00:00:00
This may be the most controversial thing we have on this table. This is a peptide
00:00:05
that absolutely torches belly fat at a disproportionate rate. And what we found is not only do patients lose an
00:00:11
incredible amount of weight, but they also get the best improvements we've ever seen in their liver health. It's
00:00:16
absolutely wild. And I think this is going to be a trillion dollar drug when it comes out. And I brought you here
00:00:22
because you're an expert on this subject matter. And it's worth saying that there
00:00:24
was some significant news about this. >> Correct. from the FDA saying that in
00:00:28
July they are going to consider legalizing seven peptides and by pharma's estimate it might be the most
00:00:34
dangerous thing to their entire business model. >> So do you think it is plausible that big
00:00:39
farmer didn't want these in the hands of regular people because they can't patent
00:00:42
this and it's powerful >> 110%. Because the question isn't what can peptides do, it's what can't they do
00:00:49
and we've got several peptides here in front of us and I want to go through all
00:00:52
of them. >> Let's do it. So, this is probably the most well-known peptide for skin
00:00:57
complexion and it improves quality of hair and nails. And then epialon is maybe maybe not going to be the fountain
00:01:03
of youth, but I'm very skeptical as far as that goes. Next, we've got this. And
00:01:07
if you injected that at night, it would improve your quality of your sleep. Next, melan too. And this will actually
00:01:12
end up giving you a deep tan in response to just a little bit of UV sun exposure.
00:01:17
It'll also give you some of the most impressive erections you've ever had in
00:01:20
your life. So, be warned. And what else have we got? Oh my gosh. There's methyline blue where people take it and
00:01:24
they think it's going to make them live forever. Don't take this. It literally
00:01:27
will stain your nails blue and your hair blue. These two here stimulates building
00:01:30
muscle. This one can aid with healing after an injury. And then is this this? This this. It's crazy. It's wild.
00:01:37
>> So why don't I take it? >> Well, we need to talk about that because
00:01:40
there are trade-offs. >> But also outside of the world of peptides for a second. I've got these
00:01:44
three vials. Do you know what those are? >> Yeah. This is unfortunately our future
00:01:48
if we're not careful. >> Explain. So, what we've got here is representing the fertility trajectory
00:01:53
for young men. And I'm so scared. This is super interesting to me. My team given me this report to show me how many
00:02:01
of you that watch this show subscribe. And some of you have told us according to this that you are unsubscribed from
00:02:06
the channel randomly. So, favor to ask all of you, please could you check right now if you've hit the subscribe button
00:02:11
if you are a regular viewer of the show and you like what we do here. We're approaching quite a significant landmark
00:02:15
on this show in terms of a subscriber number. So, if there was one simple free thing that you could do to help us, my
00:02:21
team, everyone here, to keep this show free, to keep it improving year over year and week over week, it is just to
00:02:27
hit that subscribe button and to double check if you've hit it. Only thing I'll
00:02:29
ever ask of you. Do we have a deal? If you do it, I'll tell you what I'll do.
00:02:33
I'll make sure every single week, every single month, we fight harder and harder
00:02:37
and harder and harder to bring you the guests and conversations that you want to hear. I've stayed true to that
00:02:41
promise since the very beginning of the D of Sio, and I will not let you down. Please help us. Really appreciate it.
00:02:47
Let's get on with the show. Dr. Alex Tatum. There's this word that has exploded in
00:03:01
society in recent times. In fact, when I look at the data, people searching this
00:03:05
word has increased by 400% just recently. And that word is peptides. I have no idea what peptides are. I'm
00:03:16
someone that wants to be healthy, that wants to optimize my health, wants to live long, doesn't doesn't love aging.
00:03:22
>> Yeah. >> And I'm told that this word peptides is somewhat linked to it. So, I've brought
00:03:27
you here because you're an expert on this subject matter. I've watched your
00:03:29
videos on YouTube. To start at the very beginning, Dr. Alex. >> Sure. What the hell is a peptide?
00:03:35
Peptides are a structural class of medications. The best way to think about peptides is that just like we have small
00:03:42
molecules which are drugs that are very small taken in a pill and have a wide ranging effect throughout the body.
00:03:50
Peptides are derived from little pieces of amino acids which think of them as the Legos that make up the human body.
00:03:58
The Legos that make up proteins. These are fragments of proteins that are designed to specifically target certain
00:04:05
receptors and affect cells in a very targeted fashion. Or a best way to think about it is a very specific targeted key
00:04:13
to unlock a very specific lock. So instead of a small molecule that may have a wide ranging effect throughout
00:04:19
the body, peptides are much much more focused. >> So you've got different types of Lego
00:04:25
cubes here. Would they be different types of peptides or are they different types of amino acids that come together
00:04:31
to make a peptide? >> The best way to think about it is my son loves Legos, which is why I'm glad that
00:04:36
we have these here. But he can take the same set of Legos and he can build a rocket ship and then just a few minutes
00:04:43
later he can build a pirate ship and then he builds a race car. And he's using the same Legos, but he's creating
00:04:50
very, very different things that all do very, very different things. And so peptides have become incredibly popular
00:04:56
because yes, we have some really fascinating peptides that can help with anti-aging, with healing, and with
00:05:02
tissue repair. We're going to talk about some of those hopefully, but they can do
00:05:06
so much more than that. The first peptide that was actually isolated and used in medicine, was insulin back in
00:05:10
1921. And then all the way in 1985 in the world of urology which is where I was trained we had luplide which is a
00:05:19
different peptide that again also had peptide like insulin but instead of having wide-ranging metabolic effects it
00:05:25
had an endocrine effect. It was designed to shut down the production of testosterone for prostate cancer
00:05:30
patients that needed to have their testosterone taken away. >> Interesting. Okay. So insulin is a
00:05:35
peptide. >> Insulin is a peptide >> because it's a series of amino acids
00:05:39
>> amino acids that are put together. >> Okay. So you said that the combination
00:05:43
of amino acids forms a key. >> So what is the lock? >> The lock could be a cellular receptor.
00:05:49
It could actually be regulating a certain pathway within the cell. >> Okay. So let me repeat this back to you
00:05:54
to make sure I understand it. So peptides are like a key. >> Yes. >> Which you can make by configuring amino
00:06:01
acids in a certain way. And there's different locks in our body that these keys can go into. So if I take, you
00:06:08
know, we got some peptides on the table in front of us here. So, a a good way to
00:06:13
think about it is this. If you've got a hammer, right, which is what a lot of
00:06:18
small molecules are, like you can do a lot with that, right? Like you could a hammer in a nail, but if you try to use
00:06:24
that hammer when you're trying to put in a screw or you're trying to put
00:06:27
together, you know, a table that you got from IKEA, it may not always end the way
00:06:32
that you want to. And that's the problem that we have with a lot of small molecules. It's not that they don't do
00:06:37
what we want them to. They do a lot of other things while they're at that job
00:06:40
that can have significant negative side effects, which is why a lot of these small molecules actually don't make it
00:06:46
all the way through the FDA approval process because we find something, it does what we want to do, but has
00:06:52
significant safety concerns down the line. All right. Now, what we see with peptides, for example, I've got in my
00:06:58
hand right now a little vial labeled, you know, BPC57. This is probably one of the most popular
00:07:03
peptides that we're talking about right now because BPC-157 is a synthetic version of a naturally found peptide in
00:07:11
the gut. But what this actually does is it enhances blood vessel growth in areas
00:07:18
of injury. And it kind of makes sense because if you think about it, our gut, our stomach is really just this bag of
00:07:26
acid that sits inside of our abdomen. And yet somehow you and I are here talking to each other and our bodies
00:07:31
aren't eating themselves. Well, how does that work? Well, it's because we've
00:07:34
developed a lot of really robust systems to encourage healing of the gastric lining. And so the idea is like, well,
00:07:40
if this is one of the compounds that can help do that, it's been proven in multiple animal models. For example,
00:07:45
they have completely transsected the Achilles tendon in rats and then >> transected
00:07:50
>> transected. So they've cut across the Achilles tendon. So, not just a small
00:07:54
injury that you or I might experience in the gym where we pull it or strain it, but actually surgically cut the uh
00:08:00
Achilles tendon and then they administer it to rats and they are healing spontaneously with administration of
00:08:06
BPC7. If you have an Achilles tendon injury and you're a rat, BPC7 is one of the
00:08:12
best things that you can ever have. Now that is not a onetoone translation to what we might see in humans. But as we
00:08:18
talked about earlier with our point on safety when they were studying BPC57 we try to look for something called the
00:08:25
LD1 or the LD50. How much can I give this to someone until 50% of the population that receives that dose
00:08:32
doesn't do well or dies. Okay, that's called the LD50 dose. We have yet to
00:08:37
figure out what the LD1 dose is for this, which is the amount that it would take to hurt even 1% of the population
00:08:44
because it is so incredibly well tolerated. So, just giving you an example of this is a compound that can
00:08:51
have profound healing effects at least in our animal models that we've seen so
00:08:55
far, but so far we haven't seen any precipitous negative effects in human patients when taking this. Okay. But we
00:09:04
need more data. I am mind blown and I'm very very excited. We've got all of the
00:09:09
se several peptides here in front of us. I want to go through all of that and understand which ones do which things.
00:09:13
But there's a bigger question here which is why now why have the subject of peptides suddenly exploded into
00:09:21
society's consciousness? What's going on? What's the big picture? >> So this is really interesting. In 2013
00:09:28
there was actually a court case in the United States. It was the it was called Myriad Genetics case. This was the
00:09:34
company that actually patented the BRAA 1 and BA 2 genes. They discovered the genes that cause breast cancer. All
00:09:39
right, this was mind-blowing. They identified the specific genes that would predispose patients to developing both
00:09:45
breast, ovarian, and since we've learned also prostate cancer. It was a fantastic
00:09:49
discovery, but they patented it and they said, "We now own this intellectual
00:09:53
property." And then everyone else said, "No, no, no. That's that's the human
00:09:56
body. You can't patent that." And the Supreme Court actually sided with that
00:10:00
argument saying that if something is natural, it's found within us. Okay, I can't patent you know your muscle cells,
00:10:06
right? Which is a wonderful thing. But the unintention unintentional byproduct of that is all of a sudden pharma had no
00:10:13
incentive whatsoever to pursue really promising compounds that they could not monetize. So that happens in 2013. At
00:10:22
the same time, I believe it was around 2012 2013, there was a terrible event that happened in New England where there
00:10:28
was a compounding pharmacy that was not doing the right thing and they ended up having a bunch of contaminated specimens
00:10:35
that caused a fungal menitis. Bunch of patients got really sick. It was a huge scandal and all of a sudden the FDA
00:10:42
stepped in and said, "Hey, historically, all right, states have been allowed to
00:10:47
regulate compoundingies themselves, but we need some federal oversight here because this is not acceptable."
00:10:52
Completely agree with that. And they introduced a new set of regulations on top of compoundingies, basically saying
00:10:59
what you can and cannot make. And what they eventually said is, well, the only you can only make three things. You can
00:11:06
make things that are in the USP uh United States Pharmacopia, okay? Things that have been, you know, well
00:11:12
described, already published, things that are already in drugs that are already on the market, or three, things
00:11:17
that are on a very specific list that we're going to give you. Okay. And in that list, they actually included a lot
00:11:25
of these very promising compounds that were stuck in drug development, you know, limbo.
