier you mentioned stem cell therapies y those are not FDA approved in this country they are actually they you can you can Sor my mistake yeah so uh I think that using the term stem cell is a problem right if we use the term autus cell right which would be PRP it's basically the same plasma right they take your blood they spin down they take the right and so the ruling is I understand it as long as you're taking a cell that from you and you give it back within four hours then that is allowed with under the FDA guidelines interesting there was this clinic in um Florida a few years ago was um touting stem cell therapies for macular degeneration injected some stem cells into these patients eyes and they went blind really quickly and they were not blind prior to the injections that to my understanding caused a severe setback to the whole field um I'm old enough to remember when gene therapy was set back by about 10 years because a patient received gene therapy um which is now pretty common um for certain diseases and the patient died it's unclear exactly why they died um but that delayed the field of gene therapy um by at least a decade I mean they this country is very conservative when it comes to the approval of new Therapeutics yeah sure yeah yeah no and I think um like anything there's going to be people who get too aggressive and I've heard of doctors injecting stem cells into people's Diss and then they get discitis an infection and that can just spiral very quickly I think it's you got to be reasonable in you know what you're trying to accomplish I I'm excited about stem cells and exosome therapy and PRP and prf and using them as you kind of biologics and uh because I think there's a lot to learn I think we only know very little um from what we've seen from working with our patients it's been tremendous from a Rejuvenation standpoint I mean we're as long as you know I think it's taking from your own you know and then giving back your own within how the FDA outlines it I think that's a great way to do it well certainly you have the clinical uh clinical data um to back those statements a thymosin Alpha One uh what is this peptide but maybe before we discuss it did the FDA nuke thymus and Alpha One they did whoa okay they're coming through with a with a Howitzer and taking out all these peptides um okay um well then let's keep this relatively brief what what was thymosin alpha 1 being used for previously yeah I think it was uh from my observation the best peptide for immune modulation so we would use it uh if you had an overactive immune system like autoimmune disease by definition if someone has an autoimmune disease their immun their immune system is attacking their own self right that's classically lupus rheumato arthritis things like that celiac disease type 1 diabetes those are all you know autoimmune diseases we could use thymus and Alpha 1 and we ton down the immune response we'd also use it a lot in postco where you have an abnormal immune response or the immune system hasn't caught back up and you can kind of dial it up using thymus and Alpha 1 in a very safe way use it a lot with long covid um and we were using 5,000 micrograms a day um sometimes intravenously getting great results very very safe had no issues with it um but unfortunately it's off the table I hear a lot of complaints about um brain fog um with long covid um and brain fog generally um cerebral lysen is a very interesting compound um my understanding is that cerebral lysen is available in Europe more broadly than it is in the US is it did the FDA is it Tak out Avil okay all right cerebral licon made the cut we see what happens after this podcast that's right um we've used a lot of cerebral license um we I actually have a clinic that's open in London we actually did use it uh we've used it a lot more over there than over here ah so you have a US clinic and a and a UK Clinic we have a one in based in London and and one in Charleston yeah and um I think you know cerebral license has been used for decades in the setting of you know poststroke um post traumatic brain injury the trouble with it again I've observed with people they get cerebral license we're talking about IV you can also use it subq is they will have a day or two where they feel really down and out like it's like their mood shifts to like this dark place um scary yeah and they come out of it um but most people don't like that feeling and so we just we stopped using it mostly yeah for that reason my understanding is that cerebral license is a kind of a cocktail of brain derive neutrophic factor cery neutrophic factor like some other things it's not one thing yeah and I think right I think I think collectively it increases bdnf levels right like uh there was dihexa too you know if you're familiar with aexa it's another one that was removed by the FDA uh supposedly the most potent way to increase you know brain derived neurotropic Factor kind of the juice the neurons live in again oversimplification that's gone but I think seron did the same thing interesting so as long as we're talking about um maintaining or boosting cognitive function um here's one never tried um but you and I have talked a little bit about and uh it it's still seen as kind of renegade but it's becoming more common place um and that's methylene blue and I always make the joke uh that I used to use methylene blue to clean my fish tanks right um cuz I was I'm a big uh fish tank a ficado at least I was when I was a kid right now I don't my have a tank but it's it's it's empty um nope pun intended um what is methylene blue and what are people using it for and does it turn your tongue blue it does for sure um not permanently not permanently it's actually the uh the first pharmaceutical ever prescribed in this country in the late 1800 was methylene blue goodness here so it sounds like really Renegade but it's it's not got it yep um but it's it's gained favor in the last five years that's certainly when we learned about it particularly you know I learned about it through this doctor who was telling me with covid patients he was getting immediate like within a day uh of stopping of Co symptoms from using methylene blue that's what like peaked my interest like wow that's incredible and then he went on to say that then covid test