#172 Dr. Kyle Gillett

Welcome to the Protein Bros podcast on today's podcast. We have a returning guest in Kyle Gillette. Kyle is one of the most smart people I have ever met in my life. He is an obesity doctor, a specialist when it comes to metabolic health and hormonal health. And on today's podcast, we get into everything there is to know about peptides. If you've heard about peptides, if somebody has been trying to talk you into buying peptides and you don't know exactly what they are, this is the podcast for you because we talk all things peptides. Like I said, we appreciate Kyle coming on for a second time. He is a very, very close friend of ours and I think the podcast was great. It was packed full of information. So get a note pad out because you're going to need to write some stuff down and look some stuff up. But let's get you to the show. All right, talking the smartest human in America, Calculate today. That's a big man you like getting that put on you like that. No. You I mean, it's very convincing. Everybody just let him let him. He just believe. If you didn't listen to our first podcast, you're going to know here pretty quickly. Yeah. I mean, I'm going to start asking questions. You like talk to me like I'm seven years old. I just start with that. But dude, so funny is thing about the last time you were here, we talked at length about it was epic and just kind of it's rise if you will. And you'd mentioned I think it was probably like our most like one of our most viewed clips we'd ever had out of the shows. You talking about there's going to be there's going to have to be a documentary coming out one day called those Zempsick because of just the amount of bad stuff that's going into it. And I'd like for you to one, ask you two questions. One, could you break down kind of what those bad things were at the time and kind of where they've gone since then? And then to tell us about your new documentary, you're making those Zempsick. Yeah. So I decided to actually film this documentary and I have been filming it. I'm trying to say unbiased. So the reason why I called it a Zempsick is because Netflix had this big documentary about pain meds like oxy cotton. And they called it dope sick another great documentary. But just like anything else, there's fads and they kind of come in and go out. But I think GLP ones, which are Zempick, which is some of Glutide or some agglutide, Zepbound or Mjara, which is Terzapatide. And soon Rheta, which is Retatrutide. Yeah. I think that that's how you say it. Good job. Hey, for all of us, what, what, how do you say it again? Retatrutide. Retatrutrat. Yep. There's a lot of people on the internet that say that wrong. I just want to say it, not just me. You can call it Rheta. So, you know, it's Zemoglutide. Zemaglutide, say it either way. But anyways, these are here to stay. And there's a lot of upsides and downsides. And basically it has become such a big fad that myself and a lot of other experts like Jim Lovalle, we think that about 50% or more of overweight or obese Americans have already tried a GLP one. That's crazy. That being said, if you noticed, then yes, there's a lot of city rates haven't dropped in that. Not significantly. We don't have half the obesity rate. Right. So the question is, well, of the 50% of people that I've tried it, you know, some have had great success. And perhaps those people do have better health. And maybe it was just one or two injections. Cost is an obvious reason that is a downside. Often these are very expensive and they get the brand names. Sometimes they're not covered. And even if they are covered, not everybody tolerates the brand name. Terzepatide molecule is a good example. Again, that is Muncharo or is that bound? Yeah. And a lot of people actually benefit and don't need the full 2.5 milligram dose. You asked about downsides. There's a lot of them. And they're actually different for each molecule. But the big ones are constipation, nausea, diarrhea. And it also covers up, especially the first two or three months or so, then it kind of wears off. But it covers up your natural food drive. So that's not necessarily a good thing. If you're also trying to learn how to eat healthy, when you say food driver, you're talking about like, Grellen or. Yeah. So it works in your limbic system in the brain, which is your hypothalamus, your hippocampus, your mingdala, these other areas. And Grellen is one of the hunger hormones, actually a binds to an area in the brain increases growth hormone. We actually found the receptor for Grellen before we found Grellen itself. And then we actually had molecules like MK677, which is Ibuda moron or Ipomerrellen or GHRP2. And these all bind Grellen and eventually found Grellen itself. So yes, it makes you hungry, but it also increases growth hormones. So it's called a growth hormone, secrete a gog. And yes, those levels can change someone, GLP ones, but it's not its primary mechanisms of action. There's actually receptors to GLP one that in dodging as GLP one is the natural ligand for, but just means it finds that receptor in the brain. So a lot of people call it an appetite suppressant, but GLP ones have many more mechanisms that are completely unrelated to appetite suppression. So five or six years ago, when I was helping Derek make Mary Kelt, I was a medical director there. And I think we were among the first. I didn't know of any other people that were micro dosing GLP ones. Maybe some bodybuilders were doing it. Maybe some football players or strong men, but basically you can take a low enough dose to where your appetite is not significantly suppressed, but you still have other health benefits to the system. And I still think that a lot of people would benefit from this, but most people that take it just want to get shredded and lose as much weight as possible. Yeah. Anyways. When you say other other health benefits are from a blood work standpoint, I'm guessing because it is a diabetic drug, it's lowering resting glucose levels. What else health benefits wise? Yeah. So both eat herzepityd molecule and somaguitide molecule. That's again, Mujaro and ozepic. They are FDA approved for different liver diseases. Mache and Natch. Yeah. Liver inflammation and terzepityd is also FDA approved and it is at bound form or obstructive sleep apnea. So if you get if you like to get hammered, you can take a somaguitide and it'll basically erase your bad habits with drinking. Not necessarily. So there's a good question though. And they might have some benefit in that case because a lot of people that have alcohol related liver damage also have metabolic associated liver damage, which is what it is FDA approved for. Okay. You talked about the first part of your answer. I didn't want to interrupt and change course, but the first part of your answer on just the the downsides of this. You mentioned the price, right? Somebody might have this 51% of people who who are overweight or obese that have tried in America could have been just one or two shots. You were saying because the entry level is so high. But with this mass adoption, do you see the price going down or it is going down significantly? And there's also peptide companies. So not pharmacies, but a peptide company, basically a research chemical. And so not for human consumption on the bottle, but nobody besides humans uses it. Correct. And a lot of these places are getting, especially the larger ones. They're dropping off. I could say the names of many of them, but I won't. I was about to say one of the biggest ones just got got hammered for that. Yeah. And a lot of the, anyway, just a topic, compounding pharmacies make these. And a lot of compounding pharmacies are not great quality, but there is, you know, mechanisms to which the FDA and other regulatory bodies and state by state pharmacy regulatory bodies. They can look for the bad ones and they can deal with them. That is how it should work. But what I'm afraid is going to happen is that the big pharmacy, big pharmacy company lobby is going to try to shut down the compounding of all GLP ones and potentially even all peptides nationwide, even from the very good compounding pharmacies. Which in my opinion, and the opinion of actually most people for people that can't tolerate the dose or the brand name product. It is extremely hopeful to have these compounding pharmacies as an option. A secondary benefit of them is their prices have come down and down and down because they get better at it. There's higher volume. Right. And the cash pay programs from the brand name company. At first, they had no cash pay program at all. And now then they had a really high priced cash pay program, you know, 500, 600 a month. And that keeps getting brought down by 100 or $200 every two to three months. And in my opinion, it's purely because of the competition. Yeah, they are not selling any because there's so many other people making just again, similar options. What is what's FDA siding as for the reasoning for this is this because they're saying the regulation over these compounding pharmacies isn't up to the standard that it should be. Or they saying what exactly is the their argument as to why these need to be shut down. They haven't really came out with a strong position to my knowledge at this point. For various peptides, they have different categories. I'm reading a paper on this, but there's category one category two, category three. It has to do with whether you can bulk compound them or whether or not you can't bulk compound them. Or if they should even be a pharmaceutical product at all. And the current, I guess, actions of the FDA have been against individual compounding pharmacies, which I think is how it should be. But what I'm worried is that they're going to put a product like a GLP1 into a category like category two, and it can no longer be bulk compounded, it can no longer, or even category three where it can't be compounded. So I think that it's completely fine if they find the compounding pharmacies that aren't doing a great job. And basically-- - Eleminate them. - Yeah. - Eleminate them or make them improve. - Right. Yeah. It's my understanding that when it comes to these compounding pharmacies, they are typically, the good ones are holding themselves to a higher standard than what the FDA production facilities are at. If you're the FDA and you're making drugs, who are you regulating yourself, or is there a third party independent company that comes in and makes sure that the standards of the manufacturing facilities that the FDA owns in his running, or the government owns in his running, who's checking to make sure that their quality and standards are where they need to be. - Good question. So without getting into too much detail, basically the FDA just oversees, they don't technically own. So there's some facilities, I know there's a big one in Indiana and the FDA inspects it, and then a lot of the raw materials come from that one, and you certainly