00:11:29
>> And you say compoundingies, you said that a few times. What is a compounding
00:11:33
pharmacy? Just just so I'm clear on the definition. >> Back in the 1800s or early 1900s, if you
00:11:38
ever needed a medication, you'd go see the pharmacist who had a shop down the
00:11:41
road and he would actually make your medication in front of you and he would do that custom for every single patient
00:11:45
that came by. All right? And it was only since the advent of modern factories that we had the modern pharmaceutical
00:11:50
industry come about. But the truth is is that again, you know, that's kind of
00:11:54
paint by numbers. You're creating this one pill and you know, it always seemed
00:11:58
kind of crazy that the adult dose is one standardized dose for all adults. Like if you look at what your body
00:12:04
composition is some of my patients, why is the dose your blood pressure medicine
00:12:08
the exact same? Like that doesn't seem to be quite right. But it is what it is.
00:12:11
So when patients fall outside of that and they need custom medication, we still have those people who make custom
00:12:18
formulations of medications, but instead of it being just your local pharmacist who's using a mortar and pestle and you
00:12:23
know is creating something in his back office, these are now large sophisticated industrial operations that
00:12:28
can make custom formulations for patients. I think I think the important context for people that don't understand
00:12:33
how drug development occurs is that to get chemicals like the ones we have in front of us on the table through FDA
00:12:40
approval, you've got to spend millions and millions and millions of dollars,
00:12:43
>> tens if not hundreds of millions of dollars. >> Sometimes hundreds of millions of
00:12:45
dollars. >> Yeah. An incredible amount of money. And >> and if you know you can't protect it
00:12:49
once you spend $100 million, you have no incentive to just do charity work. >> Absolutely not. Okay. Because you have
00:12:55
shareholders and you have to make payroll. And so because drug development is so expensive, there is no incentive
00:13:02
for commercial pharmaceutical companies to pursue the development of these compounds. And then on the other side of
00:13:08
that, well, we have compoundingies that, you know, for them it makes sense. What
00:13:12
if we could just make these compounds and then sell them directly to patients? We make a small margin. We sell it. This
00:13:16
makes sense for us. Well, they could do that starting in about 2014 whenever that legislation finished. All right.
00:13:22
>> What did it do? Essentially what it did is it gave a it gave a assignment to
00:13:28
each one of these compounds. It was either going to be category one which is you uh can compound this. This is on our
00:13:34
specific list of approved compoundable drug ingredients. Number two was hey we see some negative safety signals here.
00:13:41
You cannot make this. Okay. Something goes on category 2. It's forbidden. And
00:13:44
then we have category three which is we just need more information. And all of these original compounds, these peptides
00:13:50
that we're so interested in now were originally on that first list, category
00:13:54
one. All right? And so they were able to be compounded. We could prescribe them patients. I prescribed them to patients.
00:14:00
All right? From 2014 onward. But then in 2023, the FDA at that time switched all
00:14:07
of those peptides, 19 of them that were popular to category 2. And then they were banned. Overnight, we got
00:14:14
notifications in our email inboxes from our compounding pharmacy partners saying, "Hey, we can't make this
00:14:18
anymore. We're sorry." >> So, I've got two questions there. Yes.
00:14:21
>> Um, the first is when you were prescribing these pepsides to your patient,
00:14:26
>> yes. >> Were you seeing incredible results? >> Very much so. Very much. Again, you have
00:14:32
to use the right key for the right lock. Okay. But I think a really good example.
00:14:38
All right. So, there is a compound that is not technically a peptide. It is a small molecule but it was lumped in with
00:14:44
all of these and was the victim to the same process. Uh something called MK677 also known as ibutamorin. So this is a
00:14:52
small molecule but when a patient takes it it's orally available it binds to
00:14:56
this receptor called ghrein and it actually stimulates the release of significant growth hormone. But what was
00:15:01
really interesting is that it would actually stimulate hunger a profound amount. And all of a sudden patients
00:15:07
that were struggling with cexia, okay, so being very very thin, very malnourished, maybe they're going
00:15:12
through cancer treatment. >> Grein's the thing that makes us feel hungry.
00:15:15
>> Absolutely. Yeah. Yeah. So they were able to stimulate the hunger response
00:15:19
and patients were actually able to eat more to meet caloric goals. And so this was a medication that was fantastically
00:15:26
effective at that. Again, it had gone through some clinical trials, but was never taken all the way to commercial.
00:15:33
And so it was never going to be available from CVS or Walgreens, but you could get it from a compounding
00:15:38
pharmacy. And so that was one that made a big difference for us. We also had other peptides. So, uh, GHRP2 and GHRP6
00:15:45
were some of the ones we were using at that time. Uh, those are growth hormone releasing peptides that stimulate the
00:15:52
release of your body's natural growth hormone, which can help with tissue repair, can also help with fat loss, and
00:15:57
with building muscle. We also had BPC-157 and we had uh derivatives like thymus and beta 4. These are also compounds
00:16:06
that can help stimulate angioenesis, so making new blood vessels. All right? And
00:16:10
tissue repair. So if we have a patient that's injured themselves, maybe we could help them get back at life faster.
00:16:16
These were all things that were used very commonplace for many years. And truthfully, they weren't super popular
00:16:21
at the time. We were just using them. And then they were banned overnight. >> And they were working.
00:16:26
>> And they were working. And they were working. We were not seeing adverse
00:16:28
events, which is the most important thing. >> What's an adverse event?
00:16:32
>> An adverse event is a patient has a terrible side effect. They call you,
00:16:36
they have an allergic reaction to something, they call, they've got shortness of breath, and it's a direct
00:16:40
result of the medication that you gave them. It was working. It was working and by all accounts seemed to be incredibly
00:16:45
safe. >> And then they banned it. >> And then they banned it. >> Why?
00:16:48
>> That's a great question. So officially what happened is there was a meeting
00:16:53
where they brought together the experts at the time and they said there is insufficient data for us to say that
00:16:58
these are safe because again they had not gone through the full FDA approval process and so as a result of lacking
00:17:04
that data we're going to say that they're too dangerous. Now there wasn't
00:17:07
any evidence of any of that in the population. These were widely used at the time. potentially we had commercial
00:17:14
pharmaceutical companies saying well hey this is people spending money on a compound on something that isn't coming
00:17:20
to us. So hey like we love medicine but maybe only when it's our medicine. >> And so there's concern that that was at
00:17:28
play as well. And so there's not a great paper trail and there's not a great
00:17:31
explanation why. And that's something that's been iterated by our current
00:17:34
administration from RFK himself. You know, he himself has characterized that move done in 2023 as being illegal.
00:17:41
>> With everything you know about the medical industry, do you think it is
00:17:44
plausible that big farmer >> 110%. >> Didn't want >> 110%.
00:17:51
>> These in the hands of regular people because they can't patent this and it's
00:17:55
powerful. >> So ultimately the way to think about it is this. Um, pharma may not have a compound that
00:18:04
directly competes for BPC57. >> BPC-157. >> So, this is the medication or the
00:18:10
peptide that can aid with healing after an injury. Okay? So, it's not necessarily there's direct competition,
00:18:17
but at the end of the day, your average patient going throughout their daily life only has so much money that they
00:18:23
can spend on medicine. and $10, $15, however much money that goes to this doesn't go to a prescription drug from a
00:18:32
commercial pharmaceutical company. And so there is real concern that potentially that was at play during that
00:18:37
decision. And >> you said 110%. >> Yeah. I Well, you know, it's interesting
00:18:41
because, you know, I try to walk a very fine line between what I can prove uh versus what I suspect after being in
00:18:49
this space for a long time. And you know ultimately you know I don't think it's
00:18:54
accurate to characterize pharmaceutical companies or really any other entity as being you know evil or or bad. The truth
00:19:03
is maybe a little bit more ominous. The truth is is that they are these large machines that are designed to prioritize
00:19:09
profit over everything. >> Yeah. >> And that's everything. >> I think this is one of the really
00:19:13
interesting observations I've had the higher I've gone in my career is that
00:19:17
often times you we heard about the Illuminati. Like when I was growing up, I was like, "Oh, there's this
00:19:20
Illuminati." >> And you think of it as these like shadow hooded people that get together and
00:19:24
decide evil things. But the further I've gone in business, the more I've realized
00:19:27
that the Illuminati or these evil forces are actually just machines that were designed to optimize for profit.
00:19:32
>> Correct. Correct. >> So like corporations are the Illuminati. >> Yeah. And so I don't actually think that
00:19:37
there's necessarily, you know, a a group of maniacal individuals, you know, the
00:19:42
Legion of Doom, you know, plotting to like take away your health. But at the same time, I think that there are these
00:19:48
large organizations that really couldn't care less about your health. You know,
00:19:51
they are prioritizing what's important for them. And regular people just get
00:19:55
caught up in the mix. And what's challenging is that as a physician, you know, I took a hypocratic oath. You
00:20:00
know, I care about my patients. And so those are the people that are in front of me every single day that are seeking
00:20:05
to improve their lives to recover from injury. I have, you know, fertility patients that are just dying to start
00:20:10
their family. And I have patients that are suffering from hormonal imbalances that haven't felt right in years. I I
00:20:16
treat erectile dysfunction in men that have been struggling for years after prostate cancer treatment. I mean, these
00:20:20
are people that are broken and hurting. You want to be able to help them. And so, I feel that is a very strong
00:20:26
personal calling that I have to be that advocate for that patient both in the room whenever I'm treating them and
00:20:31
taking care of them, but also when I'm talking to others and I'm, you know,
00:20:35
speaking out about these issues. like I want access to these medications because
00:20:38
I care about the patients who benefit from them. >> So they banned these peptides that we
00:20:44
have here, >> correct? >> And we're sat here 2 years after the ban, I believe, roughly 2 years after
00:20:48
that ban. >> Yeah. >> And suddenly everybody's talking about peptides again.
00:20:51
>> Yes. >> Why? What's going on? >> So I think what we're seeing is the
00:20:56
forbidden fruit effect because this was banned and all of a sudden, oh well, why'd they ban it? Well, they wouldn't
00:21:00
have banned it if it weren't working, right? And we're also seeing the effect
00:21:04
of Tik Tok and short form content being spread very rapidly, very virally. And that's been going on for two years now,
00:21:10
combined with new uh emphasis from administration leadership and HHS and RFK. >> What is the most incredible
00:21:19
impact that you've seen peptides create in a patient? >> Oh my gosh, I have the best story for
00:21:24
you. So, one of the most frustrating uh things about my practice is treating infertility in young men that have
00:21:32
significant metabolic dysfunction. These are young men that have a low sperm count, right? So, they can't get
00:21:39
pregnant because they just don't have the numbers to make it happen. And you're looking at them and they're
00:21:43
morbidly obese, okay? They have high insulin resistance. All right? And their endocrine system has been damaged by
00:21:49
that obesity. So they don't have have low testosterone levels and their brain
00:21:53
is not making enough of the signals to stimulate their testicles. Now we have medications that we can use to help
00:22:00
stimulate that to make more of that signal stimulate the testicles, right? But really what is eating at them, what
00:22:06
is causing this is not that chemical imbalance. That's the the symptom. That's not the the problem. Okay? And
00:22:11
treating symptoms doesn't really get you very far. And so I would have patients
00:22:14
that I would take care of and we would never see a significant improvement in their numbers because losing weight is
00:22:19
really really hard. you know, regardless of all of the education and resources I
00:22:22
try to give them. But now we have peptides in the form of GLP-1 drugs like simaglutide and tzepatide. And I just
00:22:30
saw a patient le last week who increased his sperm count 10 times over and is now
00:22:36
in a normal range because he's lost 100 pounds due to using tzepatide, exercising, and improving his diet. And
00:22:44
he has totally changed his life. >> And that started with a peptide. >> It started with a peptide. So I we've
00:22:49
got lots of peptides on the table in front of you. We will go to into them individually, but just can you give me a
00:22:54
a highle view of the types of areas in our health and life that these peptides can help with? So we've talked there
00:23:00
about infertility, >> correct? >> As a downstream consequence of the like
00:23:03
weight loss and fixing metabolic health, what what other parts of the body do peptides touch?