ret turning negative within a matter of like two days which was unheard of I've seen that with something else but I'll get back to that yeah and so that's when I was like oh this is you know it started to be talked about and learned about it um so methylene blue when we talk about the mitochondria using that mitochondrial membrane binds to cytochrome C oxidase and I think of it you know traditionally it's used when people have carbon Bon oxide poisoning they'll still use it you go in emergency your carbon monoxide poison it'll give you methylene blue and it helps your red blood cells displace the the carbon monoxide and put oxygen there and so you're it's an oxygenator that's how I think of it is it used as a performance-enhancing drug in in uh Endurance Sports because this sounds like the kind of thing that cyclist would would really want to use check with your local governing body there's always a question I get people like they hear something in the podcast and they go can I take it or am I going to get disqualified and I always say I have no idea if you'll get disqualified I don't believe it's on the water list okay I don't believe we we we'll just look for the people with the blue tongues yeah easy test so um methylene blue very absorbed very well orally you know I think of it like NAD the molecule NAD because it works on that you know on those cytochromes different than Ned though because Ned is not if you're taking Ned by itself not absorbed orally well at all it's one of the trouble with it methine blue is and actually you can take way bigger dosages orally than intravenously we've given it intravenously a lot but we're Limited and using it intravenously just cuz it'll start to cause some spasma of the vein the arm starts hurting if you're giving too much methylene blue either too much or too quickly and so we can give it orally you can get a capsule of it that's how we our phy so I think a good dose is no more than 10 milligrams 10 milligrams taken when in the morning it is you know it's a cognitive stimulant for sure I mean I've had more people over the last 5 years because we make methylene blue we combine it with some other agents a little bit of caffeine some B vitamins and people say this is the best thing for you know my brain function recall memory kind of quote unquote neut Tropic a term I don't really like because yeah you know there aren't circuits for being smart there circuits for y Tas switching but y so it's 10 milligrams of methylene blue combined and you've got some other things in the cocktail version that you make take it in the morning on an empty stomach yeah I you could take it with food though again it's going to be well absorbed um it will interesting to people and I need to say it will turn your urine green or blue for how long um about 24 hours hour depending and that be kind of fun yeah well and a good caveat is if it doesn't and I've had patients then that's interesting to me as a clinician because it means that your mitochondria is not working well right like the way I see this is you should get spill over you shouldn't kind of use it all and if you're not there's something wrong there that you're using all of it and you're getting no spill over back into your bloodstream which gets filtered into your bladder your urine which you urinate out that and that's happened with a couple patients so it's like oh wow you had no green or blue urine there's a problem with your mitochondria so it's putting more oxygen onto the blood cells correct like your your hemoglobin is able to pick up more oxygen that's exactly right um but then there's the you know a mild MAOI inhibitor which is monamine oxidase inhibitor yeah which going to allow things like serotonin to work a little bit longer in that synaptic Clift um you know and you've expounded way better than I can about serotonin and dop me and how those work but um there is a cognitive enhancement from it for sure it's very real and we have a lot of people using it and love it it also seems to be an antiviral you know you get this again that's probably through the mitochondria making your mitochondria more efficient it's a prescription drug it's a prescription drug but there's there's now and I don't totally understand it there's now strictly over-the-counter neutral supplement options that are methylene blue for sure anyone can go online and buy it for sure trust me now now there there are going to be a few and and you talked about turning your mouth blue if you take a liquid form right uh and we'll do that sometimes in the office when we're doing other treatments we'll give a big dose of methylene blue to kind of help fuel kind of quickly make a lot of ATP which we want to do with some different IV treatments we do um so we'll give sometimes up to 50 5 milligrams at a time um their gums teeth lips are blue for about an hour or two and how often um Can people take methylene blue again I you you could take it every day I think it I think it's a little bit longer acting I don't I don't take it every day I take it about three times a week I think that's about right um I do have people who need it more you know for whatever they're dealing with I do think you know as a nutrient if we're going to call it that it's it's a lot of it's an insurance policy for your mitochondria so earlier you mentioned um a patient or maybe it was patients plural that experienced a more rapid transition out of a uh a covid infection or maybe more recovery from long covid symptoms Etc uh it reminded me of um the second time I got covid um far less intense than uh the first time U but the second time I got covid I had an amazing experience where um my covid test was very strong band it was very clear like I I had Co there was no question about it um I didn't feel good I was fatigued um wasn't super severe I would put it more kind of on a six six out of 10 okay on the kind of malaise level no fever okay so I stayed in stayed in bed and you know stayed away from people this sort of thing um but I did an NAD infusion M of course told them I had Co they came over they gave me an NAD infusion right and correlation is not causation but um I think it was 750 mgram NAD infusion over the course of about 45 minutes um I had the usual feelings that one gets when you get an Ned