# Peptide Expert: What Do Peptides Actually Do? (EXPLAINED) - Dr Alex Tatem

https://www.youtube.com/watch?v=jt5hHb6kzYM

[00:00] This may be the most controversial thing we have on this table.
[00:03] This is peptide that actually tortures belly fat at a disproportionate rate.
[00:07] And what we found is not only do patients lose an incredible amount of weight, but they also get the best improvements we've ever seen in their liver health.
[00:15] It's absolutely wild, and I think this is going to be a trillion-dollar drug when it comes out.
[00:19] I have brought you here because you're an expert on this subject, and it's worth saying that there was some significant news about this.
[00:25] Correct.
[00:25] From the FDA saying that in July they are going to consider legalizing seven peptides.
[00:30] And by pharma's estimate, it might be the most dangerous thing to their entire business model.
[00:35] So, do you think it is plausible that big pharma didn't want these in the hands of regular people because they can't patent this and it's powerful?
[00:43] 110% because the question isn't what can peptides do, it's what can't they do.
[00:48] And we've got several peptides here in front of us.
[00:49] I don't want to go through all of them.
[00:51] Let's do it.
[00:52] So, this is probably the most well-known peptide for skin complexion, and it improves quality of hair and nails.
[00:59] And then epithalon is.
[01:01] Maybe, maybe not going to be the fountain of youth, but I'm very skeptical as far as that goes.
[01:05] Next, we've got this.
[01:07] And if you injected that at night, it would improve your quality of your sleep.
[01:10] Next, melanotan two.
[01:12] And this will actually end up giving you a deep tan in response to just a little bit of UV sun exposure.
[01:16] It'll also give you some of the most impressive erections you've ever had in your life, so be warned.
[01:20] And what else have we got?
[01:22] Oh my gosh.
[01:23] There's methylene blue where people take it and they think it's going to make them live forever.
[01:25] Don't take this.
[01:26] It literally will stain your nails blue and your hair blue.
[01:28] These two here stimulates building muscle.
[01:30] This one can aid with healing after an injury.
[01:32] And then is this.
[01:33] This.
[01:34] This.
[01:34] This.
[01:35] It's crazy.
[01:36] It's wild.
[01:36] So, why don't I take it?
[01:38] Well, we need to talk about that because there are trade-offs.
[01:39] But also outside of the world of peptides for a second, I've got these three vials.
[01:42] Do you know what those are?
[01:45] Yeah, this is unfortunately our future if we're not careful.
[01:48] Explain.
[01:50] So, what we've got here is representing the fertility trajectory for young men.
[01:55] I'm so scared.
[01:58] This is super to me.
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[02:49] [music]
[02:55] Dr. Alex Tatem.
[02:59] There's this word that has exploded in society in recent times.
[03:01] In fact, when I look at the data,
[03:04] People searching this word has increased by 400% just recently, and that word is peptides.
[03:12] I have no idea what peptides are.
[03:15] I'm someone that wants to be healthy, that wants to optimize my health, wants to live long, doesn't love aging.
[03:22] Yeah.
[03:23] And I'm told that this word peptides is somewhat linked to it.
[03:25] So, I've brought you here because you're an expert on the subject, man.
[03:28] I've watched your videos on YouTube.
[03:31] To start at the very beginning, Dr. Alex, what the hell is a peptide?
[03:35] Peptides are a structural class of medications.
[03:38] The best way to think about peptides is that just like we have small molecules which are drugs that are very small, taken in a pill, and have a wide-ranging effect throughout the body.
[03:50] Peptides are derived from little pieces of amino acids, which think of them as the Legos that make up the human body, the Legos that make up proteins.
[04:00] These are fragments of proteins that are designed to specifically target certain.
[04:05] Receptors and affect cells in a very targeted fashion.
[04:08] Or a best way to think about it is a very specific targeted key to unlock a very specific lock.
[04:16] So, instead of a small molecule that may have a wide-ranging effect throughout the body, peptides are much, much more focused.
[04:21] So, you've got different types of Lego cubes here.
[04:24] Would they be different types of peptides or are they different types of amino acids that come together to make a peptide?
[04:32] The best way to think about it is my son loves Legos, which is why I'm glad that we have these here.
[04:36] But, he can take the same set of Legos and he can build a rocket ship.
[04:41] And then, just a few minutes later, he can build a pirate ship.
[04:46] And then, he builds a race car.
[04:48] He's using the same Legos, but he's creating very, very different things that all do very, different things.
[04:54] And so, peptides have become incredibly popular because, yes, we have some really fascinating peptides that can help with anti-aging, with healing, and with tissue repair.
[05:02] We're going to talk about some of those, hopefully.
[05:03] But, they can do so much more than that.
[05:05] The
[05:06] First peptide that was actually isolated and used in medicine was insulin back in 1921.
[05:12] And then, all the way in 1985, in the world of urology, which is where I was trained, we had Lupron, which is a different peptide that, again, also a peptide like insulin, but instead of having wide-ranging metabolic effects, it had an endocrine effect.
[05:26] It was designed to shut down the production of testosterone for prostate cancer patients that needed to have their testosterone taken away.
[05:33] Interesting.
[05:34] Okay, so insulin's a peptide.
[05:36] Insulin's a peptide because it's a series of amino acids.
[05:39] Amino acids that are put together.
[05:41] Okay, so you said that the combination of amino acids forms a key.
[05:44] So, what is the lock?
[05:45] The lock could be a cellular receptor.
[05:48] It could actually be regulating a certain pathway within the cell.
[05:53] Okay, so let me repeat this back to you to make sure I understand it.
[05:54] So, yes.
[05:56] Yes.
[05:56] Peptides are like a key, which you can make by configuring amino acids in a certain way, and there's different locks in our body that these keys can go.
[06:07] Into.
[06:09] So, if I take, you know, we've got some peptides on the table in front of us here.
[06:11] So, a good way to think about it is this.
[06:13] If you've got a hammer, right?
[06:17] Which is what a lot of small molecules are.
[06:19] Like you can do a lot with that, right?
[06:20] Like you could hammer in a nail.
[06:23] But if you try to use that hammer when you're trying to put in a screw, or you're trying to put together, you know, a table that you got from IKEA, it may not always end the way that you want to.
[06:33] And that's the problem that we have with a lot of small molecules.
[06:34] It's not that they don't do what we want them to.
[06:36] They do a lot of other things while they're at that job that can have significant negative side effects, which is why a lot of these small molecules actually don't make it all the way through the FDA approval process, because we find something, it does what we want it to but has significant safety concerns down the line.
[06:53] All right?
[06:55] Now, what we see with peptides, for example, I've got in my hand right now a little vial labeled, you know, BPC 157.
[07:00] This is probably one of the most popular peptides that we're talking about right now, because BPC 157.
[07:07] Is a synthetic version of a naturally found peptide in the gut.
[07:13] But what this actually does is it enhances blood vessel growth in areas of injury.
[07:19] And it kind of makes sense, because if you think about it, our gut, our stomach, is really just this bag of acid that sits inside of our abdomen, and yet somehow you and I are here talking to each other and our bodies aren't eating themselves.
[07:32] Well, how does that work?
[07:34] Well, it's because we've developed a lot of really robust systems to encourage healing of the gastric lining.
[07:39] And so the idea is like, well, if this is one of the compounds that can help do that, it's been proven in multiple animal models.
[07:45] For example, they have completely transected the Achilles tendon in rats and then they transected transected so they've cut across the Achilles tendon.
[07:53] So not just a small injury that you or I might experience in the gym where we pull it or strain it, but actually surgically cut the Achilles tendon.
[08:01] And then they administer it to rats and they are healing spontaneously with administration of BPC 157.
[08:05] If you have
[08:09] An Achilles tendon injury and you're a rat, BPC 157 is one of the best things that you can ever have.
[08:13] Now, that is not a one-to-one translation to what we might see in humans, but as we talked about earlier with our point on safety, when they are studying BPC 157, we try to look for something called the LD1 or the LD50.
[08:26] How much can I give this to someone until 50% of the population that receives that dose doesn't do well or dies, okay?
[08:32] That's called the LD50 dose.
[08:36] We have yet to figure out what the LD1 dose is for this, which is the amount that it would take to hurt even 1% of the population because it is so incredibly well tolerated.
[08:45] So, just giving you an example of this is a compound that can have profound healing effects, at least in our animal models that we've seen so far, but so far we haven't seen any precipitous negative effects in human patients when taking this, okay?
[09:02] But we need more data.
[09:05] I am mind-blown and I'm very, very excited.
[09:07] We've got all of the several.
[09:09] Peptides here in front of us.
[09:10] I want to go through all of that and understand which ones do which things.
[09:13] Sure.
[09:13] But there's a bigger question here.
[09:14] Yes.
[09:14] Which is, why now?
[09:14] Why have the subject of peptides suddenly exploded into society's consciousness?
[09:20] What's going on?
[09:23] What's the big picture?
[09:23] So, this is really interesting.
[09:25] In 2013, there was actually a court case in the United States.
[09:29] It was called Myriad Genetics case.
[09:32] This was the company that actually patented the BRCA1 and BRCA2 genes.
[09:36] They discovered the genes that cause breast cancer, all right?
[09:39] This was mind-blowing.
[09:41] They identified the specific genes that would predispose patients to developing both breast, ovarian, and since we've learned also prostate cancer.
[09:47] It was a fantastic discovery, but they patented it.
[09:49] And they said, "We now own this intellectual property."
[09:53] And then everyone else said, "No, no, no, that's the human body."
[09:56] You can't patent that.
[09:58] And the Supreme Court actually sided with that argument, saying that if something is natural, it's found within us, okay?
[10:04] I can't patent, you know, your muscle cells, right?
[10:05] Which is a wonderful thing.
[10:07] But the unintended unintentional.
[10:09] Byproduct of that is all of a sudden pharma had no incentive whatsoever to pursue really promising compounds that they could not monetize.
[10:20] So, that happens in 2013.
[10:22] At the same time, I believe it was around 2012, 2013, there was a terrible event that happened in New England where there was a compounding pharmacy that was not doing the right thing, and they ended up having a bunch of contaminated specimens that caused a fungal meningitis.
[10:38] Bunch of patients got really sick.
[10:40] It was a huge scandal.
[10:42] And all of a sudden the FDA stepped in and said, "Hey, historically, all right, states have been allowed to regulate compounding pharmacies themselves, but we need some federal oversight here cuz this is not acceptable."
[10:52] Completely agree with that.
[10:53] And they introduced a new set of regulations on top of compounding pharmacies, basically saying what you can and cannot make.
[11:01] And what they eventually said is, "Well, the only you can only make three things."
[11:05] You can make things that are in the USP uh United States Pharmacopoeia, okay?
[11:10] Things that have been, you know, well described, already published, things that are already in drugs that are already on the market.
[11:15] Or three, things that are on a very specific list that we're going to give you, okay?
[11:21] And in that list, they actually included a lot of these very promising compounds that were stuck in drug development, you know, limbo.
[11:28] And you say compounding pharmacies.
[11:31] You said that a few times.
[11:32] What is a compounding pharmacy?
[11:34] Just just so I'm clear on the definition.
[11:35] Back in the 1800s or you know early 1900s, if you ever needed a medication, you'd go see the pharmacist who had a shop down the road and he would actually make your medication in front of you.
[11:43] And he would do that custom for every single patient that came by, all right?
[11:46] It was only since the advent of modern factories that we had the modern pharmaceutical industry come about.
[11:51] But the truth is is that again, you know, that's kind of paint by numbers.
[11:53] You're creating this one pill and you know, it always seemed kind of crazy that the adult dose is one standardized dose for all adults.
[12:01] Like if you look at what your body composition is versus some of my patients, why is the dose in your blood pressure medicine the exact same?
[12:08] Like that doesn't seem to be quite right, but it is what it is.
[12:09] So when
[12:12] Patients fall outside of that and they need custom medication, we still have those people who make custom formulations of medications.
[12:20] But instead of it being just your local pharmacist who's using a mortar and pestle and you know, he's creating something in his back office, these are now large sophisticated industrial operations that can make custom formulations for patients.
[12:29] I think I think the important context Yeah.
[12:31] For people that don't understand how drug development occurs is that to get chemicals like the ones we have in front of us on the table through FDA approval, you've got to spend millions and millions and millions of dollars.
[12:42] Tens if not hundreds of millions of dollars.
[12:43] Sometimes hundreds of millions of dollars.
[12:44] Yeah, an incredible amount of money.
[12:45] And And if you know you can't protect it once you spend a hundred million dollars, you have no incentive to just do charity work.
[12:52] Absolutely not, okay?
[12:54] Because you have shareholders and you have to make payroll.
[12:56] And so because drug development is so expensive, there's no incentive for commercial pharmaceutical companies to pursue the development of these compounds.
[13:05] And then on the other side of that, well we have compounding pharmacies that you know, for them it makes sense.
[13:11] What if we could just make?
[13:13] These compounds and then sell them directly to patients?
[13:14] We make a small margin when we sell it.
[13:15] This makes sense for us.
[13:16] Well, they could do that starting in about 2014 whenever that legislation finished, all right?
[13:20] What did it do?
[13:22] Essentially what it did is it gave a it gave a assignment to each one of these compounds.
[13:28] It was either going to be category one, which is you can compound this.
[13:33] This is on our specific list of approved compoundable drug ingredients.
[13:38] Number two was, "Hey, we see some negative safety signals here."
[13:40] You cannot make this, okay?
[13:41] Something goes in category two, it's forbidden.
[13:44] And then we have category three, which is we just need more information.
[13:46] And all of these original compounds, these peptides that we're so interested in now, were originally on that first list, category one, all right?
[13:53] And so, they were able to be compounded.
[13:56] We could prescribe them patients.
[13:58] I prescribe them to patients, all right?
[13:59] From 2014 onward.
[14:03] But then in 2023, the FDA at that time switched all of those peptides, 19 of them that were popular, to category two, and then they were banned.
[14:12] Overnight, we got.
[14:13] Notifications in our email inboxes from our compounding pharmacy partners saying, "Hey, we can't make this anymore."
[14:18] We're sorry.
[14:18] So, I've got two questions there.
[14:20] Um, the first is when you were prescribing these peptides to your patient, were you seeing incredible results?
[14:26] Yes.
[14:29] Very much so.
[14:29] Very much.
[14:30] Again, you have to use the right key for the right lock, okay?
[14:34] But I think a really good example, all right?
[14:38] So, there is a compound that is not technically a peptide.