want your raw materials to come from an FDA-inspected and-- - Facilit-- - Receive facility. So I think that's kind of like the gold standard, but the FDA doesn't necessarily like own this. And there is some mechanism by which you can pay a bribe. I mean, a fee in order to like expedite your FDA approval. - No, dude, no one ever gets bribed in the government. Sorry, yeah. - That would never happen. - Words were coming out, but anyways, there is some odd things about how the money is exchanged between the FDA, the pharmaceutical company, and what's called the PBM, the pharmacy benefits manager. And at the end of the day, the PBM is really the most nefarious of the organization. So I think in the FDA, regardless of which administration it is, a lot of good people can involve with the FDA because they want to help. They have their hands tied because they're basically trying to pick the least bad option that's gonna make the least people upset. Because you have big pharma over here, that's lobbying to make more profit. You have big functional over here, which is the compounding pharmacies, the pharmacy benefits. - Which is probably not big compared to big pharma, obviously. - Correct, but they are getting much bigger. And they're obviously lobbying to do what they're doing. And there's a lot of good in there. There's a lot of bad in here. And actually in pharma, there's a lot of good and bad as well. But the pharmacy benefits managers are in between. And they can make a lot of profit. And they also don't have to disclose the different money that was dealt and accepted to near the degree as pharmaceutical companies, or even as functional non-pharmaceutical health companies. If we really wanted to make a big change, and I've actually heard some talk about this, we would get rid of all PBMs. - And remind me, what's a PBM? - A PBM is a pharmacy benefits manager that's the middle man between the pharma company, the insurance company, and us, the individual patients. They're the ones that are setting the price artificially. - This was common to say is for our listeners. - For our listeners. - 'Cause he knew, you know. - No, he had said it, I was just trying to. (laughing) Interestingly, companies can't set any of these prices, but they can own PBMs. For example, there's a drug company called Merck that owns a big stake in a PBM, or United Health Care and Insurance Company, also owns stake in a PBM. So why are pharma companies and insurance companies owning stake in PBM? 'Cause they're very lucrative, and because they can basically deal, and they don't have the public's eye, because these are mostly secret amounts of money that are exchanging hands. - On the interest of, specifically the compounding pharmacy versus big pharma versus insurance companies. We haven't really talked about insurance companies much. How do they play a role in this as far as what's going to be the future of semi-glutide, the GLP ones, peptides, et cetera, because it seems like they play a large role in the healthcare system. - Yeah, and the last six months, most insurance companies have been qualifying obesity medications as a non-essential health med. So it's for, you know, it's treating a pathology. So there's this big thing about how obesity was considered A disease, and we need to treat it. Lots of doctors became obesity medicine, board certified, like myself, and an insurance company started covering it, but basically they changed the definition because so many people needed it, and it was such a high price that it would have been corrupted the system if they gave everybody approval. So basically, but a lot of patients that had been on both of the GLP ones, and the main GLP ones are some agglutide, which is wigovii, and tersepatide, which is upbound. But there's actually a lot of other ones. For example, lyrgluetide, which used to be sex-senda, is now generic. You just have to take it daily. And dulagluetide, which is truicity still, is on shortage, but just not many people are on those GLP ones. But the connection to-- - Do you think-- - Yeah, I was about to say, you mentioned that, basically, they couldn't approve it. They couldn't say that this is something they qualified for insurance, because it would bankrupt everything. - They need an excuse. But do you think that plays a role in how you said that basically 50% of people that are obese have tried these drugs, but the obesity rate hasn't gone down? Do you think that's purely from the standpoint of people having stayed on them long enough? Because they're not covered by insurance? - Great question. About 10% of people, even that stay on them religiously, don't lose any weight. Even if they increase to the max dose, which is kind of crazy to think about. So these people are likely just hardly moving at all, or their brain is so dysregulated that their appetite control is harder to control, or that they're finding foods of such high caloric density that even if they can't eat out of the calories-- - Defacit. - Yeah, that's crazy. So even if they stay on them, you have about 10% of people don't. You see a lot of clinics and they say, "Hey, we'll start you on a plan "or you get a health coach and a GLP one." If it's indicated by your doctor, and then pretty much always just say it's indicated, 'cause they make a margin on it. But they say, "You're money back "if you don't lose weight or whatnot "and 60 or 90 days." But then they just titrate your dose up, and you're pretty likely to initially lose some weight. So I think that's, you know what? And as long as you're up front with that, I don't think that's particular. You can do that, but I think a better choice is to treat someone holistically, and then try to have a sustained lifestyle change regardless of GLP one. So like I'm not anti- or pro GLP one, five to 10 years ago, I was extremely pro GLP one. I was starting lots of my non-diabetic patients on them when possible. And now that everybody's so pro GLP one, they're like, "Well, you gotta be on reddit. "Why aren't you on reddit?" If you're not shredded, then just take reddit. I'm like, "Well, the real goal here "is to get people as healthy as possible "and have them make a sustainable lifestyle change. "That's gonna increase their health span "and increase how happy they are." - You, real quick, do you have anything that you can cite that would be a negative too long jeopardy when it comes to GLP ones? - Yeah, great question. So, you know, there's rare things called the zebra's and medicine that you don't see very often, like multiple endocrineoplasia and GLP ones be contraindicated due to cancer risk. But there's other things like even if you don't-- - Can you explain that real quick? So you're saying that GLP ones help with reducing cancer risk? - If you had multiple endocrineoplasia, which is a genetic condition, then your risk of cancers like medulary thyroid carcinoma, thyroid cancer would increase significantly. - Okay. - It's possible. So if you take a growth hormone, a lot of times you tend to, you think about what bodybuilders get a lot of. It's very suspicious bodybuilders get a ton of thyroid cancers and brain cancers like Dallas. - Dallas Macarver. - Yeah, thyroid cancer. - Thyroid cancer. And he was in, I say early 20s, I believe. But growth hormones do tend, you do tend to see more thyroid cancers and brain cancers. And interestingly, all GLP ones are growth hormones created dogs. So people have heard of GHRPs. They're gonna have three classes. GLP ones are the first. And you actually, in some people, you get a huge increase in growth hormone. For example, let's say a teenager comes into me and he or she is suspected to be growth hormone deficient. They might have low IGF1. I give them glucagon to test to see if it stimulates your growth hormone. You can do glucagon, you can do a GHRP, you can do clonidine. But a glucagon is one of the receptors that are tetrotyped binds. So we're tetrotyped. Once we see the phase three data, 'cause it's actually not FDA approved yet, I think it's going to significantly increase growth hormone and IGF1. So, which could increase cancer? If I had a, let's say I had a history of a thyroid cancer, I probably would not want to take retatretide. I would rather take chersepatide, or if I had an active cancer of any point. Let's say I had like a low grade cancer. I can't think of why retatretide would be better than chersepatide. other than it just makes you lose more weight. Right. But isn't it kind of a two-way street because it isn't obesity like one of the number one predetermining factors for cancer? Definitely. So, GLP ones also might decrease cancer risk because insulin resistance gets better. So you're more insulin-sensitive. Insulin can fuel a lot of cancers. You think about a type 1 diabetic. They actually have low IGF1 levels, but they have to take insulin to live and most of them get insulin resistant. And they actually also have very high growth hormone levels, despite low IGF1. It's kind of a paradox because generally you think high growth hormone, high IGF1, but type ones are opposite. Partly because of liver health, but anyways, they have unfortunately higher cancer risks due to those factors. So yeah, you want. The ideal scenario is optimal growth hormone levels, not too high, not too low. All insulin levels, which for almost all Americans is less. And then you have a healthy body composition that's not crashing or peaking too quickly. Very cool. I want to get into peptides because peptides, the last six months or so, have really come on strong. And when I say come on strong, when I'm looking at Facebook and you have middle-aged women hawking peptides through Facebook, that's when I'm like, "Ooh!" Specifically like, they stay at home on. The government is not going to like this at some point. So can you start by giving our listeners just an idea of what a peptide is, what a peptide is considered, and what they do and why they've become so popular? Yeah, so a peptide is just a string of amino acids, a small protein, between two and a couple dozen amino acids. Carnotine is an example of a dipeptide. It's over the counter as well. I'm sure you guys sell probably several for the carnotine. And it's just two amino acids and it's overly bioavailable, probably 10%, but you can also inject it. So it's kind of an example I like to start with because most people agree, yeah, carnotine actually creatines of peptide too. Creatines of tripeptide. So everyone thinks creatine should be over the counter now. That's not going to hurt your kidneys, et cetera. Probably everybody should be on it. But those are examples of what I call like the first group of peptides. Everyone agrees over the counter. It's fine. And then you have prescription peptides, GLP1s that we just spoke about and actually insulin as well and growth hormone or prescription peptides. Pretty much everybody agrees insulin and GLP1s that are injected should be prescription only. And in between you have lots of gray zone