#222 Peptides, Hormones, and Longevity: Safety, Skin Aging, NAD+, GLP-1s, and Mitochondrial Health with Dr. Ksenia

Is Melotanon too dangerous? Yes, absolutely. And I believe in that from the bottom. Again, there is no proof of it that it is dangerous, but from the mechanistic standpoint, if you do understand why a chemistry of that molecule, what it does, it can be potentially dangerous. And especially in people who are prone to malls, especially in people who have the history of women basal cell carcinoma, do not take that. (upbeat music) Dr. Kay, or Dr. Cassania, welcome to the show. Thank you, nice to be here. Well, it's excellent to chat with you today. And I've got a lot of questions prepared for you. And I'm super excited to get into it here. So, you work in hormones, peptides, regenerative medicine, longevity. What do you think mainstream medicine gets wrong about the space? And what do you think health influencers get wrong about this space? Well, get thrown about this space. Conventional medicine does not believe in prevent, in what we do, correct? Because what I do, I work with peptides, stem cells, IV therapies, hormones, and conventional medicine doesn't really recognize that as anything that can help people. But as we see the real world evidence, we see that it actually does. I have many patients who got off blood pressure medication and cholesterol drugs, just by losing weight and getting the micronutrient via intravenous infusions, because most of, if you see in today's society, nobody really absorbs food as we did before. We have gotten flamed, disinflamed, everything is inflamed. So number one is to decrease the inflammation. And when you tell medical doctor who are conventional medicine about things like that, it's not FDA approved. You have evidence. Can you prove that? Can you prove this? I cannot, but I can mechanistically hypothesize, right? Based on my analogy, biology and biochemistry, and I have a background in bio-pharmaceutical science. But yes, absolutely, we do not have evidence on most of the things that we're going to talk about, but we understand some mechanism. We do have some data. So if it's not FDA approved, it doesn't mean that it's bad for you or we should not be using it. - Yeah, I agree. I think that mainstream medicine is always, unfortunately, a little bit behind and sort of a little bit timid about getting into preventative medicine and things that people are using, particularly, you know, peptides and some of these things that we're going to talk about today. And then unfortunately, too, there's, you know, wellness grifters online that are kind of saying that it's the only thing that you need and they bypass some of the other things and kind of over-promise. So it's a bit of a strange area that we're in here today. - Of course. - So should women be taking low-dose dialysis? - Why not, again, but let's, what's the mechanism of the low-dose? It's five milligrams of the dialofil. And what it does, it's vasodilates. Why it was, again, it was initially invented to prevent man to develop prostate cancer because it, but vasodilates, it brings the circulation to the prostate which decreases inflammation, decreases the occurrence of infections. Can it be done with women? Absolutely. The tissue is the same. And if you do ask athletes, ex-athletes from, let's say, Soviet Union, all of them took Seattleists. - So even the women? - Yes, even the women, yes. It gives you the boost of nitrous oxide before the workout. So I have, I know a few heavy lifters from back home who would take that before 31 hour before the lift. So the endurance, I guess it helps with endurance. I've never tried it. I guess when I get to the manopause, I'll start taking it. - And is five milligrams of upper data limit or can we increase that dosage a little bit? - You could, you could, but then the effect of, with man, the erection may start. So it depends on man. When I give them five milligrams Seattle, some say it has absolutely, does not affect the erection, but some say, "Hey, even five milligrams will give me a boner." So. - So you gotta be a little bit careful. - Yeah. - So, but for some men, they can go beyond five milligrams. - Correct. - Like additional benefit? - I don't think there's that gonna be additional benefit. Five milligrams is five, I mean, that's what it works. So that's what we have evidence for. Can we take seven point five? Yes, but they don't make in seven point five. They take in five, 10, 20. So I'd say that every man should probably explore that. - And you mentioned something interesting too about Seattle's moment ago. You said that it can be effective for prostate cancer. Is that correct? - Yes. - It's a proof of. - Prevent it. - But it can actually be helpful for preventing prostate cancer. - Exactly. Because again, cancer is a multifactorial disease. And I actually worked in cancer research. I was a part of Radcliffe University at Harvard at one time of my life. What is cancer? Some of, well, again, multifactorial disease, but inflammation dries for proliferation and we know that inflammation can actually influence bad genetics. It can influence switching on the genes and all of that. So Seattle is five milligrams. If we just could decrease the inflammation at the prostate, it means we will decrease the chances again. I'm not saying that we prevent 100%, but we will decrease the chances of prostate cancer. Absolutely. - Interesting. And the reason to you, Seattle is over Sedanaphael or Viagra is because of the half-life. - Most likely it is half-life. I've never seen anyone take cell-denafil. It's a hundred milligrams. I mean, that's the medication that comes in hundred milligrams for erectile dysfunction. But the dialafil is what the research is where? - And can you develop a tolerance to Seattle? So meaning if people start taking it daily, can they eventually find that it's not effective for erectile dysfunction? - But you don't take five milligrams to Seattle for erectile dysfunction. You take five milligrams to increase some circulation to give you, let's say, a boost. But people do develop, again, resistance to even cell-denafil. So in my practice, when I give somebody cell-denafil, let's say four a year, they come back and they say, give me something else is not working. So yes, I'm not sure where the research is on that, but in the practice, what I see in my observational practice, yes, I see that people can develop resistance to cell-denafil. - Interesting. So you don't think that it's necessary that something else is going on. Like maybe this person has developed low testosterone or maybe there's some neurodegeneric thing going on or you can't develop absolutely a resistance to. - Seattleists and then just having it not work. - In my practice, we don't have any men with low testosterone, we put them on testosterone, if it's a low-dose testosterone. So most of them have the stosh on us in the 700s and they