[14:42] It is a small molecule, but it was lumped in with all of these and was the victim to the same process.
[14:47] Uh, something called MK-677, also known as ibutamoren.
[14:50] So, this is a small molecule, but when a patient takes it, it's orally available.
[14:54] It binds to this receptor called ghrelin, and it actually stimulates the release of significant growth hormone.
[15:01] But what was really interesting is that it would actually stimulate hunger a profound amount.
[15:05] And all of a sudden, patients that were struggling with cachexia, okay?
[15:09] So, being very, very thin, very malnourished, maybe they're going through cancer treatment.
[15:13] Ghrelin's the thing that makes us feel.
[15:14] Hungry.
[15:15] Absolutely.
[15:15] Yeah.
[15:15] Yeah.
[15:16] So, they were able to stimulate the hunger response, and patients were actually able to eat more to meet caloric goals.
[15:22] And so, this was a medication that was fantastically effective at that.
[15:27] Again, it had gone through some clinical trials, but was never taken all the way to commercial.
[15:32] And so, it was never going to be available from CVS or Walgreens, but you could get it from a compounding pharmacy.
[15:38] And so, that was one that made a big difference for us.
[15:41] We also had other peptides.
[15:42] So, GHRP-2 and GHRP-6 were some of the ones we were using at that time.
[15:47] Those are growth hormone-releasing peptides that stimulate the release of your body's natural growth hormone, which can help with tissue repair, can also help with fat loss, and with building muscle.
[15:58] We also had BPC-157, and we had derivatives like thymosin beta-4.
[16:03] These are also compounds that can help stimulate angiogenesis, so making new blood vessels, all right, and tissue repair.
[16:10] So, if we have a patient that's injured themselves, maybe we could help them get back at life faster.
[16:15] These were all.
[16:16] Things that were used very commonplace for many years, and truthfully, they weren't super popular at the time.
[16:22] We were just using them, and then they were banned overnight.
[16:23] And they were working.
[16:27] And they were working, [clears throat] and we were not seeing adverse events, which is the most important thing.
[16:30] What's an adverse event?
[16:32] An adverse event is a patient has a terrible side effect.
[16:34] They call you, they have an allergic reaction to something.
[16:37] They call, they've got shortness of breath, and it's a direct result of the medication that you gave them.
[16:41] It was working.
[16:42] It was working, and by all accounts, seemed to be incredibly safe.
[16:45] And then they banned it.
[16:47] Why?
[16:47] That's a great question.
[16:48] So, officially, what happened is there was a meeting where they brought together the experts at the time, and they said, "There is insufficient data for us to say that these are safe."
[16:58] Because again, they had not gone through the full FDA approval process.
[17:01] And so, as a result of lacking that data, we're going to say that they're too dangerous.
[17:06] Now, there wasn't any evidence of any of that in the population.
[17:09] These were widely used at the time.
[17:10] Potentially, we had commercial pharmaceutical companies saying, "Well, hey, this is people spending money on a
[17:18] Compound, on something that isn't coming to us.
[17:20] So, hey, like we love medicine, but maybe only when it's our medicine.
[17:25] Mhm.
[17:25] And so, there's concern that that was at at play as well.
[17:29] And so, there is not a great paper trail, and there's not a great explanation why.
[17:32] And that's something that's been iterated by our current administration, from RFK himself.
[17:36] You know, he himself has characterized that move done in 2023 as being illegal.
[17:40] With everything you know about the medical industry, do you think it is plausible that big farmer 110% didn't want 110% these in the hands of regular people, because they can't patent this, and it's powerful.
[17:54] So, ultimately, the way to think about it is this.
[17:59] Um pharma may not have a compound that directly competes for BPC-157.
[18:07] BPC-157.
[18:07] So, this is the medication or the peptide that can aid with healing after an injury, okay?
[18:13] So, it's not necessarily there's direct competition, but at the end of the day, your average.
[18:19] A patient going throughout their daily life only has so much money that they can spend on medicine.
[18:24] Mhm.
[18:25] [clears throat]
[18:26] $10, $15, however much money that goes to this doesn't go to a prescription drug from a commercial pharmaceutical company.
[18:33] And so, there is real concern that potentially that was at play during that decision.
[18:37] You said 110%.
[18:38] Yeah, I well, you know, it's interesting because you know, I try to walk a very fine line between what I can prove versus what I suspect after being in this space for a long time.
[18:50] And, [clears throat] you know, ultimately, you know, I don't think it's accurate to characterize pharmaceutical companies or really any other entity as being, you know, evil or or bad.
[19:02] The truth is maybe a little bit more ominous.
[19:04] The truth is that they are these large machines that are designed to prioritize profit over everything.
[19:10] Yeah.
[19:11] And that's everything.
[19:12] I think this is one of the really interesting observations I've had the higher I've gone in my career is that often times here we heard about the Illuminati like when I was growing up I was like oh.
[19:20] There's this Illuminati.
[19:21] Yeah.
[19:21] And you think of it as these like shadow hooded people that get together and decide evil things, but at the further I've gone in business, the more I've realized that the Illuminati or these evil forces are actually just machines that were designed to optimize for profit.
[19:32] Correct.
[19:32] Correct.
[19:32] So like corporations are the Illuminati.
[19:35] Yeah, and so I don't actually think that there is necessarily you know a group of maniacal individuals, you know the Legion of Doom, you know plotting to like take away your health.
[19:45] But at the same time, I think that there are these large organizations that really couldn't care less about your health.
[19:50] You know, they are prioritizing what's important for them and regular people just get caught up in the mix.
[19:56] And what's challenging is that as a physician, you know, I took a Hippocratic oath.
[20:00] You know, I care about my patients and so those are the people that are in front of me every single day that are seeking to improve their lives to recover from injury.
[20:06] I have, you know, fertility patients that are just dying to start their family and I have patients that are suffering from hormonal imbalances that haven't felt right in years.
[20:15] I treat erectile dysfunction in men that have been struggling for years after prostate cancer treatment.
[20:19] I mean, these are.
[20:20] people that are broken and hurting. You
[20:22] want to be able to help them and so I
[20:24] feel that as a very strong personal
[20:26] calling that I have to be the advocate
[20:28] for that patient both in the room
[20:30] whenever I'm treating them and taking
[20:31] care of them but also when I'm talking
[20:33] to others and I'm you know speaking out
[20:35] about these issues. Like I want access
[20:37] to these medications because I care
[20:39] about the patients who benefit from
[20:40] them.
[20:42] Sweden banned these peptides that we
[20:44] have here. Correct.
[20:45] And we're sat here two years after the
[20:46] ban I believe roughly two years after
[20:48] that ban.
[20:48] Yeah. And suddenly everybody's talking
[20:50] about peptides again. Yes. Why? What's
[20:52] going on? So I think what we're seeing
[20:54] is the forbidden fruit effect because
[20:57] this was banned and all of a sudden oh
[20:59] well why'd they ban it? Well they
[21:00] wouldn't have banned it if it weren't
[21:01] working right and we're also seeing the
[21:03] effect of TikTok and short form content
[21:05] being spread very rapidly very virally
[21:08] and that's been going on for 2 years
[21:09] now, combined with new emphasis from
[21:13] administration leadership and HHS and
[21:15] then RFK. What is the most incredible
[21:18] impact that you've seen peptides create
[21:21] in a patient? Oh my gosh, I have a best
[21:23] story for you. So, one of the most
[21:26] frustrating things about my practice is
[21:29] treating infertility in young men that
[21:32] have significant metabolic dysfunction.
[21:34] These are young men that have a low
[21:37] sperm count, right? So, they can't get
[21:38] pregnant because they just don't have
[21:40] the numbers to make it happen. And
[21:42] you're looking at them and they're
[21:43] morbidly obese, okay? They have high
[21:45] insulin resistance, all right? And their
[21:48] endocrine system has been damaged by
[21:49] that obesity. So, they don't have have
[21:51] low testosterone levels and their brain
[21:53] is not making enough of the signals to
[21:55] stimulate their testicles. Now, we have
[21:57] medications that we can use to help
[21:59] stimulate that to make more of that
[22:01] signal stimulate the testicles, right?
[22:03] But, really what is eating at them, what
[22:06] is causing this, is not that chemical
[22:08] imbalance. That's the the symptom.
[22:09] That's not the the problem, okay? And
[22:11] treating symptoms doesn't really get you
[22:12] very far. And so, I would have patients
[22:14] that I would take care of and we would
[22:16] never see a significant improvement in
[22:17] their numbers because losing weight is
[22:18] really, really hard, you know,
[22:20] regardless of all of the education and
[22:21] resources I try to give them. But, now
[22:23] we have peptides in the form of GLP-1
[22:26] drugs like semaglutide and tirzepatide.
[22:29] And I just saw a patient last last week
[22:31] who increased his sperm count 10 times
[22:34] over and is now in a normal range
[22:37] because he's lost 100 lb due to using
[22:40] tirzepatide, exercising, and improving
[22:43] his diet. And he has totally changed his
[22:45] life.
[22:46] And that started with a peptide. Started
[22:47] with a peptide.
[22:48] So, I we've got lots of peptides on the
[22:50] table in front of you. We will go to the
[22:51] into them individually, but just can you
[22:53] give me a a high-level view of the types
[22:56] of areas in our health and life that
[22:58] these peptides can help with? So, So,
[23:00] talked there about infertility Correct.
[23:02] as a downstream consequence of the like
[23:03] weight loss and fixing the metabolic
[23:05] health. What are What other parts of the
[23:07] body the peptides touch? The best way to
[23:09] think about it is like this. So,
[23:11] peptides are almost like an app on your
[23:14] phone. So, imagine before we had apps.
[23:18] I'm old enough to remember trying to log
[23:19] on and do my banking online before we
[23:21] had apps and gosh, it was so painful,
[23:23] right? Like there were ways to
[23:24] accomplish things, but they were very
[23:25] inconvenient and a roundabout way. And
[23:27] now all of a sudden we have these apps
[23:29] on our phone that can do just about
[23:31] anything except fold your laundry,
[23:32] right? You know, there's some limits to
[23:33] it, but I mean really the sky's the
[23:35] limit from an electronic standpoint. And
[23:37] really that's what peptides are. So, the
[23:39] thing is is that we have peptides that
[23:42] can help you lose weight like the GLP-1
[23:43] drugs. We have peptides that can improve
[23:47] skin quality like GHK-Cu.
[23:50] We have peptides that can help heal your
[23:52] gut like BPC-157, particularly effective
[23:55] in ulcerative colitis, which is
[23:57] something that's being investigated with
[23:58] the FDA's planned upcoming meeting on
[24:00] it. We also have peptides that can help
[24:03] with sleep and with recovering the gland
[24:06] in your brain that's responsible for
[24:07] melatonin and regulating your sleep-wake
[24:09] cycles. So, the question isn't, you
[24:11] know, what can peptides do? It's kind
[24:12] of, well, what can't they do? And if
[24:14] they can't do that yet, can we develop a
[24:16] peptide that can accomplish that task?
[24:19] And the answer is probably and
[24:21] simultaneously while there may be
[24:22] resistance from pharmaceutical industry
[24:24] in these peptides, the ones that were
[24:26] most interested right now, they have
[24:28] signed multi-billion dollar deals with
[24:31] other pharmaceutical companies that are
[24:33] involved in peptide development aided by
[24:35] AI to try and fast-track their own
[24:38] peptide products. Interesting.
[24:40] And so, we are going to see
[24:42] exponentially more of these products
[24:43] come down the pipeline from
[24:45] pharmaceutical companies in the form of
[24:47] commercial products. And it's worth
[24:48] saying that there was some significant
[24:50] news today. Correct. What happened
[24:52] today, but also what's going on? And
[24:53] just for anyone that doesn't know, it's
[24:54] April the 15th. Yes. So, today
[24:58] we got a really press release from the
[25:01] FDA saying that in July they are going
[25:03] to consider seven peptides for removing
[25:07] from category two back to category one.
[25:09] Legalizing them. Legalizing them, okay?
[25:12] And some of the heavy hitters from that
[25:15] list include BPC 157. Which is the one
[25:19] we talked about to do with like repair
[25:21] and injury. Absolutely, okay? And then
[25:23] we have
[25:24] the brother to that which is TB 500,
[25:27] this vial over here. This improves blood
[25:29] flow to an injured area. You could think
[25:31] of this as sending the soldiers, as
[25:34] sending the cells that are required for
[25:36] rebuilding that tissue matrix that was
[25:38] damaged by a tear or a cut, all right?
[25:40] On top of that, we're also getting
[25:43] something called KPV. May not have it
[25:45] here, but that is another
[25:48] peptide that has been linked to
[25:50] angiogenesis and tissue repair. We're
[25:52] also getting MOTS-c and you know, some
[25:54] people just will call it exercise in a
[25:56] vial. It improves your VO2 max and your
[25:58] exercise tolerance and by up regulating
[26:02] the energy pathway, basically making
[26:03] more ATP, the energy that we all use to
[26:05] move, it makes more of that available,
[26:07] all right? We're also going to get DSIP,
[26:10] epithalon, and C-max which are all
[26:13] peptides that affect cognitive function.
[26:15] So, improving thinking, like C-max is a
[26:18] great option for that. And then DSIP and
[26:20] epithalon both have roles in regulating
[26:23] sleep and recovery.
[26:25] Wow. Yeah, [clears throat] pretty wild.
[26:28] And I've got to say, how does So, some
[26:30] of them are becoming legalized, but even
[26:32] the ones that aren't legal right now, a
[26:33] lot of people are taking them anyway.
[26:34] Correct. So, my my question is, how are
[26:37] people getting them? Listen, I don't
[26:38] want to promote illegal drugs here. This
[26:40] is not that kind of But, I just
[26:42] want to know what's going on. No, this
[26:43] is Well, this is important to talk
[26:44] about, right? Cuz we have to understand
[26:46] like what's going on in the marketplace.
[26:47] The moment that these drugs were banned
[26:50] or these medications were banned in
[26:51] 2023, It's kind of like the United
[26:53] States experimented banning alcohol. It
[26:55] didn't go very well, right? All of a
[26:56] sudden, you know, they you know, the mob
[26:59] came around and we started, you know,
[27:01] seeing unregulated
[27:03] uh saloons and unregulated alcohol
[27:05] production and it was contaminated with
[27:07] all the stuff that you didn't want. And
[27:08] so like people were trafficking. Yeah,
[27:09] exactly. It's just it's not a good idea,
[27:11] right? And so what happened is we banned
[27:14] these and the gray market stepped in.