peptides. These are your BPC157s. These are your TB500s. These are your GHRPs like Tess and Rowlan, like Sermarallan and like CJC or even Mk677. It's an orally bioavailable GHRP. And there's a couple different ways that you can go with this. But some of them like Tess Morlan are actually FDA approved. I believe GRIF does the brand name, but it's almost never covered and the dosing flexibility is very little. But it's gone through clinical trials. It's very near to bioidentical GHRH. So I like that it's not an extremely synthetic unnatural molecule. We know exactly what it does and we have a lot of safety data. So I think this is one that should probably go more in the prescription side of things. But yeah, I hear people say often, oh, yeah, you need to get on all this stack. There's lots of names, Wolverine, Glow, Clow, etc. And you got to market it, brother. You got to get it. You got to get a good. It's a great, pretty cool name. It is cool. Yeah, it's definitely top tier. But anyways, I think that a lot of these should be more on the prescription side, especially if they're injected. You know, I posted the meme. I got it from the vegetarian meme like where do you draw the line for eating animals? Apocalypse, you eat rabbits and then if it's not an apocalypse, you don't eat the rabbits. But for peptides, you've rye draw the line as if you inject it and it's supposed to be sterile. You're injecting it into your body. You should probably get it from a pharmacy. Like a pharmacist should make that. And then if it's not, I do think it's reasonable to be over the counter. There's lots of things that are over the counter. Like insides, that's your ibuprofen and your relieve. And those things can be extremely harsh on your body. Yeah, there's the meme. So yeah, I think it's completely fine. You know, people can go to a lot of peptide websites and get various peptides that do have some harm. And as long as they have a decent idea of what the risk and benefit is as a population, that can then be sold over the counter. Let's talk about a couple of the most popular peptides. BPC157, TB500, those are typically sold together as someone say the Wolverine stack. Can you give an overview as to what those peptides are, what they are doing in the body and the potential upside, the potential downsides? Yeah, so BPC157 is body protective compound 157. It comes from a gastric peptide. I actually just dropped an episode just to make some peptides today. If you want to see the Gillette health podcast on BPC157, it's like a 12 minute video. Check it out. Shout out. Gillette health podcast. Yeah. That is, it increases blood flow, which is called angiogenesis, and it increases veg F. Other things like hyperbaric oxygen also increase veg F a lot and PRP, you're injecting veg F. So you're using your body's natural healing mechanism. There's some cancer medications like Avastin that block veg F. So if you have an active cancer, you probably don't want to blast BPC157 all the time, but it's found in gastric juice. So I think it's gastric pentadecoeic peptide. And it's just a bioidentical fragment of that. So I like that a lot that decreases this time passes if you have an unhealthy gut that also decreases. So I also use BPC in cases like inflammatory bowel disease, like Crohn's. TB500 is a fragment of a bioidentical peptide that comes from the thymus. It's a gland that is very active when you're young and that completely goes away when you're an adult. So it's probably one of the reasons why kids heal so well. And there is actually human data. So a lot of people say, oh, there's no human data on BPC157. There was a study on me pain for BPC157. It wasn't a great study, but it is a human, it is clinical data. It is a clinical trial actually, or it's a clinical study. And there's another study, but I suppose I think got a central America, but they never posted the results. So there's a couple of human studies on BPC157. For how popular it is, why wouldn't the FDA want to do trials on this and try to get it to market under a brand name? I believe they do. One thing that makes it more difficult is it's bioidentical. So I bet somebody's going to change a one amino acid on BPC157, do a trial, and then get it branded. Is BPC157 and TB500 is that orally bioavailable or do you have to take it subcutaneously? Yeah. So it actually is. Most people don't realize that. It just works a lot better subcutaneous. Right. But for my patients, it's a big thing. They go for your gut if you take it orally. Yeah. If someone's taking it for gut reasons, things like BPC and KPV, I specifically have them take it orally. And there's also orally dissolving forms of it as well. Okay. What is the name of a gentleman that was on Joe Rogan's podcast who is the guy who started a revive? Is it Brigham? Brigham, Brigham Mueller. He's such a unique last name. Brigham Mueller. Yeah. Brigham, he was like a three hour episode of just straight up. The whole gambit of peptides, right? And just where it's going, what happened? You know, but this was this this episode was like a year ago, probably at this point. Yeah. Which one I'm talking about. A lot of peptide companies are using or clipping up that episode as a reason to buy their peptides. Interesting. Yeah. Because he starts off the podcast just basically, you know, giving you the background of the DOJ and, you know, basically the whole medical industrial complex, right? But what I thought that he said that was really interesting is simply that these companies that are like basically the fear for him was, and this is my paraphrasing of it, of course. But he mentioned like the efficacy of, you know, the problem that we had for, he basically directly compared this to the opioid epidemic and that we're going into a peptide epidemic for the same capacity or the same rationale behind it, which was no one could get good opioids. So then they started getting street opioids and now we have this fentanyl epidemic and tons and tons of the highest amount of opioid deaths we've ever had just last year in the country. And this was, I guess, now I'm assuming in 2024 is when that happened. And so now he's saying, well, if we're going to get rid of all of these peptides and now these compound pharmacies aren't able to make them, people are still going to find their way of getting them. And now we're just going to increase the amount of terrible things that are out there. Yeah, we should definitely not. So I think the solution's actually pretty simple and he's right, I call it peptide prohibition. I compare it to alcohol prohibition. Yeah, and it's really, I think that's a great question. You can pull up my post on that too if you like. My post is about that maybe a week or two ago. Is that on your personal or gelatte health? On my Instagram. Okay. But basically between 1920 and 1933 they banned alcohol but people of high socioeconomic status still had easy access. from his doctor. So if you get a doctor's note, you get basically drink as much alcohol as you like for medical reasons, you know, take some other times. But yeah, and basically the same thing, people, people are still going to have access to peptides that are high SES, but people that just can't afford that access. They're going to get peptides off the street, just like they got alcohol that, you know, was like bathtub gin and they got lead poisoning and methanol, they got blindness, etc. So it was bad. But with peptide prohibition, they just need to take. So they're kind of like, you pick two of the three, you want something that is either FDA approved, well, human studied, or they have good, it's not yet FDA approved, but it's bio identical. And it also has good human trials. So if something's not bio identical, just like testosterone for women, there's no FDA approved testosterone for females. But in the last five to 10 years, thanks to a lot, just due to podcasters actually, the society in general is totally fine with women taking testosterone, which is also in their bodies, women have more testosterone than estrogen societies find with them taking that as part of HRT, even though it is not FDA approved. Right. Wild man, but it's my own PITRAT is started talking about that. And I mean, years ago at this point, you probably have talked about it quite a bit too. I think James and I were the first one to mention that females are about three times more testosterone than estrogen. Right. So James O'Hare is the nurse practitioner that does the gelat health podcast with me. But yeah, I apply the same logic to peptides, even if it's not FDA approved, if it's bio identical, and it has good human clinical safety data, for example, ARA290, not many people know about that peptide. It's actually for neuropathy, but it's well studied for diabetic neuropathy. There's many human studies that go decades back. Because that's one of the critiques of GLP ones is, and studied long enough. But some GLP ones we study 30 years back, like Xenotide, and ARA290 is just a fragment of bio identical etyropoetun. And there's good human data. It's not yet FDA approved. But the condition that it's treating has almost like there's not much you can do for it. Right. The thing I fear about this though, like, you know, going back to my original question of just like the black market, if you will, if this is the route that we're going to go where the FDA wants to come in and ban all of these, people are so going to find their way of doing it. Well, I mean, it's not unlike steroids. I mean, for the last, I mean, when were steroids banned, they were banned in 1987 or 85. And then there was like a 30 year period where people were just like making it at their house and selling it at the gym. So it'd be similar to that, I would guess. People didn't stop taking steroids during, I mean, I mean, I increased. That makes it so. But what makes it so different is like, you know, I don't know, I imagine now it's like, you know, with fentanyl. And what do you, you know, what Brigham was talking about? It's like, you know, just a Kyle's point that he made earlier, we have people who are hawking peptides that, you know, tried them for the first time a month ago. And now all of a sudden, they're selling them. And you know, my just is like a personal experience, my jeweler quit her jooling job. And as I'm like, I bought watches from this woman. And now she's like a full time peptide rep. I sold watches for 20 years. And it's like, well, gold rush. I'm in this now. And then there's another woman that I know that used to do, you know, like a classic MLM. And now she's doing a peptide MLM. And you're like, Whoa, this is getting everybody has a peptide company. Here's when people are talking about peptides, they're talking about BPC 157, Tessa Moreland, CJC, TB 500, injectable GHK copper peptide. And for those peptides, if people just replace the word peptide with medication, that would fix almost all the problems. But what I see here is if we do for like the governing body right now