can still potentially develop resistance to cell-denafil and then we give them something with upper morphine. Upper morphine also is a very potent way to dial error. There is a company you can order it from compounding pharmacy to dialer field, upper morphine. I forgot the exact combination, but there are so many options nowadays. It's the dialer field, still-denafil, upper morphine, PT141, I mean, you name it. - Okay. Can you maybe go ahead and explain the other two besides the dialer field and to dialer field, the other ones that you mentioned? - PT141, it's the pre-lamb, I can't pronounce that word, it's the peptide that is FDA approved by LEC for women hypoactive sexual disorder, but we do compounding pharmacies, they can make it, it's in category one right now, so they do make it in the nasal spray formulation for men and women with a hypoactive sexual disorder and it does help. The dosage is very tricky though, I mean, you have to really, for one person, one spray, I'm not gonna go into milligrams, let's say gonna work, but the other person, and he's gonna fall asleep. It's very tricky. - It's very tricky. - It is part of the, so it was derived from Melana-ton2, PT141, so it is Melana-quartic stimulating hormone, so it is part of that family. That's why it acts on MC1 and MC2 receptors, so yes, you can actually fall asleep or become nauseous or have those GI effects that Melana-ton2 can give you if the dosage is not correct, but I, again, I tell patients you should try it, it doesn't cost a lot of money, you should try it, and if it works, it works. And what I see in practice, it works better for women, that men, women require a lot bigger dose than men. - And when you say it works for women, like, they're able to get a rouse more easily climbing. - Yes. - And it was more, so they do have this desire that they used to have, let's say, when they met their husband then this playfulness that they describe. I did try it a long time ago, did not do anything for me, but I still couldn't figure out what my daughter was. I once I sprayed four times in my, and I just, I almost passed out. I had this dizziness and nausea. And I'm like, nobody wants sex after this. But if you do find the right knowledge, one or two sprays, it can do magic. It can do magic. It can give you much brighter and exciting orgasm. It can disband between two. There's also some, I think, acytosis and also plays role a little bit there. It's an interesting peptide. And then the last one you mentioned, apomorphine? - Apomorphine. I can't talk about that a lot because I'm not, I haven't researched it much. We have a few patients of ours who are resistant, again, to the dialyphil, sodanaphyl. It's not, nothing works for them. We give them a mix of the dialyphil, but apomorphine that I cannot talk about milligrams. I really don't remember, but the compounding pharmacy can take and make a compound for those specific individuals where the dialyphil and sodanaphyl fail the loan. - Okay, apomorphine is a cotton, cotton is a dilator. You can have revaction up to four hours with that. - Okay, interesting. I'll have to learn a little bit more about that one. All right, let's move on a little bit from the ED stuff, but I appreciate you introducing me to those last two compounds. I knew a little bit about PT-141, but I didn't know too much about apomorphine. Let's talk a little bit about aesthetics. So what are the three best ways of slow aging of the skin? - I say stop drinking alcohol number one. Stop eating processed food. Avoid sun, use sunscreen, I mean, those are aesthetics. I would say, but if we go deeper and deeper, there's so much things involved. - Okay, how about GHKCU? I know a lot of people are using that right now. Do you feel like that's better when applied topically to the skin or better when injected? - Well, when injected, we don't have much evidence about injections, right? We do have a lot of evidence on GHKCU topical. I do use the serum myself. I did try GHKCU injections. I did absolutely nothing to my skin, but I gave it to a few of my, of many of my patients, not few, and I did a lot for them. But they did, and I have melasma, and I gave it to one of the patients who after childbirth had severe melasma, and it's subsided by close to 50% on GHKCU injections, not the topical. I do use the topical, do I see results? I've been using it for about four months now, maybe, but I cannot really brag about it. - Okay, and what would be the upper daily limit of GHKCU that you can inject? I think don't inject more than two milligrams. - Okay, and is that because of copper toxicity? - I think copper toxicity should be analyst there. Also, remember that copper and zinc, they occupy the same receptors, so they will fight for the receptors. If you do prolong zinc injections, I mean, copper injections, you will deplete the zinc storage, and that also affects skin negatively, because zinc, we have zinc, if you, I have some knowledge in genetics, DNA is held by the zinc ions and copper. So if we get too much copper and do not supplement the zinc, we actually will get older, and nobody talks about that for some reason, on internet, right? - Yeah, no, I don't hear too many people talk about that, you're right. And with regards to the GHKCU and the zinc, so if someone was going to take, say, two milligrams a day by injection, would you then recommend that they take a certain amount of zinc or all supplementation per week? - They probably, yes, the zinc should be supplemented, but not, you have to wait eight to 10 hours between injection to take the zinc supplements so the receptors don't mess up the receptors, because again, if you just injected copper and you wanna take zinc two hours later, receptors are already occupied. So you need to wait until the receptors are freed. - Okay. - For the zinc. - Okay, so you definitely wanna separate the dose and what would be the dose that you would recommend for zinc if someone is injecting two milligrams of GHKUC daily? - I do not remember the zinc, honestly, what do I have to, I don't even remember the dose, the dosages of the zinc, honestly, we need to look it up. - Okay, sounds good. - Yeah, I mean, I, you know, urged people to look it up too, but I think, you know, taking maybe, you know, 100, maybe 150 milligrams a week, something like that. - I do, and I did take zinc, I just don't remember. I did take zinc, I would inject at night, I would inject at 10 PM, and I would take zinc at 8 AM. - Okay, and what was the reason for doing it at night, say, versus the morning? - Oh, well, because all the V-pares in our body are happening at night, and I think all the, if you want to take peptide to repair something, you should be taking it before bed. - Okay, yeah, that definitely makes sense to me. Anything else that we missed on GHKUC, I think? - Have you heard about copper agglies? - I haven't heard about copper agglies, tell me about it. - No, everyone talks