Transcript: Peptide Therapy Needs Measurement Before Momentum

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All right, guys. This is an incredible interview with Dr. Vicky. We are talking about all things peptides. Let's get into it. So, hello Dr. Vicky. How are you? Hey, I'm well, Kelly. How are you doing? It's been a little while since we've caught up. Yeah, I'm doing really good. Everyone knows I'm interviewing you today, so they're they're all looking forward to uh this discussion. So, um I will say Oh, go ahead. No, that was all I was saying. Great. I'm glad to have your audience and I back engaged again. Yeah. And I still we'll have to maybe for the next one, I know we do it every few months, we can do another live Q & A. That was a lot of fun. You know, if people come if you're into that, but no pressure. Um but yeah, I've been, you know, I've been taking your supplement stack um for quite some time now and love the creatine. Love Thorne. What a great company. um love the nitric oxide. I obviously take your, you know, vitamins and and um yes, amino acids and then um a few other things, but I it's hard to know what is helping because I'm also on HR2, but I just feel better overall in general. You know, you look good. You do. Yes. You have a healthy look about you. Thank you. I did find and I'm curious, you know, we can go into the pep peptide discussion, but I wanted to ask this one question because it's something I noticed recently. So, I'm

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something I noticed recently. So, I'm ADHD. I'm not severe. I've never taken Adderall. I didn't know I was ADHD, though, so there was no reason to to be medicated because I didn't know. And um I've kind of learned to to work with it. I started Tzepide. I felt at the beginning that it kind of helped. Um, but then as I went up in dose, it's like it got worse. Like my focus was just horrible. And, you know, looking into it, I realized a lot of that has to do with your dopamine because the tride, you know, um, and so I I started experimenting with like splitting my dose to not have such a heavy three or four days of fatigue and, you know, mental fatigue more than physical. And that seems to be helping. And of course, lowering the dose a little bit helped as well. But I'm curious what your thoughts are on that on the trazipotide and the effect on focus. Yeah. On AD especially if you are ADHD. Yeah. I don't I mean now I would have to go do a deeper dive the research. So what I'm going to offer you is just you know kind of my opinion based on what I do know. I don't know of any mechanisms by which I mean the decoupling of dopamine primarily has to do with reward systemdriven behavior. Um, typically mood, overall mood is improved with GLP-1s through a variety of mechanisms including augmenting neurotransmitter balance, reducing neuroinflammation, which also affects neurotransmitter synthesis, and reducing oxidative stress, potential mitochondrial uh,

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stress, potential mitochondrial uh, function improvements potential. So, you know, the overall typical impact at again the lower doses where you're not, you know, like massively sending a GLP-p1 signal, uh, is mood improvement. And typically people have more mental energy and a better mood. What you would guess, but it could be wrong, was that your focus would actually improve, right? But yeah. But you know it and so I don't know of any direct reason that in the like in the areas that modulate focus and attention especially in the prefrontal cortex that GLP1s would have a detrimental effect on that. Yeah. But there could be I don't recall in any of my recent reviews of the research identifying ADHD being reported as a common side effect. I don't think it is. But you know every human system is unique um and there are a lot of downstream compensations that take place when we uh you know exert a particular pressure on the body on the body's systems and and the brain specifically which obviously GLP1 receptors are prolific in the brain that you uh the brain is designed in such a way is to counterregulate uh quickly to any type of stimulus And that is a survival mechanism. And so that's why uh if you go if you get if if you're somebody who actually gets a nice euphoric buzz from a couple drinks, you know, after you have a

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drinks, you know, after you have a couple drinks every night, you stop having that euphoric buzz and you actually start feeling at baseline worse because your brain is downregulating that response trying to keep you from not being all bliss out all the time where you would be, you know, uh potentially vulnerable, right, to threats and things of that sort. So the in the brain specifically anything we do that exerts a like a cellular response and and do consistently there is eventually compensating mechanisms to try and counterregulate against that. Now and that's just a general principle. What would that look like from a GLP1 perspective is hard to say. Of course, a lot of people who've needed to lose a lot of weight have used high doses of these GLP1s over extended periods of time and you know that you're going to have some down some attenuation of receptor response when that happens, right? You're going to short term you may decouple receptors where they're just not sending the signal through any longer. Long term you actually downregulate the number of receptors available. And so there's always going to be that type of impact and perhaps after an extended period of a GLP-1, there could be some of that taking place that might have an impact. Again, I'm kind of rambling. I know. Yeah. Well, and I think I might have even expressed it incorrectly. I I it's not, you know, with ADHD, I don't know how much you know about it, but you like things that really fire you up and interest you, you can go all day. It's almost like there's not that much that fires me up right now. Um, so therefore, I have