infusion of you feel like an elephant is stepping on your legs y um your chest kind of cramp so you feel and then when that stops you feel much better than you go into the thing yeah um the band was absent the next day my symptoms were I went from I don't want to say gone I went from you know like a 5 six out of 10 as I mentioned to like a two out of 10 yeah and within another 48 hours I was good good to go and better awes now this is correlation not causation I don't know what was going could have been the sailing bag right could have been any number of things sure um but the shift from a dark band to no band was so dramatic that I took another test okay after the no band and then of course the next day and the next day you know this kind of thing um um it it's interesting I I don't know what it means um but one wonders whether or not it's just a um a global way of combating inflammation you know I I just sort of anytime I think about a systemic effect um and the reason I rais this is that I don't want to give the impression that I think that like NAD is specifically in the pathway that was targeted um but that my brain and body were inflamed clearly I had an infection so you don't you could have a flu you could have a cold you're flamed um what are your thoughts on that anecdote again it's just anecdote but what are your clinical Reflections we've seen it so many times yeah I mean the for the longest time and so we've been using NAD longer than most I'm fortunate that I was given the original NAD infusion protocol which came from Mexico it's kind of a long story I don't want to bore you but um that dosage of 750 milligrams is actually what we came up with in my office and that's what most people adopted just because we've used used it more than probably anyone else on the planet huge fan of NAD very biased but that's only because I've seen it work over and over and over in inexplicable scenarios just like you're describing where it's not just you go from A to B but you're going to A to Z very quickly and I used to use the word transformational talking about it not just okay going from a sick state to a well state but and most people going from a well state to a super well State really quickly and it's super impressive so there's a lot more to nid than we understand right because just very empirically giving someone this co-enzyme this vitamin B3 derivative how is it dramatically changing symptomatically how someone feels but it does and I've seen it with thousands upon thousands of people certainly in the setting of covid certainly in other virile infections you name it I have been more impressed with the work of Ned than probably any other agent we've ever used amazing yeah I take sublingual nmn each day um it makes my hair grow ridiculously fast I've done the control experiments I'm a scientist I know how to do control experiments it's still just n of one it's just me makes my nails grow really fast makes my hair grow fast that's the major consequence um I don't by the way I want to be clear I don't have any stake in any company that sells NAD sure or Ned infusion so I'm just reporting what I'm reporting um uh somebody who's uh quite expert in the uh NAD pathway Charles brener um who I believe has a relationship to a company that makes NR supplements I think that's correct encouraged me to try NR I I took these um NR supplements this is what it's um NAD minus a phosphate group is my understanding um and those I took orally I I couldn't tell if I got the same or different effect because I was taking them together um I didn't continue to take them because compared to nmn it was very expensive yeah um and uh I just stopped taking so I that's why I use sublingual NN but um in brief discussions with Charles and kind you know forging online it seems that there is some literature human clinical literature showing that NR can reduce inflammation is that right yeah okay less data that nmn can reduce inflammation at least lack of human studies okay so we're still kind of in the it's still murky murky foggy territory with with respect to the the research and clinical the biochemistry yeah and like what does the biochemistry do in the way I think about it again because we kind of pioneered the infusions the NAD drips which for me transformational just observing lots of people who I never saw the same thing with nmn and R you know you're not having these transformational experiences within a week um you know that I I tell the story a lot is I had a patient he was diagnosed with a chronic Epstein bar virus which is rare there it does exist he was depressed and on disability just cuz he couldn't almost get out of bed this is mono um but it was reactivation of epin bar yeah yeah and so very like fatigued and depressed and literally on disability couldn't work and he I said before we do anything I I the way I operate I want him to get you feeling better first before we start to tackle some of the bigger things we we did the loading dose of NAD which we came up with five treatments in 10 days came back to my office his wife was there she was crying she goes within a week my husband is back wow and I've seen that so many times with NAD and I can't explain it right and I and if I just stick to the biochemistry doesn't makees sense oh you're increased in the Ned n ratio fueling the mitochondria which are all over the body thousands per cell there's something that we just to there's there's got to be outside the mitochondrial effect of NAD that's not well understood so in the backdrop of our conversation today there have been uh uh a number of themes but one of the themes that seems to keep coming up is that um there are a lot of things about medicine that we don't understand totally um and yet there are tools that seem to work for certain people extremely well um a few years ago I went to a meeting this is a foundation meeting a foundation I was a part of um where you get to see talks from really the the best of the best Laboratories um and they only show unpublished data and at the time I don't know if this paper is published yet but at the time they were showing that they took people that were diagnosed with um major depression okay and they start doing a bunch of metabolomics on them okay now this sounds pretty standard for social media