about the copper agglies, a lower tic-tac, and they say, "Oh, you're gonna take copper, and if you break out, "and have this severe facial reaction," I was like, "Oh my God, why, why?" So I dug deep into the copper biochemistry and molecular structure, and I didn't find anything. So, but what I did find, we have the copper acts on E-C-M, the extracellular matrix. So there's two, the molecule that is involved in destroying that matrix is MMP, matrix metalloprotease, cannot pronounce that either, matrix metalloprotease. So when you inject copper, let's say in your body, or something, not the one you'd find it in, so those teenagers who injects in copper and have copper agglies, it means they bought unfiltered medication from the unknown website, and it's just not pure, and there are endotoxins and blah, blah, blah, that's why they have the pimples and everything else. But if we look to population over 40, women who have, let's say, fibrolysis in their skin, so that molecule, the MMP, it will destroy the bad collagen. That's its job, and copper will influence that. So let's say someone has been injecting sculptor, and you have these fibrolysis within your dermis. That's what copper is going to do. First, it's going to activate ECM to break down the bad collagen, and then it's going to start building new collagen. And that's again, this is hypothesis, no, it's nowhere in the research, just I'm making it, I'm putting two and two together because I understand biochemistry and biology and molecular signaling of the molecule itself. So what did that, how I came up with this actually? So I would say copper argolus in women over 40, especially who are entering the mandipose, we do have fibrolysis, we do a lot of injections, we do have bad collagen and fibrolysis within our dermis. So if we do inject copper within two months, you notice some uneven structure, it means the collagen, that bad collagen is being broken down, and the new collagen will start forming. Again, it's going to take time. - And for people who come in and see you and they want to improve their skin, do you ever prescribe them retinae or some kind of compound of cream that may contain something like estriol? - We have something, not, I would have something over the counter from quick silver pharmaceuticals. They actually sell the serum with estriol, and I do recommend that product. It has copper and estriol in the same vial. I think patients can buy direct from the website, if I'm not mistaken, and that's what I do recommend. - And also retinae as well? - No, I do use, but I do not prescribe. Most of my patients, they actually use it, they do go to dermatologists and they've been using retinae for a long time. It's a great, I mean, I think everybody, every woman should use retinae at some point in her life. It's a great compound. The cell turnover is awesome. - So would you say then your top three topical compounds would be retinae, G, E, E, E, E, E, and then estriol, those three? - Yes, and yes, hydroquinone, if you really have very bad melasma, yes, but you're right. - Interesting, okay. Well, thanks for letting us know how we can improve our skin. Let's talk about another anti-aging compound, so NAD. So why is it important to maintain high NAD plus levels? - Well, because NAD is involved in aging, and when I'm talking about the end of the day, know that we do have research that shows that as we age the level of NAD get depleted. Now we have a lot of precursors as NMN or NR or NAD itself, an intravenous infusions. And it's all controversial, of course. We do have some studies on NR and NMN. Not much studies on NAD because NAD is a very large molecule. It's very hard for it to be converted back to NMN and then back to NAD+ within a cell. But I use NAD+ infusions in my practice. And I know there is no research about that. But as a detox, benzode attacks, any drugs, detox. And we do see the blood work before and the blood work after with the levels of benzos, the IVs of 750 milligrams will get rid of benzos in your system. For someone who's been on benzos for two years and want to get off benzos, it's going to be very, it's going to be health for them. They're going to be at home shivering with high fever after the infusions, but within three weeks they'll be clean of it. And there's no research about it, but I see it in my practice and I also see that it does help patient with autoimmune disease. I have patients with serenica tritus who's joined the hurt and the large doses of NAD, three hour infusion. Two days later they would come and they say that the pain is virtually gone, not for long. So even though we do not have the research, it's very interesting that we should research that because it does something on a cellular level. And so it seems to be helpful to NAD+ infusions for particularly autoimmune disease and then also withdrawal from certain substances. Again in my practice, yes. Excellent. And then just coming back to NMN and NR, because I know there's a lot of people that have explored these different supplements. And so do you have a preference over one or the other for increasing NAD+ levels? No, I do not because everyone is different. Then there is no guarantee it's going to increase. There is no guarantee that again, if you have a IBS or Crohn disease or any issues with your gut, how can you guarantee that absorption is going to be there? If you take oral NMN or oral NR, you should have something like an enzyme that comes and puts that into the cell, we have to be absorbed into the cell. Then it has to convert it to back to NAD. And also some microbiome plays a great role with NMN and NR conversion. But what if you don't have that? Okay. So if you want to have high NAD+ levels and you're taking these supplements, you need to have a healthy gut microbiome. I would say yes. And I've taken through NIAGEN. I've taken through NIAGEN for two years. And then I went to conference. It was four or five years ago where we couldn't, I didn't know that we could actually measure the NAD levels in our capillary blood. And I went to the conference and the gentleman said, do you want to test your NAD levels? I'm like, yeah, I've been taking through NIAGEN for now two years. Let's do it. I came back to almost zero. And I was like, they said your levels were zero after taking through NIAGEN for two years. It was such negligent number. I was shocked. Wow. And how much were you taking? They're recommended dosages. I mean, I was on our subscription for two years. And then I stopped and I said, okay, I'm going to start microdozing NAD+. And I did microdozing NAD+. For about a year. And I retested levels did go up, not drastically, but the levels did go up. So maybe I do have a deficiency in an enzyme. Interesting. And so how do people get this test done? There's one test. You can order it online. Google NAD+. Maybe now it's more than one laboratory that does it. But you can actually order it in your