00:23:09
>> The best way to think about it is like this. So peptides are almost like an app
00:23:14
on your phone. So imagine before we had apps. Like I I'm old enough to remember
00:23:19
trying to log on and do my banking online before we had apps. And gosh, it was so painful, right? Like there were
00:23:24
ways to accomplish things, but they were very inconvenient and in a roundabout way. And now all of a sudden, we have
00:23:28
these apps on our phone that can do just about anything except fold your laundry,
00:23:32
right? You know, there's some limits to it, but I mean really the sky's the
00:23:35
limit from an electronic standpoint. And really, that's what peptides are. So the
00:23:39
thing is is that we have peptides that can help you lose weight, like the GLP-1 drugs. We have peptides that can improve
00:23:47
skin quality like uh GHKCU. We have peptides that can help heal your gut like BPC 157 particularly effective
00:23:55
in ulcerative colitis which is something that's being investigated with the FDA's
00:23:59
planned upcoming meeting on it. We also have peptides that can help with sleep and with uh recovering the gland in your
00:24:06
brain that's responsible for melatonin and regulating your sleep wake cycles.
00:24:10
So the question isn't you know what can peptides do? kind of well what can't
00:24:14
they do and if they can't do that yet can we develop a peptide that can accomplish that task and the answer is
00:24:20
probably and simultaneously while there may be resistance from pharmaceutical industry in these peptides the ones that
00:24:26
we're most interested right now they have signed multi-billion dollar deals with other pharmaceutical companies that
00:24:33
are involved in peptide uh development aided by AI to try and fasttrack their own peptide uh products
00:24:40
>> interesting >> and so we are going to see exponentially more of these products come down the
00:24:44
pipeline from pharmaceutical companies in the form of commercial products. >> And it's worth saying that there was
00:24:49
some significant news today. >> Correct. >> What happened today, but also what's
00:24:53
going on. And just for anyone that doesn't know, it's April the 15th. >> Yes. So today uh we got a press release
00:25:00
from the FDA saying that in July they are going to consider seven peptides for removing from category 2 back to
00:25:09
category 1, >> legalizing them. >> Legalizing them. Okay. And uh some of
00:25:14
the heavy hitters from that list include BPC uh 157, >> which is the one we talked about to do
00:25:20
with like repair and injury. >> Absolutely. Okay. And then we have uh the brother to that, which is TV500.
00:25:27
This vial over here, this improves blood flow to an injured area. You could think
00:25:31
of this as sending the soldiers as sending the cells that are required for rebuilding that tissue matrix that was
00:25:38
damaged by a tear or a cut. All right. On top of that, uh we're also getting
00:25:43
something called uh KPV. May not have it here, but that is another uh peptide that has been linked to angioenesis and
00:25:51
tissue repair. We're also getting MOT C and you know, some patients will call it
00:25:55
exercise in a vial. It improves your V2 max and your exercise tolerance. And by up uh regulating the energy pathway,
00:26:03
basically making more ATP, the energy that we all use to move, it makes more of that available. All right, we're also
00:26:09
going to get DIP, epylon, and CAX, which are all peptides that affect cognitive function. So, improving thinking like uh
00:26:17
CAX is a great option for that. And then DIP and epylon both have roles in regulating uh sleep and recovery.
00:26:25
>> Wow. >> Yeah. Pretty wild. And I've got to say, how does So, some
00:26:30
of them are becoming legalized, but even the ones that aren't legal right now, a
00:26:33
lot of people are taking them anyway. >> Correct. So my my question is how are
00:26:37
people getting them? Listen, I don't want to promote illegal drugs here. This
00:26:40
is not that kind of [ __ ] but I just want to know what's going on. >> No, this is well this is important to
00:26:44
talk about, right? We have to understand like what's going on in the marketplace.
00:26:47
The moment that these drugs were banned or these medications were banned in 2023, it was kind of like the United
00:26:53
States experiment at banning alcohol, it didn't go very well, right? All of a
00:26:57
sudden, you know, they we, you know, the mob came around and we started, you know, seeing unregulated uh uh saloons
00:27:04
and unregulated alcohol production and it was contaminated with all the stuff that you didn't want. And so we're like,
00:27:08
>> people are traveling. >> Yeah. Exactly. It's just it's not a good
00:27:11
idea, right? And so what happened is we banned these and the gray market stepped
00:27:15
in. And so these are companies that will sell peptides that have on the label for
00:27:21
research use only. All right? And the idea is that that takes them out of the FDA's jurisdiction because they're not
00:27:26
selling it for people to inject into themselves, out of the FDA's hands. I'm
00:27:30
just creating a vial of this magical juice that you can use for your rat. Okay, that's the idea. We all know
00:27:36
that's not what's really happening. But because there isn't any quality control,
00:27:41
it's kind of like getting gas station sushi. Like, yeah, you can do it, but you don't really know if it's sushi, and
00:27:46
it may not end very well for you. And so again, not saying that there aren't some
00:27:50
people who have gotten good results with research use only peptides, but again, it's not standardized, which is why I
00:27:57
think moving this back into the 503A compounding world is the best thing for everyone,
00:28:01
>> which is the legal framework. Okay, so how does one take a peptide? >> That's a great question. So what's
00:28:07
interesting is that, as we mentioned, you know, peptides are just made up of building blocks of amino acids. And you
00:28:12
know, if you were to go make yourself a uh protein shake, you know what is that gonna look like from a Lego standpoint?
00:28:17
It just looks like this. A handful of Legos in your hand, right? >> All sort of ground up.
00:28:21
>> All ground up in individual pieces, right? And the thing is is that your gut
00:28:25
is designed to break up any sort of protein that you ingest orally into these little pieces. And so if you were
00:28:33
to say, I don't know, drink some of, you know, this TB500, your body wouldn't be
00:28:38
able to tell the difference between that and a piece of chicken >> cuz it would it would break it all
00:28:41
apart. break it all apart. Now, there are some very uh unique exceptions to that. There's a form of BPC157 that
00:28:46
actually is tolerated in the gut, but by and large, the overwhelming majority of
00:28:50
these have to be injected either subcutaneously or into the muscle. And that's usually a preference.
00:28:56
>> Subcutaneous being my belly >> under just underneath the skin. You
00:28:58
know, as I tell patients, just pinch an inch, inject under the skin. We do that for a lot of other medications as well.
00:29:03
>> Is that what this is? >> Yeah. So, this is a prescription MARO pen. So, Mangjaro is the brand name for
00:29:10
Tzepide. All right, trespatide being the leading GLP-1 product right now from Lily. So, this produces more weight loss
00:29:18
per milligram than any other product that we've got out right now. >> Is this the mechanism in which people
00:29:23
inject peptides? >> No, a little bit different. So, this is an auto injector pen. And so, what you
00:29:29
do is you're able to actually ratchet the dose there on the right side and then you pinch an inch in your skin and
00:29:34
then push it up against and it'll autodeploy. And so, there's nothing that
00:29:36
you need to do. You don't have to learn how to drop medication and inject. Whenever you're administering peptides
00:29:42
at home, especially for patients that have obtained them from research use only markets, they usually come in just
00:29:47
little vials that need to be drawn up with a needle. Okay? Now, the benefit of that is that you can do custom dosing.
00:29:54
All right. But the drawback is is that well, you have to know how to calculate that and put it together. This may be
00:30:00
the most controversial thing we have on this table. And by farmer's estimate, it
00:30:06
might be the most dangerous thing to their entire business model because this is trozepatide, the exact same thing
00:30:12
that you had in that pen. But this is made by a highquality 503A compounding pharmacy. And the reason why this is uh
00:30:21
so controversial right now is because it offers an incredible amount of flexibility because what you have in
00:30:26
your hand there is very standardized and you administer it once a week because that's what's approved by interest.
00:30:31
>> This is like the thing everyone's been talking about. >> Exactly. Yeah, but think of that as
00:30:35
paint by numbers. Okay, you are this section is this color. This section is that color. All right. Think of this as
00:30:43
>> the thing you've got in your hand >> right now. Yeah, exactly. Just a vial of
00:30:46
trapide as being a having infinite permutations and dosing ability because you can draw this up with a small
00:30:53
syringe and do micro dosing. So instead of one large dose once a week because what many patients will experience is
00:30:58
they'll have a return of their hunger by the end of the week and they end up
00:31:02
losing ground. You can actually instead of doing a full dose once a week, you could do multiple mini doses throughout
00:31:08
the week with this formulation and with this presentation of the medication. All
00:31:12
right, but the challenge is is that that is the benefit that allows this to be compounded by compoundingies because
00:31:18
they are able to provide something that is similar to what's in your hand. All
00:31:22
right. But it offers more flexibility that may be the right choice for some patients. So personaliz personalization
00:31:28
of medicine. Okay. But the challenge is is that if you spend however much money on this, you're not giving it to Lily.
00:31:36
And so as a result, we have seen an unprecedented crackdown in the United States from the FDA and trying to shut
00:31:43
down compoundingies and prevent them from making these medications. Even though that ability to customize the
00:31:50
fact that this is not an exact copy of what's in your hand right now should protect it under current legislation,
00:31:57
but there is now enough pressure from the powers that be and from lobbyists from both Lily and Nova Nordisk that
00:32:04
which are the two companies that make the GLP-1 medications that we're seeing
00:32:09
Marty Macher the FDA commissioner has now tweeted more about cracking down on compounded GLP-1 medications than he's
00:32:16
tweeted about diabetes. disease or heart disease in his entire time in office. >> And just so I understand, I want to play
00:32:21
this back to you to make sure I understand. >> Sure. >> In my hand here, I have
00:32:27
Tepatitide on my left. >> And this is made by Lily, which is a corporate company who've patented it, so
00:32:33
they can make lots of money from it. >> Correct. >> In my right hand, I have tepide
00:32:38
with nycinomide >> with nyinomide. Y >> and this is not patentable. So Lily has
00:32:45
a patent on the trazepatide molecule in that formulation in your hand. Okay. >> And if anyone violates a patent that can
00:32:54
be pursued in US court. Yeah. Patent law. Right. But what's interesting is that Lily and Novo Nordisk know that
00:33:03
that's different in your right hand. It doesn't look the same. You can dose it
00:33:06
differently. And they know that if they were going to fight that in court, it would cost a lot of money and take a lot
00:33:12
of time. So, you know what's a lot easier? Calling your friend at the FDA and getting him to step on the
00:33:17
competition so you don't have to. And then who's paying for that enforcement?
00:33:21
It's not the lawyers that the pharma company is paying for. Uh it's the taxpayer paying for the FDA through
00:33:28
taxes. >> And you seem to imply that this was actually better because you could take
00:33:31
it in a more flexible dose. You could take a little bit, a lot, you can take it when you want. Whereas this is kind
00:33:36
of once a once a week. >> Well, I mean, you know what is better, right? So I like this option for many of
00:33:41
my patients because it's flexible. All right, so that is something that works
00:33:45
for most patients. All right, but then then again, this works great for patients too. Okay, but what you want is
00:33:50
you want an ecosystem where you have choice so you can make the right choice for the right patient. For a lot of
00:33:55
patients, they're going to do exceedingly well on this. And there's so much data to support that. But I also
00:34:01
have a lot of patients who get really ill after they do a large dose of Mangaro or of GLP-1 med. And if we take
00:34:08
that same dose and we just cut it into multiple doses within a week, we can avoid those side effects.