[27:16] And so these are companies that will
[27:18] sell peptides that have on the label for
[27:20] research use only, all right? And the
[27:22] idea is that that takes them out of the
[27:24] FDA's jurisdiction because they're not
[27:26] selling it for people to inject into
[27:27] themselves out of the FDA's hands. I'm
[27:29] just creating a vial of this magical
[27:32] juice that you can use for your rat,
[27:34] okay? That's the idea. We all know
[27:36] that's not what's really happening. But
[27:38] because there isn't any quality control,
[27:41] it's kind of like getting gas station
[27:42] sushi. Like yeah, you can do it, but you
[27:44] don't really know if it's sushi and it
[27:46] may not end very well for you. And so
[27:48] again, not saying that there aren't some
[27:50] people who have gotten good results with
[27:52] research use only peptides, but again,
[27:55] it's not standardized, which is why I
[27:57] think moving this back into the 503A
[27:59] compounding world is the best thing for
[28:01] everyone. Which is the legal
[28:02] framework. Okay, so how does one take a
[28:04] peptide? That's a great question. So
[28:07] what's interesting is that as we
[28:08] mentioned, you know, peptides are just
[28:10] made up of building blocks of amino
[28:11] acids. And you know, if you were to go
[28:13] make yourself a protein shake, you know,
[28:15] what is that going to look like from a
[28:16] Lego standpoint? It just looks like
[28:18] this, a handful of Legos in your hand,
[28:20] right? All sort of like ground up. All
[28:21] ground up in individual pieces, right?
[28:23] But the thing is is that your gut is
[28:25] designed to break up any sort of protein
[28:28] that you ingest orally into these little
[28:30] pieces. And so if you were to say, I
[28:33] don't know, drink some of, you know,
[28:35] this TB-500, your body wouldn't be able
[28:38] to tell the difference between that and
[28:39] a piece of chicken cuz it would it would
[28:40] break it all apart. It'd break it all
[28:41] apart. Now, there are some very
[28:43] unique exceptions to that. There's a
[28:45] form of BPC-157 that actually is
[28:47] tolerated in the gut, but by and large
[28:49] the overwhelming majority of these have
[28:51] to be injected either subcutaneously or
[28:53] into the muscle, and that's usually a
[28:55] preference. Subcutaneous being my belly.
[28:57] Under Just underneath the skin. You
[28:58] know, as I tell patients, just pinch an
[29:00] inch, inject under the skin. We do that
[29:01] for a lot of other medications as well.
[29:03] Isn't that what this is? Yeah, so this
[29:05] is a prescription Mounjaro pen. So,
[29:07] Mounjaro is the brand name for
[29:09] tirzepatide, all right? Tirzepatide
[29:11] being the leading GLP-1 product right
[29:14] now from Lilly. So, this produces more
[29:17] weight loss per milligram than any other
[29:20] product that we've got out right now. Is
[29:22] this the mechanism in which people
[29:23] inject peptides? No, a little bit
[29:25] different. So, this is an auto-injector
[29:28] pen. And so, what you do is you're able
[29:29] to actually ratchet the dose there on
[29:31] the right side, and then you pinch an
[29:33] inch in your skin, and then push it up
[29:34] against and it'll auto-deploy. And so,
[29:36] there's nothing that you need to do. You
[29:37] don't have to learn how to drop
[29:38] medication and inject. Whenever you're
[29:40] administering peptides at home,
[29:43] especially for patients that have
[29:44] obtained them from research use only
[29:45] markets, they usually come in just
[29:47] little vials that need to be drawn up
[29:49] with a needle, okay? Now, the benefit of
[29:52] that is that you can do custom dosing,
[29:54] all right? But, the drawback is is that,
[29:56] well, you have to know how to calculate
[29:57] that and put it together. This may be
[30:00] the most controversial thing we have on
[30:02] this table. And by Pharma's estimate, it
[30:05] might be the most dangerous thing to
[30:07] their entire business model. Because
[30:09] this is tirzepatide, the exact same
[30:12] thing that you had in that pen. But,
[30:13] this is made by a high-quality 503A
[30:16] compounding pharmacy. And the reason why
[30:19] this is uh so controversial right now is
[30:23] because it offers an incredible amount
[30:24] of flexibility because what you have in
[30:26] your hand there is very standardized,
[30:28] and you administer it once a week cuz
[30:30] that's what's approved by interest.
[30:31] This is like the Ozempic thing
[30:32] everyone's been talking about.
[30:32] Exactly, right? But, think of that as
[30:35] paint by numbers, okay? You are This co-
[30:38] This section is this color, this section
[30:40] is that color, all right? Think of this
[30:42] as the thing you've got in your hand
[30:44] right now. Yeah, exactly. Just a vial of
[30:46] tirzepatide as being a having infinite
[30:49] permutations and dosing ability because
[30:51] you can draw this up with a small
[30:53] syringe and do microdosing. So, instead
[30:55] of one large dose once a week because
[30:57] what many patients will experience is
[30:58] they'll have a return of their hunger by
[31:00] the end of the week and they end up
[31:02] losing ground, you can actually, instead
[31:04] of doing a full dose once a week, you
[31:06] could do multiple mini doses throughout
[31:08] the week with this formulation and with
[31:10] this presentation of the medication. All
[31:12] right? But, the challenge is is that
[31:14] that is the benefit that allows us to be
[31:16] compounded by compounding pharmacies
[31:17] because they are able to provide
[31:20] something that is similar to what's in
[31:22] your hand, all right, but it offers more
[31:23] flexibility that may be the right choice
[31:26] for some patients. So, personal is
[31:28] personalization of medicine, okay? But,
[31:30] the challenge is is that if you spend
[31:33] however much money on this, you're not
[31:34] giving it to Lilly. And so, as a result,
[31:37] we have seen an unprecedented crackdown
[31:39] in the United States from the FDA in
[31:42] trying to shut down compounding
[31:43] pharmacies and prevent them from making
[31:46] these medications even though that
[31:48] ability to customize, the fact that this
[31:51] is not an exact copy of what's in your
[31:53] hand right now, should protect it under
[31:55] current legislation. But, there is now
[31:58] enough pressure from the powers that be
[32:00] and from lobbyists from both Lilly and
[32:03] Novo Nordisk that, which are the two
[32:05] companies that make the GLP-1
[32:06] medications, that we're seeing Marty
[32:09] Makary, the FDA commissioner, has now
[32:12] tweeted more about cracking down on
[32:14] compounded GLP-1 medications than he's
[32:16] tweeted about diabetes or heart disease
[32:18] in his entire time in office. And just
[32:20] so I understand, I want to play this
[32:21] back to you to make sure I understand.
[32:23] Sure.
[32:24] In my hand here, I have
[32:27] tirzepatide on my left.
[32:29] And this is made by Lilly, which is a
[32:30] corporate company who's patented it so
[32:32] they can make lots of money from it.
[32:34] Correct. In In right hand, I have
[32:37] tirzepatide.
[32:38] Tirzepatide with niacinamide. With
[32:40] niacinamide.
[32:41] Yep. And this is not patentable. So,
[32:44] Lilly has a patent on the tirzepatide
[32:47] molecule in that formulation in your
[32:49] hand. Okay?
[32:50] [clears throat]
[32:50] And if anyone violates a patent, that
[32:54] can be pursued in US court. Yep. Patent
[32:57] law, right? But what's interesting is
[32:59] that Lilly and Novo Nordisk know that
[33:03] that's different in your right hand. It
[33:04] doesn't look the same. You can dose it
[33:06] differently.
[33:07] And they know that if they were going to
[33:09] fight that in court, it would cost a lot
[33:11] of money and take a lot of time. So, you
[33:13] know what's a lot easier? Calling your
[33:14] friend at the FDA and getting him to
[33:16] step on the competition so you don't
[33:17] have to. And then who's paying for that
[33:20] enforcement? It's not the lawyers that
[33:23] the pharma company is paying for.
[33:25] Uh it's the taxpayer paying for the FDA
[33:27] through taxes. And you seem to imply
[33:29] that this was actually better because
[33:31] you could take it in a more flexible
[33:32] dose. You could take a little bit, a
[33:33] lot. You can take it when you want,
[33:35] whereas this is kind of once a once a
[33:36] week. Well, I mean, you know, what is
[33:38] better, right? So, I like this option
[33:41] for many of my patients because it's
[33:42] flexible. All right? So, that is
[33:44] something that works for most patients.
[33:46] All right? But then then again, this
[33:47] works great for patients, too. Okay. But
[33:49] what you want is you want an ecosystem
[33:51] where you have choice so you can make
[33:53] the right choice for the right patient.
[33:55] For a lot of patients, they're going to
[33:56] do exceedingly well on this and there's
[33:58] so much data to support that. But I also
[34:01] have a lot of patients who get really
[34:02] ill after they do a large dose of
[34:05] Mounjaro or of GLP-1 men. And if we take
[34:08] that same dose and we just cut it into
[34:10] multiple doses within a week, we can
[34:11] avoid those side effects.
[34:13] So, you've told me that these peptides
[34:15] we have on the table in front of us can
[34:16] improve your skin, weight loss, muscle,
[34:19] energy, chronic illnesses. You talked
[34:21] about the cognitive upsides.
[34:23] And you talk about it very passionately.
[34:25] Yeah.
[34:25] So, one should ask you presumably you're
[34:28] taking some peptides. I am. Yeah. So,
[34:31] do you take? So, I will tell you that as
[34:33] of right now, the only peptide I'm
[34:35] taking is a small dose of tirzepatide,
[34:38] all right? Which is the one we were just
[34:38] talking about.
[34:39] Yeah. Because uh back uh couple of
[34:42] couple of months ago, I was probably
[34:44] close to about 240 or so, and I was into
[34:47] powerlifting, you know, I still am. But,
[34:49] you know, it's really great to be able
[34:51] to deadlift 500 lb, but then stairs
[34:53] become really hard when you're trying to
[34:55] walk up. You're like, I don't know. I
[34:56] kind of like uh being able to not take a
[34:58] break after two or three flights of
[35:00] stairs. And so, I was like, okay, all
[35:02] right, longevity is a priority of mine.
[35:03] I'm going to slim down a little bit. I
[35:05] was like, let me just try this for a
[35:06] little bit. And what I found is that it
[35:08] is incredibly potent and at a very low
[35:09] dose, very, very tolerable. Why didn't
[35:12] you take some of the others? Honestly,
[35:14] because right now there is not a legal
[35:16] framework for me to obtain them. And the
[35:18] truth is is that I want to be an example
[35:20] for my patients. And that's why I'm out
[35:23] here advocating that we get access to
[35:25] these peptides in a legal, safe way
[35:27] again, all right? And cuz it's it's the
[35:29] best thing for everyone. If they were
[35:31] legal,
[35:32] which ones might you consider? Oh, man,
[35:34] I will tell you this. As some like I I
[35:37] don't know how old you are, so even but
[35:38] I'm in my
[35:38] 33. 33? God bless you. I will tell you,
[35:41] once you get over 35, man, that is
[35:42] brutal, all right? I sleep on my neck in
[35:44] a wrong way, and I need like a freaking
[35:46] brace for like 2 weeks. And so, as
[35:48] someone who spends a lot of time in the
[35:50] gym, you know, working out, like you
[35:51] start to accumulate all these little
[35:52] aches and pains. And so, the idea of,
[35:55] for example, I have a very finicky right
[35:57] shoulder. If I try to do a really heavy
[36:00] bench and I haven't warmed up, I can
[36:02] tweak this, and it takes me out of the
[36:03] fight for at least a month, okay? And I
[36:05] have to do other things. You know, I
[36:07] would have killed at various points in
[36:08] time over the past 2 years to have had
[36:10] BPC and TB-500 to hopefully speed that
[36:14] sort of healing, all right? Um also, for
[36:16] example, I suffer from really bad uh
[36:19] rosacea. It flares constantly.
[36:21] What's that? So, just redness of the
[36:22] face, okay? That, you know, it makes me
[36:25] look like I'm sunburnt. And then I come
[36:26] in on the office on like a Tuesday and
[36:28] then my staff's like, "Oh my gosh, you
[36:29] got in the yard and do some work this
[36:30] week?" I'm like, "It's just my face." Um
[36:33] you know, for example, that's something
[36:34] that a lot of people have reported
[36:35] benefits from GH KCU from. So, again,
[36:39] another compound, another peptide that
[36:41] could be beneficial for a patient like
[36:42] myself. What about muscle mass and
[36:44] gaining muscle? Yeah, so that is an
[36:47] interesting misnomer because that has
[36:50] been a common selling point that you'll
[36:51] see on social media, but as of right
[36:54] now, the only peptide that you might
[36:57] construe that way would be
[37:00] this guy right here in my hand, IGF-1
[37:02] LR3, okay? Now, IGF-1 LR3 is basically
[37:07] the longer-lasting version of IGF-1,
[37:09] which is the downstream effect of growth
[37:11] hormone. I'm sure you've heard of
[37:12] bodybuilders taking growth hormone to
[37:14] increase size and you know, lose fat. In
[37:16] higher doses, it can help contribute to
[37:18] muscle uh mass, all right? But
[37:21] truthfully, if you're trying to gain
[37:23] significant muscle mass, this is this is
[37:25] not the way to do it. And so, the right
[37:28] now, one of the things that peptides
[37:30] can't do for you is independently put on
[37:33] significant amounts of lean mass. You
[37:34] still have to go to the gym. You still
[37:36] have to go to the gym, believe it or
[37:37] not. And guess what?
[37:38] that's the end of the podcast.
[37:39] I I tell you and but something that
[37:41] blows my mind is that I have so many
[37:42] patients that think that they can just
[37:44] take testosterone and just put on muscle
[37:46] naturally. And it doesn't work that way.
[37:47] You might get a tiny little bit, but you
[37:49] still have to have stimulus. You still
[37:50] have to get in the gym, you still have
[37:51] to put the work in. And so, I tell
[37:53] patients that I am not a replacement for
[37:55] a personal trainer. I'm your doctor, you
[37:57] also need your personal trainer, and
[37:58] most of you need a nutritionist, man.
[38:00] And so, I'm lucky to work with some
[38:02] great people in the community who
[38:03] partner with me on that. But, you know,
[38:05] it's a it's a full court press when
[38:06] you're trying to get people to you know,
[38:07] live the highest quality life. What
[38:09] about some of these metabolic disorders
[38:11] and diseases in terms of like insulin
[38:13] Yeah.