pre-cured finger. You smudge it on a glass thing and you send it back. Interesting. Well, I mean, I know a lot of people are using these supplements and they're actually the cheapest supplements in the world either. Yeah. And then, and so I think it would be reasonable for people to get their blood tested to see if in fact, you know, they are increasing their levels of NAD+. But guess what now we have NR in injections. I'm going to start using that. It's much more expensive than NAD. It just, I think, through NIAGEN actually developed that, the injectable NR. And now all over Miami plastic surgeon are using NR intravenous infusions after the plastic surgery because they say the recovery is amazing. So I'm going to order it in my practice and I'm going to try. So what would be the benefit of taking NR infusion instead of NAD plus infusion? So now you can guarantee that it's going to be converted to NAD because again, NR, if you take an oral NR, it has to convert to with your microbiome, it has to be converted to nice and nice and the domino effect, I mean, it's a chain. But with NR intravenous, it goes directly into the cell. Again, we don't have much studies, but mechanistically looking at the pathway itself, it's so much shorter. So your body doesn't have to work so much harder to convert it back to NAD+. So I want to try it. Okay. And so basically you think that maybe the NR may be better than the NAD plus because of all the substrates that produces interesting. Okay. And when did this become a thing? I haven't even heard of this. I think this year someone contacted me, I've wrapped from two NIs and they just contacted the clinic and they said, are you interested? And I said, I am maybe interested, let me research it. And then I started to look into that and then I had a Zoom call with a wrap and she gave me all bunch of names from plastic, if you want to speak to plastic surgeons about that that are in your area, they all using it. I was like, wow, interesting. And is there a reason why they haven't developed NMN infusions? Not sure. Okay. And so I think you do inject 30 milligrams of NAD plus daily, is that correct? Yes. I don't forget, yes, but mostly probably four to five times a week I do. And what benefits have you seen? Right now, not much benefits, honestly, but when I did start, I should take a break because maybe we do over-seveulator receptors. When I do take a break, when I go on vacation for two, three weeks and I don't inject anything, when I come back and I inject, I do feel the burst of energy actually. I do inject it before exercise. Okay. And that would be the time that people should take that injection daily before exercise or in the morning or in the morning or before exercise, either or many of my patients that again, post-minopause, or women who have, we're still trying to balance their hormones and they do have this chronic fatigue. We do give them an AD up to 50 milligrams per injections and they do report that they feel more energy and they actually can go with their life, with their day. All right. Let's talk about another important anti-aging molecule. Let's glutathione. All right. Why is glutathione so important for anti-aging? It's master antioxidant. I mean, it's one of my favorites because it has skin whitening, abit abilities. It's one of the electron transfer chain. It's there together with NAD and serotonin and copper and zinc. It also plays a huge role in aging and anti-aging. One of the research that I read, I think if I'm not mistaken, I have to, it actually stimulates T cell proliferation. So that's a great for immune system. Someone who has autoimmune disease should probably explore glycephrine injections. Not again, not stimulation, but modulation. I'm sorry, let me correct myself. It's not stimulation. The immune system, it's modulation. It's where T cells have become not overactive. For example, we do give glutathione injection with people with Hashimoto because what's Hashimoto? There's high TPO's and lymphocytes that try to attack your immune system. I have that. My ATTPO's are like 340 and like 540. I have patients with 2000 and something. If you're reference for people listening, they should be under 30. But go ahead, I kind of interrupt you there. Yes, and so I do give glycephine injections that take them home and they just inject them subcutaneously. Up to 40 milligrams daily if they can tolerate that. We see after three months, I do see the decrease in antibodies, absolutely. And how much of a decrease are we talking about? From 2000 to 1200. One of the patients I remember. Again, why does he have to. Healthy patients, I mean, all the biomarkers are fine, no deficiency in zinc or iodine or anything, you know, very fit. We inject minimum testosterone there on few peptides and just nothing. I mean, with thyroid, it's crazy. And usually what I've learned in school, and I'm sure you, Dr. Hart, who went to medical school, they teach you third world countries with iodine. and deficiency will develop Hashimoto thyroiditis. But we live in America, and we have a lot of people with Hashimoto, and there is no iodine deficiency. So now there's speculation with Hashimoto and got Microbium. Actually, there is a research at Bula from 2025. - Interesting. Yeah, the only things I take for it now are very low doses of selenium and iodine. But I think the doses are 150 micrograms of selenium, I think 100 micrograms of iodine daily, if I'm not. - But again, nobody's iodine deficiency. So I implore people to actually test the urine for iodine before getting iodine supplementation, because if you're not deficient, we're not gonna do any good to your thyroid by adding iodine. - And in terms of TSH levels, is there a number that you try to get your patients to? Because generally speaking in Canada anyways, like four is generally the cutoff, but a lot of people think that it should be between one and two, or certainly under three. Like what are your thoughts on that? - Are we talking about those with Hashimoto's? - We're talking about just TSH in general. - But TSH in general is not. We monitor drugs with TSH, right? But if you're healthy, individual, you can TSH is produced by your brain, not by your thyroid, your thyroid, ST3 and T4, people get confused. So my TSH, my thyroid, it's not your thyroid, it's the brain, acts some, you know, for some reason it stimulates. But anyways, I would think 2.5 would be an optimal number for a healthy individual. - Mine was again like drifting, you know, towards the threes, and my T4 and my T3 were normal. And then, you know, I decided to experiment just to see with, you know, what would happen with about 25 micrograms, like a pretty low dose of drugs. - A thyroid, yeah, or a thyroxin. And I didn't like it, like I felt a little bit more anxious in jittery, I felt like I was getting warm. And then I backed off to 12 and a half, and I kind of still felt the same thing. So I've stopped it, you