00:34:13
>> So you've told me that these peptides we have on the table in front of us can
00:34:16
improve your skin, weight loss, muscle, energy, chronic illnesses. You talked about the cognitive upsides and you talk
00:34:24
about it very passionately. >> Yeah. >> So one should ask you presumably you're
00:34:28
taking some peptides. >> I am. Yeah. So >> which ones do you take? So I will tell
00:34:32
you that as of right now the only peptide I'm taking is a small dose of tzapatide. All right.
00:34:38
>> Which is the one we were just talking about. >> Yeah. Okay. >> Because back uh couple of couple of
00:34:42
months ago I was probably close to about 240 or so and I was into powerlifting. You know I still am. But you know it's
00:34:50
really great to be able to deadlift 500 lb. But then stairs become really hard when you're trying to walk up and you're
00:34:56
like I don't know. I kind of like uh being able to not take a break after two
00:34:59
or three flights of stairs. And so I was like, "Okay, all right. Longevity is a
00:35:03
priority of mine. I'm going to slim down a little bit." I like, "Let me just try
00:35:06
this for a little bit." And what I found is that it is incredibly potent and at a
00:35:09
very low dose, very, very tolerable. >> Why didn't you take some of the others?
00:35:13
>> Honestly, because right now there is not a legal framework for me to obtain them.
00:35:18
And the truth is is that I want to be an example for my patients. And that's why
00:35:22
I'm out here advocating that we get access to these peptides in a legal, safe way again. All right? And because
00:35:29
it's it's the best thing for everyone. >> If they were legal, which ones might you
00:35:33
consider? >> Oh, man. I will tell you this as some like I I don't know how old you are,
00:35:38
Stephen, but I'm 33. God bless you. I will tell you once you get over 35, man,
00:35:42
that is brutal. All right. I sleep on my neck in a wrong way and I need like a freaking brace for like two weeks. And
00:35:48
so, as someone who spends a lot of time in the gym, you know, working out, like you start to accumulate all these little
00:35:53
aches and pains. And so the idea of, for example, I have a a very finicky right shoulder. If I try to do a really heavy
00:36:00
bench and I haven't warmed up, I can tweak this and it takes me out of the fight for at least a month, okay? And I
00:36:05
have to do other things. You know, I would have killed at various points in time over the past two years to have had
00:36:11
BPC and TB500 to hopefully speed that sort of healing. All right. Um, also, for example, I suffer from really bad
00:36:19
rosacea. It flares constantly. >> What's that? So, just a redness of the
00:36:23
face, okay, that you know, it makes me look like I'm sunburned. And then I come
00:36:26
in on the office on like a Tuesday and then my staff's like, "Oh my gosh, you
00:36:29
go out in the yard and do some work this week." I'm like, "It's just my face."
00:36:32
Um, you know, for example, that's something that a lot of people have reported benefits from GH KCU from. So,
00:36:38
again, another compound, another peptide that could be beneficial for a patient like myself.
00:36:43
>> What about muscle mass and gaining muscle? Yeah. So, that is an interesting
00:36:48
misnomer because that has been a common selling point you'll see on social media. But as of right now, the only
00:36:56
peptide that you might construe that way would be this guy right here in my hand,
00:37:02
IGF-1 LR3. Okay. Now, IGF-1 LR3 is basically the longerlasting version of IGF-1, which is the downstream effect of
00:37:11
growth hormone. I'm sure you've heard of bodybuilders taking growth hormone to
00:37:14
increase size and, you know, lose fat. In higher doses, it can help contribute to muscle uh mass. All right? But
00:37:21
truthfully, if you're trying to gain significant muscle mass, this is this is
00:37:25
not the way to do it. And so, the right now, one of the things that peptides can't do for you is independently put on
00:37:33
significant amounts of lean mass. >> You still have to go to the gym. >> You still have to go to the gym, believe
00:37:36
it or not. And guess what? >> Well, that's the end of the podcast. >> Yeah. I I'll tell you. And but something
00:37:41
that blows my mind is that I have so many patients that think that they can just take testosterone and just put on
00:37:46
muscle naturally. And it doesn't work that way. You might get a tiny little bit, but you still have to have
00:37:50
stimulus. You still have to get in the gym. You still have to put the work in. And so I tell patients that I am not a
00:37:54
replacement for a personal trainer. I'm your doctor. You also need your personal
00:37:58
trainer. And most of you need a nutritionist, man. And so I'm lucky to work with some great people in the
00:38:03
community who partner with me on that. But you know it's a it's a fullcourt
00:38:06
press when you're trying to get people to you know live the highest quality of
00:38:09
life. >> What about some of these metabolic disorders and diseases in terms of like
00:38:12
insulin yeah resistance? People on the di the audience are very interested to learn about insulin. I see that a lot in
00:38:19
the comments section and a lot of the data. Yeah. >> So how can if someone's struggling with
00:38:23
their insulin levels or their you know their glucose response how does these peptides help?
00:38:26
>> Honestly the best peptides for that right now are the GLP1 drugs. Okay.
00:38:30
Hands down. because what you're doing is you are slowing gastric emptying and so
00:38:34
you have a slower absorption of that bolus of food that you've eaten so your
00:38:39
glucose doesn't spike and so as a result that increases insulin sensitivity significantly. Now again you have to be
00:38:46
careful about what peptide you're using for what. A lot of these peptides that
00:38:50
boost growth hormone and boost let's say IGF-1, those can actually increase serum
00:38:57
glucose and that may not be what you want if you are someone that is trying to work on your insulin sensitivity.
00:39:02
>> And do any of these peptides come as like creams or as pills or anything like
00:39:07
that? If you look online, you can probably find a version of everything. But if we're talking about actual
00:39:12
legitimate formulations, the best example of a topical cream is going to be GHKCU. And this is interesting
00:39:19
because this is a copper tripeptide that has been found to decrease in expression
00:39:24
and concentration as we age. But when it is applied topically, it's highly effective topically. So putting on a
00:39:31
cream on your face. All right. It's been found to be extremely beneficial in
00:39:35
regenerating the quality of skin. So, complexion. All right. Increasing the amount of collagen and elastin, the
00:39:41
things that we need to keep our faces taut and youthful. The things that people will pay lots of money to go get
00:39:47
lasered to get improvements. Not that it's a replacement for that, but that's
00:39:50
a topical form that believe it or not, you could go out and buy today because topical GHKCU is regulated very
00:39:57
differently than the injectable form. Is it expensive? Usually, >> you know, growing up, I thought all
00:40:02
these sort of anti-aging creams were [ __ ] >> But but you're telling me that this has
00:40:07
actually been associated with improving signs of aging. >> I will tell you this, when I was going
00:40:12
through college and medical school, I was the biggest skeptic. Like, I did not believe any of the health or wellness
00:40:18
claims that we saw coming out at the time. And again, you know, that was at a time where we were getting bombarded
00:40:22
with stuff about the Atkins diet and this that or the other. But then all of a sudden you start having patients come
00:40:27
back to you and they're testifying as the benefits they've seen from these
00:40:30
things. You start to actually look at the biochemistry behind them and you're
00:40:32
like there's a lot of science backing this up. This isn't just mumbo jumbo.
00:40:37
And so believe it or not, yeah, there are creams that can slow the process of aging at least from a visual standpoint
00:40:43
when it comes to your skin. I have yet to figure out anything that uh you know makes me as energetic as I was in my
00:40:48
early 20s, but you know I'm working on it. Mhm. But on that point of energy and
00:40:52
cognition, if I wanted to become a better podcaster. Yeah. >> And you know, I sit here sometimes,
00:40:56
sometimes we do two in a day, which means I might sit here for eight hours. Once we do, I think a couple of times
00:41:00
we've done three in a day. >> That's brutal. >> Which is 12 hours of recording. Yeah.
00:41:03
>> But what would you recommend if I was trying to improve my cognitive performance? So again, as a physician
00:41:08
who likes keeping my license, I wouldn't say necessarily recommend, but I would
00:41:11
say if we're looking at how these medications have been used and potentially one that may be legal again
00:41:17
coming this July depending what the FDA says, intraasal CAX. And this was one that was originally studied actually in
00:41:24
Russia many years ago. And what they found is that this seven amino acid peptide when it was administered after a
00:41:33
uh TBI, so a traumatic brain injury, all right, or acute injury, that patients tended to bounce back faster. Also, they
00:41:40
saw evidence of it improving outcomes after stroke. And it also seems to upregulate the same sort of factors that
00:41:46
help with cognition and with, you know, connecting sentences and bits of data in
00:41:51
your brain. And so it's also one of the, interestingly enough, one of the ones
00:41:55
that is available, you know, intraasally because it goes through the mucous membranes and gets right where you need
00:42:00
it. And so that's going to be a really really fascinating uh compound to see
00:42:04
back on the market. And then we can actually get more data regarding efficacy and across a wide population.
00:42:10
>> So interesting. And you you sniff that through your nose. >> Sniff like you would for any nasal
00:42:15
decongestant, right? And if you have allergies or something like that. Also, for someone like yourself, you travel a
00:42:21
lot. you know, you're going in between different time zones, you're balancing
00:42:23
multiple obligations at different odd times of the day. I I shudder to think what your circadium rhythm looks like,
00:42:29
my friend. Um, but you know, that is what we have some of these other compounds that are uh going to be
00:42:33
available for. So, if we look at uh uh dip, okay, that has been shown to be helpful with regulating your circadian
00:42:41
rhythm. All right, that is one of the ones that's going to be approved hopefully here soon again in July,
00:42:46
right? And then you know on top of that um you've got you know uh things like
00:42:50
selen which is another one that can help calm you as you're going to sleep about
00:42:54
an hour ahead of time and again hope help those you know deep delta wave brain waves that are so restorative
00:43:00
whenever you actually are you know resting. >> Where will we be able to buy these when
00:43:05
and if they are legalized? >> So from uh 503A compounders here in the United
00:43:12
States with a prescription from a physician. >> So you still need a prescription. still
00:43:16
need a prescription. Correct. It's >> going to be quite a crazy world when
00:43:19
everybody seem is going to be injecting themselves every every day. I mean, we're already getting to that point now
00:43:24
with the Zen where I've got loads of people in my my friendship group that are
00:43:27
>> Yeah. And they're Yeah. And they're doing great. >> Yeah. They're doing great.
00:43:30
>> They're doing great. And that's what I like about, you know, the advent of
00:43:34
these GLP1s is they're removing the stigma of a needle. >> And I look at some of my friends who
00:43:39
have been on it. I can't recognize them. They look awesome. >> Are you concerned with with any of them?
00:43:44
You know, I've got a couple of friends in my circle where I'm I'm a little bit
00:43:47
concerned. I don't even know if I should be concerned, but it's just when you see
00:43:50
someone, you know, change so dramatically, so quickly. >> Yeah. >> I think there's something in us which
00:43:56
something prehistoric in us which goes, "Oh my god, there's a problem."