[38:13] resistance. People in the data we see of
[38:15] the audience uh
[38:16] very interested to learn about insulin.
[38:18] I see that a lot in the comment section
[38:19] and a lot of at
[38:20] Yeah. So, how can if someone's
[38:22] struggling with their insulin levels or
[38:23] their you know their glucose response,
[38:25] how does these peptides help? Honestly,
[38:27] the best peptides for that right now are
[38:28] the GLP-1 drugs. Okay, hands down.
[38:31] Because what you're doing is you are
[38:33] slowing gastric emptying and so you have
[38:35] a slower absorption of that bolus of
[38:38] food that you've eaten, so your glucose
[38:40] doesn't spike. And so, as a result, that
[38:42] increases insulin sensitivity
[38:44] significantly. Now, again, you have to
[38:46] be [clears throat] careful about what
[38:47] peptide you're using for what. A lot of
[38:49] these peptides that boost growth hormone
[38:51] and boost, let's say, IGF-1, those can
[38:54] actually increase serum glucose and that
[38:57] may not be what you want if you are
[38:59] someone that is trying to work on your
[39:01] insulin sensitivity.
[39:02] And do any of these peptides come as
[39:04] like creams or as pills or anything like
[39:07] that? If you look online, you can
[39:09] probably find a version of everything.
[39:10] But if we're talking about actual
[39:11] legitimate formulations, the best
[39:14] example of a topical cream is going to
[39:16] be GHK-Cu. And this is interesting
[39:19] because this is a copper tripeptide that
[39:21] has been found to decrease in expression
[39:24] and concentration as we age. But when it
[39:27] is applied topically, it's highly
[39:28] effective. Topically, so putting on a
[39:30] cream on your face, all right? It's been
[39:32] found to be extremely beneficial in
[39:34] regenerating the quality of skin. So,
[39:37] complexion, all right? Increasing the
[39:39] amount of collagen and elastin, the
[39:41] things that we need to keep our faces
[39:43] taut and youthful, the things that
[39:45] people will pay lots of money to go get
[39:46] laser to get improvements. Not that it's
[39:48] a replacement for that, but that's a
[39:50] topical form that, believe it or not,
[39:52] you could go out and buy today because
[39:54] topical GHK-Cu is regulated very
[39:57] differently than the injectable form. Is
[39:59] it expensive? Usually. You know, growing
[40:01] up, I thought well, these sort of
[40:03] anti-aging creams were
[40:05] But but you're telling me that this has
[40:06] actually been associated with improving
[40:09] signs of aging. I will tell you this,
[40:11] when I was going through college and
[40:13] medical school, I was the biggest
[40:14] skeptic. Like I did not believe any of
[40:17] the health or wellness claims that we
[40:18] saw coming out at the time. And again,
[40:20] you know, that was at a time where we
[40:21] were getting bombarded with stuff about
[40:22] the Atkins diet and this, that, and the
[40:24] other. But then all of a sudden, you
[40:26] start having patients come back to you
[40:27] and they're testifying as the benefits
[40:29] they've seen from these things. You
[40:30] start to actually look at the
[40:31] biochemistry behind them and you're
[40:32] like, there's a lot of science backing
[40:34] this up. This isn't just mumbo jumbo.
[40:36] And so, believe it or not, yeah, there
[40:39] are creams that can slow the process of
[40:41] aging, at least from a visual
[40:42] standpoint, when it comes to your skin.
[40:44] I have yet to figure out anything that,
[40:46] uh, you know, makes me as energetic as I
[40:48] was in my early 20s, but you know, I'm
[40:49] working on it.
[40:51] But on that point of energy and
[40:52] cognition, if I wanted to become a
[40:54] better podcaster,
[40:55] Yeah. and you know, I sit here
[40:56] sometimes. Sometimes we do two in a day,
[40:57] which means I might sit here for hours.
[40:59] Once we do, I think a couple of times
[41:00] we've done three in a day. That's
[41:01] brutal.
[41:02] 12 hours of recording. But what would
[41:04] you recommend if I was trying to improve
[41:05] my cognitive performance?
[41:06] So, again, as a physician who likes
[41:08] keeping my license, I wouldn't say
[41:09] necessarily recommend, but I would say
[41:11] if we're looking at how these
[41:13] medications have been used, and
[41:15] potentially one that may be legal again
[41:17] coming this July, pending what the FDA
[41:19] says, intranasal C-Max. And this is one
[41:22] that was originally studied actually in
[41:24] Russia many years ago. And what they
[41:27] found is that this seven-amino acid
[41:29] peptide, when it was administered after
[41:32] a, uh,
[41:33] TBI, so a traumatic brain injury, all
[41:35] right, or acute injury, that patients
[41:38] tended to bounce back faster. Also, they
[41:40] saw evidence of it improving outcomes
[41:42] after stroke. And it also seems to
[41:44] upregulate the same sort of factors that
[41:46] help with cognition and with, you know,
[41:49] connecting sentences and bits of data in
[41:51] your brain. And so, it's also one of
[41:53] the, interestingly enough, one of the
[41:54] ones that is available, you know,
[41:56] intranasally, because it goes through
[41:58] the mucus membranes and gets right where
[41:59] you need it. And so, that's going to be
[42:01] a really, really fascinating, uh,
[42:03] compound to see back on the market, and
[42:05] then we can actually get more data
[42:06] regarding efficacy and, you know, across
[42:08] a wide population.
[42:10] So interesting. And you you you sniff
[42:12] that through your nose.
[42:13] Sniff through like like you would for
[42:15] any nasal decongestant, right? And if
[42:17] you have allergies or something like
[42:18] that. Also, for someone like yourself,
[42:20] you travel a lot. You know, you're going
[42:21] in between different time zones. You're
[42:23] balancing multiple obligations at
[42:24] different odd times of the day. I I
[42:26] shudder to think what your circadian
[42:28] rhythm looks like, my friend. Um but,
[42:30] you know, that is what we have some of
[42:31] these other compounds that are coming
[42:33] going to be available for. So, if we
[42:34] look at
[42:36] uh D sip, okay? That has been shown to
[42:38] be helpful with regulating your
[42:41] circadian rhythm. All right? That is one
[42:42] of the ones that's going to be approved,
[42:44] hopefully, here soon. Again, in July,
[42:46] right? And then, you know, on top of
[42:48] that, um you've got, you know, things
[42:50] like Selank, which is another one that
[42:52] can help calm you as you're going to
[42:54] sleep about an hour ahead of time. And
[42:56] again, hope help those, you know, deep
[42:57] delta wave brain waves that are so
[43:00] restorative whenever you actually are,
[43:02] you know, resting.
[43:03] Where will we be able to buy these when
[43:05] and if they are legalized? So, from
[43:09] [clears throat]
[43:09] uh
[43:09] 503A compounders here in the United
[43:11] States with a prescription from a
[43:13] physician. So, you still need a
[43:15] prescription?
[43:15] Still need a prescription, correct.
[43:18] Could be quite crazy world when
[43:19] everybody seem is going to be in
[43:20] injecting themselves every
[43:22] every day. I mean, we're already getting
[43:23] to that point now with this Empatic
[43:24] where I've got loads of people in my my
[43:26] friendship group that are Yeah. And
[43:28] they're Yeah, and they're doing great.
[43:29] Yeah, they're doing great.
[43:30] doing great. And that's what I like
[43:32] about, you know, the advent of these
[43:34] GLP-1s is they're removing the stigma of
[43:36] a needle. And I look at some of my
[43:38] friends who have been on it. I can't
[43:40] recognize them. They look awesome. Are
[43:41] you concerned with with any of them? You
[43:44] know, I've got a couple of friends in my
[43:45] circle where I'm I'm a little bit
[43:47] concerned. I I don't even know if I
[43:48] should be concerned, but it's just when
[43:50] you see someone you know change so
[43:52] dramatically so quickly, Yeah. I think
[43:54] there's something in us which
[43:56] something prehistoric in us which goes,
[43:57] "Oh my god, there's a problem." Yeah.
[43:59] One thing I'm I am concerned about is
[44:01] the rapid weight loss with GLP-1
[44:03] medications. Because the problem is is
[44:05] that when you go into such a radical
[44:06] caloric deficit, your body goes into
[44:09] catabolism, which is breaking down
[44:11] tissue. And you want to break down fat,
[44:12] right? But your body isn't that
[44:14] judicious. It's going to break down
[44:15] muscle. And muscle is the most
[44:17] metabolically important tissue that any
[44:19] of us have. And so if you really want to
[44:21] optimize your insulin sensitivity, well,
[44:23] you need to maintain your muscle. And
[44:25] right now, really the only compounds
[44:27] that we have that are really good at
[44:28] preserving muscle with resistance
[44:30] training is testosterone, right? But
[44:31] that isn't going to be a good option for
[44:33] our male patients that want to get
[44:35] pregnant cuz testosterone turns off
[44:36] fertility in men, all right? It's also
[44:38] not a great idea for our female
[44:40] patients, all right? Depending on their
[44:41] age, testosterone TRT is a thing in
[44:44] older, you know, women, menopausal,
[44:46] won't go into that. But truthfully,
[44:48] testosterone is not the right answer for
[44:49] everybody. And so what we are going to
[44:52] see come down the pipe very soon is kind
[44:55] of the older brother of peptides, the
[44:56] more complex form, biologics, called
[44:58] monoclonal antibodies, that are
[45:00] specifically designed to inhibit the
[45:03] enzymes that break down muscle. So these
[45:05] are specifically called myostatin
[45:06] inhibitors. There are three that are
[45:08] coming down the pipeline. There is one
[45:10] called bimagrumab, which is owned by
[45:12] Lilly. That is going to bind to the
[45:14] peanut butter to myostatin's jelly,
[45:16] which is called activin. And then you
[45:18] have roledumab and trevogrumab, which
[45:21] are two other compounds owned by
[45:24] different pharmaceutical company that
[45:25] are all designed to maintain muscle even
[45:28] in a significant caloric deficit. This
[45:30] is getting interesting now.
[45:31] Yeah. Yeah. So you're you're telling me
[45:32] I'm going to be able to inject myself
[45:34] with this peptide to lose the fat and
[45:36] then inject myself with something else
[45:37] to keep the muscle. It's wild.
[45:39] It's wild.
[45:42] And and I'll tell you, you know, one of
[45:44] the hardest things that I'm sure you've
[45:46] heard being on the receiving end of this
[45:48] is just the complexity of it. And there
[45:49] are so many levers that are moving at
[45:51] once. And trying to get your head around
[45:53] it and balance it all. Like it requires
[45:56] nuance and it requires a thoughtful
[45:58] discussion with your doctor who is well
[46:00] educated on them. And that's one of the
[46:03] challenges is that there isn't broad
[46:05] great education on these products right
[46:07] now in the medical space. And so, that's
[46:09] something that I'm very passionate about
[46:11] is improving education across my
[46:13] colleagues so that they're not afraid of
[46:15] these anymore.
[46:16] What do you say to people who are
[46:17] listening to this now who are
[46:18] out, why don't you just like eat your
[46:19] greens and go to the gym? Yeah. And just
[46:22] be more human and you'll be fine. I love
[46:24] that. I love eating your greens and
[46:26] going to the gym, okay? Um but the
[46:28] unfortunate reality is that here in the
[46:29] United States uh it depends on what
[46:32] database you look at, but obesity rates
[46:34] are estimated to be 40 to 70%, okay?
[46:37] Whether you depending on what BMI cutoff
[46:39] you're using, okay? BMI's not perfect,
[46:41] but it is what it is. And so, the thing
[46:43] is is that well, eating greens and going
[46:45] to the gym are not working for us as a
[46:47] society. And we could talk about how we
[46:50] don't have real food anymore, we have
[46:51] food deserts, we have this nut-
[46:54] calorically dense but nutritionally poor
[46:56] food. I'll tell you the most disturbing
[46:58] thing I see as a surgeon is I'll see a
[47:00] patient come in the door and they're
[47:02] morbidly obese. They're a large
[47:03] individual, but I have to do surgery on
[47:05] them, but the connective tissue, the
[47:06] stuff that's made up of protein that
[47:07] makes them them that literally holds
[47:09] them together is paper paper thin
[47:11] because they're eating an incredible
[47:13] amount of calories, they're gaining fat,
[47:14] but they don't have any protein in their
[47:16] diet. And that's not something that's
[47:18] rare. I see that on a daily basis. And
[47:20] so, the truth is is that, you know,
[47:21] we're talking about this from the angle
[47:23] of biohackers and people that are super
[47:26] engaged in our health, but the truth is
[47:28] is that this is going to be able to be
[47:29] used to help our population at large
[47:32] and, you know, ultimately hopefully
[47:35] avoid a lot of the terrible disease
[47:37] states that we're seeing overwhelm the
[47:38] medical system right now. How big is the
[47:40] peptide industry right now?
[47:42] If we look at the top four large
[47:44] language models companies, all right?
[47:46] So, all the heavy hitters and how much
[47:48] revenue they're generating, it's
[47:49] estimated between be between 58 billion
[47:53] up to maybe 62 billion. Yet the income
[47:56] and the revenue from just semaglutide
[47:59] and tirzepatide alone is going to be
[48:02] over 55 billion this year. And so, what
[48:04] we have is peptides without even
[48:07] considering all of this happening in the
[48:08] research space or the research use only
[48:10] space. Without even considering the
[48:12] peptides that we'll see come from
[48:14] compounding pharmacies, we're already
[48:17] approaching parity with what we're
[48:18] seeing in AI as far as revenue goes.
[48:21] That is the demand that we're seeing in
[48:22] the marketplace.
[48:24] I run multiple companies that have
[48:25] multiple sales teams. And one of the
[48:27] things as a founder of a company that's
[48:29] often confusing is you find it hard to
[48:31] figure out where sales are. So, about 10
[48:33] years ago, I started using Pipedrive in
[48:35] my former company, and it's also the
[48:37] reason why I switched over all of my
[48:38] commercial teams in my current media
[48:39] company called steven.com to use
[48:41] Pipedrive as well. Not only do they
[48:42] sponsor this show, but they've been an
[48:44] incredibly effective way of scaling our
[48:45] sales engine over the years. Pipedrive
[48:47] is an easy-to-use intelligent CRM, and
[48:50] at its very core, it makes your sales
[48:52] process visible through one dashboard, a
[48:55] visual pipeline showing every deal, what
[48:58] stage it's in, what needs to happen
[49:00] next, and it's all in real time with no
[49:02] delay. It doesn't magically close the
[49:04] deal for you, of course, but it does
[49:05] replace complexity with clarity. If you
[49:08] want to join over 100,000 companies
[49:10] already using Pipedrive, you can use my
[49:12] link for a 30-day free trial with no
[49:14] credit card payment needed. Head to
[49:16] pipedrive.com/ceo
[49:19] to get started. That's
[49:20] pipedrive.com/ceo.
