CHATTING PEPTIDES with Dr. Jamie Gabel of Advitam

[MUSIC] >> Hi, welcome to the Doctors in Podcast. I'm your host, Dr. Alexis Azen, of a board certified plastic surgeon who specializes in breast surgery and transgender surgery with a holistic approach to wellness and anti-agic. I've been practicing in New York City for over 20 years. I continue to learn and educate as an associate professor at NYU Langbone Health plastic surgery. This podcast will explore stories of transformation and healing, struggles and victories, new technology, anti-aging wellness and spiritual health. I will speak with guests and tell their stories, and together we will learn from experts in science, technology, medicine, and wellness. Please join me in our mission to discover Zen. [MUSIC] >> Welcome to the Zen podcast. And I'm here with Jamie Gable, who is the founding director. What do we call you? >> Founding partner. >> Founding partner and clinical director of ad-vitam, which is to store, to do, to generate. And it's metabolic aesthetics and he's going to explain exactly what that is. And I'm really happy to have him back here on the 29th floor at 535 Fifth Avenue, shape for clinic. We were floor partners for almost a year. He moved floors and now he has his own floor and I have three quarters of floor. So we missed him dearly, but it's really fun to have you back. First let's just give me a little bit on your background and how you ended up doing what you do now. My background was first an athletic trainer at a undergraduate a very long time ago. So my passion was sports medicine for a long time. I like getting athletes ready for competition, taking care of them after competition. Being part of the team or part of the players world in terms of kind of like a mechanic and a mascot and your job is to treat this instrument to perform better. I really love that. And then at some point it was time for career change. I was working with professional tennis, which was fun and really exciting and going to all the big matches and sitting in. >> Did you still watch? Do you watch the show? >> I do, I did as much because I'm working. >> Working, did you watch the US Open? >> Yeah, I'll go back later on. >> Yeah, yeah. >> But I was traveling a ton. And this was really, really fun. I was going through a different country every week for 36 weeks. I would come home for two weeks at a time and then leave for four or six weeks. >> Sounds glamorous, but I think it's really brutal, right? >> Yeah, it's hard. >> It's not that hard. >> The rest of the world was moving on in normal pens. I would come home and be like, hey, is anyone want to get together? And we have work tomorrow. >> Right. >> But also, you know, wanted to have a steadier relationship. >> Yeah. >> Even job per se. It was just time. And just time to move on. And my wife encouraged me to go back to school for, well, I was wanted to do physician assistant. >> Yeah. >> But I think 13 years out of undergrad, I was like, I don't know, going back and sitting in a chair and hoping to open books. >> It's a big endeavor to kind of get psyched up about. >> Came out and went into orthopedics. >> Yeah, that makes a perfect sense. >> Yeah. And then through that is where I started getting the bug for longevity regenerative medicine because we started doing PRP injection, and some stem cell injections. And I wanted to learn a little more. So I got involved with some of the organizations that trained for these things. And then all the other one, everything's kind of there in front of me. And I started, you know, taking different courses, you know, since going back about six years. And then just putting it all together and making a challenge. The approach, at least the approach that I take here is like, let me take in all that information and see what we can do to optimize you on a cellular level using fairly natural substances. To be honest, it was very rewarding when I first started doing this because people might not feel great when they first come in, but they weren't hospitalized. You know, they weren't sick. >> Yeah, they weren't sick. >> So it's kind of like, could you really make someone feel better who's not feeling terrible? >> The answer is yes. >> Right. >> So, you know, a little by little, I started applying different things. Eventually, you know, creative system, different programs within our practice. We are three years after our intersection. >> And you've hired staff and you have more, I mean, now you're not the only practitioner in your practice, right, the other folks. So you really, you've really expanded, which I think speaks to a couple of things. I think it speaks to the desire for what you're doing and the population right now. But I also think it speaks to the results and it's not numbers on the scale, it's muscle mass, it's how people look. So you know, if it's not working, like, you're in about it and people in New York are very, you know, the bar is very high and there is sort of quote unquote competition for this. [MUSIC] So what do you feel are like the biggest areas where what you're doing can help people? So I mean, it's interesting because you used to be sort of in prevention of injuries or treatment of injuries. And now it's really like, it's almost like lifestyle, medicine, you know? >> Yeah. >> You know, I think always that first initial consult with the patient kind of directs me where it's going. >> Yeah. >> You know, are they someone who's suffering, weight loss is a hot, hot topic right now? >> Yeah. >> But 90% of the time, they'll start off with that and then as we dig during the