00:43:58
>> Yeah. One thing I'm I am concerned about is the rapid weight loss with GLP-1
00:44:03
medications. Because the problem is is that when you go into such a radical caloric deficit, your body goes into
00:44:09
catabolism, which is breaking down tissue. And you want to break down fat, right? But your body isn't that
00:44:14
judicious. It's going to break down muscle. And muscle is the most metabolically important tissue that any
00:44:19
of us have. And so if you really want to optimize your insulin sensitivity, well,
00:44:23
you need to maintain your muscle. And right now, really the only compounds that we have that are really good at
00:44:28
preserving muscle with resistance training is testosterone, right? But that isn't going to be a good option for
00:44:33
our male patients that want to get pregnant because testosterone turns off fertility in men. All right? It's also
00:44:38
not a great idea for our female patients. All right? depending on their age, testosterone, TRT is a thing in
00:44:44
older, you know, uh, women, menopausal, won't go into that. But truthfully, testosterone is not the right answer for
00:44:49
everybody. And so, what we are going to see come down the pipe very soon is kind
00:44:55
of the older brother of peptides, the more complex form, biologics, called monoconal antibodies that are
00:45:00
specifically designed to inhibit the enzymes that break down muscle. So, these are specifically called myatin
00:45:06
inhibitors. There are three that are coming down the uh pipeline. There is one called bamagrammab which is owned by
00:45:12
lily that is going to bind to the peanut butter to myastatin jelly which is called actin. And then you have mab and
00:45:20
travogumab which are two other compounds owned by a different pharmaceutical company that are all designed to
00:45:27
maintain muscle even in a significant caloric deficit. >> This is getting interesting now.
00:45:31
>> Yeah. Yeah. So you're you're telling me I'm going to be able to inject myself
00:45:34
with a zmpe to lose the fat and then inject myself with something else to keep the muscle.
00:45:38
>> It's wild. is wild and and I will tell you, you know, one of the hardest things that I'm sure
00:45:46
you've heard being on the receiving end of this is just the complexity of it.
00:45:49
And there are so many levers that are moving at once and trying to get your head around it and balance it all. Like
00:45:55
it requires nuance and it requires a thoughtful discussion with your doctor who is well educated on them. And that's
00:46:03
one of the challenges is that there isn't broad great education on these products right now in the medical space.
00:46:08
And so that's something that I'm very passionate about is improving education
00:46:12
across my colleagues so that they're not afraid of these anymore. >> What do you say to people that are
00:46:17
listening to this now go, "Fucking hell, why don't you just like eat your greens
00:46:20
and go to the gym?" Yeah. >> And just be more human and you'll be
00:46:23
fine. >> I love that. I love eating your greens and going to the gym. Okay. Um but the
00:46:28
unfortunate reality is that here in the United States, it depends on what database you look at, but obesity rates
00:46:34
are estimated to be 40 to 70%. Okay? whether you depending on what BMI cut off you're using. Okay, BMI is not
00:46:41
perfect, but it is what it is. And so the thing is is that well eating greens and going to the gym are not working for
00:46:47
us as a society. And we could talk about how we don't have real food anymore. We
00:46:51
have food deserts. We have this nut calorically dense but nutritionally poor food. I'll tell you the most disturbing
00:46:58
thing I see as a surgeon is I'll see a patient come in the door and they're
00:47:02
morbidly obese. They're a large individual, but I have to do surgery on them. But the connective tissue, the
00:47:06
stuff that's made up of protein that makes them them, that literally holds them together, is paper paper thin
00:47:12
because they're eating an incredible amount of calories. They're gaining fat,
00:47:14
but they don't have any protein in their diet. And that's not something that's
00:47:18
rare. I see that on a daily basis. And so the truth is is that, you know, we're
00:47:22
talking about this from the angle of biohackers and people that are super engaged in our health. But the truth is
00:47:28
is that this is going to be able to be used to help our population at large. and you know ultimately hopefully avoid
00:47:35
a lot of the terrible disease states that we're seeing overwhelm the medical
00:47:38
system right now. >> How big is the peptide industry right now? >> If we look at the top four large
00:47:44
language models companies, all right, so all the heavy hitters and how much revenue they're generating, it's
00:47:49
estimated between be between 58 billion up to maybe 62 billion. Yet the income and the revenue from just simaglutide
00:47:59
and tzepatide alone is going to be over 55 billion this year. And so what we have is peptides without even
00:48:07
considering all of this happening in the research space or the research use only
00:48:10
space without even considering the peptides that uh we'll see come from compounding pharmacies. We're already
00:48:17
approaching parody with what we're seeing in AI as far as revenue goes. That is the demand that we're seeing in
00:48:23
the marketplace. I run multiple companies that have multiple sales teams and one of the things as a founder of a
00:48:29
company that's often confusing is you find it hard to figure out where sales
00:48:32
are. So about 10 years ago I started using Pipe Drive in my former company and it's also the reason why I switched
00:48:38
over all of my commercial teams in my current media company called Steven.com to use Pipe Drive as well. Not only did
00:48:42
they sponsor this show, but they've been an incredibly effective way of scaling
00:48:45
our sales engine over the years. Pipe Drive is an easy to use intelligent CRM and at its very core it makes your sales
00:48:52
process visible through one dashboard. A visual pipeline showing every deal, what
00:48:58
stage it's in, what needs to happen next, and it's all in real time with no
00:49:02
delay. It doesn't magically close the deal for you, of course, but it does replace complexity with clarity. If you
00:49:08
want to join over a 100,000 companies already using Pipe Drive, you can use my link for a 30-day free trial with no
00:49:14
credit card payment needed. Head to piperive.com to get started. That's piperive.comceo.
00:49:23
I'll see you over there. >> When your patients come and see you, Dr. Alex, what are they asking you most
00:49:30
frequently as it relates to peptides? What are like the top three questions you get asked the most?
00:49:35
>> The first thing I get asked is, "What peptides do I need?" And then I just
00:49:39
look at them. I'm like, "What's your problem?" You know, like what's
00:49:42
bothering you? >> And what do they say? you know, and then they'll come in and they'll start
00:49:46
talking about energy, sex drive, and that sort of things. And I'm like, "Okay, if that's it, well, we need to
00:49:50
check your testosterone levels, brother." Okay? So, instead of looking for peptides, right? You know, you don't
00:49:56
walk into a Home Depot or a Lowe's. You like, "What tools do do I need?" And
00:49:59
you're like, "What are you trying to do?" Right? And then you start to talk
00:50:02
to someone there like, "Well, I'm trying to build this." Okay, you need a saw.
00:50:04
You need a screwdriver. You need this. And some of those tools might be peptides. All right? But some of them
00:50:08
may be hormones. You know, some of it may be diet and exercise. And so peptides are just another type of tool
00:50:13
that we can use. >> We all want a shortcut though, doctor. We all want a quick way to to be better
00:50:18
and ideally not to have to do hard work. That's like what most, you know, the
00:50:20
average person is looking for. And we hear about these peptides. We hear other people are taking them. We hear the
00:50:24
fantastic results in skin, hair, muscle. And we go, "Fucking, what about me?"
00:50:28
>> You know what I tell patients? I'm like, "Me too, man." You know, but my alarm
00:50:31
still went off at 4:45 this morning so I could hit the gym before I made it to clinic. Because there are no real
00:50:36
shortcuts. There are things that can help, right? GLP-1s are the best example of that, right? Okay, this is the
00:50:42
closest thing to a shortcut you're going to get. But the truth is is that this
00:50:45
isn't going to go to the gym for you and it's not going to lift the weight so you
00:50:47
can maintain that muscle mass so you get the best possible result and try to hold
00:50:50
on to your muscle while losing the fat. >> One thing I've learned from doing this
00:50:53
podcast that that has really grown with me over time. People ask me all the time
00:50:56
like, "What's the one thing you've learned from the podcast?" One of the
00:50:59
answers that I've never given that I'm going to give now is that I've learned
00:51:02
that there's no such thing in life as a free lunch. >> No, absolutely not.
00:51:06
And what I mean by that is like everything is a tradeoff. And if you ever hear on a podcast or in any medium
00:51:14
that something has tremendous upsides, the first question one should ask is what's the trade and like just with
00:51:20
everything you can apply this to having a relationship with a partner. Huge upsides.
00:51:24
>> Also trade-off. >> Trade-off. Yeah. Yeah. Kids like >> I love my children. I haven't slept in
00:51:29
years, right? You know, like this is just this is this is life, right? There are trade-offs. And even with great
00:51:34
tools, there are trade-offs. So, what are the trade-offs of these peptides? >> The biggest trade-off right now is you
00:51:39
don't know if you're even getting what you're what you want, right? Because
00:51:42
you're ordering this from some research, you know, uh, compound only. You don't
00:51:45
know whether or not they've gotten out all the appropriate endotoxins. You don't know if you're getting what you
00:51:48
actually paid for. So, that's the biggest thing. And also, the thing is is that, well, all right, I these have a
00:51:54
good example of, okay, preventing or helping heal injury. But the thing is that well we've got other compounds over
00:52:01
here. You know, let's go ahead and like let's just pull Tessa Morlin as an
00:52:05
example. So this is actually interesting. It's a peptide that is commercially available right now. I
00:52:10
could write the script for you. You could go pick it up from CVS or Walgreens. Okay, this is available as a
00:52:14
commercial product and people really like it because it'll help boost growth
00:52:17
hormone and it happens to be uniquely good at stripping abdominal fat. Okay, or visceral fat. But the thing is is
00:52:23
that, you know, the moment you stop taking it for a brief period of time, well, if you haven't changed anything
00:52:27
about your lifestyle, you're going to go right back to where you were. >> It's good at stripping abdominal fat.
00:52:31
Belly fat. >> Belly fat. This is what it's known for. Yeah. >> It's good at stripping belly fat.
00:52:35
>> Stripping belly fat specifically. So, bodybuilders actually really like it for
00:52:38
that particular application. >> I had no idea there was a peptide for stripping belly fat.
00:52:44
>> There you go, man. You know, and like for example, here we've got another one.
00:52:47
So, this is melanotan 2, right? So this is a uh melanoorton receptor agonist. So
00:52:52
melano cortins that's what makes you tan right? So you could administer this. All
00:52:56
right. And it will actually end up giving you a deep tan in response to just a little bit of UV sun exposure.
00:53:03
All right. Now I know right. Um listen I've embraced my pasty whiteness. So I'm
00:53:07
not you know not necessarily my uh my bag but it's real. Now again there are
00:53:11
some safety concerns with this because again could that potentially stimulate a melanoma or something like that? But
00:53:16
this is something again, it's a peptide that gives a wildly different result
00:53:20
than Tessa Moralin, right? Because it's a different tan. It does. Yeah, it does.
00:53:24
It'll also give you um uh some of the most impressive erections you've ever
00:53:28
had in your life. So, uh be be warned. Um >> wait, it's literally turning you into a
00:53:33
black guy. >> IT DOES. >> FINALLY. YEAH. RIGHT. And it's wild. So
00:53:38
there's actually and there's even a derivative a melanotan 2 called PT-141
00:53:44
uh bremalanide that is a commercial product right now that you can write as a prescription. Okay. But that doesn't
00:53:51
have the tanning benefit but has the sexual you know benefits. >> Oh wow. >> Yeah.
00:53:56
>> Keep those ones over here. >> We have to talk about this. Another
00:53:59
really interesting thing that phenomenon that we've seen right is that now we've
00:54:02
got all of these companies that are making these research use only compounds. Right. It used to be that you
00:54:07
would have a compound that's in drug development and you're seeing all the
00:54:10
advertisements for it. You know, maybe if you follow these sorts of things like I do cuz I'm a nerd, right? You get
00:54:14
excited about it, but you don't get access to it, right? Well, believe it or
00:54:17
not, the next blockbuster drug that Lily is going to come out with probably in the next couple of months is this guy
00:54:22
called retatride. All right? And reatride is fantastic in that it is the first three receptor agonist GLP-1 drug.