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right now. Um, so therefore, I have trouble focusing because I really don't want to do the thing that I need to do because it's not like Yeah. Whereas before Tzepide, there were things that I could focus on that I didn't really want to do, but I could, you know. So, it's almost it's that's why I'm kind of thinking dopamine because it's like I just have no desire, you know, to do these things. It's not a I don't know. But that's it's it's more than that's why I don't focus on them because I don't really What about your overall emotional well-being? How is that? I feel good. I mean, I'm not depressed. I'm not you know, I I try to understand the difference between being depressed and just not being motivated or feeling that motivation, you know. Yeah. So, well, you know, there of course it gets very existential. I know. But I uh I mean it is possible that there was something to do with dopamine um dopamine regulation with the brain that over time with the impact the GLP-1 that could have played a role in focus because dopamine is one of those hormones that plays a role. But it's also possible that this is just different altogether, you know, and it has nothing to do with the GLP1 whatsoever. Yeah. No, absolutely. I mean, it's, you know, there's so much going on at this age, too, in menopause and all the things. Yeah. And you went through surgery and you went through anesthesia and you have to have your brain recover from that and even though you did well and you, you know, you're great and you wouldn't complain. Two surgeries is traumatic to the body. It's a lot. Yeah. I mean, you get cut open. I mean, there's a lot of I mean,

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open. I mean, there's a lot of I mean, it's really a traumatic and from the standpoint of your nervous system. Yeah. that you can talk to it a little bit but there are aspects of your nervous system that you don't have conscious control over all it knows is like serious threat you know we just got seriously traumatized even though you know it was for beneficial purposes so I wouldn't underestimate the impact of two surgeries also over a period of time on just kind of your general zeal to push into things well I've been using my Vegas nerve stimulator so that's yes those work I'm telling you I'm beginning to get data reports back from patients heart rate variability resting heart rate sleep data and most people are be are seeing improvements in these metrics. And I don't know if it's just me, but I I am I crank it all the way up like to really because they say you should like feel it, you know, and it almost takes a full Yeah, it depends on the individual and of course how precisely located you are right up in that little soft crest. I try to get Yeah, I've been experiment, you know, I try to find that sweet spot. So, and and so whatever level of stimulus, it's just that you don't need to do it more than two minutes twice a day. Some people think, oh, more will be even better, but you could actually overstimulate the vag nerve. Yeah. U my I'm going to pause for one sec. My dog's at the door. Hang on. Okay, no problem. All right. So, um I thought we could talk about peptides today. Um, you know, I'll share. Most people already know because I talk about it all the time, but um, obviously my first introduction to peptides was Tzepide, but I didn't really know about the world of peptides.

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really know about the world of peptides. Um, and then you and I chatted and talked about my upcoming knee surgery, and we talked about DPC157 and TB500, which in my opinion changed the game. I mean, I was out of physical therapy both times in four weeks. um they were fully impressed. I even told my doctor um he's like, "What are you doing?" And so I let him know and you know, even though he's an MD, he was definitely open to it, listened to it, thought it was interesting. Um so, you know, I guess to start the conversation, a lot of peptides are out there that actually people want to try, but you can't get them through a compound pharmacy. So, I'd love to kind of just hear your general thoughts on research grade and and going that route, you know, if that's your only option and and what your thoughts are there. Yeah. And so, this really goes back 10 years into my practice history where I began to get introduced to uh peptides as therapeutics to augment my overall plans trying to help patients whether reverse disease, optimize, whatever. And early on, there were two well there were three main classes of peptides that we would use. the the body repair like inflammatory anti-inflammatory pathways both for gut and body BPC-157 and some back then we had thyus and beta 4 now it's we got to get the TB500 version and then there were the growth hormone secret so these are there are number of them and they end up increasing pituitary signal for IGF-1