over the efficacy of these peptide companies that are in the United States, because obviously a lot of people are buying them from China, etc. But who is directly in charge of those that efficacy of those peptide companies right now? That's one of the big problems is if you're not a pharmacy, then you're not under the same rules according to the FDA. So they kind of have to prove that you're trying to act like a pharmacy. That's why they just say not for human consumption research chemical. So there's not really a direct party responsible, but they can fix that problem by just removing all the bio identical peptides with good human clinical trials like air a 290, Tessa Moreland, etc. Just put all those out of category 2 and it fixes all the problem. I don't really hear anybody talking about this. That's what the and some compounding pharmacies are lobbying for this because it's also good for them. But they need to fix that issue because at the end of the day, people are going to continue to be interested in peptides. And if they fill that supply with much higher quality, then people are not going to buy, you know, you can go to, I won't name the Chinese websites, but you can go there and buy 100 vials for $5 of aisle and then sell them to your buddies for $65. And a lot of people are doing that. That's crazy. If with your best guess, you know, five or 10 years down the road, what do what do peptides look like in America? Like where do you where are people selling them? How are they getting them? How many people are using them? Just your overview of what peptides look like, you know, down the road? Yeah. I'm glass half full. So regardless of what the administration is and who's in charge of the FDA, I do think that the current FDA commissioner in general is doing a good job. And I'm not a particularly political person. But I think that in five to 10 years, we have a lot more peptides that have been FDA approved. SS 31 is the most recent one, and Lamma preside. And it was approved for Barth's syndrome, which is extremely rare, but it's great that it's approved. I think more are going to go that way. And then I think that there's also a good chance that there's some sort of new regulation that hopefully shuts down a lot of these research chemical peptide companies and allows pharmacies to make more of them. Right. Is there is there any peptides that you see basically getting, you know, siphoned off and basically being essentially just sold as like supplements in the future? Not GLP ones. I'm not sure what's going to happen with GLP ones. Right. But they're starting to do oral that as well. Of course. So it's like, yeah, to your meme. Right. Yeah. And that would be able to do a GLP one over the counter. Yeah. Potentially. Yeah, it's what what wires a lot more oversight. So you know, I that's that's more of my thought from a health advice standpoint. You know, that's a general of thumb. But I think that I think peptides like KPV BPC 157, those are going to have oral and sublingual versions, you know, they dissolve in your mouth. I think a lot of people will be buying those over the counter. In fact, you can go to places like metabolic elite or anular and get those peptides over the counter right now. And those are actually made by pharmacists. But I also know those are gray area. Right. You can't sell you can't actually sell them over the illegally do it. Can you? As long as they're not injected. So if you go to annular.com or metabolic elites, you thought CEO something like that. None of those are injected. So it's kind of the opposite of a research chemical website. They're all either oral tablets or sublingual lead dissolving tablets. Is there any non, I would say like one of these non-regulated pharmacies. I shouldn't even call them that, right? But a chemical research companies, if you will, right? Which does there any of them that you actually stand behind? There's one that's decent and a couple that are interesting, but none that I'll name the names of. Sure. I there is a lot of pharmacies that I like. You mentioned revive. That's actually one of my go to sources for testimonial and that's compounded. So not the brand name, a grifter. And a lot of people do well on much lower doses. I don't want their IGF one to get above about 300. And I've also heard some people say that IGF one doesn't increase from GHRPs. It's not true. I actually just saw a patient today that's IGF one was over 300. So we needed to decrease the dose just like if you're on testosterone. And especially every side effects. And also your levels too high, you might want to decrease the dose peptides in the same way, especially injected peptides. Because you don't have to worry about bioavailability. But a strive is another one that I think is great quality. I think that Anisea was another pharmacy. Very good quality. And there's many other ones too. But in general, if I was choosing to inject something into my body, I would choose a pharmacy over something that says kind of like my main red flag if it says not for human use research chemical only. It's like, oh, maybe I should listen to that. Yeah. What what if you had to, you know, make a I mean, you are your whole business is basically the opposite of what I'm about to ask you to do. But if you had, if you had to make a recommendation on, you know, three or four peptides that you like that you think are going to be mainstays in that in the peptide industry that you think that people would benefit from what are those? Yeah. So hopefully these are mainstay. But I think the particularly underrated peptides number one, I'll actually put as a array to 90 partly because nobody talks about it. But there's a lot of people with neuropathy, whether it's diabetic neuropathy or otherwise, that have just gone to the end of the road. Maybe they've tried hyperbaric oxygen, they've tried high doses of B vitamins, but they haven't tried that. So I think similar to people with a debilitating disease like cancer or some syndrome, the look for orphan drugs or other urgent use authorization things. I think that that can help a lot of people. And I've seen some phenomenal results from that. And it's bioidentical and there's good clinical safety data. Next would be a testimonial. So I think that that's just one of the best GHRH analogs. It increases growth hormone, decreases visceral out of post. There's a lot of recovery benefit. BPC157 has got to be in there too. Almost for obvious reasons at this point. I've used it personally for and was very surprised at how well it worked. I had injured my shoulder. I got what I call crossfit shoulder. And I tried red light therapy. I tried hydrogen water. I tried rehab exercises. I even tried PRP, which helped a little bit all the previous things unfortunately didn't help my shoulder for two months. And within two to three weeks on PPC157 and TB500. And I also took a Russian peptide called cartylaxe that Putin's doctor invented. As a doctor, Kavinssen has a lot of interesting peptides. And frankly, I have a hard time discerning like because he posts the studies. But then Western medicine says his studies aren't legit. I can read and see his studies. And then it used to be I'd put in consensus was my favorite app. And you can download the consensus for chat GBT as well. But I put it in there and they'd pop up the studies. And now I put it in there. It doesn't pop up. So they must have excluded. So something's happening. It's a CIA. Anyways, I did that stack and my shoulder has been fantastic since doing that. So doctor, your own doctor about those peptides, but those are, all right, I hope that those reach mainstream use. And with that, you would, we would ideally have a lot more clinical trials. Yeah. Yeah, I think that's the, the big thing there is because. Yeah, there's going no matter what, I've been in the fitness industry for a long, I mean, long enough since, you know, 2010. And I've seen a lot of quote unquote gold rushes happen in the fitness industry. And they are always, always followed by the heavy hand of the government every time. And so when I see, when I see things that are, that are getting basically that are uncontrolled, you know, not coming from people like you, they're coming from like people that are far dumber than, you know, the random person I went to high school with, then I know, oh, there's about to be a swift, swift, a swing back of the pendulum when it comes to the, to the government at some point. So I think the, the trials need to happen. And some kind of, some kind of regulatory, you know, oversight has to happen to where it kind of reels things back in because are, I mean, would you agree that these things can be dangerous, they need to have, you know, people need to have oversight when using them, right? Yeah. I tend to be overly utilitarian, which basically means you go by the no harm principle, you're not harbing somebody else. I think that people can do whatever they like with their bodies. I'm definitely not a doctor that gets upset that somebody comes in on their own, you know, Jim Bro TRT or they come in on their own stack or what. And I think it's great that they're trying to learn as much as possible. But whenever possible, I try to recommend removing regulation rather than adding more. And I do think that there's a lot of other things, for example, stimulants or, uh, charms that are in kind of like the research chemical standpoint, but there's just so many better alternatives. Lots of people aren't interested in those because they're able to get, like, they, there's lots of physicians that if somebody would benefit more than they are harmed from a stimulant, it's all about the benefit to detriment ratio. Lots of people are on stimulants and, uh, TRT HRT from their doctor. So less people are on the research chemical versions. Same thing should be true of peptides. I do think if they removed almost all those category two peptides and allowed pharmacies to bulk compound them, those pharmacies would just out compete all these other companies and they would be shut down without having to, you know, hire a huge amount of staff and spend all of our taxpayer money in order to do so. Let's change gears to the blood test now. Blood tests are getting really popular too, man. It seems like it's more and more easy to do that online or do that and grab something from a kit from somewhere and then take it home. You know, what process, do you think is best and can you trust these ones that are, you know, you can buy off the shelf, if you will? Yeah, it's a great question. So, um, you know, it's kind of like if you had a car, except for organic machines. If you have a car, then there's a lot of ways that you can analyze it. Some are more accurate than others. You can hook up these computers to your car and think of labs like that. So if you're trying to figure out, um, you know, let's say what your progesterone or estrogen metabolite tests are, there's easy at home tests that you can do. But