00:54:31
So the GLP-1 drugs, okay, whenever you're talking about semiglutide and trazepide, they have slightly different
00:54:37
profiles. >> This is the ampic category, >> correct? Right. So GLP-1 is the primary
00:54:42
receptor that they work on. And what that will do is it slows gastric emptying and it limits caloric intake.
00:54:48
All right. But then inepathide, not simaglutide, but tepide is a dual agonist. So it has effect on GIP, which
00:54:56
is a different receptor. Well, retatrutide adds in glucagon receptor activation. And so, believe it or not,
00:55:03
your liver actually acts like a repository of energy where it stores glycogen and fat that your body can use
00:55:10
as energy. But that's a problem, right? If you get too much fat there, if you
00:55:13
have a caloric excess, then you could end up having what's called nash cerosis, but non-alcoholic stopatitis.
00:55:20
Basically, inflammation of your liver due to accumulating too much fat. It's a
00:55:23
problem. But by stimulating the glucagon receptor while simultaneously hitting GLP-1 and GIP, what we found is not only
00:55:31
do patients lose an incredible amount of weight, but they also get the best improvements we've ever seen in their
00:55:37
liver liver health that we've ever seen. And people have been buying that from
00:55:41
research use only websites and using it for about two years now. And bodybuilders have already made this the
00:55:47
standard in their protocol when it comes to cutting for a show. And it is wildly
00:55:52
effective. And we're now seeing the population using a drug at scale that hasn't even made it through
00:55:59
commercialization yet. >> Why are you smacking you're using it? >> No,
00:56:04
I have not. I can honestly say I have not used Retta, but uh I find it fascinating though. It's absolutely
00:56:10
wild. You know, talk about power to the people, right? >> What about these others then? What else
00:56:14
have we got here that you think is interesting? >> So um we've got these two here that I
00:56:18
think are really interesting. So CJC1295 and Morland. So the whole idea is that you know can we stimulate growth hormone
00:56:25
and there's an interesting story behind that you know actually growth hormone
00:56:28
itself was very very popular for many many years as an anti-aging compound but then we changed some laws here in the 19
00:56:33
in 1990 okay that made it a little dicey to prescribe growth hormone and also you
00:56:37
know it's kind of a blunt instrument we wanted something to stimulate more natural growth hormone release so we
00:56:42
have this entire class of medications called secrets that help stimulate natural growth hormone release and these
00:56:46
are two of the most potent ones that are often combined together >> and when we say growth hormone Yes.
00:56:51
>> What does growth hormone do? >> So, growth hormone acts like a signal
00:56:55
that tells your liver to make more of uh another compound we talked about, IGF-1.
00:56:59
What growth hormone does is growth hormone actually stimulates building muscle. Okay? It also strips uh fat.
00:57:07
Okay? And uh it's also been found to help with tissue healing. >> Okay?
00:57:11
>> And so there's a significant benefit in that regard. And so people want to boost
00:57:15
their growth hormone. Improves quality of skin, improves quality of hair and nails and that sort of thing. And so uh
00:57:20
these two compounds together are particularly potent. CJC1295 being a growth hormone releasing uh
00:57:28
hormone derivative and then we have uh epomoralin which is a ghrein receptor uh agonist. So again release improving the
00:57:35
release of growth hormone through two different synergistic mechanisms and so that one is really really interesting or
00:57:41
these two together and then uh on top of that so this one sematotropen another word for growth hormone. Okay. So this
00:57:47
is growth hormone. Okay. Just a different word for it. >> So what would happen? Let's just take
00:57:52
this one. Somatropen. >> Yeah. >> Somatropen. If I bought this for research purposes,
00:57:58
>> research purposes only. >> And I started injecting some of this into me. What would change?
00:58:03
>> So it depends on how much you do and when you do it. So the idea is that if
00:58:07
you injected that at night, it would improve your quality of sleep. Okay. You would get a boost in your quality of
00:58:14
your hair, your skin, nails. Uh theoretically it'd be easier for you to recover from injuries, hopefully put on
00:58:19
a little bit more muscle, a little bit easier, maybe lose a little bit of fat. >> So why don't I take it?
00:58:23
>> Well, because if you take a little bit too much, you can actually get uh
00:58:26
insulin resistance because your glucose levels will go too high for too long. All right? You abuse too much for too
00:58:31
long. You will actually get acromegaly. So that's development of the your bones
00:58:36
continue to grow, but not along only in certain junctures. And so there's a very
00:58:40
specific look that bodybuilders who abuse growth hormone in high amounts will get to them. All right? which is an
00:58:44
irreversible change to the facial bone structure. You can also theoretically if you had a cancer maybe it could make it
00:58:50
worse. All right. Um we've never shown it that it causes new cancers but that
00:58:54
could be a concern. And you know on top of that it could give you insulin resistance because you know you're Yeah.
00:58:59
Exactly right. Um and if you take too much it could potentially make your hands numb in the morning because you
00:59:04
get eusions into the joint space. And so bodybuilders will talk about lifting a dumbbell and having to drop it because
00:59:09
their hand goes numb temporarily if they're taking too much growth hormone too soon.
00:59:13
And what else have we got here? >> Oh my gosh. So, epathylon. So, this is uh the uh medication that is
00:59:22
theoretically going to be available to us in uh July. Okay. And so, uh the hope is that you know this is going to uh
00:59:30
expand cell life. So, epialon the uh purpose of it is it works to enhance uh tomeorase. So, at the end of your cells,
00:59:40
imagine it this way. You're trying to copy the genome, but the little copier
00:59:44
that copies it, it takes up space and of itself. So, it's kind of like it cuts
00:59:48
off the last couple letters every single time. >> This is when you're aging, right?
00:59:51
>> When you're aging, you're creating new cells, right? Cells divide through this
00:59:54
process called mitosis where they split. All right? Well, if you got to make an exact copy, well, you've got to read
00:59:59
through all these lines of code. But because of the way that we're built, we
01:00:02
always end up cutting off the last little bit of code. Now, >> which is how we age,
01:00:05
>> which is how we age. It is one of the things that contributes to aging. All
01:00:08
right? Now, that is considered to be quote unquote junk information. It's at
01:00:13
the very end called the telomeir. All right? But we know that shorter telomeres are associated with aging,
01:00:18
potentially worse health outcomes. Then there's an enzyme that can help heal or
01:00:22
repair the telomeir called tomeores. Epiolon helps encourage that. And so some people are looking at that as being
01:00:29
one of the fountain of youth uh compounds. I'm very skeptical as far as that goes, but it does show some
01:00:35
benefits when it comes to uh, you know, healing parts of your brain that are, you know, associated with regulating
01:00:40
your circadian rhythm. >> So, the average person listening now, they've heard a lot of stuff about a lot
01:00:46
of things. How do they know if they should pursue getting and taking peptides? Like, how
01:00:54
do they know? What are they looking for? >> So, what I will say is that think of
01:00:58
peptides as falling into three categories. All right, you've got category one which are peptides that you
01:01:03
can prescribe right now legal from you know a commercial pharmacy that includes the GLP ones PT-141 bremalanide I
01:01:09
mentioned to you earlier oxytocin is another one we have these different compounds that are available and then we
01:01:14
have what we call category 2 which we don't have anything in right now but that will consist of the seven peptides
01:01:20
that are hopefully going to be approved in July whenever they get moved from category 2 cannot compound to category 1
01:01:27
can compound all right and then everything else is kind of in this category three where it's only available
01:01:32
for research use only. And so my recommendation for patients is don't go out and buy research use only compounds.
01:01:38
All right? You don't know what you're getting and you don't know if you're
01:01:40
dosing it right. You don't know if it's contaminated. So really what the public
01:01:44
should be doing is educating themselves on this and then going and talking to their doctors about what problems they
01:01:50
have and then potentially when those options become available, a peptide might be part of the answer for their
01:01:56
problem. >> Okay. So speak to your doctor. >> Yeah. Consult with your doctor and make
01:02:00
it a conver conversation with whoever your medical professional is about your symptoms and what might be useful and
01:02:06
what the range the toolbox the options are correct >> to attack those symptoms.
01:02:10
>> Yes, absolutely. Talk collaborate with your doctor. Your doctor should be your
01:02:14
partner in you getting as healthy as humanly possible. >> We talked about um tepatide semiglutide.
01:02:22
One of the questions that's front of mind for everybody, whether they're
01:02:25
taking them or watching others take them. Sure. Is what happens when you stop. >> We've looked at that, you actually
01:02:29
regain the weight. And so, because the truth is is that you have introduced something into your life that has moved
01:02:36
the needle in one direction, but if you don't change anything else, well, you
01:02:40
take that back out, well, you're going to go back to where you were. And so, if
01:02:43
you're going to maintain that weight loss, you have to make lifestyle changes
01:02:47
associated with that. And what we found is that people do regain if they do make
01:02:50
lifestyle changes, they do regain some of the weight but not necessarily all of the weight. And there's also data
01:02:56
showing that you could potentially stay on that medication but at a much lower dose and then maintain your weight.
01:03:02
Okay. So there are options to minimize your medication burden long term. >> And of all the things we've talked about
01:03:08
today, if you had to just pick one thing that excites you the most that's either
01:03:11
coming down the pipe or here already. >> Yeah. >> What is the thing you're most excited
01:03:14
about? I see your eyes wondering. Uh, hands down it's that one over there, Redat True Tide, because the changes in
01:03:22
body composition that we have seen both in clinical trials, okay, and in anecdotal reports from users who have
01:03:29
obtained on their own are wild. We're talking losing 20 to 25% of total body
01:03:35
weight within a relatively short period of time. And I think that this is going to be basically the Ferrari of GLP1
01:03:45
medications when it comes out. It's not for everybody, right? It's going to go
01:03:48
faster than everything else, but it's going to change the game. I think this
01:03:52
is going to be a trillion dollar drug when it comes out >> and no one's going to earn the patent,
01:03:57
so everybody will be able to access it. Is that right? >> No. No. That is going to belong solely
01:04:01
to Lily. And so you are going to see and they are going to enforce it you know uh
01:04:06
as aggressively as they've ever enforced anything but you will see profound results in patients.
01:04:13
>> People are referring to peptides as Silicon Valley's miracle drug and I I
01:04:18
wondered why that was why it's been associated with Silicon Valley. Have you
01:04:20
heard that at all? I have and I'll tell you I've seen some uh peptide stacks
01:04:24
from you know Silicon Valley you know uh founders and uh you know uh individuals
01:04:31
that blow my mind. I'm like oh man even I think that's a lot. >> Why would pe people in Silicon Valley
01:04:35
why would founders be interested in peptides? >> Well I think it's because we all want to
01:04:39
live our you know best version of our own lives right we want to perform at the highest level and so you know people
01:04:44
will do whatever they can. They'll drink caffeine, you know, they'll, you know,
01:04:47
pop a zen in their mouth, you know, and they'll try to tweak whatever variable
01:04:51
they possibly can to get the best possible performance. And the thing is is that anabolic steroids come with, you
01:04:56
know, significant side effects. And that's not everybody's cup of tea, right? And the health consequences from
01:05:00
highdose androgens dwarf anything that you might experience with peptides. And so peptides offer a lot of flexibility
01:05:06
in pulling many different levers that are interesting to like your regular average, you know, person. And honestly,
01:05:12
you know, it requires a little bit of DIY right now because of the nature of these peptides. And I think you combine
01:05:19
that with the kind of rogue, you know, uh founder uh uh spirit that is common in Silicon Valley and I think it's a
01:05:28
perfect fit. >> I asked you a second ago, what are the three questions that people come to you
01:05:31
and ask you as as a doctor? The first one as it related to peptides was which peptide should I be taking? Yeah.