know, completely. And so I'm okay with, you know, having, you know, a somewhat high normal TSH, but again, my T3 and my T4 are normal. - Exactly. - Exactly. You know, if you're someone who has, you know, a high normal TSH, and then, you know, your T3 and your T4 are, you know, in the boots, like that's a little bit of a different story. Like for me, you know, that wasn't the story. Mine were basically like right in the middle of the normal range for both. I can't remember the exact numbers for my T3. And so that's probably why I had, you know, a bad experience with it overall. - And again, I would never give a patient a left eye, if they're TSH with a normal range, even if it's one point elevated, but T3 and T4 are normal, I would not give them a left eye, because they are converting. They convert T4 to T3 normally. What is the left eye, what is the left eye, and it's inactive form of T4 virtually. And I have many patients who I switch from left eye, to NPSIRO, because their conversion suffers. And I see that the left eye, Xynas no longer an option for my patients. - Yeah, yeah, it was definitely, you know, a poor experiment and a lesson learned for me, but I'm still sort of glad I did it, I guess you could say anyway, just because now I, you know, don't have the thought of it, you know, what I benefit, what I know that I don't, you know, definitively. And then in terms of glutathione, you know, coming back to that, a lot of people are supplementing now with NAC or anacetylcystine or glycine. - And it's just the first issue. - The patients are enough to increase glutathione. - But again, we go back to absorption, gut absorption. For some people, it's going to be okay. For some people, it's going to do nothing, absolutely nothing. And every second, I'm not afraid to say that every second patient that comes to my office have some gut issues, honestly. - And, you know, I don't wanna actually, you know, just a cyber, I didn't actually mean to ask you this today, but since we're talking about gut so much, you know, what are the things that you recommend to your patients to improve their gut health? Like for myself, what I do is I eat a lot of sourcrow, and then I also eat quite a bit of fiber. So I add salient husk, and then I also add acacia fiber as well, you know, that second fiber, the acacia fiber, you know, it really produces a decent amount of buterg acid, piponic acid, and then I forget the third really important gut acid that it produces, that the short chain fatty acid, and I know that the salient husk is primarily buterate. - Oh, yes, I do take it too. - Yeah. - Yes, I do recommend that very much. - And so is that like what sort of your general gut protocol that you recommend for your patients? - One of them is an AD, one of them is going to be an AD+ infusions. Second, what can decrease inflammation? - Yes, the fiber, absolutely everybody should try fiber, and see how they feel many, but again, with fiber, also some people say make them constipated. But why do we have inflammation in the gut? And the gut is your second brain. So if you have, it's not feeling well here, you're not going to feel well here either. So I do offer an AD infusions, then many people with gut issues have insulin resistance. So we do microdosing of GLP1's to zip it out. And actually within two to three months, their gut inflammation decreases. - That's very interesting. So for some people who have gut health issues, maybe even if they're not looking to lose weight, - Exactly. - The GLP1 can be effective for improving overall gut health. - Okay. - Excellent. And then, turns the patide, like the starting dose for that is two and a half milligrams. What would be the starting dose for someone? Like that's the recommended starting dose. I mean, what would be the starting dose that you would recommend for many of your patients? - 1.5. - 1.5. - For those who does not want to lose weight, and I look at them, you know, if they're skinny, if they're fit, but they do have this blurring and either diarrhea or constipation. And it's been going for years and years. I do offer as a trial, microdosing for about three months and see if there is any improvement in most of them. Yes, we do have improvement. - Interesting. And are you of the camp where it should be just injected once a week or are you of the camp that some of the GLP1s should be split up in their dose? - But let's look at the half-life. Semaglutide, the mechanism of action up to seven days. To zap, retarded try it now, it's sick days, six days. And to zap it out is five days. So I use only to zap it out in my practice and so we inject every five days. - Interesting. And then what is the reason for the teazepotide as the year preferred one? And again, it's my preferred. - Because of the GIP. Because GIP also plays role in decreasing inflammation. GLP1 alone with GIP in synergy, they work much better. That's why I think that where when it comes out, it's still not going to be the preferred medication to decrease inflammation in patients with PCOS or endometriosis or got issues because of glucagon. Glucagon will drive your metabolism. You don't want that. If you have an autoimmune disease as a chronic or IBS or any other diseases that associate it, but God, you do not take rarer. And I probably need to make a video on that that people take rarer and then they feel worse, but they're God. And I have some people DMs me on Instagram saying, I do take microdose rarer and my God is worse. And yes, mechanistically looking at the mechanism glucagon, it should not be injected by people without immune disease. Terzepatite should be. - Okay, so regarding the terzepatite, you still believe just once every five day dosing. - Yes. - That's your protocol? - Yes, yes. And then just coming back again to the glutathione. So what would be the best protocol for increasing glutathione? - Injecting glutes of hyone. - And how often would you do that? - Well, I would start daily with someone who've never injected, who've never, I would start daily for about a month. And then we can do three times a week as a maintenance dose. If you can inject 200 milligrams, three times a week would be great, but most people, again, it's things, it's in trimarscal, you cannot really inject 200 milligrams subcutaneously, so we have to divide the doses. But what I see, 600 milligrams a week, with injections is the dosage to decrease the inflammation that actually have some whitening effect in the face, people with some sun damage in the plasma. - Okay, and so the desired effect is to get a bit of a whitening on the face, and that would be from decreasing overall UVA damage from the sun. - The mechanism, you know, the mechanism is really, I couldn't come up with the mechanism of how glizzothion is whitening, maybe if I were to dig deeper, but I didn't, but that's the known mechanism of glizzothion is a whitening because you do have an even serum but glizzothion and