it is actually like pretty heretical like not a lot of uh of places have done this right so you know a couple thousand patients blood draws they're they're trying to figure out ask a simple question are there any specific vitamin deficiencies that are associated with depression and as I recall they identified a few different types of vitamin deficiencies so it's not like one vitamin it's not always methylated B6 or something like that excuse me it's not always B6 or B12 um but they found these you know clusters of patients that had major depression that were deficient in a particular B vitamin they supplemented back the B vitamin and lo and behold those patients showed remission of their of their depression so one could you know conveniently conclude oh well all depression is a B vitamin deficiency but of course that's not true right more likely depression like fever is just a broad description of symptoms right but what was so exciting about this talk to me anyway was that people were starting to look at nutritional def deficiencies as a potential source of mental illness which now has a bit more traction but at the time was like whoa what what are we really saying here I thought all of depression was a serotonin deficiency right this kind of thing so when you talk about NAD having these transformative effects and the fact that NAD can kind of um raise the tide on a number of different biological processes to me it makes perfect sense it might have kicked off some mitochondrial pathway or some some seller pathway that then fills in a blank that's desperately needed is that is that one way that we can conceptualize that makes total sense to me okay I like how you described it so how often do you encourage your already healthy patients to do NAD infusions what are the dosages I should mention the NAD infusions for most people are a little bit costly they are costly they're like anywhere from $500 to ,000 or more you're in Los Angeles if you're in Los Angeles um so assuming someone has the means so here's what we found and again just found it by treating a lot of people and learning is um we do a loading dose um for most people uh we found the sweet spot to be 750 milligrams intravenous intravenous um when they when they were doing uh NAD in the '90s and they were doing it for substance abuse so alcohol pain medicine you know morphine they used it for that that's where it came from actually it was in the '90s people traveling to Mexico for NAD infusions that that protocol was 10 straight days of intravenous n y the dose to use was 3,000 milligram 3,000 Mig and that's why it took 6 to 8 to 10 hours per infusion you could not get through it putting 500 milligrams in over the course of 45 minutes is going to be very uncomfortable many people take a anti nausea med so I'll tell you about that so that that comes from so there was a gentleman in the states in 2006 lived in Louisiana he had a pain medicine addiction went to Mexico got the NAD protocol changed his life he then licensed the use of the only inject Ned product which was from a South African company at the time brought it to the United States opened a clinic in Atlanta all he did was addiction and I got to know him because I'm in Charleston not too far involved in IV work he was not a physician I don't remember the time but he came to me and said hey I need some help because I'm getting a lot of questions about this NAD stuff and so he handed me the original protocol I mean I'm super grateful and fortunate um but what I realized is no one has time to spend 6 to 8 to 10 hours in someone's office you know they may do that once but they're not doing it more than once so we started triing you know different dosages 250 500 750,000 on up and I just found collectively by watching people how they did 750 milligrams was a sweet spot meaning they'd get the benefits which we can talk about but then they could get through it in an hour or two hours and that was meaningful and then we found that we don't need 10 straight days that's too much that just is crazy we found that five treatments in 10 days again a four people the ability to have great benefits which were uniform probably 95% of people who do a loading disc will come back and tell you their brain is getting bigger they feel more creative they have an elevated mood they can sleep less but have more energy colors look brighter languaging is easier I mean this is all very real so I think it affects the nervous system first just because of the concentration of the mitochondria for every single neuron in the body the physical components meaning you know recovery and helping with physical exercise those come but I think they come later and so we settled on 750 milligram we settled on the you know loading dose and then what I noticed is that people were coming back between 3 and four weeks saying hey I don't feel as good as I did after I did that loading dose and so we start doing a once a month maintenance dose and that is what we still recommend to today some people will do less and some people do more I have some people who do it once a week um but plenty of people do it once a month and then some people do it quarterly some people do it whenever they can on average once a month seems to work really well for people then during the pandemic um and realizing this is growing because again we train practices kind of in the medicine that we practice we trained 300 350 practices and kind of give them the Playbook so to speak um people weren't coming to the office as much with Co so we started doing it subcutaneously and actually that's worked out really well we'll do 100 milligrams subcutaneously again 5 days on take two days off you get a little bit of that stomach cramping from a 100 milligram injection um like you said can't really be absorbed well or not going to really work so you're going to have to inject it or Infuse it agreed there's a price point here right um it's going to cost money um but like most things it's you know it's to me if I had to pick one thing for people engaging in N would be it really yeah yeah I would all the things we've all the things I've just been so impressed over the years now peptides are amazing not to knock peptides peptides there's so many peptides and I will get there right because you