01:05:37
>> Are there any other questions we haven't covered off that are common place in
01:05:40
your practice? The second one is, you know, can you prescribe me? And then I have to explain to them the regulatory
01:05:45
environment, you know, surrounding peptides that, you know, as of right now, the only peptides that I can
01:05:49
prescribe are the ones you can get from CVS or Walgreens, which is going to be your GLP-1 medications, and a handful of
01:05:55
others that usually aren't applying to the young men that I see in my practice.
01:05:59
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Terms and conditions apply. We have finally caved in. So many of you have asked us if we could bundle the
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single time a guest sits here with me in the chair, they leave a question in the
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that, we also have the 1% diary, which is this incredible tool to change habits in your life. So many of you have asked
01:07:36
if it was possible to buy both at the same time, especially people in big companies. So, what we've done is we've
01:07:42
bundled them together and you can buy both at the same time. And if you want to drive connection and instill habit
01:07:48
change in your company, head to the diary.com to inquire and our team will be in touch. Is there a super peptide
01:07:54
for anti-aging in skin and some of those issues? >> Oh, for skin, GHKQ. So it's key.
01:07:59
>> Yeah. So this is, you know, uh probably the most well-known peptide for uh use
01:08:05
for skin complexion and uh I mean really it may have some small benefits when it
01:08:10
comes to hair. All right. But th those reports are a little bit more spotty. >> Okay.
01:08:14
>> Yeah. >> And then outside of the world of peptides for a second. Yeah.
01:08:17
>> I've got these three vials in my hand. >> I'm so scared. >> All right.
01:08:24
Do you know what those are? >> Oh, yeah. Uh this is uh unfortunately our future if we're not careful.
01:08:32
>> Explain. >> So you know what we've got here is we have uh three different uh canisters
01:08:38
containing water that has a little bit of coloring in it. And what you can see is that all the way back in 1973, this
01:08:45
is pretty opaque. All right? Like you know this is not uh what you would you can't see through it. And then 2026 has
01:08:51
a little bit of color to it. And then we've got over here 2045 which is totally uh clear. Uh this unfortunately
01:08:58
is actually representing the fertility trajectory for young men because what we're seeing is that back in 1973 total
01:09:07
modal sperm count so how many healthy swimming sperm do we have in each ejaculation is exponentially higher and
01:09:13
more dense than what we're seeing today. And so what we're seeing is a progressive decline in male fertility
01:09:19
over time. And that's been demonstrated in multiple studies. We've debated this
01:09:22
at multiple meetings. People tried to argue that it's a measuring difference.
01:09:25
But as we give it more time and as we give it more scrutiny, this is real. We are experiencing a significant decline
01:09:32
in uh sperm quality and motility and concentration. >> Why? So the leading culprits are going
01:09:41
to be yes microplastics and environmental toxins. Okay, things that are put in our environment that we have
01:09:48
been exposed to that we can't help. But again, the biggest modifiable risk factor is insulin resistance and
01:09:54
metabolic disease, >> obesity, >> obesity. And so a downstream effect that
01:09:59
we may see from peptides like we discussed before is we may be able to help reverse this for the first time in
01:10:06
history by trying to prevent the development of metabolic disease >> using some of the peptides we talked
01:10:11
about earlier. >> Exactly. I gave you the example of a patient that I saw in clinic this past
01:10:14
week that increased his sperm count 10 times over. Imagine if we had given that to him before he even got that obese
01:10:20
when he just started to get a little bit overweight and at a lower dose. Well, he
01:10:24
may have never ended up in my office, right? Because his primary care doctor would have identified that, treated it,
01:10:28
and he never would have needed the specialist. It's crazy. It's wild. So ultimately you know if you look at
01:10:39
what are the ills that are affecting health care in you know any first world nation uh the number one offender is
01:10:46
metabolic disease and metabolic dysfunction and this is something that was actually hinted at you know by you
01:10:52
know RFK whenever he was talking about uh root cause of disease. Well, yes, we have many many diseases and many many
01:11:00
infections that don't stem necessarily from insulin resistance. But if we look
01:11:03
at cardiac disease, if we look at issues with lack of profusion, my my specialty,
01:11:09
erectile dysfunction, right? We look at cancer, all of this is related back to obesity and metabolic dysfunction. And
01:11:15
so if we can eliminate that, you know, as a society, or we can minimize it to as little as possible, well, I mean,
01:11:21
man, maybe I'd finally work myself out of a job. >> Your specialtity is erectile
01:11:25
dysfunction. >> Yeah. So my specialty is this branch off of urology that we broadly call men's
01:11:31
health. Okay? And so what that incorporates for us is going to be low testosterone, advanced hormone
01:11:36
management. I take that a little bit further than most people. That's totally
01:11:39
cool. And then also uh erectile dysfunction, peronis disease, which is damage to the penis that causes
01:11:44
curvature. And then uh male fertility on top of that. And I do a little other thing uh treating leakage after uh
01:11:52
prostate cancer treatment. And that's basically it. I treat like five things
01:11:56
maybe and you know that's it. So I'm very very specialized because I was the
01:12:02
kid that you know like to take my sandwiches apart and eat it one at a time. I was very precise and I figured
01:12:06
you know you can do a lot of things in this world and be okay at them or you can pick like I don't know four or five
01:12:10
and get pretty good at them. So that seemed to work for me. >> I was looking at a photo of you 5 years
01:12:16
ago and you were very different. >> Yeah. >> You've changed a lot. So,
01:12:21
I will I will tell you this. Um, medical training in the United States has gotten better,
01:12:33
but it is grueling. It's absolutely grueling. For 5 years, I worked anywhere from 80
01:12:41
to 100 hours a week in a hospital. No eating, very little sleep, did not care for yourself at all. Um, and again,
01:12:50
we can argue whether or not that's necessary all day long, but the truth is is that it really beat me down. It
01:12:58
absolutely took me apart physically and psychologically. In part, it's designed to do that
01:13:05
because the idea is that as a surgeon, you have to be able to perform when all the lights are on, when everything is
01:13:12
against you. You have to be the one to hold it together in the operating room and command that ship and save that
01:13:16
patient. And I remember being totally devastated towards the end of training and I did a
01:13:25
very challenging surgery on a very needy patient. Gentleman was about to go into
01:13:30
renal failure. Did not have a lot of kidney left and he had a very challenging kidney tumor that was in a
01:13:37
very treacherous location. It was in a location where he should have lost that kidney by all measure if we were going
01:13:43
to take out that cancer. And he was at a county hospital. He had no insurance, you know, and we swung for the fences
01:13:52
and did a very, very challenging operation on him. And against our best efforts with having everybody there, he
01:13:59
ended up having a bleed postoperatively that night. And I remember getting the call, I was on call, and that his blood
01:14:07
pressure had dropped and that he did not look well. And I knew exactly what it was because, again, this was a very
01:14:12
treacherous surgery. And I went in in the middle of the night with my attending, who was a different
01:14:17
attending, than the one I did the initial surgery with. And I remember just opening him up
01:14:23
and just being covered in blood that we were taking out of the abdominal field that
01:14:29
we were evacuating, eventually identifying the area of the bleed, and there was no way that it could have been
01:14:34
avoided. I remember my attendant yelling at me and we ultimately had to take that
01:14:38
guy's kidney. And I remember walking out of there just being totally shattered, covered in blood, crying in a
01:14:47
hallway by myself, wondering if, you know, like what what was the point? Like is there going to be is there a tomorrow
01:14:53
after this? Like I spent all this time in this training like am I good enough? Am I going to be able to make this? And
01:14:59
you know, I wasn't well put together, wasn't healthy. Uh and I ended up spending a lot of time with that
01:15:05
patient. literally held his hand throughout the rest of his hospital stay and he ended up recovering uh and uh
01:15:11
against all odds. But you know afterwards I took a strong interest in not only taking care of my patients but
01:15:20
also practicing what I preach taking care of myself and prioritizing my own health. I
01:15:27
got evaluated. I was diagnosed with low testosterone myself. Turns out not eating or sleeping for 5 years will do a
01:15:32
number on you. >> All stress >> through the roof 24/7. I cannot even
01:15:38
imagine what you know there's a part in the brain called the hippocampus that
01:15:42
they when they do MRIs on soldiers that come back from war that'll be degenerated in them. I wonder if we did
01:15:49
that in surgical trainee what that would look like. But I made a commitment to take care of my patients, to take care
01:15:57
of myself and make that a priority and uh to be you know simultaneously the best doctor and you know the best father
01:16:04
and you know husband that I could be. Not perfect made a lot of mistakes along the way but you know what you're seeing
01:16:10
from 5 years ago is where I was. You know, I've been in training out for seven years, so it took a while to kind
01:16:15
of recover from that. But what you're seeing is, you know, what focusing on health and wellness can potentially look
01:16:20
like. The emotion in you is palpable when you talk about this. And I'm wondering where
01:16:27
that comes from. What is it? Cuz you're looking off into the distance at something. And I don't know what you're
01:16:33
looking at. >> Yeah. I mean, I when I'm caring for my patients and I see a young man that is struggling with
01:16:46
his fertility and he wants to be a father, I was that guy. Me and my wife couldn't
01:16:53
get pregnant when we first tried. We ended up having to do in vitro fertilization at IVF. I remember feeling
01:16:59
like I wasn't a man because I was sitting in that room holding her hand and not having an answer as to why
01:17:04
things weren't working. Um, when I see my patients who come in that are, you
01:17:09
know, struggling because their hormones are out of whack and no matter how they try to take care of themselves,
01:17:14
something just isn't clicking. I've been that guy. And then when I see my other patients, you know, that are
01:17:20
further on in life and struggling with things like, you know, prostate cancer or erectile dysfunction, whatever the
01:17:25
case may be, I see like I see my my my father, my uncle, my grandfather. I like these but and they are someone's father,
01:17:33
grandfather and uncle. like these are our brothers and this is who I have been called to care for and I care for my
01:17:40
patients deeply and it's because I care for my patients and like this is a calling for me that I care about stuff
01:17:47
like this because I want my patients to have every tool physically possible to live their best quality of life so that
01:17:54
they can be whole and they can be happy and so that they can be the best version
01:17:58
of themselves for their loved ones. Well, thank you for caring because it matters and uh a lot of this stuff is
01:18:12
quite opaque and confusing to an average person like me, but it's glad I'm so
01:18:16
glad that we have people out there in the world like you that are demystifying all of this for us and explaining it in
01:18:21
simple terms, but also championing it because, you know, one of the things other things I've learned from doing
01:18:25
this podcast is solutions to problems that a lot of people are suffering with are option right in front of us, but
01:18:30
they need voices and educators like yourself out there um leading the charge so that these types of things are
01:18:35
available to everyone, not just the few. >> Absolutely. >> Not just the billionaires who can get
01:18:40
whatever they want straight away, any day. >> Yeah. I mean, you know, it's uh one
01:18:45
thing I I love is that I've I've been very blessed in my practice to take care
01:18:50
of people that are much fancier than I am and sit in boardrooms and that sort of thing. But, you know what? I love
01:18:55
taking care of my my regular patients who are, you know, farmers, iron workers, you know, tradesmen, guys that,
01:19:03
you know, truthfully I have more in common with than anyone else. You know, I joke with my patients, I'm just an
01:19:08
over educated plumber at the end of the day, right? Urologist. And so, um, it's,
01:19:13
uh, health is for everyone, not just for the fortunate. >> The last thing I wanted to talk to you
01:19:18
about is linked but random. >> Yes, >> it's the enhanced games. Let's do it. I
01:19:26
I am so excited about these. So, um, >> do you know them? >> I do very well. So, for those of you or
01:19:32
for for those who may not know, the enhanced games is a project based off of the world anti-doping ay's own data.