it says they're the whitening. But again, I've taken it myself, and my amulasma would decrease, so summer comes, and after summer I will do a cycle of glizzothion for about a month. - And do you find that taking it during the summer months then protects you from UVA rays from the sun? - No, but it will help, because during summer, my spots get darker. Even though I put sunscreen, no matter how much sun, the heat itself, I live in Florida, the heat outs itself outside will hit the melasma and bring it to the surface. And then once the summer is over, I'll start injecting in October. So I'll do the months of injecting little time. Then I go back to an AD or I switch to something else because there's so many compounds, I'm not doing polypharmacy and I do three maximum three compounds at once. And that's my protocol again. I play and I play but I do experiment on myself and then I recommend it to the patient. And what people would benefit the most from glute thion? Again, people without immune disease or aging individuals, we're enough to over 40. Okay. Let's talk about a few more peptides. Does BPC157 cause cancer? No, it does not cause cancer. I mean, besides I would and I hate that people inject IGFRLR3 but it's a different story. BPC157 itself cannot cause cancer. And you can, and your genesis, if you have a cancer, you shouldn't inject anything. But let's talk about angelogenesis. We have physiological angelogenesis and we have pathological angelogenesis, correct? And BPC157 cannot produce pathological angelogenesis unless there is a right now something's growing within you. That's why physiological angelogenesis and when you catch yourself, when you hurt yourself, that's what physiological angelogenesis. That's when it happens. You know, you have the fiber blasts and migration of the cells and everything. But BPC itself again cannot cause cancer but we should be again careful because we have only research and rodent. And nobody knows whether cancer is growing within you. Will it promote cancer? If you really have an aggressive cancer, I should, I would not advise you to use any peptides ever. We've talked quite a bit about gut health today. Do you think that BPC157 helps with gut health? Yes, absolutely. It was BPC157 is a synthetic fragment of a big protein that is found in your gastrointestinal lining and which is responsible for healing the mucosa. And that's BPC157 can help. Does help not everybody but with some people. Again, I see it. I've given it to people with IVS and chronic disease. Some people say nothing. Some people say, oh yes, I do feel some relief. But you know, if someone has an injury and they want to use BPC157, should they inject locally at the site or is it okay just inject subcutaneously? It's a lot of total evidence. People say some researchers say that doing inject close to the injury. But again, from a mechanistic standpoint, when you inject BPC, it goes systemically. It has to go systemically. The receptors have, I mean, it has to travel and picked up by receptors. Even if you look at the literature on BPC157, there is not really, they don't really attach it. It doesn't attach itself to any receptors. It modulates something, a signal. Yeah, that's very interesting actually that it doesn't have any receptors. How much more effective is BPC157 when combined with TB500 for healing injuries? I would say much more effective because BPC157 heals mostly angiogenesis and BPC157 migrations. So it will tell the body to bring the fiber blast. It will tell them to build the new blood vessels. It will tell the extra cell matrix to start moving around the injury and closing the injury and healing it. And that's the evidence on rats, rodents, not people. And is there some that people can take continuously or should they just do it in cycles? See, we don't have those recommendations. We can, but I think not continuously. I think we should do anything continuously with peptides. I think you have an injury, do it for a month, two, three. Well, you probably should do it for about eight weeks to 10 weeks because the research suggests that it takes about up to three weeks for the BPC to, for your body to respond to the message. You know, and again, if your body is inflamed, if your body is low on testosterone, low on estrogen, low on many things, do you think your body is going to go and say, oh, let me go read that message that BPC gave me? That's why it works so well on Jan athletes, those, you know, broad gene pros who are between 20 and 30 year old, it works great on them. But then take a 60 year old man with BPH with low testosterone with CRP highs, F. Do you think BPC is going to work on them as good as beyond absolutely not? Okay. So the healthier and younger you are, the more likely you're going to respond to BPC 157, TP 500. That's what I see. Yes. Is Melotanin too dangerous? Yes, absolutely. And I believe in that from the bottom, again, there's no proof of it that it is dangerous, but from the mechanistic standpoint, if you do understand biochemistry of that molecule, what it does, it is, it can be potentially dangerous and especially in people who are prone to malls, especially in people who have the history of even basal cell carcinoma, do not take that. Again, I know I have a, in my office building, I have a dermatologist on the seven floor, who I go see, check my malls every two years, and he's like, oh, I have these patients, I know get a lot of those with melanoma and Melanatan too. Yeah. Oh, wow. So it is definitely increasing, like, scale can be different. Definitely. Definitely. If you had melanoma in your life, you should never touch it. If you see that every suburb, your number of malls are increasing, do not touch Melanatan too. You stimulate Melanatan too. X and one, two, three, four, five receptors of melanocortex family. Melanatan one, only on one and two. The more receptors you're going to touch, the more side effects you can expect to have. I'm just kind of thinking out loud now, and this might be a little bit of a silly question, but it is, anyway, you can take the melatonin too and then glutathione at the same time, and then that way they would kind of can't sleep out of the route when you would still get the tan. No, they won't cancel each other out because of the, again, molecular pathways. Okay. The most glistine cannot cancel MCR-5, for example, that Melanatan too affects our high levels of IGF-1 anti-aging or pro-aging. It is bad for your heart. I'd say that, especially if you have high less ventricular hypertrophy and you keep injecting something that elevates your IGF-1 and your heart muscle have those receptors, you will make more hypertrophy and people don't understand that. Because a lot of people, as you know, are taking peptides like GHs, secreted grogues, right? They're very, very popular. Semirellin, Tess Mirellin, Ipanmirellin, CJC-1295. There's a ton of them out there. The goal is obviously to increase