can take this peptide for the nervous system this peptide for the immune system but collectively One agent one thing it's NAD has been the most impactful from where I sit working with patients well that's a significant statement so 100 milligrams injected subcutaneously get a little bit of stomach cramping yes as compared to the 500 milligrams to 750 or th000 milligrams that one brings in IV the fastest I've ever dripped it in was I think like 40 minutes um I can tell you the record what's the record 3 minutes and 26 seconds is that you no no no no no never 500 Mig 750 milligram two separate people did it 500 cc's of saling 3 minutes 26 seconds wow it's insane yeah I don't recommend it no no we wouldn't allow it to happen it's too much it's it's you got to have a lot of experience with that yeah I I found that because you have to sit there for a while you you could think okay well you organize the you know the the plumbing correctly that you could type or something but you feel hard garbage enough during the infusion that like you get irritable it's actually a very interesting um window into empathy for people who have pain totally you know when when you're in this kind of whole body kind of systemic pain and discomfort and you're getting that saliva I'm kind of sensing it now I have a distinct memory of this kind of like for people that get seasick you think about being on a boat and walking back and forth um get a little nauseous someone would walk in the room and you're like God why are they walking like that right you know and it's your own it's your sense of pain I normally don't have that response to people I I'm not a moody person um in general but then you know when you remove the infusion you feel great and all of a sudden people seem delightful the the irritating person it's it's a very interesting experiment in in Social empathy it is it's this is just what I postulate is that a lot of people are challenged because a lot of people are numb to the world they live in they don't feel things and when you do NAD there is nothing like that experience and that feeling and so you are going to just psychologically say something is changing inside of me and it's something in powerful because it's when I receive it it's a lot and to your point what what we do is we have a kind of an IV room where we have like eight chairs and we make it social because when you're talking to people and learning about their experiencing it it's there's actually a lot of healing that incurs just from that Community that's a bonding exper experiment um for people that can't afford the infusions um injections would be the next best bet if they can't afford those would it be the sublingual nmn or NR I think so I think the nmn I would choose over NR yeah so it going from most expensive to least expensive most expensive would be in uh IV then it would be um subcutaneous then it would be NR and then it would be sub a sublingual nmn yeah okay that's about right I mean you could do NAD topically it's a little bit Wild Card doing it topically you could do it under under your yeah ptic patches those give me a really terrible problem is the patch I get this the patch it's adhesive it's too strong lots of people get irritated their skin gets irritated I think the Ned gets in well but the the patch itself is a hindrance obstacle and for those that are listening to this and they may recall I did episode of this podcast with Dr Peter AA where we talked about NAD and nmn and NR and that was mainly focused on the the research literature you're not going to find much um you know so what we're talking about here is clinical experience yeah I'm a full disclosure I'm a clinician through and through so my experience is observing people and you're interested in what works well and but but you know I I'm confident about it because I've done a lot of it you know I've seen a lot of you know how peptides work because we've done a lot of it this NAD because we've overseen again a lot of NAD here and in London all over and the and the providers we work with so we get a lot of feedback about what works and what doesn't work you know speaking of um clinicians and Science and and all of this um there are a couple other peptides that have received FDA approval um that are commonly in use things like uh pt41 um which is in this um melany uh hormone pathway uh that's used one of its FDA appr proofed uses uh is I think the brand name is VII is for um uh female hypo libido so it stimulates libido in women it's also used to stimulate libido in men is that right can be and it can be helpful for it's like a neurogenic uh mechanism for erectile dysfunction so so it's not just related to blood flow it's not actually it's not in pt41 yeah like a fragment or derivative of the peptide melanotan um which stimulates Alpha mocy stimulating hormone which you know uh is becoming more in play I guess in the environment I operate in just because of mold tox toity and we think of mol toxicity being a biotoxin and hitting you know msh being kind of the the General in terms of a lot of these hormonal Pathways actually and melanotan can bolster by putting out more melany stimulating hormone seems to bolster immune response I think there's an element with energy too um the downside of melanotan is it stimulates melany so you're going to get this tanning and it's not like a it's like an orange looking tanning from the inside out yeah you see it you recognize it so pt41 what they found is in rats I think it was female rats were copulating more when they got this compound and they're like oh cool and let's try it in humans and it it's led to that our trouble with it is very small uh or narrow therapeutic window and if you give too much you're going to get nauseous pretty quickly and some people don't like particularly women don't like that tanning look it's not a not a very it can look very unnatural unnatural is the word yeah the medial pituitary which it at least my understanding is the origin of the these peptides that we're talking about now is is super interesting and you mentioned the nausea these peptides hit multiple Pathways um when we had Dr Zachary knight from University of California San Francisco on to talk about glp1 in a lot of uh detail um he mentioned that you know some of the nausea