in general, if you want very accurate tests, then it needs to be phlebotomy. There's some exceptions to that that you can do dried blood spot tests and other tests that don't require phlebotomy, which is where they put a needle into your vein. And for example, I'll place like lab core request. But if you're trying to say, like let's say you're, um, a male and you're trying to figure out your estrogen level, then it needs to be a phlebotomy test because the test that you get otherwise is just kind of random. And, um, you know, people can go to sage bio.com, even if they don't buy the labs from that company that I'm affiliated with, they can still bring that panel to their doctor and if their doctor is willing to order it, then they can get those specific tests. But in general, I recommend getting your hormones, your inflammatory markers, and then your basic tests, like your lipids, your blood count, and then also as many vitamins and nutrients as you have the budget for those tend to be the most expensive tests. So you'll see my wellness panel is actually about the same price as my nutrition and vitamin panel. Yeah. When you do a dried blood spot test, explain that for our listeners as well. What's the difference between that? I know you did a great job of explaining the phlebotomy test, but would be the dried blood spot test. Yeah. So if people have had a child, they're probably familiar with like the PKU screen. To, you know, in the hospital, they do a little finger prick or a toe prick if it's baby, and then they fill up the little circle with blood. They send that off and generally companies that sell these. And I do order these tests occasionally, but they say, well, we're just as accurate as like the regular blood test, but they're comparing against the immunosacay blood test. So that being too specific, if you're comparing the cheap blood test to the cheap dried blood dried blood spot test, then yeah, it's about as accurate. But if you're a male, your estrogen level is not going to be accurate. If you're a female, your testosterone level is not going to be accurate. And if you're a postman, a pausal female, your estrogen level also won't be accurate. And those are tests that most people want to know an accurate marker of and not just kind of a random guess that could be, you know, plus or minus 50% higher or lower. And that being said, there's things like vitamin D or lipoprotein, little A that are very accurate for those tests. What about I always going to ask, you know, the future of blood testing, I feel like is got to get to the point where you're able to screen for cancers and for genes that, you know, are precursors to cancers. Where do you stay up on that and where are we at with those type of testing protocols? Yeah, great question. A lot of sage bios competitors do offer those tests on the website, but those tests, in my opinion, are ones that are best ordered after a conversation with your healthcare provider, your doctor or your MP. For a couple of reasons, one is they can obviously cause a lot of stress and anxiousness if you get a test back. So you want to be able to interpret it. Right. And then two is that there's also false positives and false negatives. So a genetic test that I like to order is called the Indivitae genetic health panel. It's one of the, you know, it's a company that is testing a lot of different things. So if there's a rare syndrome, they have tests for most rare syndromes that you can think of. And they also screen for different genetic cancer risks like multiple endocrine eoplasia that we discussed earlier. Actually, it's one of them. But you can get a panel that looks at things like your blood clotting risk. You can get a panel, the same panel actually called the genetic health panel. Also looks at your cancer predisposition risks. People might be familiar with the BRACA and it has both of the BRACA genes, but it has a bunch of other genes in addition to that. And actually a lot of these tests are positive because they're not just looking for this one little snip, which is like one little letter. They're looking at the entire gene and they tell you if it's like a common mutation and uncommon mutation. So they're unfortunately not easy to interpret for the layman. Right. There's also a, are they working to get those tests to where they are easy to interpret? Like is that work being done or is it, is this going to be like into the weird voodoo medicine avenue where people will try and act like that. You know, they have the answers or they have the blood tests that would, you know, tell you, but they're not super accurate. I'm sure they're working toward that, but we're a ways away. Yeah. Because if you have an uncommon mutation, then they do give you an estimate of how normal the protein would fold because a gene has a protein product. The gene is activated, then it transcribes and get the protein. So sometimes even we don't know when we have to discuss what it might be. But there's another cancer test that people are familiar with. People call it the grail or the liquid biopsy. It's called the grail gallery test. Grail is a company. Galeries the test. And this is not a screening test. So you have your screening test, which are like your colon cancer screenings, colonoscopy, mammogram for breast cancer, etc. then you have an early cancer. detection tests. So you think about a good screening test, it finds almost all cancers. So if you get a colonoscopy or a cologard, it finds about 98% of cancers. Whereas with a gallery test, it only finds about half the cancers. So if you get this test to 100 people over the age of 50, about 1% of them will be positive. But they'll miss about half of the people that have a cancer. Of the 1% of people they get a positive test, it'll tell you a signal where it's coming from, like the esophagus or the pancreas. About 60% are a true positive and you find the cancer and you take it out as early as fast as you can. And about 40% are a false positive. So we call these pre-cancers. But those people get unnecessary MRIs and CT scans and EGDs, etc. Depending on where the signal is coming from, that would otherwise not need it. So it's not a zero harm test. So that's why I don't list this test as something that's able to be ordered on sage bio. But it is a good test. And I think it's something that everybody over the age of 50 or so or that has more cancer risks should consider. What's the, I read an article the other day that was talking about people under 40 getting their cancer rates going up. What's your opinion on? What's the cause behind that? Yeah. What's that lifestyle or? Yeah. So it's both, you know, the conspiracy theory stuff is fun. And maybe some of the, I like a rabbit hole. Where are we going? Yeah. I mean, microplastics is the same one. Plastics. Yeah. Two big source of microplastics. Damn it. Damn it. Probably not a huge source compared to just the plastics in our room. So like, I don't know what the fire retardant is in this building, but you know, this is a huge building. So I'm sure they have a crazy amount of fire retardant and other materials. But yeah, just being indoors and breathing is by far the largest source of microplastics. No. Okay. I never guess that was a red that most, most adults have enough microplastics that you could make a plastic spoon from what's in your body currently. You heard that before? I've heard that. I don't know if that's true. Sure. Yeah. Sounds like a meme though. Yeah. I don't know. So you think microplastics is one of the main contributors? Are you saying this is a conspiracy theory? I think it's a contributor. Yeah. I'd say the main contributor I've had to guess is just metabolic syndrome. There's people being unhealthy and inactive. But those GLP ones aren't necessary, right? For the insurance companies, they say, yeah. You know, they don't need those. Yeah. So that, you know, that does help because if you're less insulin resistant, then you're probably going to develop less insulin-related cancers. Right. But another one is just inactivity. So one of the big ways that you can detox people talk about sauna, but literally doing cardio and sweating also helps you detox from microplastics. Another reason why I recommend people shower right after they work out partly because, you know, you usually wear like plastic clothes, basically. But if you sweat on a bunch of plastic in toxins, I think it makes sense to wash that off in a shower as soon as possible, even if you're not going to, even if it's your home gym, you're not concerned about like other people's bacteria. And then another source of microplastics would be coffee cups because lots of cups are lined with this plastic type of substance. I do a lot of coffee cups. And I know that it has like that that I'm still on it. Yeah. So you can order coffee cups that don't have, it has like a plant-based film that has no plastic in it. Yeah, I forget where I order mine from, but you can do that. But yeah, make sure you sweat, make sure that your diet has as many whole foods as possible because processed foods, yeah, a variety of different mechanisms are likely also increasing cancer risk. We'll probably figure out 30 years from now. It'll be obvious. But just try to live as naturally as possible. To Kyle's point as far as like the cancer risks going up or was it risk with the one you used? No, I mean, just overall cancer numbers of young adults is going sky high. And it's a lot of it's like, yeah, like you mentioned colon cancer and colon cancer one. It's also like prostate cancer. A lot of a lot of like they're saying they just lower the age that they're recommending your first prostate exam, I believe. Generally, we don't do prostate exams unless you have a high PSA. But yeah, most people don't get a PSA until around. Even thinking colonoscopy then. Colonoscopies. So there's several reasons why colon cancer risk is increasing. In fact, there was a recent study that said marathon runners and ultra marathon runners are at higher risk because they did colonoscopies on all these marathon and ultra marathon runners between 35 and 45 and a ton of them had colon cancer. And part of the theory there is and these people were big time runners. They had to run like four marathons a year or multiple ultra marathons. Wow. And they ran a ton of miles per week. But one of the theories is your fight or flight system is on so much and you're just consuming all these gels and carbs and just like junk on your system, which is feeding the cancer. Yeah. And also it's turning off your parasympathetic system, which generally heals the gut. So you don't have that balance between fight or flight and rest and digest nervous systems. Or it could be that a lot of those products are processed. But I think there is some truth that you want to have your parasympathetic nervous system turned on. It's not really a natural thing to be running three or four hours a day and not having that time. So let your gut digest