[49:23] I'll see you over there.
[49:25] When your patients come and see you, Dr.
[49:27] Alex,
[49:28] what are they asking you most frequently
[49:31] as it relates to peptides? What are like
[49:32] the top three questions you get asked
[49:34] the most? The first thing I get asked is
[49:37] what peptides do I need? And then I just
[49:39] look at them. I'm like, well, what's
[49:40] your problem? You [laughter] know, like,
[49:41] what what's bothering you? And what do
[49:43] they say? You know, and then they'll
[49:45] come in and they'll start talking about
[49:46] energy, sex drive, and that sort of
[49:48] things. And I'm like, okay, if that's
[49:50] it, well, we need to check your
[49:50] testosterone levels, brother. Okay? So,
[49:52] instead of looking for peptides, right?
[49:55] You know, you don't walk into a Home
[49:56] Depot or a Lowe's, you know, and be
[49:58] like, "What tools do I do I need?" And
[49:59] you're like, "What are you trying to do,
[50:00] right?" And then you start to talk to
[50:02] someone there like, "Well, I'm trying to
[50:03] build this." Okay, you need a saw, you
[50:04] need a screwdriver, you need this. And
[50:05] some of those tools might be peptides,
[50:07] all right? But some of them may be
[50:08] hormones. You know, some of it may be
[50:10] diet and exercise. And so, peptides are
[50:12] just another type of tool that we can
[50:14] use.
[50:14] want a shortcut, though, doctor. We all
[50:16] want a quick way to to be better, and
[50:18] ideally not have to do hard work. That's
[50:20] like what most people, you know, the
[50:20] average person is looking for. And we
[50:22] hear about these peptides, we hear other
[50:23] people are taking them, we hear they're
[50:24] fantastic results in skin, hair, muscle,
[50:26] and we go, "Fucking, what about me?" You
[50:28] know what I tell patients? I'm like,
[50:29] "Me, too, man." You know, but my alarm
[50:31] still went off at 4:45 this morning so I
[50:33] could hit the gym before I made it to
[50:34] clinic because there are no real
[50:36] shortcuts. There are things that can
[50:38] help, right? GLP-1s are the best example
[50:40] of that, right? Okay, this is the
[50:41] closest thing to a shortcut you're going
[50:43] to get. But the truth is is that this
[50:45] isn't going to go to the gym for you,
[50:46] and it's not going to lift the weights
[50:47] so you can maintain that muscle mass so
[50:48] you get the best possible result. Try to
[50:50] hold on to your muscle while losing the
[50:51] fat. One thing I've learned from doing
[50:52] this podcast that that has really grown
[50:55] with me over time. People ask me all the
[50:56] time, like, "What's the one thing you've
[50:57] learned from the podcast?" One of the
[50:59] answers that I've never given that I'm
[51:00] going to give now is that I've learned
[51:02] that there's no such thing in life as a
[51:04] free lunch. No,
[51:05] [clears throat]
[51:05] absolutely not. And what I mean by that
[51:07] is like everything is a trade-off. And
[51:11] if you ever hear on a podcast or in any
[51:13] medium that something has tremendous
[51:16] upsides, the first question one should
[51:18] ask is what's the trade? And like just
[51:20] with everything, you can apply this to
[51:21] having a relationship with a partner.
[51:23] Huge upsides. Also, trade-off.
[51:25] Trade-off. Yeah, yeah, yeah. Kids, like
[51:27] I love my children. I haven't slept in
[51:28] years, right?
[51:29] [laughter]
[51:29] You know, like this is just this is this
[51:31] is life, right? There are trade-offs.
[51:32] And even with great tools, there are
[51:34] trade-offs.
[51:34] So, what are the trade-offs of these
[51:36] peptides? The biggest trade-off right
[51:38] now is you don't know if you're even
[51:40] getting what you're what you want,
[51:41] right? Because you're ordering this from
[51:42] some research, you know, compound only.
[51:45] You don't know whether or not they've
[51:46] gotten out all the appropriate
[51:47] endotoxins. You don't know if you're
[51:48] getting what you actually paid for. So,
[51:49] that's the biggest thing. And also, the
[51:51] thing is is that, well, all right, I
[51:53] these have a good example of, okay,
[51:55] preventing or helping heal injury. But,
[51:58] the thing is that, well, we've got other
[52:00] compounds over here, you know, let's go
[52:02] ahead and like let's just pull
[52:04] tesamorelin as an example. So, this is
[52:06] actually interesting. It's a peptide
[52:08] that is commercially available right
[52:10] now. I could write the script for you.
[52:11] You could go pick it up from CVS or
[52:12] Walgreens, okay? This is available as a
[52:14] commercial product. And people really
[52:16] like it because it'll help boost growth
[52:17] hormone, and it happens to be uniquely
[52:19] good at stripping abdominal fat, okay?
[52:21] Or visceral fat. But, the thing is is
[52:23] that, you know, the moment you stop
[52:24] taking it for a brief period of time,
[52:26] well, if you haven't changed anything
[52:27] about your lifestyle, you're going to go
[52:28] right back to where you were.
[52:29] It's good at stripping abdominal fat,
[52:31] belly The belly fat. This is what it's
[52:33] known for. Yeah. It's good at stripping
[52:35] belly fat.
[52:35] Stripping belly fat specifically. So,
[52:37] bodybuilders actually really like it for
[52:38] that particular application.
[52:40] [clears throat]
[52:40] I had no idea there was a a peptide for
[52:43] stripping belly fat. There you go, man.
[52:45] You know, and like for example here,
[52:46] we've got another one. So, this is
[52:47] melanotan II, right? So, this is a
[52:50] melanocortin receptor agonist. So,
[52:52] melanocortin's this what makes you tan,
[52:54] right? So, you could administer this,
[52:56] all right? And it will actually end up
[52:58] giving you a deep tan in response to
[53:01] just a little bit of UV sun exposure,
[53:03] all right? Now, I know, right? Um
[53:05] listen, I've embraced my pasty
[53:06] whiteness, so I'm not, you know, I'm not
[53:08] necessarily my my bag, but it it's real.
[53:10] Now, again, there are some safety
[53:11] concerns with this because again, could
[53:13] that potentially stimulate a melanoma or
[53:15] something like that? But, this is
[53:17] something again, it's a peptide that
[53:18] gives a wildly different result than
[53:20] tesamorelin, right? Because it's a
[53:21] different application.
[53:22] It does. Yeah, it does. It'll also give
[53:25] you um
[53:26] some of the most impressive erections
[53:28] you've ever had in your life, so uh be
[53:30] warned. Um
[53:31] Wait, it's literally turning you into A
[53:33] BLACK GUY.
[53:34] [laughter]
[53:36] FINALLY. YEAH, RIGHT? AND IT'S WILD. SO,
[53:38] there's actually and there's even a
[53:39] derivative of melanotan II called PT-141
[53:44] uh bremelanotide that is a commercial
[53:46] product right now that you can write as
[53:48] a prescription, okay? But it that
[53:50] doesn't have the tanning benefit, but
[53:52] has the sexual, you know, benefits.
[53:54] Oh, wow. Yeah.
[53:56] Keep those ones over here. We have to
[53:58] talk about this. Another really
[53:59] interesting thing that phenomenon that
[54:01] we've seen, right? Is that now we've got
[54:02] all of these companies that are making
[54:04] these research use only compounds,
[54:05] right? It used to be that you would have
[54:07] a compound that's in drug development
[54:09] and you're seeing all the advertisements
[54:10] for it, you know, maybe if you follow
[54:12] these sorts of things like I do cuz I'm
[54:13] a nerd, right? You get excited about it,
[54:14] but you don't get access to it, right?
[54:16] Well, believe it or not, the next
[54:18] blockbuster drug that Lilly is going to
[54:19] come out with probably in the next
[54:21] couple of months is this guy called
[54:22] retatrutide, all right? And retatrutide
[54:25] is fantastic in that it is the first
[54:28] three receptor agonist GLP-1 drug. So,
[54:31] the GLP-1 drugs, okay? Whenever you're
[54:33] talking about semaglutide and
[54:35] tirzepatide, they have slightly
[54:37] different profiles.
[54:37] This is the Ozempic category. Correct,
[54:39] right? So, GLP-1 is the primary receptor
[54:42] that they work on and what that will do
[54:44] is it slows gastric emptying and it
[54:46] limits caloric intake, all right? But
[54:49] then in tirzepatide, not semaglutide,
[54:51] but tirzepatide is a dual agonist. So,
[54:53] it has effect on GIP, which is a
[54:56] different receptor. Well, retatrutide
[54:59] adds in glucagon receptor activation.
[55:02] And so, believe it or not, your liver
[55:04] actually acts like a repository of
[55:06] energy where it stores glycogen and fat
[55:09] that your body can use as energy. But
[55:10] that's a problem, right? If you get too
[55:12] much fat there, if you have a caloric
[55:13] excess, then you can end up having
[55:15] what's called NASH cirrhosis, but
[55:18] non-alcoholic steatohepatitis.
[55:20] Basically, inflammation of your liver
[55:21] due to accumulating too much fat. It's a
[55:23] problem. But by stimulating the glucagon
[55:26] receptor while simultaneously hitting
[55:28] GLP-1 and GIP, what we found is not only
[55:31] do patients lose an incredible amount of
[55:33] weight, but they also get the best
[55:35] improvements we've ever seen in their
[55:36] liver liver health that we've ever seen.
[55:38] And people have been buying that from
[55:41] research use only websites and using it
[55:44] for about 2 years now. And bodybuilders
[55:46] have already made this the standard in
[55:47] their protocol when it comes to cutting
[55:49] for a show. And it is wildly effective.
[55:52] And we're now seeing the population
[55:55] using a drug at scale that hasn't even
[55:57] made it through
[55:59] commercialization yet. What are you
[56:01] smoking? You using it? No.
[56:03] [laughter]
[56:04] I have not I can honestly say I have not
[56:06] used Retta. But I find it fascinating
[56:09] though. It's absolutely wild. Yeah, and
[56:11] talk about power to the people, right?
[56:13] What about these others then? What else
[56:14] have we got here that you think's
[56:15] interesting?
[56:16] So, um we've got these two here that I
[56:18] think are really interesting. So,
[56:19] CJC-1295 and Ipamorelin. So, the whole
[56:22] idea is that, you know, can we stimulate
[56:24] growth hormone? And there's an
[56:25] interesting story behind that. You know,
[56:26] actually growth hormone itself was very
[56:28] very popular for many many years as an
[56:30] anti-aging compound, but then we changed
[56:32] some laws here in the 19 in 1990, okay?
[56:34] That made it a little dicey to prescribe
[56:36] growth hormone. And also, you know, it's
[56:38] kind of a blunt instrument. We wanted
[56:39] something to stimulate more natural
[56:40] growth hormone release. So, we have this
[56:42] entire class of medications called
[56:43] secretagogues that help stimulate
[56:44] natural growth hormone release. And
[56:46] these are two of the most potent ones
[56:47] that are often combined together. And
[56:49] when we say growth hormone Yes. what
[56:52] does growth hormone do? So, growth
[56:54] hormone acts like a signal that tells
[56:56] your liver to make more of another
[56:58] compound we talked about, IGF-1. What
[57:00] growth hormone does is growth hormone
[57:02] actually stimulates building muscle,
[57:03] okay? It also strips
[57:06] fat, okay? And it's also been found to
[57:09] help with tissue healing. Okay. And so,
[57:11] there's a significant benefit in that
[57:13] regard. And so, people want to boost
[57:15] their growth hormone. Improves quality
[57:16] of skin, improves quality of hair and
[57:18] nails and that sort of thing. And so,
[57:20] these two compounds together are
[57:22] particularly potent. CJC-1295
[57:25] being a growth hormone-releasing hormone
[57:28] derivative. And then we have Ipamorelin,
[57:31] which is a ghrelin receptor agonist. So
[57:34] again, release improving the release of
[57:36] growth hormone through two different
[57:37] synergistic mechanisms. And so, that one
[57:39] is really really interesting, or these
[57:41] two together. And then, on top of that,
[57:43] so this one, somatotropin, another word
[57:46] for growth hormone. Okay, so this is
[57:48] growth hormone, okay? Just a different
[57:49] word for it. So, what would happen?
[57:51] Let's just take this one. Sure.
[57:52] Somatotropin. Yeah. Somatotropin. Yeah.
[57:55] If I bought this for research purposes,
[57:58] Research purposes only. and I started
[58:00] injecting some of this into me, what
[58:02] would change? So, it depends on how much
[58:04] you do and when you do it. So, the idea
[58:07] is that if you injected that at night,
[58:09] it would improve your quality of sleep,
[58:10] okay? You would get a boost in your
[58:13] quality of your hair, your skin, nails.
[58:16] Theoretically, it'd be easier for you to
[58:17] recover from injuries, hopefully put on
[58:19] a little bit more muscle a little bit
[58:20] easier, maybe lose a little bit of fat.
[58:22] So, why don't I take it? Well, because
[58:23] if you take a little bit too much, you
[58:25] can actually get insulin resistance
[58:27] because your glucose levels will go too
[58:28] high for too long, all right? You abuse
[58:30] too much for too long, you will actually
[58:32] get acromegaly, so that's development of
[58:34] the your bones continue to grow, but not
[58:37] alongs, only in certain junctures. And
[58:39] so, there's a very specific look that
[58:40] bodybuilders who abuse growth hormone at
[58:42] high amounts will get to them, all
[58:43] right? Which is an irreversible change
[58:45] to the facial bone structure. You can
[58:47] also, theoretically, if you had a
[58:49] cancer, maybe it could make it worse,
[58:50] all right? We've never shown it that it
[58:53] causes new cancers, but that could be a
[58:54] concern. And, you know, on top of that,
[58:56] it could give you insulin resistance
[58:57] because, Okay. you know, you're again,
[58:59] Yeah, exactly, right? Um, and if you
[59:01] take too much, it could potentially make
[59:02] your hands numb in the morning because
[59:04] you get effusions into the joint space.