associated with um OIC and mararo and things like that relates to the fact that there's um you know there are receptors for these things not just in one hypothalamic structure but also in like like area postma and areas of the of the brain that are these quote unquote primitive areas that are associated with um generating nausea when you need to rid yourself of a poison that you know nature conveniently uh engineered us with um with neurons that when they detect chemical changes in the blood make us vomit yeah and but to touch on that is what we found is if we start with a again a micro do and go slowly with the gp1s the N is virtually unheard of not saying it doesn't occur but it's super rare if you just take your time with I think people have most problems they're doing they're shotgunning the dose essentially you're overwhelming your system so I have two more questions the first one is a bit of a controversial one okay um today we've talked about a lot of peptides that you've observed incredible clinical utility for uh we also talked about a lot of peptides that the FDA has banned basically to be blunt um we've also talked about pep that at one point not too long ago were considered part of kind of Niche culture like Fitness or bodybuilding culture that are now approaching what will probably be trillion dollar Industries over the next 10 years things like gp1 Agonist so any listener with um their neurons firing will'll put two and two together and say okay what's the deal obviously the FDA I like to believe has a genuine interest in our safety they don't want us taking things that are dangerous for us at the same time um there seems to be a kind of clawing back of what's out there and then um a handing off to pharmaceutical companies to put out compounds for which there are tremendous profit margins corre I mean the profit margins on these are insane we can't comprehend it we can't comprehend it so um I you know mk677 I crossed out right the FDA grabbed that one um thus alpha 1 crossed out okay bunch bunch of other things um that have been uh bpc 157 clawed back um so how should we frame this in our mind in other words do you think that the FDA has um genuine good intentions of trying to protect the general public and that's why they're doing this or is this a plan to kind of um make that appear to be the case so that these can then be sold at a very very high profit margin and perhaps it could be both right it's not in either or and and I want to be very clear you know I work at a major medical school I um but I'll speak freely anyway right you know um as would my colleagues like I like to think that these governing bodies have some people there at least with very good intentions sure I don't think it's a bunch of bad people like writhing their hands together with getting Kickbacks on far I don't believe that in fact I know that not to be the case but like what's really going on here because this is kind of weird there's this huge class of of compounds we call peptides that clearly have IM immensely beneficial uses in the right dosage in the right hands with the right Physicians they're being clawed back why it's confusing I I think it's probably both I think you know I would say that unfortunately a lot of times when the government acts they overreach right like I do think they probably have good intentions I think there's a there are probably sound reasons to want to have oversight of things that seemingly is the Wild Wild West right and there's truth to that right because peptides came on the scene and people started using them they're recommended here and there people could get them from still can research companies and there's not a lot of corralling of understanding what what is going on so I'm sure there's an element to like hey let's understand this better but on that side I think they went too far right because I think if you really look at data or if you were really interested in that there's ways to understand how things work without removing them from the marketplace so the other side of me is like just like we're talking about OIC and mouro semaglutide and tepati are Blockbuster drugs if you're a pharmaceutical company and you see that there's 15 to 20 other peptides which are really working and really working because again we've just seen the clinical response over and over and over it's not a large you know leap to think hey if we're a pharmaceutical company what if we turn that peptide which was available to the commoner for lack of a better term into a drug oh like VII that was done for melany stimulating hormone Pathways yeah and so I'm sure I think it's both you know I think um and that's why I go back to we have to operate within certain boundaries right like that's that's great we have to understand those boundaries it would be and I and I say this sincerely I I don't when we're talking about Healthcare and we're talking about People's Health I we're not even close to talking about the truth for most things right we we're not talking about why people get chronic disease we're not talking about how our food is really overprocessed and the availability of high quality nutrients and what that means we're not talking about all the toxicities we just look at Roundup glyphosate and its interference with so many Pathways in the body and people say you know and Monsanto and whoever runs that now saying it's so safe and it's just not true so I think it's in line with and what I support is unfortunately and fortunately as an individual you have to be your own best Advocate you can't rely on someone to say particularly the government that you have permission or not permission to do this you think it's best for people to do their own research you know seek out reliable information right start here I mean you guys vet so much stuff very safe place for people to be like this is where I want to start and then life is you you learn by exploring and seeing what works for you it's like you start with a recipe to cook right but some people like it saltier some people like it spicier you got to see what works best for you and that's why seek out other people people like myself other Physicians other people who have experience saying hey we'll help you guide you in this and that's where the magic happens but to