these things, you know, running eight hours and then consuming a thousand grams of carbohydrates is certainly like not a very natural thing to do and not great for your gut health. The one half marathon I ran, I had about two minutes before I was like, oh no, I need to find a bathroom. What is going on with me? And I just emptied everything in my stomach. Yeah. How does this, you know, we talked about microplastics. We talked about these are variables that have gone into these higher cancer numbers. Do any of these correlate with the lower fertility numbers that are happening? It's like a real epidemic in the country. Yeah. There's microplastics and everyone's gonads, ovaries and testes. Unfortunately. Now I still think that metabolic syndrome and the other lifestyle factors we mentioned are contributing, I think, our unnatural environment actually also contributes. So if more things were outdoors, then I think that like regardless of if there's microplastics indoors, I think that also helps with the like a two-at-airy hypothalamus/goodnatal axis. And there's a lot of other inputs that are important as well. So for example, Kispeptin is a kind of like a neuropeptide. It's also a peptide, Kispeptin is, but the brain will make it and it helps release a G and R H, which helps release L H and F S H. And there's a lot of social inputs to Kispeptin release as well. So, you know, it's involved in delayed puberty and early puberty, et cetera. So I think that are like, you know, humans right now live very different to humans in the past. It's kind of hard to prove scientifically, but I think that it's true. One of the other issues with fertility is that people are taking a lot of substances that can temporarily alter fertility, and it's not popular to say. But, you know, things like oral contraceptives can temporarily obviously decrease fertility, and it can take a few months after you stop those oral contraceptives. They're just synthetic hormone replacement therapy, which is fine if the benefit is enough. Being able to choose to have a child at the right time of your life is a huge benefit. So I'm not necessarily anti-all oral contraceptives, but lots of medications can affect that. For example, metformin, SSRIs, statin medications, and other lipid medications. And then a lot of supplements can likely affect fertility as well. Lots of peptides affect fertility for the better or for the worse, actually. But at the end of the day, and there's other things too, for example, with cancer and fertility, like a lot of people asking about immunizations, there's probably comments right now asking about immunizations, which is kind of a whole nother topic. But, yeah, just replace immunization with medication and then talk about the upside and the downside at each one, because a lot of them are more or less inflammatory. And how much your body is inflamed, how much your C-reactive protein spike after taking something does temporarily, mostly temporarily, affect your fertility and cancer risk. Speaking of immunizations, are you a big guy that gets a bunch of, you know, vaccines or shots? Like as a doctor? Yeah. Good question. I have had some immunizations. I've actually had something like 40 happy immunizations. I still don't have any tighter. So in hindsight, I would not have had so many hepatitis B immunizations. I do think that there is a lot of benefit to some of them, especially if you, like, let's say you have someone with a cochlear implant, then you really want to make sure you preserve that ear as much as possible. You want to get immunized against things that commonly cause ear infections, like streptococcus pneumoniae, and also like hyb, which is homophilus influenza. And you probably want to get a T-dap, like a tetanus shot. That being said, all of those actually have downsides, even in addition to Gionn-Beraisin room, which is a GPS, which is kind of like when you go to the doctor and they say, oh, well, the only downside is like a 1 and a million risk of GPS. A lot of immunizations transiently raise your CRP, your C-reactive protein. And you can also have things happen like cluster headaches. You can also have meningitis. You can also have basically just be ill. And that transient neuro inflammation is not great. But guess what else is not great? If you actually get the disease or the virus of the bacteria. Generally, you have much more inflammation. So there's a lot of. causation and correlation studies and dependent on if people are like pro or anti-fax or immunization friendly, which I think is the term that they use for like middle ground people, which I would consider myself to be in That you just talk about the upsides and the downsides There's a lot of correlation between bad outcomes both for doing a lot of them or not doing a lot of them But my overall opinion to directly answer your question is I think in general people get way too many And they should instead of asking about like a vaccine or immunization just think about as a medication So if we were giving if you're giving your kid your child, you know Multiple dozen medications. You would think well, why am I giving my child so many different medications? But if somebody gets sick a lot then I like checking titers to the disease that it's specifically Gonna target sorry for the long answer, but yeah, the short answer is most people get too many and then most people are getting zero I think are getting too few are you happy about the peelback that Mahad did you know with RFK juniors far as with newborns as far as the amount of Recommended vaccinations. I think it was a great step. Yeah, I think that it probably needs to be trimmed a little bit more in general But what my big hope here is that there's Ideally no schedule at all because for medicines, we don't have a schedule For healthy people for unhealthy people we kind of have a schedule So let's say somebody gets chronic respiratory infections chronic sinus infections and chronic ear infections then Then you would go down the algorithm where you get streptococcus pneumonia you get hyb and you get Pertossus that way if you got them you wouldn't get extremely sick and then maybe RSV as well if you're an older age category But but in general, that's not one that I'd recommend to most people so I'm generally not a fan of recommending a medication of any type like an injected immunization to a hundred percent of people or Or zero percent. Yeah, so is there one that comes to mind for you that you just simply think like why is this even on the list? For a newborn specifically. Yeah back when there was COVID immunizations for six months old. I thought that was crazy Yeah, now they've scaled that back obviously And you know there are some newborns that benefit from you know somebody will also say well. I knew this newborn and they The mother tested negative for happy and they still got vertical transmission of hepatitis B which is where it passed from the mother to the baby And you know, that's a risk, but there's always exceptions actually. I don't know if this is true, but I read something that if you state a general of thumb and Then somebody said it brings up the very rare exception. It's a sign of low IQ. Not sure if that's true or not, but There's always exceptions to all these things, but yeah, I think that The first six months or so. It's reasonable not to get any I also think getting one at a time is very reasonable. I'm personally very upset at this because I have three kids as well and we're on Christian health sharing So we don't even do health insurance routes at the system There's a medallion there's eye on their chn. There's some meritons. There's a lot of good ones and Especially if you're healthy without pre-existing conditions, but they don't cover immunizations So I have to go to the health department to get mine and They're extremely expensive Even for me. So if the government really cared about Herd immunity and public health they would be free every one of them and you'd be able to get just one at a time They wouldn't have these combos where you're getting You know six different ones at the same visit That part's bananas and then for me and for us, there's what is a health share? Christian health share is not health insurance, but it basically functions like health insurance if I broke my leg went to the hospital I'd pay my it's not deductible, but they call it like your share and I pay my I think it's $5,000 and then after that They would reimburse and it for me it was like one six the cup in the monthly cost of health insurance So it's great and at your let health. That's what probably half of our patients have half of them have a high deductible plan Where they just use their HSA to pay for everything sure yeah, and I do have two dear friends of mine the goldsmiths Dr. Kelly and Dr. Paul she's a pediatrician. He is a family medicine doctor and they're going to start in August and Amanda doctor Mark who's my dad and myself. We also see pediatric patients as well but Yeah, I think that the The average person who has no pre-existing conditions that is thinking health insurance is not doing anything for me I think they should at least consider health insurance. I know there's a cross fair specific One is insurance, but a sure health sharing. Yeah, yeah, health sharing I forget what it's called. I think it's called community care something like that But if you remember of CrossFit gym, there's one that is even a lower monthly price Hmm, that's a good deal for a lot of people. Some of them to consider. That's really interesting. I got a I get a quick question for you And I can't remember if we talked about this on the last podcast or not, but Along with some of glutides and GLP ones the There has been a rise in the young population using nicotine pouches. We talked about this on the last podcast What is your what is your because you know there are studies of nicotine being beneficial, but I believe Not at the not at the rate that they're being consumed now. So what is your what is your overall opinion on nicotine pouches? And their rise in America currently I am pro nicotine, but I'm anti nicotine pouch Oh, I've seen the things where they they compare the out to the zin and the help is so much cleaner whatnot, but I have never seen somebody start nicotine pouches and take them every day and not escalate their dose sure Basically borrowing tomorrow's Nicotine or agnitian for today, which is okay if you want to do it I occasionally use a nicotine trokey or something called Tabex, which is a non nicotine Alchaloid or it's not made from the tobacco planet. It's a different plant from the cytosus plant and you can actually get that on Amazon tablets and then occasionally I'll do a patch. I probably do this once every two to three months a lot less recently but the nicotine molecule in and of itself. I don't believe his carcinogenic at the right dose What is that dose to you? half of a milligram for a trokey and the lowest dose patch, which