your IGF-1 levels overall. Do you think that potentially there's some negative downside there because it seems like a lot of the studies, some of them wrote in studies anyway, indicate that it's more of like a pro-aging molecule than anti-aging molecule. Right. There is actually a rodent study where the mice who were exposed to IGF-1 aged faster and died faster than those who had IGF-1 levels are much, much lower. Absolutely. But can they be translated to humans? Maybe, maybe not, because if we, can any of the mice study can translate it to humans? At some, at some degree, of course. But again, your natural growth hormone, if you look at your natural growth hormone positivity, releases growth growth hormone two hours after a fall asleep, if you fall asleep. At 11, let's say it's going to start at 1 o'clock, it's going to last for about two hours, again, in pulses. And that's natural. Now, when you inject something, and I'm not against few of the IGF-1s, for example, Tessamorellen because it is FDA-approved form, HIV associated lipidistrophy, and we do it GHRH, it means it is very controlled. So the release of growth hormone will be controlled. Your body will still control it. Another one, we have Sermorellen that was actually FDA-approved for kids. Haxe-relin will also have, but Haxe-relin is very selective to the IGF-1 in your heart. So for those who are listening, if you do have high hypertrophy of your left ventricles, stay away from Haxe-relin, 100%, and just stay away from a long exposure to IGF-1, because why would you want, you know, everywhere, the receptors are there? What do you think is the safest GH to create a God peptide? Tessamorellen. Tessamorellen. It would be the safest. Is that something that you use on your patients? Yes, we do microdose at, yes, at point from 0.5 to 0.8 milligrams, 45 days a week for about three months, then you take a break. And you feel like at that dose, it's okay if their IGF-1 levels go up, it's not going to create some kind of like pro-aging. I do check their IGF levels, I don't see them higher than 300. So if I see, if someone comes into me and I do check before any peptide that I would suggest, that we do today. extensive blood work. If your IGF is already 300, I'm not giving you anything. What do you think are the most overrated and underrated peptides? Underrated probably time is an alpha. Time is an alpha is a immunomodulator with time olymp. Because inflammation is pro aging. If you decrease that inflammation and I use again, I use time is an alpha in many of my patients with Hashimoto's also. So I give I let them choose which I glue the tie and if glue the tie doesn't do anything for the antibodies, we switch in four to six months to time is an alpha and then we switch to thymoline and we see which one actually works best. And what I found that time is an alpha not only decreases with thyroid but also with your gut health. So everyone with out immune should probably explore time is an alpha because it's not stimulator. It's a modulator. It modulates your T cell response. T cells are very overactive during any autoimmune condition. So that medication actually modulates the response of the T lymphocytes. And again, time is an alpha is well studied. We have it, we have research time is an alpha and sepsis and Europe it's been used in Europe for the past 10 years. If not more in hospitalized patient in acute viral patients, Epstein bar virus, there's a lot of studies. I say it's safe. And it's an adjunct to chemotherapy or cancer patients. Is that correct as well? Or did I get that wrong? I did not see that. Something about yeah, I did read something about cancer. Okay. Yeah, I'll have to check on. But maybe it is because during some cancers they used the immune therapy. So maybe that's when it is used. Got to look into that, yes. And which ones do you think which peptides do you think are most overrated? The IGF ones, Melana Tantus. Maybe even copper pep. But again, over how old are you? If you're 70, will the peptides really help you much? You know, your body have to respond to that. Again, I can't stress this enough. It's a message. It's a message for your body to do something. It does not force your body to do anything. It actually, it comes and say, would you? And we may say no, I would not. Thank you. I have other things to do. So I know you've talked about mitochondrial health. I'm only having a few minutes left. I just want to ask you a few questions about that. So why should people care about protecting their mitochondria health? mitochondria is your powerhouse of the cell. It gives you a then a triphus ATP. And that's what is also responsible for your aging. And if you support your mitochondria, I sound like a commercial. You will age slower. mitochondria, again, SS31, right? That's the only medication that peptide that I can actually talk about, about mitochondria health, because we do know from a mechanistic standpoint that it attaches itself to cardio-lipin. It stabilizes the cardio-lipin. And there is a crystal within the metac. If you remember from biology class, you know, to remember the mitochondria and you have this little thing. So it does a crystal. And it actually stabilizes the membrane. So the production of ATP is so controlled and so regulated. It's very interesting. We do not have the proof of it. It is approved for a bar syndrome. And the latest research that I read, patients with bar syndrome, injecting SS31 could walk more than. Let's say they used to. They can walk 30 meters, but then with. I'm sure injecting SS31, they could walk 40 meters. So it means the endurance, the muscular endurance, you actually have more strength. Also, it's good for your heart. It's very cardio-protective. And I did not find any side effects. I think it's very safe in a small doses. I would say two to five milligrams. So SS31 should. Anyone who is over 40 should explore, because if you thought 25, it's not going to do anything. I mean, it's really not going to do anything. And do you think that it can be beneficial for endurance athletes who are already well trained? No, I don't think so. SS31 should be used with those with metabolic dysfunction, because if you are an athlete, your mitochondria is working great, because what increases mitochondria, even proliferation of the molecule itself is physical activity. The actual sport is making you. you know, is making you produce more ATP and more healthier mitochondria. What about MOTC? So this is the most overrated drug. Yes, this is exactly the most AMPK. Do you actually know what AMPK does? Rearounds, the energy, okay. So MOTC should be used, not in 20-year-old athletes. It should be used with chronically abys, with hypertension, and abys with hypertension and metabolic dysfunction. Then we can use it with GLP1 to help the GLP1, to rev out the energy from whatever the energy is doing, we're sleeping somewhere to actually burn something. But again, I