be honest we're not being truthful on many levels when we talk about health we're just not we spend so much money for what we're not making a dent and chronic disease we're not making an impact we're not helping people lead Better Lives you know medicine is great for life and death things it really is you know I in 200 August of 2020 I had terrible abdominal pain I just come back from visiting our friends in Hawaii I kind of tried to treat myself unsuccessfully eventually it was on Labor Day I had so much pain the next day called my friend who was a radiologist said I need to do a CAT scan I did the CAT scan he called me on the way back to the office I had a blood clot in the vein going to my liver that had completely cut off I almost died like it was really serious it could be hospitalized I'm on blood thinners now I am forever grateful for Pharmaceutical save my life right but those same medicines aren't probably going to help me lead my best life right and there's it's it's challenging having been educated in a very formal conventional medical system which is dominated by the pharmaceutical industry is a problem right we go back to the flexner report which is like 1917 1915 or something where they studied medical education and basically said if you're a medical school and you're not promoting Pharmaceuticals and in line and we're going to kick out alternative remedies and modalities like Chiropractic and acupuncture and nutrition they don't count anymore and that's where we are the only thing that matters and we see it as a society we're deemed healthy by the pills we take right if we're going to be really honest those pills aren't making us healthy and by and large they're not even making us well anymore you know what I mean and so I think it's time and it's wonderful to have this form to be able to talk about like and this why I support so many other people talking about it like we need to make a change in that we need to start being honest about what we're doing our health is not going to be coming from doctors saying taking this pill or that potion it's not not at this stage and it's more likely that people are going to feel healthy from seeing their trainer in their gym right these why these things go to the gray Market or black market because people actually get results you know what I mean and it's just sad but true and so to answer your question I think it's both I think the pharmaceutical companies are greedy I think they like making money right I think they also like helping people right they want to help people um but it comes with a big cost and um the government's there to kind of Corral that but like most things the government does they go too far right and uh I think we need to be honest about those discussions and it's not threatening and it's not harmful just to be saying Hey how do we make this better and how do we even agree to disagree let's just start there I really appreciate your take I I too rely on prescription drugs now and again um I don't know maybe I'll lose some following for saying this but I I I've had some some situations where it made sense to like take an antibiotic like after a surgery or something or like I'm not I'm not like anti- antibiotics right I also don't take I don't also don't eat them like M&M's I also um believe that uh well everything you said I I generally agree with I don't have the clinical expertise or the Nuance to really understand these governing bodies that's one of the reasons why I'm asking today and really appreciate you uh shedding light on this I think um your clearly a truth teller you're telling us your truth from the clinical perspective but it's clear you also have a a broad uh broad Optics here um we appreciate that sure yeah this podcast has always been about bringing in diverse uh uh outlooks on the same things and um it's been wonderful today to be able to explore peptides NAD and and this issue of FDA approval and FDA removal as the case may be you said something earlier a couple of times that I'd like to uh finish up on um he talked about positive thoughts yeah you're a physician yeah uh not a psychologist no but you're a physician and you're in the business of making people feel better and it's clear to me that among your many talents you have great powers of observation so what is this thing about positive thoughts I mean there are a lot of neuroimmunological data out there showing that you know stress makes us sick if we stress too long for repeatedly for two for to Long stress in the short period is actually good for us right um there are some data showing that positive thoughts can enhance immune system function Etc the data are pretty cool um clinically however what's your observation about mindset and health I think we're just scratching the surface and I think it is the most profound way to affect your life right so there's a couple things I'll say about it one no good has ever come from a negative thought nothing ever good has come from a negative thought and because all of us have a choice about every decision we make to me it's always best to make a to slant that decision in a positive frame now it doesn't mean you're fake about it right people really suffer people really go I mean it is a very stressful time right now maybe the most stressful time in human history and there's no need to gloss over it and saying life is you know peaches and cream cuz it's not for a lot of people people but what I know just personally and professionally is that when you start pivoting towards positivity you get more positivity right and all of us every single human has that opportunity to do that that some people it's way harder choices they are dealt a much more challenging and difficult hand lots of people but if we think about it we didn't get to choose our eye color we didn't get to choose our family we didn't get to choose where we were born or how we were brought up but we do get to choose how we respond to those things and so what I've learned is the more I there's never enough positivity I can exude there's never enough positivity I can be around ever in my life it is just the most amazing thing and it can never be taken from you right and so when we talk about success and Longevity and health span to me positivity has to be a part of that because