is the seven milligram patch But you take it off after two or three hours. You don't leave it on for 24 hours Because you eventually are gonna desensitize your nicotine or receptor your nicotine It's so is there oral like the fact that it's in an oral pouch Let's say they there's I believe as an athletic nicotine car. What's it called? Yeah, I think there's is like a milligram. It's like a milligram I think they only do like one to three. That's the highest they go Is it the the milogrammage dose that's that's the issue to you Kyle or outside of like you know the habit forming that you're doing But is it the is there something wrong the pressure more about the pouch itself? What I'm asking about is is the oral pouch an issue because you're mentioning a trokey which is also oral but You know is that the pouch itself or the flavorings that that you have an issue with it's not the pouch trokeys can be an issue as well if I if I take a trokey it's 0.25 or 0.5 at the max and even then a lot of times I'm just feeling it because I'm so sensitive to it If a pouch was a low enough dose then it would probably be okay I just haven't seen one to where and some people do a one milligram pouch and they only take it once a week and they just After they take it they know that they'll feel a little bit depleted after taking one milligram But they take no more than one a week the issue is when people are taking it daily But if somebody's ever taken or have seven days of daily what is what is let's say somebody was taking it daily What what's the negatives of doing that not just from like a biological standpoint but also from you you mentioned feeling depleted what what what are the When you say depleted what exactly are you talking about? The receptor itself that nicotine binds to there's a lot of endogenous ligands basically molecules in the body that bind the same receptor as nicotine nicotine Necotinergic receptors you have nicotinic receptors and muscarinic receptors and These have a lot of different important nervous system functions and if you escalate the dose like let's say you're taking three milligrams six times a day of a pouch Then as you come off of that then all of those important body systems that are just running in the background are going to be down regulated So and you are going to be less Fluent your cognition is going to be worse. You're basically going to seem dumber if you're not utilizing nicotine Yeah, so it's similar to the it's not as big of an issue as high doses of ADHD meds But think of it kind of similar leads you somebody's on a really low dose of ADHD med and they just take it every once in a while They're not gonna have that like a little bit of a crash afterward where they just fill blah It's the same thing with nicotine. What's what's your opinion? What's the best way if somebody was taking high doses of nicotine to get off it? Is do you have any special tricks personal preference? Probably the combination of a patch plus Tbex tablets you do six a day five a day four day three two one and Tbex is just nicotine, but it's in a pill form. Tbex is not nicotine. I believe it's Scysticin And it comes from the cytosus plant so it's a different alkaloid It's still an alkaloid, but it's not tobacco some people call it Russian nicotine But you can get an online on Amazon. There's yep. There's one of them. What's that there's several versions? What are your thoughts on this call where it's where it's where about the habit of just the behavior? You know, you see somebody put a pouch in and you think I want to put it out immediately, you know, like you weren't even thinking about grabbing one, but now you won't want, you know, and the cigarettes obviously have the same effect on people, you know, I can't drive my car without having a cigarette as well, you know, I've heard before, you know, so is this, you know, the tabx or what was the other one? The patch, it's like, is it the physical behavior, right? Is it the crave right? And then the cue, the crave that, you know, sometimes it's both. Tabx and Canada actually was called crave, CRAVYV. If it was just a habit for the majority of people, then the zero nicotine vapes would be way more popular. Makes sense. So sometimes, yeah, usually not. We've experimented with some different pouches, our cognacyle, but we've experimented different pouches that that have no nicotine, right? We looked at trying like a the tropic, there's even a designer nicotine as a, gosh, what's the name of that? I can't remember it. Lookup sets, Luke, SCTT, nicotide or something. Yeah, nicodine, nicodine, yeah, nicodine, that's what it's called. And so we've tried these and like the truth is, I feel nothing. I mean, like legitimately, I feel almost nothing. I did say, I will say this on the pure nicodine pouch. We did like eight milligram, which was supposed to be like to the equivalent of doing a three milligram nicotine pouch. And it had like the smell of nicotine. It had kind of the texture. It made you feel like you were having it, but just I literally felt nothing, you know? And I'm not a big nicotine pouch guy. I don't take a lot of nicotine pouches and I have a high milligramage of those. I'm very sensitive to it. So to me, it was just surprising. Is there any other pouches out there or ingredients that you think would be really good in the form of an oral pouch to help somebody, you know, who wants to continue the behavior, but not get on anything that leads to addiction? I know a lot of people use chose descriptions. That's Dr. Scott's company and they have a bunch of different notropics. I used to try their calm pouch, which actually had some l-thiening in it, which is similar to sets. But a lot of people just aren't sensitive to l-thiening. They don't feel that much. And l-thiening natural comes from green tea, black tea increases like alpha waves, like calm, cool collected waves. I'm not going to do the same thing as nicotine. That I know of, nobody has taken the active ingredient in tabx and put it in a pouch. But it is possible that so part of the issue with the pouch or anything that's absorbed very quickly, including a high enough dose trokey, is it's absorbed so it peaks very fast. So it's the fast peak itself that you want to avoid. But if somebody wants a good company idea, then yeah, I just take the cysteine cytosine every say it and then put it in a pouch. The tabx? Yeah. What's the milligram? I think it's 1.5. This is naturally occurring. It comes from a plant, right? It does. I believe the story is one of the Eastern European militaries ran out at nicotine, which is not good for your military run at nicotine. And they gave them this instead and it actually worked pretty well. It was not very popular, but it prevented it withdrawal quite well. And there was a study out of the new adrenaline medicine that actually compared nicotine replacement versus tabx for side effects and also how efficacious it was for tobacco cessation and tabx outperformed it in both categories. Look up Nixidine, Luke. Let's see if Nixidine is tabx. What's, yeah, very just trademarked. You know what I mean? Right. Right. What's nicotine increases anxiety, correct? It can. It can. In high doses. I think so. What about what that you know, you mentioned being carcinogenic? What's the difference in the level of carcinogenic with chewing tobacco versus a pouch? Yeah. Chewing tobacco is much higher. Not anything that has anything that's tobacco derived is going to have more carcinogens in it. Right. And what's the reasoning for that? There's a lot of other carcinogens in the alkaloid. There's a lot of the alkaloids in tobacco other than nicotine. Right. So think of like a cratum. Cratum is not just one opioid receptor agonist. It's like, you know, hundreds of molecules that are biologically active. Same thing with tobacco. How do these, how do these other stimulants compare to nicotine in the form of like you mentioned about just the crash feeling, you know, there's caffeine, there's theine, there's ginseng. There's a million different ways that you can do stimulants or nitropics, which is obviously very popular as well. Now mushrooms is getting into the game when it comes to that, I feel like as well. Yeah. Great question. How do these compare? So there's a couple of different classes. The first class I would consider the adenosine receptor agonists or that bind adenosine receptors. Caffeine is the main one, but also metabolites of caffeine like perazantine or PX or rarebird. That's going to bind the same receptor. So don't take it with caffeine because it doesn't really make sense. I believe dinamine is in the same category and design a mic, which is like the mango something derived one. So a lot of different adenosine receptor agonists doesn't really make sense to stack them, especially if you already have caffeine. So most stimulants, either pick caffeine or pick an on caffeine that's going to exit the system faster. That's how people like PX or perazantine, a bunch of inner-d drinks that have that, for example, that are not tolerant of caffeine, but still want to have the exact same mechanism of action. And then you have your colonergic molecules. So think of like alpha GPC, colon by chart rate, anything that's colonergic is going to have that mechanism of action. And then you have your dipmunergic molecules with that mechanism of action. And then you have your nicotineergic molecules with that mechanism of action. And then last you have your niacinamides. So those are things that kind of give you energy via vitamin B3, which that looks like that's what the, I forget what you called it, but the other pouch, the niacidine is a form of a to nicotine mitre vitamin B3 derivative. So nicotine mitreibicide or NR is a very similar molecule. And there's interesting studies that show even if you take vitamin B3 itself, it will correct an NAD plus deplete state. So people have heard of NAD plus is like anti-aging, great for energy. I don't think it's necessarily anti-aging, but vitamin B3 converts to nicotine mites like NR small molecule, which convert to NMN, bigger molecule, and then convert to NAD plus. You mentioned NAD plus. What's your thoughts on if somebody was looking for energy, you know, taking it orally versus taking it, you know, subcutaneously or through injection? Actually, I think you take it intravenously, doing you? Yeah. You can do IVs, takes a while. Right. It's hard to tolerate. But that versus, you know, taking it orally versus taking it intravenously, and then also what's the difference between NMN and, sorry, it's hard to say versus NAD plus because I know it's a precursor, but they're essentially functioning in the same way. So NR is a very small molecule so your body can take it up, you know, think of like lots of things have it, but true NIAGen is kind of like the main brand name. Thorne has NIACELL as well, but that's easy to take into your liver, it's orally bioavailable. NMN is to some degree, but it has, you