have MOTC. You have MOTC within you. 25-year-old have MOTC that DMs me daily. Can I take MOTC? No, you have MOTC. Why? You do, and we have research about that. And so if you're an athlete, then there's no peptides out there that are going to boost your mitochondria health. No, I don't think it's, again, depends how old are you, okay? In the athlete, how do we have 40-year-old athletes? We have 40-year-old athletes, I mean. Yeah, well, again, the older you are, then you should probably, but if you're 20-22, I don't think it's going to do anything because, again, if you have enough SS-31 circulating in your already, that message, I mean, that molecule, MOTC, you have so much MOTC at 22-25-year-old that X-RMOTC will do, it's to be excreted by your kidneys in a bile. It will do absolutely nothing. It's a waste of medication. What about mitochondrial supplements like uralithin A or coenzyme Q10? Coenzyme Q10 will not be absorbed and I did the video on that, but uralithin A, I am taking it now, it's been three months. And what do you think? I do not feel anything, but I just hope for the best day of research is really impressive. If you read the research and uralithin A, it is impressive. Do I know? For some reason, I don't notice much. And we just have to maybe pause and start noticing, but I'm always on the run. And so when you said, you know, you won't absorb coenzyme Q10, are you saying that we should be taking ubiquinol instead or do you think that they're both kind of useless? What are your thoughts? No, they're mostly useless. If you look at the research, if you look at the breakdown of ubiquinol happens within your gut into the molecules that will do absolutely nothing to you. And so if you want to improve your mitochondrial health, just basically do more zone two cardio or like Norwegian four by four is like VO2 max kind of workouts. That's two. In my clinic, we do have COQ tens in injectable form. I do inject my patients with that. Okay, so injectable co-cutane can be effective. Yeah, it could be effective. If bypasses the first pass metabolism, bypasses liver, bypasses gut, it goes straight into the cells. And what's the dose that you use for your patients? I think it's 10 milligrams up to, if I'm not me, I need to look at the, see, I don't remember milligram. I think it is 10 milligrams that we stretch over two weeks so we can inject every once a week or every two weeks. And for sure. But they do. I know this nothing, but I have patients are like, I have so much more energy and they're coming for that, you know, they're coming back for the injections because they do know, maybe it's possible. In fact, maybe it's not, but they they come back. And why are you so confident about ubiquinol not being effective? But it's oral. It has to be absorbed through the GI tract. It has to go, it has to go through so much. The part is long process. And do we have ubiquinol in what? In capsule form? It's in capsule form. Do you take it? I've taken it before. Did you notice anything? It's really hard to say because I'm always pushing myself as much as I can. And so it's got a challenging to know. But you know, I can't say like, yeah, like, you know, since I've been taking this, I've noticed a gigantic difference. I've only also been taking it for maybe two or three weeks, something like that. So, you know, maybe it takes a little bit longer to see, you know, a good effect. But I'm going to finish the bottle anyway about two months. I have of a supply and see what happens. I mean, if you every month's physiology is different, maybe your physiology is more superior than mine. You have a special enzyme that you have a plenty of it that's going to come and it's going to just take it by the hand to the cell and say, go do your job. Sure. I hope so. Anything else on mitochondria health that we missed? Might be. So it's MOTC, NAD SS31, COQ10 exercise, of course. avoid alcohol and I want to stress that if you want to inject peptide you should stop drinking alcohol because your body will not go with those messages if you constantly drinking alcohol it will be It will be busy detoxing you Even if you're just having a couple of drinks on the weekends There's no what did you see the research the card cardio Cardio vascular Association of United States and 2024 I think said we are removing the moderate from the Commendation the word moderate so there is no save those of alcohol now I don't drink and I I've never really drink but are there any supplements that people should be taking if they are on a GLP1 drug Pantcreatic enzymes number one. I would say yes, absolutely lipase and amylase and the Hask silo sub I can pronounce it Silium silium husk and plant creatic enzymes and hydrate and If you do take a large doses of GLP1s you should check your for micronutrient deficiency three months into taking the large doses because of the slow gastric empty and the absorption also Get get slow and I have I mean I've Patients not die but not diabetic you know you I take a normal I be patient. Let's say a lady Who is 45 and I and I have a diabetic patient who both on the same medication in three months I check their micronutrient panel. We have an alcat test They they take a lymphocytes they proliferate them and they check micronutrient within those lymphocytes So it's the great test not the whole blood that you know whole blood Absolutely nothing is today tomorrow is going to be different and next week It's going to be different but lymphocytes it's the my it's an interest seller on micronutrient assay And those who have diabetes do not have as much deficiency who does not have diabetes now go figure Yeah, see yeah, it's definitely an interesting finding for sure and just coming back to the Enzons that you recommended how are people supposed to take those? They take it before food. That's so many on the market. I cannot I'm not going to recommend specific brand But there is you for every meal essentially. Yes, I maybe once a day twice a day you have to Check on the label, but you and people should try because some people will react Negatively and have a persistent diarrhea. So try other brands decrease the dosages just you know, it's a supplement to play with it Okay, all right, excellent. Well, I think our our hours off. It's been amazing chatting with you But can you let people know where they can find you online? If they want to work with you how they can do that anything else you want to share Yes, my Instagram is dr Xenia Miami dr. That Xenia Miami and I do I'm a part owner of the regenerative clinic here in Miami, Florida. I've been to Florida um And they can actually go to our website and schedule consultation with me without calling your office and website is www.idealmedwell.com Awesome. Well again, it's been a pleasure. Chadam and Fiori. Thank you so much for answering all my questions Thank you so much everyone for listening and as always I'll be back with another episode soon