[59:05] And so, bodybuilders will talk about
[59:07] lifting a dumbbell and having to drop it
[59:09] because their hand goes numb temporarily
[59:10] if they're taking too much growth
[59:11] hormone too soon.
[59:13] And what else have we got here? Oh my
[59:14] gosh. So, epithalon, so this is
[59:18] the
[59:20] medication that is theoretically going
[59:23] to be available to us in July, okay? And
[59:26] so, uh the hope is that, you know, this
[59:29] is going to uh expand cell life. So,
[59:32] epithalon, the uh purpose of it is it
[59:35] works to enhance uh telomerase. So, at
[59:39] the end of your cells, imagine it this
[59:40] way, you're trying to copy the genome,
[59:42] but the little copier that uh copies it,
[59:45] it takes up space enough itself, so it's
[59:47] kind of like it cuts off the last couple
[59:48] letters every single time. This is when
[59:50] you're aging, right? When you're aging.
[59:51] You're creating new cells, right? Cells
[59:53] divide through this process called
[59:55] mitosis, where they split, all right?
[59:56] Well, if you got to make an exact copy,
[59:58] well, you've got to read through all
[59:59] these lines of code, but because of the
[01:00:01] way that we're built, we always end up
[01:00:02] cutting off the last little bit of code.
[01:00:04] Which is what how we age. Which is how
[01:00:06] we age. It is one of the things that
[01:00:07] contributes to aging, all right? Now,
[01:00:09] that is considered to be {quote}
[01:00:11] {unquote} junk information. It's at the
[01:00:13] very end called the telomere, all right?
[01:00:15] But, we know that shorter telomeres are
[01:00:17] associated with aging, potentially worse
[01:00:19] health outcomes. Then, there's an enzyme
[01:00:21] that can help heal or repair the
[01:00:23] telomere called telomerase. Epithalon
[01:00:26] helps encourage that. And so, some
[01:00:28] people are looking at that as being one
[01:00:29] of the fountain of youth uh compounds.
[01:00:31] I'm very skeptical as far as that goes,
[01:00:33] but it does show some benefits when it
[01:00:35] comes to uh you know, healing parts of
[01:00:37] your brain that are, you know,
[01:00:38] associated with uh regulating your
[01:00:40] circadian rhythm.
[01:00:43] So, the average person listening now,
[01:00:45] they've heard a lot of stuff about a lot
[01:00:46] of things.
[01:00:48] How do they know if they should pursue
[01:00:51] getting and taking peptides? Like, how
[01:00:53] do they know? What are they looking for?
[01:00:55] So, what I will say is that think of
[01:00:58] peptides as falling into three
[01:00:59] categories, all right? You got category
[01:01:01] one, which are peptides that you can
[01:01:02] prescribe right now, legal from, you
[01:01:04] know, a commercial pharmacy. That
[01:01:05] includes the GLP-1s, PT-141, uh
[01:01:08] bremelanotide I mentioned to you
[01:01:10] earlier, oxytocin is another one. We
[01:01:11] have these different compounds that are
[01:01:13] available. And then we have what we call
[01:01:15] category two, which we don't have
[01:01:17] anything in right now, but that will
[01:01:19] consist of the seven peptides that are
[01:01:21] hopefully going to be approved in July
[01:01:23] whenever they get moved from category
[01:01:24] two cannot compound to category one can
[01:01:27] compound. All right? And then everything
[01:01:29] else is kind of in this category three
[01:01:31] where it's only available for research
[01:01:32] use only. And so my recommendation for
[01:01:34] patients is don't go out and buy
[01:01:36] research use only compounds. All right?
[01:01:38] You don't know what you're getting and
[01:01:39] you don't know if you're dosing it
[01:01:41] right, you don't know if it's
[01:01:42] contaminated. So really what the public
[01:01:44] should be doing is educating themselves
[01:01:45] on this and then going and talking to
[01:01:47] their doctors about what problems they
[01:01:50] have and then potentially when those
[01:01:52] options become available a peptide might
[01:01:54] be part of the answer for their problem.
[01:01:57] Okay, so speak to doctor. Yeah. Consult
[01:01:59] with your doctor. And make it a convers-
[01:02:01] conversation with whoever your medical
[01:02:03] professional is about your symptoms and
[01:02:05] what might be useful and what the range,
[01:02:07] the toolbox, the options are Correct. To
[01:02:09] attack those symptoms. Yes. Absolutely.
[01:02:11] Talk
[01:02:12] collaborate with your doctor. Your
[01:02:13] doctor should be your partner in you
[01:02:15] getting as healthy as humanly possible.
[01:02:18] We talked about um trizepatide, Ozempic,
[01:02:21] semaglutide. One of the questions that's
[01:02:22] front of mind for everybody
[01:02:24] whether they're taking them or watching
[01:02:25] others take them is what happens when
[01:02:27] you stop. We've looked at that. You
[01:02:29] actually regain the weight. And so cuz
[01:02:31] the truth is is that you have introduced
[01:02:34] something into your life that has moved
[01:02:36] the needle in one direction. But if you
[01:02:38] don't change anything else, well, you
[01:02:39] take that back out. Well, you're going
[01:02:41] to go back to where you were. And so if
[01:02:43] you're going to maintain that weight
[01:02:44] loss, you have to make lifestyle changes
[01:02:46] associated with that. And what we found
[01:02:48] is that people do regain if they do make
[01:02:50] lifestyle changes, they do regain some
[01:02:52] of the weight but not necessarily all of
[01:02:54] the weight. And there's also data
[01:02:56] showing that you could potentially stay
[01:02:58] on that medication but at a much lower
[01:03:00] dose and then maintain your weight,
[01:03:02] okay? So there are options to minimize
[01:03:05] your medication burden long term. And of
[01:03:07] all the things we've talked about today,
[01:03:08] if you had to just pick one thing that
[01:03:10] excites you the most that's either
[01:03:11] coming down the pipe or here already,
[01:03:13] Yeah. what is the thing you're most
[01:03:14] excited about? I I your eyes wondering.
[01:03:15] Uh
[01:03:16] hands down it's that one over there,
[01:03:17] retatrutide. Because the
[01:03:21] changes in body composition that we have
[01:03:23] seen both in clinical trials, okay, and
[01:03:26] in anecdotal reports from users who have
[01:03:29] obtained on their own are wild. We're
[01:03:31] talking losing 20 to 25% of total body
[01:03:35] weight within a relatively short period
[01:03:38] of time. And I think that this is going
[01:03:41] to be basically the Ferrari of GLP-1
[01:03:45] medications when it comes out. It's not
[01:03:46] for everybody, right? It's going to go
[01:03:48] faster than everything else, but it's
[01:03:50] going to change the game. I think this
[01:03:52] is going to be a trillion-dollar drug
[01:03:55] when it comes out. And no one's going to
[01:03:56] own the patent, so everybody will be
[01:03:58] able to access it. Is that right? No,
[01:03:59] no, that is going to belong solely to
[01:04:01] Lilly. And so you are going to see and
[01:04:03] they are going to enforce it, you know,
[01:04:05] uh, as aggressively as they've ever
[01:04:07] enforced anything. But you will see
[01:04:10] profound results in patients.
[01:04:13] People are referring to peptides as
[01:04:15] Silicon Valley's miracle drug.
[01:04:17] And I I wondered why that was, why it's
[01:04:19] been associated with Silicon Valley.
[01:04:20] Have you heard that at all? I have and
[01:04:22] I'll tell you I've seen some, uh,
[01:04:23] peptide stacks from, you know, Silicon
[01:04:25] Valley, you know, uh, founders and, uh,
[01:04:28] you know, uh, individuals that blow my
[01:04:31] mind. I'm like, oh man, even I think
[01:04:33] that's a lot. Why would peo- people in
[01:04:34] Silicon Valley, why would founders be
[01:04:36] interested in peptides? Well, I think
[01:04:38] it's because we all want to live our,
[01:04:39] you know, best version of our own lives,
[01:04:41] right? We want to perform at the highest
[01:04:42] level. And so, you know, people will do
[01:04:44] whatever they can. They'll drink
[01:04:45] caffeine, you know, they'll, you know,
[01:04:47] pop a Zyn in their mouth, you know, and
[01:04:49] they'll try to tweak whatever variable
[01:04:51] they possibly can to get the best
[01:04:52] possible performance. And thing is is
[01:04:54] that anabolic steroids come with, you
[01:04:56] know, significant side effects. And
[01:04:57] that's not everybody's cup of tea,
[01:04:58] right? And the health consequences from
[01:05:00] high-dose androgens dwarf anything that
[01:05:03] you might experience with peptides. And
[01:05:04] so peptides offer a lot of flexibility
[01:05:06] in pulling many different levers that
[01:05:08] are interesting to like your regular
[01:05:10] average, you know, person. And honestly,
[01:05:12] you know, it requires a little bit of
[01:05:14] DIY right now because of the nature of
[01:05:16] these peptides. And, I think you combine
[01:05:18] that with the kind of rogue, you know,
[01:05:22] uh founder
[01:05:24] uh
[01:05:25] spirit that is common in Silicon Valley,
[01:05:27] and I think it's a perfect fit. I asked
[01:05:29] you a second ago, what are the three
[01:05:30] questions that people come to you and
[01:05:31] ask you as as a doctor? The first one as
[01:05:33] it related to peptides was, which
[01:05:35] peptide should I be taking? Yeah. Are
[01:05:37] there any other questions we haven't
[01:05:38] covered off that are commonplace in your
[01:05:40] practice?
[01:05:41] The second one is, you know, can you
[01:05:43] prescribe me? And then I have to explain
[01:05:44] to them the regulatory environment, you
[01:05:46] know, surrounding peptides that, you
[01:05:47] know, as of right now, the only peptides
[01:05:49] that I can prescribe are the ones you
[01:05:51] can get from CVS or Walgreens, which is
[01:05:52] going to be your GLP-1 medications and a
[01:05:54] handful of others that usually aren't
[01:05:56] applying to the young men that I see in
[01:05:57] my practice.
[01:05:59] I've had so many founders speak to me
[01:06:01] and say, why didn't this particular ad
[01:06:03] that I ran on this platform work for me?
[01:06:05] Maybe the copy wasn't good, the creative
[01:06:07] wasn't strong, but usually the problem
[01:06:08] is they're not having the right
[01:06:09] conversation because that ad never
[01:06:11] reached the right person. And if you're
[01:06:13] in B2B marketing, that is much of the
[01:06:15] game. And this is where LinkedIn ads
[01:06:17] solves that problem for you. Their
[01:06:19] targeting is ridiculously specific. You
[01:06:21] can target by job title, seniority,
[01:06:23] company size, industry, and even
[01:06:26] someone's skill set. And their network
[01:06:28] includes over a billion professionals.
[01:06:30] About 130 million of them are decision
[01:06:33] makers. So, when you use LinkedIn ads,
[01:06:35] you're putting your brand in front of
[01:06:36] the right people. And LinkedIn ads also
[01:06:38] drive the highest B2B return on ad spend
[01:06:41] across all ad networks in my experience.
[01:06:43] If you want to give them a try, head
[01:06:45] over to linkedin.com/diary.
[01:06:48] And when you spend $250 on your first
[01:06:50] LinkedIn ads campaign, you'll get an
[01:06:52] extra $250 credit from me for the next
[01:06:56] one. That's linkedin.com/diary.
[01:06:59] Terms and conditions apply.
[01:07:01] We have finally caved in. So many of you
[01:07:04] have asked us if we could bundle the
[01:07:06] conversation cards with the 1% diary.
[01:07:08] For those of you that don't know, every
[01:07:10] single time a guest sits here with me in
[01:07:11] the chair, they leave a question in the
[01:07:13] Diary of a CEO, and then I ask that
[01:07:15] question to the next guest. We don't
[01:07:17] release those questions in any
[01:07:18] environment other than on these
[01:07:20] incredible conversation cards. These
[01:07:22] have become a fantastic tool for people
[01:07:24] in relationships, people in teams, in
[01:07:26] big corporations, and also family
[01:07:28] members to connect with each other. With
[01:07:29] that, we also have the 1% diary, which
[01:07:31] is this incredible tool to change habits
[01:07:33] in your life. So many of you have asked
[01:07:36] if it was possible to buy both at the
[01:07:37] same time, especially people in big
[01:07:40] companies. So what we've done is we've
[01:07:42] bundled them together, and you can buy
[01:07:44] both at the same time. And if you want
[01:07:45] to drive connection and instill habit
[01:07:47] change in your company, head to the
[01:07:49] diary.com to inquire, and our team will
[01:07:51] be in touch.
[01:07:53] Is there a super peptide for anti-aging
[01:07:55] in skin and some of those issues? Oh,
[01:07:57] for skin, GHK-Cu. GHK-Cu? Yeah. So this
[01:08:00] is, you know,
[01:08:01] probably the most well-known peptide for
[01:08:05] uh use for skin complexion, and I mean,
[01:08:08] really, it may have some small benefits
[01:08:10] when it comes to hair, all right? But
[01:08:11] the those reports are a little bit more
[01:08:13] spotty. Okay. Yeah. And then so outside
[01:08:15] of the world of peptides for a second.
[01:08:16] Yeah. I've got these three
[01:08:18] vials in my hand. I'm so scared.
[01:08:21] All right.
[01:08:24] Do you know what those are?
[01:08:26] Oh, yeah.
[01:08:28] Uh this is unfortunately our future if
[01:08:31] we're not careful.
[01:08:32] Explain. So, you know, what we've got
[01:08:34] here is we have uh three different uh
[01:08:38] canisters containing water that has a a
[01:08:41] little bit of coloring in it. And what
[01:08:43] you can see is that all the way back in
[01:08:44] 1973, this is pretty opaque, all right?
[01:08:47] Like, you know, this is not uh what you
[01:08:49] would You can't see through it. And then
[01:08:50] 2026 has a little bit of color to it.
[01:08:52] And then we've got over here 2045, which
[01:08:55] is totally uh clear. Uh and this
[01:08:57] unfortunately is actually representing
[01:08:59] the fertility trajectory for young men,
[01:09:02] because what we're seeing is that back
[01:09:05] in 1973, total modal sperm count, so how
[01:09:08] many healthy swimming sperm do we have
[01:09:09] in each ejaculation, is
[01:09:12] exponentially higher and more dense than
[01:09:14] what we're seeing today. And so what
[01:09:15] we're seeing is a progressive decline in
[01:09:18] male fertility over time. And that's
[01:09:20] been demonstrated in multiple studies.
[01:09:22] We've debated this at multiple meetings.