know, it's already in a minute, so it's already been converted from NR. And then once you're at NAD plus, it's positively charged. So if you compare NMN and NR supplements to IV or subcutaneous NAD plus, you still feel the NAD because it's working in your vascular system, it's in your bloodstream, but it actually doesn't get inside all your cells in the body as much, because it's very difficult to get something with a positive charge inside the cell. So I think of it as an energy benefit. All of these work better with CoQ10, because when you're downstream, let's say you're in R and MN, get inside the cell, or just your NAD plus is hanging out and acting on your vascular churri or endothelial cells. CoQ10 is what converts it into ATP. And ATP is like general energy for yourself. Right. So I tell people take a high dose of CoQ10 before they take their NIACENEMI or NAD plus. If you had to choose just one product and not exercise, not anything like that, but just one medication that was going to be the best medication for longevity, what is your opinion on what that product would be? Tidalophil. It's a PDE5 inhibitor. So as time progresses, it's actually generic CLS. Oh dude, I killed two birds with one stone. I love it. You know, think of it as a one-tenth dose of CLS. 2.5 milligrams instead of 20 milligrams. So you take a little bit every day, but in advanced ages, that enzyme that inhibits increases a ton. So I think it's actually very functional or natural to bring that back down to what it has been in previous years. And it helps you metabolize your nitric oxide less. So people have seen ads for prescription pre-workout. All it is is Tidalophil. Hmm. Wild. So it just gives you a great pump, huh? It does. Yeah. What you say? It can be bad. Easy. Yeah. If you're like, lifting, it's actually approved for blood pressure too. That's what I'm saying. So if you're doing some heavy sets of dead lifts or like a metcon or something, you take it to D'Alephil. Your back is pumped and your blood pressure's low so you pass out. This, I don't know why this reminded me of this, but do you, do you follow Brian Johnson, the longevity guy? What's your opinion on him? I love that he says everything that he does publicly. I think the whole people should do that. Yeah. And I talk about some of the best Gillette Health podcast episodes, it's just me talking about my frustrations with my own health or whatever's going on or whatever it is. But, and people also want to know what peptides and staxuron to do. So they can go find out. But that's one thing that's great. And then he, I think he legitimately wants to be healthier and help other people be healthier. And he has an organ system approach, which I think is a good way to approach it. He's very smart. He does seem like maybe he's like a little bit of a simp, but it is that's kind of a different story. But he just has very different goals from him. A Christian, not everybody has, you know, his big thing is don't die. Yeah. I want to die. I want to go see Jesus someday. You know, that's my metaphysical goal. Not everybody has to do that. But yeah, I just don't like that. That's the goal. I don't die sure it's our little match, right? All right. It does seem like there's a weird thing like that. Happening in America where there's, you know, tech billionaires that are obsessed with not dying. I listened to a podcast of Elon Musk the other day and the guy that was interviewing him was like, I'd like to live to 150. And I'm like, chill out. What was the name? 120 is where I draw the world. Right. What was the, what was the, it's becoming the new currency? What was the experiment that Brian did that you really liked that you wanted to try out yourself, Jeff? What was that experiment? What the longevity max? No, I'm talking about the, I'm talking to this try. I know what you're saying. Transfusing your son's blood into yourself. It was, he did measure his son. What did he measure on his? Well, first off, let's just, let's just, let's just rip on this dude for a second. His son's name is Talmage. All right, which is kind of sweet. I like it. What? Yeah. I'll never, you would never. It was a Talmage. Call him Talie. No, you would, you would never. But Talmage and him, he posted his results on the amount of nighttime boners he got. I saw that. Between his son. Jeff was like, this can't be real. This has got to be a meme page or something. Yeah, well, I mean, I watched his whole documentary before. I mean, I've talked about Brian on this podcast several times. The podcast is super interesting. I think everybody should watch it and to his point. Like, the guy has completely transformed his life. I think he's absolutely better off for it. It sounds like he truly, instead of just like, you know, going with the norm of what society would tell him to do, he just like truly went all in on what he wanted. Yeah, I mean, a lot of what he does, you like his supplements? That's what I really want to know. Do you like his longevity? I do not like his supplements. What makes you not like his supplements? That's what I want to know. Yeah. So there's a couple of reasons. One is he's supposed to be, you know, like this unbiased, unbalanced person that's doing these experiments just because. But what he ends up doing is just pushing a lot of his supplements. He also doesn't formulate them particularly well. And most of all, compared to other supplements that are higher quality and just as good, they're just very overpriced. So if somebody, I do have patients that take a supplements and some of them are OK. But for what they do, the doses aren't great. I don't like the blends and the price is just kind of like the nail and the coffin. There's just other better alternatives. And a lot of them are so niche that I don't think that they really move the needle. The average person that he's trying to sell those to is probably better off just starting your essentials, making sure your omega-3s are there, making sure your creatine is there. There's enough protein. A lot of-- most people don't have enough fiber in their diet. A lot of people could just add a fiber supplement blend, like sun fiber or whatever else. It'd be better off than adding some extremely expensive supplement. Yeah. I've got some-- we got a couple more topics I wanted to tackle with you. We're getting pretty-- an hour and a half right now. Right. I was-- But I got a couple really good topics I want to talk to you. So we might have to bring you back on here pretty soon, Kyle, because I still want to talk about hair loss. I know you have some really, really great research and some great thoughts on that. And something that I've been-- I've listened to recently that, like, they think that within five years, it just won't ever be a thing anymore. If you don't want to be bald, you won't have to be. What are your thoughts on that specifically before we get into it? We won't get any deeper, but just what are your thoughts on that? Do you think baldness is cured in quotes in five years? No. Even with-- so they're referring to Pp405, this hyped UCLA molecule. It's always a UCLA molecule. It is a new mechanism of action that kind of stimulates the stem cell, which is great. But I think that if they study it for more than six weeks, which I believe is how long they studied it, then that effect is going to wear off. So I don't think it's going to cure baldness. The other topic that came to mind was-- I was going to say, what about with-- Finasteride, Medoxidil, oral versus topical, what's your thoughts? Now we're just getting into it, Kyle. Well, I'm sorry. We won't do that. We won't do that. I know we've been holding them up. I was like, we got a podcast with them tomorrow. Right. But the other one I wanted to just speak on-- because we brought up Brian Johnson-- is him leaving the country and-- did you watch this part of the documentary where he went to a country that had no governing agency? And it was like he got-- was it stem cells? Do you have a strong opinion? Do you have a deep knowledge of that at all? It depends on the stem cell. So what made him have to leave the country for that? Because I think they do stem cell here. But why did he have to go there? Yeah. What country was it? Certain types of stem cells usually go to Central America or Southeast Asia. And it's basically because the more invasive your stem cell procedure, the more they're injecting it and the sketchier the source, the further away from the states you have to go. Now stem cells are relatively promising for some things. For example, it actually surprised me that a stem cell treatment was FDA-approved for Vidal Igo, which is a very difficult to treat in pretty debilitating skin condition. So stem cells are progressing faster than I expected for a lot of things. But I think that exosomes, which are stem cell products, are going to be the big breakthrough because exosomes can be designed more specifically. And you're going to-- like, it's already the stem cell product. So how does the stem cell help me? Is it producing exosomes or is it because it actually takes up residence and revitalizes your stem cells or both? But I think that exosomes are even more promising in the future. Man, so for future conversations, I want to talk about specifically telehealth. These brands that are-- they're turning into direct to consumer products, but using telehealth as the mechanism to get them to you and make you feel it's like it's familiar and it's easy like hymns and hers, who is probably the number one cellar of monoxidil and finasteride right now, probably in the country at this point, which is amazing. For somebody that didn't exist, probably five, six years ago. So lots to talk about there. I want to talk more about health fads. Basically, it's like, do you think cold plunging is still going to be popular in a year or two years? What's going to happen with-- It's already dropped off. We've already reached the peak. For sure on the peak, but I mean, we still are seeing brand new businesses open up as that's their main draw. You got sauna, red light. With wellness and health, I think, being-- something that's not going anywhere anytime soon. And I think people are starting to really want to take health into their own hands, which I'd love to see, wanting to be in control of their health and truly take longevity serious. I think all these things are great. And I just want to talk more about just the trends of what we're seeing and do we see them continuing. So today was really great. We talked about a ton of stuff, but tons more to unwrap. And we'll do that another time. Thank you for coming on, man. You're always one of my favorite guests. And I feel-- We don't typically have to fight over who's going to ask the next question. So you had us doing that a million times today. So, man, just such a great time talking to you. Thank you for taking the time to talk with us. And let's do it really soon. Thank you. I appreciate you. [MUSIC PLAYING]