consultation, you find some other things that kind of guides where the program is. But there are patients who are just like, hey, I feel pretty good. I just want to age as well as I can. Are there any programs where I just want to put on a little bit of muscle or I'm a long distance runner, I'm training for a marathon. Is there anything we can do in that area without going full-blown, like steroids? >> Yeah. >> But within healthy, healthy optimize. >> One of the keys is giving them some realistic expectations. We're going to start this today, but it could take one to two months before you're seeing or feeling certain changes. Now people do feel things right away sometimes. Everybody's sensitive to develop, so different, everybody perceives things different. >> There's going to be placebo effect for some people. I mean, I'm sure if you just put a needle in them, they're like, oh, I'm losing weight or I've gained muscle. >> That's me. >> That's me too. >> My wife will tell you like, as soon as I did my very first testosterone injection, seven years ago or something, I really feel that she's like, here we go. I don't know, it works. >> It works faster on me. >> People do, they're feeling this. >> Yeah, sure. >> But it's not, it's such a subtle, it's not as aggressive as a drug type of high. You know, you're correcting a lot of little things inside the body and people perceive it. You know, whether it's, you know what, I'm sleeping a little better, I'm simply deeper, and then therefore, you know, I'm getting up earlier, so I'm starting to work out. Now I feel good, some diet changes. I think people, it's easier to say that you should feel something and many other people feel different to see visual results regardless of what type of program probably takes a little bit longer with it, but it's happened. >> Yeah, because again, it's on a cellular level. >> In terms of the options, how do you categorize these medications? Are they mostly peptides? Is that how you call them? >> Yeah, we do hormone optimization, which can involve, you know, there's a lot of different peptides. Sometimes when I mention peptides, people think of, you know, example, Anguro or Zimilutide or Zepatide, and think that that's the only peptide existence, but there's tons of different peptides, and you know, you use a handful of them to do different things. When we build programs or for people, we add other things as well. So vitamin drips is something that we do. Similar to, you know, an IV infusion place, but again, that's not our only -- >> Right. >> -- our primary thing. So for me, I like to build it into this overall program. I know, okay, we're going to do this. and every month or every two months, we're going to have a vital little drip with it. the amino acids or something else. Everything still is geared towards this cellular level. Yeah. And we do some PRP work for care restoration. We do some stuff with exosomes as well. I mean, I think it's fascinating. And the majority of these medications are injected. They're injectables. So for most of the peptides, I use-- I would say subcutaneous injections. OK. So that tends to be small. Because I know people get scared about those things. But they tend to be really small needles. And not painful, really barely noticed. It's too small. Over the years, anybody that's ever had a needle for the-- Yeah. We've always been able to get them through. Oh, cool. That's great. And there are some back-- or nasal spray or sublingual even. It's just kind of, I guess, to the practitioner, which they like to use. So I just have a preference to certain ones that I use in the multiple. It's nothing to be afraid of. Right. You've been doing this work way before the ozempic craze happened. And I'm saying ozempic. But it's still really that whole category of drugs. And do you think that this is going to change the way obesity is handled in this country? That's a great question. That national hope so. These are really effective for a majority of people. And so to be honest, if it's accessible to the masses, it could really help people. They can end up so many things that I mean. It's wild, really, that category. Let's say GLP1. Yeah, too. I was going through some articles the other day. They're just finding that they do so many different things. So cardiovascular, neurological, even addiction. And various evictions. I had a woman who recently, who said, basically, I'm asking if you can put me on this because it helps me not smoke. I was like, OK. And-- Yeah, I was reading about that in alcohol. And it makes sense with how the functionality of it is. Well, I'm making my wife a king for saying this at that. But she wrote Taylor Carp for a pair recently. And so I'm doing higher dose BPC injections. And there's been a couple times where I just go back to the regular dose. She says to me the other day, every time you give me the higher dose of BPC injections, I orgasm quicker. [LAUGHTER] And it's like a wonder-- Right, we don't know the effects of it. Yeah. Well, I think that's something-- You're marketing strategy. No, totally. I think some of these men's, if they have a rejuvenative, effect on some cells, will why not on other cells? Yeah. [MUSIC PLAYING] I guess my other sort of follow a question about that is people go on these medications. And you use supervised them very tightly. And you do blood work. And before you put someone on hormones, they get screened. It's annoyingly rigorous. Because I met you and then I was like, oh, what? I was just to come back. So I was just to come back. So a lot of tests. But it's good. I'm teasing