[01:09:23] People have tried to argue that it's a
[01:09:24] measuring difference, but as we give it
[01:09:26] more time and as we give it more
[01:09:28] scrutiny, this is real. We're
[01:09:30] experiencing a significant decline in uh
[01:09:33] sperm quality and motility and
[01:09:35] concentration.
[01:09:36] [clears throat]
[01:09:37] Why?
[01:09:38] So, the leading culprits are going to
[01:09:41] be, yes, microplastics and environmental
[01:09:44] toxins. Okay, things that are put in our
[01:09:46] environment that we have been exposed to
[01:09:48] that we can't help. But again, the
[01:09:50] biggest modifiable risk factor is
[01:09:53] insulin resistance and metabolic
[01:09:54] disease. Obesity.
[01:09:56] Obesity. And so, a downstream effect
[01:09:59] that we may see from peptides like we
[01:10:01] discussed before is we may be able to
[01:10:04] help reverse this for the first time in
[01:10:06] history by trying to prevent the
[01:10:08] development of metabolic disease. Using
[01:10:10] some of the peptides we talked about
[01:10:11] earlier. Exactly. I gave you the example
[01:10:13] of a patient that I saw in clinic this
[01:10:14] past week that increased his sperm count
[01:10:15] 10 times over. Imagine if we had given
[01:10:18] that to him before he even got that
[01:10:20] obese, when he just started to get a
[01:10:21] little bit overweight and at a lower
[01:10:22] dose. Well, he may have never ended up
[01:10:24] in my office, right? Because his primary
[01:10:26] care doctor would have identified that,
[01:10:27] treated it, and he never would have
[01:10:28] needed the specialist.
[01:10:30] Mhm.
[01:10:32] It's crazy. It's wild.
[01:10:35] So,
[01:10:36] ultimately, you know, if you look at
[01:10:39] what are the ills that are affecting
[01:10:40] healthcare in, you know, any first-world
[01:10:43] nation, the number one offender is
[01:10:46] metabolic disease and metabolic
[01:10:47] dysfunction. And this is something that
[01:10:50] was actually hinted at, you know, by,
[01:10:52] you know, RFK whenever he was talking
[01:10:54] about uh root cause of disease. Well,
[01:10:57] yes, we have many many diseases and many
[01:11:00] many infections that don't stem
[01:11:01] necessarily from insulin resistance, but
[01:11:03] if we look at cardiac disease, if we
[01:11:05] look at issues with lack of perfusion,
[01:11:08] my my specialty, erectile dysfunction,
[01:11:10] right? We look at cancer. All of this is
[01:11:12] related back to obesity and metabolic
[01:11:14] dysfunction. And so, if we can eliminate
[01:11:16] that, you know, as a society or we can
[01:11:18] minimize it to as little as possible,
[01:11:20] well, I mean, man, maybe I'd finally
[01:11:22] work myself out of a job.
[01:11:24] Your specialty is these erectile
[01:11:25] dysfunction. Yeah, so my specialty is
[01:11:28] this branch off of urology that we
[01:11:30] broadly call men's health, okay? And so,
[01:11:32] what that incorporates for us is going
[01:11:34] to be low testosterone, advanced hormone
[01:11:36] management. I take that a little bit
[01:11:37] further than most people. That's totally
[01:11:38] cool. And then also uh erectile
[01:11:41] dysfunction, Peyronie's disease, which
[01:11:43] is damage to the penis that causes
[01:11:44] curvature, and then
[01:11:46] uh male fertility on top of that. And I
[01:11:49] do a little other thing uh treating
[01:11:51] leakage after uh prostate cancer
[01:11:52] treatment. And that's basically it. like
[01:11:55] five things maybe, and you know, that's
[01:11:58] it. So, I'm very very specialized
[01:12:01] because I was the kid that, you know,
[01:12:02] like to take my sandwiches apart and eat
[01:12:04] it one at a time. I was very precise.
[01:12:06] And I figured, you know, you can do a
[01:12:07] lot of things in this world and be okay
[01:12:08] at them, or you can pick like, I don't
[01:12:10] know, four or five and get pretty good
[01:12:11] at them. So, that seemed to work for me.
[01:12:14] I was looking at a at a photo of you of
[01:12:16] you 5 years ago and you were very
[01:12:17] different. Yeah.
[01:12:18] You've changed a lot. So,
[01:12:21] I will
[01:12:24] tell you this.
[01:12:26] I will tell you this.
[01:12:26] Um
[01:12:28] medical training
[01:12:30] [clears throat]
[01:12:30] in the United States has gotten better.
[01:12:33] But it is grueling.
[01:12:35] It's absolutely grueling.
[01:12:38] For 5 years,
[01:12:39] I worked anywhere from 80 to 100 hours a
[01:12:42] week in a hospital.
[01:12:44] No eating,
[01:12:45] very little sleep.
[01:12:47] Did not care for yourself at all.
[01:12:49] Um and again, we can argue whether or
[01:12:51] not that's necessary all day long.
[01:12:54] But the truth is is that it really beat
[01:12:57] me down.
[01:12:58] It absolutely took me apart physically
[01:13:01] and psychologically.
[01:13:03] In part it's designed to do that cuz the
[01:13:05] idea is that as a surgeon you have to be
[01:13:07] able to perform when
[01:13:10] all the lights are on, when everything
[01:13:11] is against you, you have to be the one
[01:13:13] to hold it together in the operating
[01:13:14] room and command that ship and save that
[01:13:16] patient.
[01:13:18] And I remember being
[01:13:20] totally devastated towards the end of
[01:13:22] training. And I did a very challenging
[01:13:26] surgery on a very needy patient.
[01:13:28] Gentleman was about to go into renal
[01:13:30] failure, did not have a lot of kidney
[01:13:32] left. And he had a very challenging
[01:13:35] kidney tumor that was in a very
[01:13:37] treacherous location. It was in a
[01:13:39] location where he should have lost that
[01:13:41] kidney by all measure if we were going
[01:13:43] to take out that cancer.
[01:13:44] And he was at a county hospital, he had
[01:13:47] no insurance, you know, and we swung for
[01:13:51] the fences and did a very, very
[01:13:53] challenging operation on him. And
[01:13:56] against our best efforts with having
[01:13:58] everybody there,
[01:13:59] he ended up having a bleed
[01:14:01] postoperatively that night. And I
[01:14:03] remember getting the call, I was on
[01:14:04] call, and that his blood pressure had
[01:14:07] dropped and that he did not look well
[01:14:09] and I knew exactly what it was because
[01:14:11] again this was a very treacherous
[01:14:12] surgery.
[01:14:13] And I went in in the middle of the night
[01:14:15] with my attending who was a different
[01:14:16] attending than the one I did the initial
[01:14:18] surgery with.
[01:14:19] And I remember just opening him up
[01:14:23] and just
[01:14:25] being covered in blood that we were
[01:14:27] taking out of the abdominal field, that
[01:14:29] we were evacuating, eventually
[01:14:30] identifying the area of the bleed, and
[01:14:33] there was no way that it could have been
[01:14:34] avoided. I remember my attending yelling
[01:14:36] at me and we ultimately had to take that
[01:14:38] guy's kidney.
[01:14:39] And
[01:14:41] I remember
[01:14:43] walking out of there just being totally
[01:14:45] shattered, covered in blood, crying in a
[01:14:47] hallway by myself, wondering if
[01:14:50] you know, like what what was the point?
[01:14:51] Like is there going to be a Is there a
[01:14:52] tomorrow after this? Like I spent all
[01:14:54] this time in this training, like am I
[01:14:55] good enough? Am I going to be able to
[01:14:56] make this?
[01:14:58] And, you know, I wasn't well put
[01:15:00] together, wasn't healthy, uh and I ended
[01:15:04] up spending a lot of time with that
[01:15:05] patient, literally held his hand
[01:15:06] throughout the rest of his hospital
[01:15:07] stay.
[01:15:08] And he ended up recovering uh and
[01:15:10] against all odds.
[01:15:12] But, you know, afterwards, I took a
[01:15:15] strong interest in not only taking care
[01:15:19] of my patients, but also
[01:15:22] practicing what I preach, taking care of
[01:15:24] myself, and prioritizing my own health.
[01:15:27] I got evaluated. I was diagnosed with
[01:15:28] low testosterone myself. Turns out not
[01:15:30] eating or sleeping for 5 years will do a
[01:15:32] number on you, you know.
[01:15:33] his old stress?
[01:15:34] Through the roof, 24/7. I cannot even
[01:15:38] imagine what, you know, there's a part
[01:15:40] in the brain called the hippocampus that
[01:15:42] they when they do MRIs on soldiers that
[01:15:45] come back from war, that'll be
[01:15:47] degenerated in them. I wonder if we did
[01:15:49] that in surgical trainees, what that
[01:15:51] would look like. But, I made a
[01:15:54] commitment to take care of my patients,
[01:15:57] to take care of myself, and make that a
[01:15:58] priority, and
[01:16:01] to be, you know, simultaneously the best
[01:16:03] doctor and you know, the best father and
[01:16:05] you know, husband I could be.
[01:16:06] Not perfect, made a lot of mistakes
[01:16:08] along the way, but you know, what you're
[01:16:10] seeing from 5 years ago is where I was,
[01:16:13] you know, I've been in training now for
[01:16:13] 7 years, so it took a while to kind of
[01:16:15] recover from that. But, what you're
[01:16:16] seeing is, you know,
[01:16:18] what focusing on health and wellness can
[01:16:20] potentially look like.
[01:16:22] The emotion in you is palpable when you
[01:16:24] talk about this.
[01:16:26] And I'm wondering where that comes from.
[01:16:28] What is it? Cuz you're looking off into
[01:16:30] the distance at something.
[01:16:32] I don't know what you're looking at.
[01:16:33] Yeah.
[01:16:34] I mean,
[01:16:38] I
[01:16:40] when I'm caring for my patients and I
[01:16:42] see a young man
[01:16:44] that is
[01:16:46] struggling with his fertility and he
[01:16:48] wants to be a father.
[01:16:50] I was that guy.
[01:16:52] Me and my wife couldn't get pregnant
[01:16:53] when we first tried.
[01:16:55] We ended up having to do in vitro
[01:16:56] fertilization and IVF.
[01:16:58] I remember feeling like I wasn't a man
[01:17:00] because I was sitting in that room
[01:17:01] holding her hand and not having any
[01:17:03] answers to why things weren't working.
[01:17:06] Um when I see my patients who come in
[01:17:08] that are, [clears throat]
[01:17:09] you know, struggling because their
[01:17:11] hormones are out of whack and no matter
[01:17:12] how they try to take care of themselves,
[01:17:14] something just isn't clicking.
[01:17:16] I've been that guy.
[01:17:18] And then when I see my other patients,
[01:17:20] you know, that are further on in life
[01:17:21] and struggling with things like, you
[01:17:22] know, prostate cancer or erectile
[01:17:24] dysfunction, whatever the case may be, I
[01:17:25] see like I see my my my father, my
[01:17:28] uncle, my grandfather. I like these
[01:17:31] but and they are someone's father,
[01:17:33] grandfather, and uncle. Like these are
[01:17:35] our brothers and this is who I have been
[01:17:37] called to care for. And I care for my
[01:17:39] patients deeply. And it's because I care
[01:17:42] for the my patients and like this is a
[01:17:45] calling for me that I care about stuff
[01:17:47] like this because I want my patients to
[01:17:50] have every tool physically possible to
[01:17:52] live their best quality of life so that
[01:17:54] they can be whole and they can be happy
[01:17:56] and so that they can be the best version
[01:17:58] of themselves for their loved ones.
[01:18:07] Well, thank you for caring.
[01:18:09] Cuz it matters.
[01:18:10] And uh a lot of this stuff is quite
[01:18:13] opaque and confusing to an average
[01:18:14] person like me, but it's going to I'm so
[01:18:15] glad that we have people like there in
[01:18:17] the world like you that are demystifying
[01:18:19] all of this for us and explaining it in
[01:18:21] simple terms, but also championing it
[01:18:22] because, you know, one of the thing
[01:18:24] other things I've learned from listening
[01:18:24] to this podcast is
[01:18:26] solutions to problems that a lot of
[01:18:27] people are suffering with are often
[01:18:28] right in front of us, but they need
[01:18:30] voices and educators like yourself out
[01:18:32] there um leading the charge so that
[01:18:34] these types of things are available to
[01:18:36] everyone, not just the few.
[01:18:37] Absolutely. Not just the billionaires
[01:18:39] who can get whatever they want straight
[01:18:40] away any day. Yeah, I mean,
[01:18:43] you know, it's a
[01:18:45] one thing I I love is that I've I've
[01:18:47] been very blessed in my practice to take
[01:18:49] care of people that are much fancier
[01:18:51] than I am and sit in boardrooms and that
[01:18:52] sort of thing. But, you know what? I
[01:18:55] love taking care of my my regular
[01:18:58] patients who are, you know, farmers,
[01:19:00] ironworkers, you know, tradesmen, guys
[01:19:03] that, you know, truthfully, I have more
[01:19:05] in common with than anyone else. You
[01:19:07] know, I joke with my patients, I'm just
[01:19:08] an over educated plumber at the end of
[01:19:09] the day, right? Urologist. And so,
[01:19:12] um it's
[01:19:13] uh health is for everyone, not just for
[01:19:16] the fortunate.
[01:19:17] The last thing I wanted to talk to you
[01:19:18] about is linked but random. Yes.
[01:19:21] It's the Enhanced Games.
[01:19:23] Let's do it.
[01:19:25] [laughter]
[01:19:25] I I am so excited about these. So,
[01:19:28] Do you know them? I do, very well. So,
[01:19:30] for those of you or for for those who
[01:19:33] may not know, the Enhanced Games is a
[01:19:36] project based off of the World
[01:19:38] Anti-Doping Agency's own data.