the mindset of positivity will override almost everything literally and and I can't tell you how that happens on a biochemical or physiological basis but I know it to be a truth I know it in the core of my being that the more positive I am the more I can influence other people's and plant seeds and help people be more positive and that is something that I cherish and just love and it's not talked about enough you know specially as a physician we're talking about the science and oh this study and you know putting people on this medicine but really the value and I made this decision back in 2010 cuz I had my own practice and I decided to stop taking insurance and it wasn't it wasn't a money thing it wasn't like oh it was because I was no longer valuable taking five to seven minutes with each person and seeing 40 patients a day and for me I felt like I'm not fulfilling my purpose here when I'm just writing prescriptions that my purpose will be fulfilled if I can really have conversations where I get to know people and peptides and NAD tie into that because they are gateways to build trust trust with me so that I can actually help you an individual learn how to be more positive and to slant yourself and have that posture because ultimately all of us need the energy and want the energy to find our purpose right and once you find that purpose oh my goodness life gets magical right because we're all unique we all have a different DNA structure God gave us that to be unique to shine our light to contribute to help others most people don't know about that cuz they're in pain or they're tired or whatever they're suffering and if we can help walk people through that and help them heal that that's going to get really good and that's that's just what I enjoy doing beautifully said and so grateful to you for doing that within your clinical practice for making that decision a few years back to shift over to being you know aligned with your purpose and and the way that you've now expanded your practice to public education will provide links to your practice and to your public education efforts and for coming here to do uh this uh significant public education effort about peptides and other compounds and um regulatory bodies and also just the field of medicine and also just you know I think so often we hear from scientists or from Physicians and and we forget the human component and what's what's so um what's so beautiful about what you do and the way you do it is that your Humanity really comes through oh I appreciate that it really does I can tell you really care and I know our listeners and viewers uh can tell as well so than you um as this field evolves and advances um please come back and talk to us again love to Meanwhile again we'll provide links so that people can find you and some of the resources uh that back up what we've discussed today and Craig Dr coner thank you ever so much well thank you Andrew no it's really I'm so honored to be here um I respect and love the work you're doing and the light you're shining and you're helping so many you have such a wide audience that you know trust you and it's amazing uh like I said I see it every day with people coming to me and and bouncing what you do and saying hey is this good for me and it's that is amazing I love that that's how we get better right we help support each other um and I just appreciate what you're doing and being here is a truly an honor really a big deal for me so thank you thank you I'll take that in and right back at you okay come back again I appreciate it I appreciate you thank you thank you for joining me for today's discussion with Dr Craig conver to learn more about his work and his Clinic as well as to find links to some of the things discussed in today's episode please see the show note captions and if you'd like to learn more about peptides including some of the ones that we discussed today but also some additional ones please see the link to the solo episode that I did about peptide Therapies in the captions if you're learning from and or enjoying this podcast please subscribe to our YouTube channel that's a terrific zeroc cost way to support us in addition please subscribe to the podcast on both Spotify and apple and on both Spotify and apple you can leave us up to a five-star review please check out the sponsors mentioned at the beginning and throughout today's episode that's the best way to support this podcast if you have questions for me or comments about the podcast or guests or topics that you'd like me to consider for the huberman Lab podcast please put those in the comment section on YouTube I do read all the comments for those of you that haven't heard I have a new book coming out it's my very first book it's entitled protocols an operating manual for the human body this is a book that I've been working on for more than 5 years and that's based on more than 30 years of research and experience and it covers protocols for everything from sleep to exercise to Stress Control protocols related to focus and motivation and of course I provide the scientific substantiation for the protocols that are included the book is now available by pre-sale protocols book.com there you can find links to various vendors you can pick the one that you like best again the book is called protocols an operating manual for the human body if you're not already following me on social media I am huberman lab on all social media platforms so that's Instagram X formerly known as Twitter threads Facebook and Linkedin and on all those platforms I discuss science and science related tools some of which overlaps with the content of the huberman Lab podcast but much of which is distinct from the content on the hubman Lab podcast again that's huberman lab on all social media channels if you haven't already subscribed to our neural network newsletter our neural network newsletter is a zeroc cost monthly newsletter that includes podcast summaries as well as protocols in the form of brief one to3 page PDFs those protocol PDFs are on things like neuroplasticity and learning optimizing dopamine improving your sleep deliberate cold exposure deliberate heat exposure we have a foundational Fitness protocol that describes a template 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