01:19:41
Potentially up to 40% of athletes that are competing at the Olympic level have either are currently using or have used
01:19:47
banned substances at some point in time. All right. And also, we know that a lot
01:19:51
of the compounds that are used for enhancement maybe aren't quite so dangerous if they're being administered
01:19:57
by a trained medical professional with proper oversight. And as of right now, that's not happening. Also, at the same
01:20:02
time, we know that Olympic athletes aren't paid enough, right? These are the
01:20:07
best of the best of the best and they're not even making the poverty line a lot
01:20:10
of years. And so, the idea is this. Well, what if we go ahead and we strip away those rules? Okay, we allow
01:20:16
athletes to use medications that can enhance performance. We watch them very closely and we have a team of doctors
01:20:21
and medical prof medical professionals watching them and then let's see what
01:20:26
they can do at these traditional Olympic events and see if they smash world records. Oh, and they're going to give
01:20:32
250 grand to any first place winners and a million dollars to anyone that hits a
01:20:36
world record. >> And just for comparison, how much are Olympic athletes getting paid?
01:20:41
>> They don't get paid to compete at all. Okay, so they don't get paid to be an
01:20:44
Olympic athlete. they uh end up getting sponsorship deals and that's potentially
01:20:48
the money that they can make. So >> yeah, >> interesting. So it's basically the
01:20:53
doping Olympics where everyone's allowed to dope. >> That's the idea. There's some caveats in
01:20:57
there. They're trying to say that only FDA approved medications can be used.
01:21:01
Okay. So you couldn't use something like Trenbolone, which is for veterinary use
01:21:04
only um or theoretically any of the compounds we've talked about today because they're not FDA approved. But
01:21:09
also at the same time, they've said that they're not going to test for those
01:21:12
things. and one of their athletes, uh, Magnus, has openly admitted to taking BPC 157 and that sort of thing. So, I
01:21:19
think we can kind of figure out that it may just be a wide openen playing field,
01:21:22
maybe. So, >> the International Olympic Committee does not pay athletes a single cent for
01:21:28
winning a gold medal. >> Yep. >> Which is crazy. >> How many billions do you think they make
01:21:33
off of those with all the advertisement? >> So much money, >> right? Yeah. And this is taking place in
01:21:39
Las Vegas >> May 21st through the 24th, I believe. >> Are you going to go?
01:21:43
>> I'm going to be watching, that's for sure. >> Do you want to go?
01:21:46
>> I would love to go. That would be incredible. >> Well, if you want to go, I know a few
01:21:50
people that are that are putting the event on, so do let me know. >> I'm there, man. I'm already interested.
01:21:55
You got my got my attention. >> Is there anything else we should have talked about that we didn't talk about
01:21:59
as it relates to this subject we've discussed today? >> I mean, honestly, I think that we've
01:22:03
gone pretty deep on peptides. And so I think we've, you know, uh, covered uh,
01:22:08
that, but one thing that I did want to just, uh, I'll leave with you cuz I think it's pretty humorous and I think
01:22:15
you've talked to some of my colleagues about this before, but you know, one of
01:22:18
the things that I deal with as a surgical specialist is the endstage of vascular disease, the endstage of
01:22:23
diabetes, which is going to be erectile dysfunction. All right? And, you know, believe it or not, whenever we're
01:22:29
dealing with that in male patients, they eventually get to a point where things like Viagra and Seialis do not work. All
01:22:34
right? And that is a dark place to be as a guy. And so you're taking these medications, all you're getting is a
01:22:39
headache and nothing else. And then maybe you have other options. They're actually injections you can do in the
01:22:44
penis, which is about as appetizing as you might imagine. But men want a better solution. And they'll come to us as
01:22:51
sexual medicine specialists, you know, seeking that. And that's what I do. So
01:22:55
the bulk of my surgical practice is actually fixing erectile dysfunction with a procedure called implant
01:23:01
placement. Okay. >> Oh, no. >> Absolutely. So now I think did Reena show you one of these last time?
01:23:06
>> She brought it and I didn't I didn't ask her to show me. It makes me like I get
01:23:10
full body shuddters when I hear about this stuff. Yeah. The thought of putting that up my penis.
01:23:14
>> Well, >> you can show me. No, you can show. >> Well, I would tell you the good news is
01:23:17
is you don't have to. Okay. Like that's that's what we have a job for. Okay. But
01:23:21
the way I explain to patients is like this. So take this out of out of the picture. Okay. Ultimately like the male
01:23:27
erection is just two inflatables tubes that start in the pelvis and go out the shaft of the penis. It makes sense,
01:23:32
right? It is a hydraulic motion. What happens is you get stimulated, get a rush of blood into those tubes, get a
01:23:38
rigid erection, able to use that for intimacy, and then when you climax, pop off valve opens back up and everything
01:23:42
drains out. All right? So, if you can understand brakes on a car, you can understand erections. But the problem is
01:23:46
that when you have long-term metabolic and vascular dysfunction, the brake lines, the blood vessels that feed those
01:23:52
erections, they fail. And all of a sudden, you can't get enough blood flow for it to work. And believe it or not,
01:23:57
you can actually get atrophy of the penis over time, and you actually lose size. All right, which no man is eager
01:24:03
to see. All right, but whenever the easy things like oral medications, Viagra and
01:24:08
Seals don't work anymore, the next best option if we're looking at patient
01:24:12
satisfaction, durability, concealability is this little thing that I do, which is
01:24:17
what if we took our own tubes, okay, and we put them inside your body's natural
01:24:22
ones. It's invisible. Nobody looking at you could ever tell that you've ever had
01:24:25
anything done. But all of a sudden, when you want to get an erection, instead of
01:24:28
having to rely on pills that don't work or putting a needle in there, right, you
01:24:32
could reach down and there's a small pump that we hide underneath the skin down in the scrotum. Okay? So, I joke
01:24:37
it's like a third testicle, but again, nothing external, nothing you can see.
01:24:40
And all of a sudden, whenever you squeeze this, what it does is it moves saline that we hide in a little
01:24:45
reservoir that goes in the belly. You never feel that into the cylinders. And all of a sudden, men are able to get a
01:24:52
firm, rigid erection that looks natural, feels natural, and they can use it as long as they want or until their
01:24:57
partner's sick of them, and then press a button and it goes back down. >> Do they still feel the same pleasure?
01:25:03
>> Yeah. So, it does not affect sensation. And so, the nerves that affect sensation
01:25:08
run along the top of the penis if you're looking at a clock at the 12:00 position. And we stay totally away from
01:25:14
those. So, this is surgically put inside the penis. >> All internal. And believe it or not,
01:25:20
that takes me about 13 minutes to do. >> How many people have these? >> Well, uh, I've put in about 11 or,200
01:25:27
personally, but >> 11 or,200. >> Yeah. >> Okay. So, it's quite a lot of people.
01:25:30
There'll be people listening now that have these. >> Well, you know, this is what's
01:25:33
interesting. If you look at in the United States right now, okay, there are 30 million men with erectile dysfunction
01:25:38
in the United States right now. That's more than the population of Australia.
01:25:42
All right. >> Oh, wow. And if you look at statistics, the oral medications are going to fail
01:25:46
in 15 to 40% of those men the first time they fail that. And so you're talking
01:25:50
about millions and millions of men who aren't responding to oral medications
01:25:53
and need a better option. >> So where's the button to get rid of the erection?
01:25:57
>> You see those two little bars right there? >> These two. >> Yep. Go ahead and put your thumb on.
01:26:01
Yep. Do that. And then squeeze from the end of the device back uh towards the pump.
01:26:06
>> So squeeze. >> Yep. Right there. There you go. It's down. And then you would have the weight of
01:26:13
your natural tissue push things down. >> Okay. And then Yeah. Okay. >> There you go.
01:26:18
>> Okay. Okay. Well, you know, I'm I'm happy people have the options because I
01:26:22
can imagine what that would be like to not be able to get an erection. It would be devastating, frankly.
01:26:27
>> Well, I'll tell you this. I get more hugs and high fives than anybody else in
01:26:30
my practice. And that includes the guys that treat kidney stones and cancer. So,
01:26:33
I feel like you're doing some doing some good work here until Peptides put me out
01:26:36
of business. >> I don't think that's going to happen anytime soon. And you have a great
01:26:40
YouTube channel. >> Thank you. I appreciate that. Which I think everybody should go check out
01:26:44
because you really are great at at explaining all this stuff in simple terms. So, I'm going to link uh Dr.
01:26:48
Alex's YouTube channel down below. We'll try and collab. So, if you just click on
01:26:52
the Dio icon now, you'll see Alex's channel. And I highly recommend you go
01:26:56
check out his content because he's really really leading the charge on this subject of peptides. When I spoke to my
01:27:01
team and said, I want to have a conversation about peptides. They gave me lots of options of lots of different
01:27:05
types of doctors and uh you were by far and away our preference because of the very fact that you're very very good at
01:27:11
communicating. You understand people and as you've demonstrated today, you have a
01:27:13
very big heart. >> I appreciate that. >> And you're clearly it's it was wonderful
01:27:16
to see what's actually driving you. Um and you did that in a way which um is
01:27:20
irrefutably authentic. So please go check out Alex's channel. Um he's around
01:27:25
you're around 100,000 subscribers on that channel now. >> I'm so close. We're at like 98.99 any
01:27:30
minute now. >> Okay. So hopefully we can help push you over um that that milestone.
01:27:37
>> Yeah. >> We have a closing tradition, Alex, on this podcast where the ask us leaves a
01:27:41
question for the next, not knowing who they're leaving it for. >> Okay.
01:27:43
>> Question left for you is if you could give $1 billion to one person you don't know
01:27:51
personally, who is it and what do they have to spend it on? Uh, honestly, I would give it to Elon Musk,
01:28:05
okay? >> And it's not because I think that he's hurting for a billion dollars right now,
01:28:11
but if you look at what he is working on to accomplish for us as a human race, right? He I truly believe from what I've
01:28:21
seen that he has a similar heart for humanity that I've seen with a lot of physicians. But on a macro scale as an
01:28:28
engineer and an entrepreneur, he's trying to solve some of the greatest problems that are facing us today. And I
01:28:34
think that what we are going to see hopefully coming from the uh Terrafab down in Austin is going to be wild with
01:28:41
recursive uh feedback and engineering on AI chips that are going to get better and better and better in a short period
01:28:47
of time and increasing, you know, independence when it comes to, you know, chip foundaries for the United States.
01:28:53
like it's wild and I think that that billion dollars would go further and do
01:28:59
more for more people than anywhere else I could put it. >> And he's also working on Neurolink which
01:29:03
is really interesting company which puts uh sort of brain chip interfaces to allow people to
01:29:10
hear again, see again, allow paraplegics to walk again. Um which is >> really really incredible. Dr. Alex,
01:29:16
thank you so much. It's so illuminating and I can't wait to have you back again
01:29:19
sometime soon to talk about all the other things we could have talked about today. We focused on peptides
01:29:23
predominantly, but I know that over on your YouTube channel, you talk about a lot more than that. So, highly recommend
01:29:27
everybody go check out Dr. Alex's YouTube channel. And uh it's been a pleasure. Thank you.
01:29:30
>> Thank you, Stephen. >> YouTube have this new crazy algorithm where they know exactly what video you
01:29:35
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