[01:19:40] Potentially up to 40% of athletes that
[01:19:43] are competing at the Olympic level have
[01:19:45] either are currently using or have used
[01:19:47] banned substances at some point in time,
[01:19:49] all right? And also, we know that a lot
[01:19:51] of the compounds that are used for
[01:19:52] enhancement maybe aren't quite so
[01:19:55] dangerous if they're being administered
[01:19:57] by a trained medical professional with
[01:19:58] proper oversight. And as of right now,
[01:20:00] that's not happening. Also, at the same
[01:20:02] time, we know that Olympic athletes
[01:20:05] aren't paid enough, right? These are the
[01:20:07] best of the best of the best and they're
[01:20:08] not even making the poverty line a lot
[01:20:10] of years. And so, the idea is this,
[01:20:12] well, what if we go ahead and we strip
[01:20:14] away those rules, okay? We allow
[01:20:16] athletes to use medications that can
[01:20:17] enhance performance. We watch them very
[01:20:20] closely and we have a team of doctors
[01:20:21] and medical medical professionals
[01:20:23] watching them. And then, let's see what
[01:20:26] they can do at these traditional Olympic
[01:20:28] events and see if they smash world
[01:20:30] records. Oh, and they're going to give
[01:20:32] 250 grand to any first place winners and
[01:20:34] a million dollars to anyone that hits a
[01:20:36] world record. And just for comparison,
[01:20:39] how much are Olympic athletes getting
[01:20:40] paid? They don't get paid to compete at
[01:20:42] all, okay? So, they don't get paid to be
[01:20:44] an Olympic athlete. They
[01:20:46] uh end up getting sponsorship deals and
[01:20:48] that's potentially the money that they
[01:20:49] can make.
[01:20:50] So,
[01:20:51] yeah. Interesting. So, it's
[01:20:52] [clears throat] basically the doping
[01:20:53] Olympics where everyone's allowed to
[01:20:54] dope. That's the idea. There are some
[01:20:57] caveats in there. They're trying to say
[01:20:58] that only FDA approved medications can
[01:21:00] be used, okay? So, you couldn't use
[01:21:02] something like trenbolone, which is for
[01:21:03] veterinary use only,
[01:21:05] um or theoretically any of the compounds
[01:21:07] we've talked about today cuz they're not
[01:21:08] FDA approved. But also at the same time,
[01:21:10] they've said that they're not going to
[01:21:11] test for those things and one of their
[01:21:13] athletes uh Magnusson has openly
[01:21:15] admitted to taking BPC 157 and that sort
[01:21:18] of thing. So, I think we can kind of
[01:21:19] figure out that it may just be a wide
[01:21:21] open playing field, maybe.
[01:21:23] So,
[01:21:24] The International Olympic Committee does
[01:21:26] not pay athletes a single cent for
[01:21:28] winning a gold medal.
[01:21:30] Yep. Just crazy. How many billions do
[01:21:32] you think they make off of those with
[01:21:33] all the advertisement? So much money.
[01:21:36] Right?
[01:21:37] Yeah. And this is taking place in Las
[01:21:39] Vegas. May 21st through the 24th, I
[01:21:41] believe. Are you going to go?
[01:21:43] I'm going to be watching, that's for
[01:21:44] sure.
[01:21:45] Do you want to go? I would love to go.
[01:21:47] That would be incredible. Well, if you
[01:21:49] want to go, I know a few people that are
[01:21:51] that are putting the event on, so do let
[01:21:53] me know. I'm there, man. I'm already
[01:21:55] interested. You got my got my attention.
[01:21:57] Is there anything else we should have
[01:21:58] talked about that we didn't talk about
[01:21:59] as it relates to this subject we've
[01:22:01] discussed today? I mean, honestly, I
[01:22:03] think that we've gone pretty deep on
[01:22:04] peptides and so I think we've, you know,
[01:22:07] uh covered uh that. But one thing that I
[01:22:10] did want to just uh leave with you cuz I
[01:22:14] think it's pretty humorous. I think
[01:22:15] you've talked to some of my colleagues
[01:22:16] about this before. But, you know, one of
[01:22:18] the things that I deal with as a
[01:22:19] surgical specialist is the end stage of
[01:22:21] vascular disease, the end stage of
[01:22:22] diabetes, which is going to be erectile
[01:22:24] dysfunction, all right? And, you know,
[01:22:27] believe it or not, whenever we're
[01:22:29] dealing with that in male patients, they
[01:22:31] eventually get to a point where things
[01:22:32] like Viagra and Cialis do not work. All
[01:22:34] right? And that is a dark place to be as
[01:22:36] a guy. And so, you're taking these
[01:22:38] medications, all you're getting is a
[01:22:39] headache and nothing else. And then,
[01:22:41] maybe you have other options. There are
[01:22:43] actually injections you can do in the
[01:22:44] penis,
[01:22:45] which is about as appetizing as you
[01:22:46] might imagine. But, men want a better
[01:22:49] solution, and they'll come to us as
[01:22:51] sexual medicine specialists, you know,
[01:22:53] seeking that. And that's what I do. So,
[01:22:55] the bulk of my surgical practice is
[01:22:57] actually fixing erectile dysfunction
[01:22:59] with a procedure called implant
[01:23:00] placement, okay?
[01:23:01] Oh, no. Absolutely. So,
[01:23:04] now, I think did Rena show you one of
[01:23:05] these last time? She brought out I
[01:23:07] didn't I didn't ask her. It She It makes
[01:23:09] me like I get full body shudders when I
[01:23:11] hear about this stuff. Yeah. The thought
[01:23:13] of putting that up my penis. Well, so
[01:23:15] You can show me. No, you can show me.
[01:23:16] Well, I would tell you the good news is
[01:23:17] you don't have to, okay? Like, that's
[01:23:19] that's what what we have a job for,
[01:23:20] okay? But, the way I explain to patients
[01:23:22] is like this. So, take this out of out
[01:23:24] of the picture, okay? Ultimately, like
[01:23:26] the male erection is just two inflatable
[01:23:29] tubes that start in the pelvis and go
[01:23:30] out the shaft of the penis. It makes
[01:23:31] sense, right? It is a hydraulic motion.
[01:23:34] What happens is you get stimulated, get
[01:23:36] a rush of blood into those tubes, get a
[01:23:37] rigid erection, able to use that for
[01:23:39] intimacy, and then when you climax,
[01:23:40] pop-off valve opens back up and
[01:23:42] everything drains out, all right? So, if
[01:23:43] you can understand brakes on a car, you
[01:23:44] can understand erections. But, the
[01:23:46] problem is that when you have long-term
[01:23:48] metabolic and vascular dysfunction, the
[01:23:50] brake lines, the blood vessels that feed
[01:23:52] those erections, they fail. And all of a
[01:23:53] sudden, you can't get enough blood flow
[01:23:55] for it to work. And believe it or not,
[01:23:57] you can actually get atrophy of the
[01:23:58] penis over time, and you actually lose
[01:24:00] size, all right? Which no man is eager
[01:24:03] to see, all right? But, whenever the
[01:24:05] easy things, like oral medications,
[01:24:07] Viagra and Cialis, don't work anymore,
[01:24:09] the next best option, if we're looking
[01:24:11] at patient satisfaction, durability,
[01:24:13] concealability, is this little thing
[01:24:15] that I do, which is what if we took our
[01:24:19] own tubes, okay? And we put them inside
[01:24:21] your body's natural ones. It's
[01:24:22] invisible. Nobody looking at you could
[01:24:24] ever tell that you've ever had anything
[01:24:25] done. But all of a sudden when you want
[01:24:27] to get an erection, instead of having to
[01:24:28] rely on pills that don't work or putting
[01:24:30] a needle in there, right? You could
[01:24:32] reach down and there's a small pump that
[01:24:33] we hide underneath the skin down in the
[01:24:35] scrotum. Okay, so I joke it's like a
[01:24:37] third testicle, but again, nothing
[01:24:38] external, nothing you can see. And all
[01:24:40] of a sudden, whenever you squeeze this,
[01:24:42] what it does is it moves saline that we
[01:24:44] hide in a little reservoir that goes in
[01:24:46] the belly. You never feel that. Into the
[01:24:48] cylinders and all of a sudden men are
[01:24:50] able to get a firm, rigid erection that
[01:24:53] looks natural, feels natural,
[01:24:55] and they can use it as long as they want
[01:24:57] or until their partner's sick of them.
[01:24:59] And then press a button and it goes back
[01:25:00] down. Do they still feel the same
[01:25:02] pleasure? Yeah. So it does not affect
[01:25:04] sensation. And so the nerves that affect
[01:25:07] sensation run along the top of the
[01:25:09] penis. If you're looking at a clock, at
[01:25:11] the 12:00 position, and we stay totally
[01:25:13] away from those. So this is
[01:25:16] surgically put inside the penis. All
[01:25:18] internal. And believe it or not, that
[01:25:21] takes me about 13 minutes to do. How
[01:25:22] many people have these?
[01:25:24] Well, uh I've put in about 11 or 1,200
[01:25:27] personally, but
[01:25:28] 1,100 or 1,200?
[01:25:29] Yeah. Yeah. Yeah.
[01:25:30] quite a lot of people. There'll be
[01:25:31] people listening now that have these.
[01:25:32] Well, you know, this is what's
[01:25:33] interesting. If you look at in the
[01:25:34] United States right now, okay, there are
[01:25:36] 30 million men with erectile dysfunction
[01:25:38] in the United States right now. That's
[01:25:39] more than the population of Australia,
[01:25:42] all right?
[01:25:43] And if you look at statistics, the oral
[01:25:45] medications are going to fail in 15% of
[01:25:47] those men the first time they feel that.
[01:25:49] And so you're talking about millions and
[01:25:50] millions of men who aren't responding to
[01:25:52] oral medications and need a better
[01:25:54] option. So where's the button to
[01:25:56] get rid of the erection?
[01:25:57] those two little bars right there? These
[01:25:58] two? Yep, go ahead and put your thumb on
[01:26:01] I yep, do that and then squeeze from the
[01:26:03] end of the device back
[01:26:05] towards the pump. So squeeze squeeze.
[01:26:07] Yep.
[01:26:08] Right there. There you go. It's down.
[01:26:12] And then you would have the weight of
[01:26:13] your natural tissue push things down.
[01:26:16] Okay, and then you Okay. There you go.
[01:26:18] Okay.
[01:26:19] Hm. Okay. Well, you know, I'm I'm happy
[01:26:21] people have the options because I can
[01:26:22] imagine
[01:26:23] what that would be like to not be able
[01:26:25] to get an erection. It would be
[01:26:25] devastating, frankly. Well, I'll tell
[01:26:27] you this. I get more hugs and high fives
[01:26:29] than anybody else in my practice, and
[01:26:30] that includes the guys that treat kidney
[01:26:32] stones and cancer. So, I feel like I'm
[01:26:33] doing some doing some good work here.
[01:26:35] Until peptides put me out of business.
[01:26:38] [laughter]
[01:26:38] I don't think that's going to happen
[01:26:39] anytime soon. And you have a great
[01:26:40] YouTube channel. Thank you. I appreciate
[01:26:42] that.
[01:26:42] Which I think everybody should go check
[01:26:43] out because you really are great at at
[01:26:45] explaining all this stuff in simple
[01:26:46] terms. So, I'm going to link uh Dr.
[01:26:48] Alex's YouTube channel down below. We'll
[01:26:50] try and collab. So, if you just click on
[01:26:52] the Drive for CEO icon now, you'll see
[01:26:54] Alex's channel. And I highly recommend
[01:26:56] you go check out his content cuz he's
[01:26:57] really really leading the charge on the
[01:26:58] subject of peptides. When
[01:27:00] I spoke to my team and said I want to
[01:27:02] have a conversation about peptides, they
[01:27:03] gave me lots of options of lots of
[01:27:04] different types of doctors, and uh you
[01:27:07] were by far and away uh our preference
[01:27:09] because of the very fact that you're
[01:27:10] very very good at communicating. You
[01:27:11] understand people. And as you've
[01:27:12] demonstrated today, you have a very big
[01:27:14] heart. I appreciate that.
[01:27:15] And you're clearly it's it was wonderful
[01:27:16] to see what's actually driving you. Um
[01:27:18] and you did that in a way which um is
[01:27:20] irrefutably authentic.
[01:27:22] So, please go check out Alex's channel.
[01:27:24] Um he's around You're around 100,000
[01:27:26] subscribers on that channel now? Um so
[01:27:28] close. We're at like 98, 99. Any minute
[01:27:30] now. Okay. So, hopefully we can help
[01:27:32] push you over
[01:27:33] um that
[01:27:36] that milestone. Yeah.
[01:27:38] We have a a closing tradition, Alex, on
[01:27:39] this podcast where the last guest leaves
[01:27:40] a question for the next, not knowing who
[01:27:42] they're leaving it for. Okay. Question
[01:27:43] left for you is if you could give
[01:27:47] $1 billion to one person you don't know
[01:27:51] personally, who is it
[01:27:54] and what do they have to spend it on?
[01:27:57] Uh
[01:28:00] Honestly, I would
[01:28:03] give it to Elon Musk. Okay. And it's not
[01:28:07] because I think that he's hurting for a
[01:28:09] billion dollars right now. But, if you
[01:28:12] look at what he is working on to
[01:28:15] accomplish for us as a human race,
[01:28:18] right? He I truly believe from what I've
[01:28:21] seen that he has a similar heart for
[01:28:23] humanity that I've seen with a lot of
[01:28:24] physicians, but on a macro scale as an
[01:28:28] engineer and an entrepreneur, he's
[01:28:29] trying to solve some of the greatest
[01:28:31] problems that are facing us today. And I
[01:28:33] think that what we are going to see,
[01:28:35] hopefully coming from the uh Terafab
[01:28:38] down in Austin, is going to be wild with
[01:28:41] recursive uh feedback and engineering on
[01:28:44] AI chips that are going to get better
[01:28:45] and better and better in a short period
[01:28:47] of time and increasing, you know,
[01:28:49] independence when it comes to, you know,
[01:28:51] chip foundries for the United States.
[01:28:53] Like, it's wild and I think that that
[01:28:56] billion dollars would go further and do
[01:28:59] more for more people than anywhere else
[01:29:01] I could put it. And he's also working on
[01:29:03] Neuralink, which is a really interesting
[01:29:04] company which puts a sort of brain chip
[01:29:06] interfaces to allow people to
[01:29:10] hear again, see again, allow paraplegics
[01:29:12] to walk again, um which is
[01:29:14] really, really incredible. Dr. Alex,
[01:29:16] thank you so much. It's so illuminating
[01:29:18] and I can't wait to have you back again
[01:29:19] sometime soon to talk about all the
[01:29:20] other things we could have talked about
[01:29:21] today. We focused on peptides
[01:29:23] predominantly, but I know that over on
[01:29:24] your YouTube channel you talk about a
[01:29:25] lot more than that. So, highly recommend
[01:29:27] everybody go check out Dr. Alex's
[01:29:28] YouTube channel and uh it's been a
[01:29:29] pleasure. Thank you. Thank you, Stephen.
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