you. But it's actually very effective. In terms of weight loss, do you ever worry that people are going to take it too far? Because I don't know what's that stupid expression. Actually, I say it all the time. You can never be too rich or too thin. And I always say, but you can't be too fat. Sure. You probably can't be too rich. I mean, I'm not sure. But that one I could have-- Yeah, we're not sure yet. But I think you could definitely be too thin. And I think for some people who have potentially struggled with weight their whole lives, I could see that being a little dicey, when do you stop? And then I think also the fear of regaining weight is an issue for people. So how are you managing that? Because I know when you started-- these are tough conversations that I've had. And I've had a few recently where we had to take someone off. And they're really scared. And they were worried. And here's the other thing, two people per se themselves. And I can print out this bioanalyser analysis. So basically, the body cop analyzer is a machine that takes measurements of your lean muscle mass, your visceral fat, your external fat. And then it shows you over time how you progress. So you can really see, even if you're not feeling it, you get on this machine and it can tell you exactly where you are compared to where you started. So it's cool. Really important. I feel like, can I know not everybody does it? When I think it's really helped our practice a lot, for really keeping track of what's happening, because sometimes there's quite a bit of muscle loss with this. And we want to know that. So we can take the right steps to making sure that's not happening or if we can improve it. But yeah, a tough conversation. There was a woman not too long ago. And I said, you've achieved your results. Now it's gone a little bit too low. And I just said, it's time to take a break. And I'd be happy to revisit it, come back in 4, 6, 8, or 8 weeks or whatever it is. We'll put you on a machine, see where you are. But you're a practitioner first. And if I feel like, potentially what I'm doing, can cause harm. Then I have to pull back and have that conversation. And it went OK. It's just so much. Some of these patients are really-- they really like it. Yeah. And they tend to fear work. Yeah. On by the same token, there is so much that's written about recently gaining the weight back after going off of these meds. Personally, I have not seen that with people. And I attribute it to-- there's nothing magical about going off the meds that changes your inherent being or metabolism. It's the behavior, as far as I can see. And so if you gain a lot of weight, go on medication, change your habits, go off the medication, go back to the old habits. Of course, you're going to have some reverses in what you did. But if you maintain the habits, that's not going to be the case. Am I thinking about this right? More thinking about it, right? I do think that it can be a little bit more-- we had to figure this out too. Yeah. I guess my question is, is there a real metabolic change that happens while you're on the meds, that even if you maintain the exact same habits, you're going to have a sub-rebound gain. I mean, I think hepatitis in general really do have a positive effect, even when some of them are stopped, maybe not for a year or two, or a year, but it's almost like retraining, because you're sending a signal to start a process. Even though you're sending a signal, the signal you're sending is through a peptide, which is a natural substance to the body. I know specifically with some of the peptides, they have demonstrated that where a month later, they were able to see that this was like a growth hormone when you see a peptide that. The body is still creating more growth hormone on its own after a couple weeks or a month after using them. I guess the question is, well, how long does that last? Yeah. And I'm not sure. From my perspective, we try to keep people on certain things as if we were just focusing on the weight loss for a minute. I think you have to have them on it for a certain amount of time. When they hit their goal, you probably shouldn't pull them off right away. There should be a plan over it. How long? Like a weaning sort of. Yeah. Let's make you stay here for a certain amount of time. Then from that point, maybe do a bit of titrating backwards. And then at some point, you release the training wheels. And it would be good to do a follow-up. Like even if they're not on a program or the medication, check on them two months later, do a body composition that helps us. I think the way we've been doing it has been-- You know what I had a woman just came back. She was on the program containing the GOP1 peptides. And she had stopped for four months. And she was a tough one, too. wasn't like falling off. - Just slow and steady. - And she came back and she was a little bit lighter. Not much, but like, if that's to me, it's two or three pounds lighter. - Off the med. - Off the med, so. - So that speaks to habits that have changed and are continuing to change. - Right. (soft music) - Thank you so much for listening to our episode today. You can find out more about Dr. Jamie Able and his clinic, AdvideM by checking out his website, myadvideM.com, which is spelled, m-y-a-d-e-i-t-a-m-d.com. If you're hungry for more in-between episodes, you can always follow me on my primary Instagram account, @lexushaysandmd, and you can also stay up to date on the launch of my new skincare line by following @theseandessentials, also on Instagram. Bye for now, have a beautiful and zen day.