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increasing pituitary signal for IGF-1 production or growth hormone which gets converted into IGF-1 in the liver which is a repair recovery hormone and also can be an additional catalyst for body composition ition shifts if you combine it with a fitness and diet plan and something you can measure because you you can start with a baseline IGF-1 level introduce these peptides and then reme-measure and see is the person responding and then there were the immune peptides thyos and alpha and then actually thyosin beta kind of crosses over into that category as well and you know when I was able to begin to do the research on these and look at their impacts in studies not a lot of human studies but in studies and that they were natural that our genetics encode these peptides. I was like, "Yeah, I would like to start running trials with patients who are willing and I was able at that time to get these through particular compoundingies. So like pharmacy grade peptides and we began and and especially in some of the more challenging body repair cases or immune cases they became indispensable meaning that if I worked with somebody who had rheumatoid arthritis uh 15 years ago it maybe we could get them into remission maybe meaning they're off their biological drugs um but it would take years of working on gut and working on nutrients and cellular mechanisms and immune system all kinds of things when we begin to stack immune peptides as part of the treatment protocol along with still doing everything else that you I just discussed. We would see

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you I just discussed. We would see people going into remission within one year, right? Including inflam bowel diseases, other autoimmune diseases. So I'm like and and they could feel the difference. They could tell the difference and if we were ordering more comprehensive immune cell tests like an imosite map, we could measure the differences in the improvement in T - cell regulation. So ultimately these just became like a standard rotating tool in my arsenal of ways of helping people reach their health goals and they could get things jobs done that the other uh therapeutics we had available to us just couldn't get done you know and so they became in really what I felt like was indispensable then we end up into the COVID years and thyus and alpha 1 gets black ballalled by the uh FDA you know basically no and so theies can no longer produce that one. And then not long thereafter, of course, we got this reclassification of most of the peptides that we commonly used into a up for review, not a ban, but a classification of until we have more safety data. And what it meant is at any given day, they could just say no more. And therefore, pharmacies were no longer going to invest in inventories that the FDA could pull the plug on in a day. No. So essentially all of these very useful tools were just rendered not avail unavailable to us and from the standpoint of someone like me working with my patients especially people with autoimmune disease I was like I didn't feel like we could stop there right like and just say oh well yeah I know this I

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and just say oh well yeah I know this I know of this therapeutic that's very safe that's natural that very well could help you possibly go into remission and improve your health in many ways but because at this point the FDA doesn't feel that it should be allowed. You know, I don't want to say it that way. I don't want to pro, but the FDA has this concerns. We no longer have access to it. It just didn't feel right. So, at that time, I really had no choice but to begin to look for sources that I could trust that were highly purified, you know, purity tested, research grade, and then of course in patient encounters explaining we're doing research here. We're we're experimenting. We're you need to consent the fact that this is what we're doing. But I was able to of course continue to maintain that menu of peptides and use them in my practice which I've continued to do so today but with lots of qualifications and consent around the fact that we are using research grade peptides and so that clearly tells you in your audience that one that the better quality research manufacturers that I'm not concerned about uh them having contaminants impurities. And the other thing is because I've been doing this now for several years, I'm able to measure it's working, right? They are effective. They are working. So essentially we've been left with if you want to use and this may change again in another year or so especially because there are I'll tell you about this in just a moment but um

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you about this in just a moment but um if somebody is interested in using these tools um they can either like with growth of hormone secrets you can still get somein y right but that is no it's nowhere close to as powerful or as good as cjc 1295 epomoralin or tessimorin it just isn't and So you could try it and if it worked for you, great. But if somebody wants to but generally speaking, if somebody wants to use these tools, then their only option is going to be. And then my my answer to that would be do your research. Do your own research. Read about the company. Read about their testing. Do they test every lot? You know, who are they? What's their reputation? Don't look for the best pricing because that's typically going to be stuff that's being shipped over from China, which may or may not be the peptide. It could have contaminants. But you do have to do your own due diligence on identifying sources that you trust that you would be willing to grab these peptides from and sign disclaimers that it's for research and not for human use and you understand that when you purchase them. Now, there's a company that's organizing right now that may go public that is actually wellunded big time investors that is planning to become a major peptide distributorship. They'll have their own synthesis labs and they're looking at having the full menu, I mean, of peptides, including new ones that are being researched in the mo most optimal forms of delivery, topical, oral, injectable, nasal, and having a robust

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injectable, nasal, and having a robust supplies. And if this company is successful, they will become like the best place to just go get the things that you want and and know that the purity standards and the because when you have companies like this that have that kind of leverage, they can start creating data. We can actually do IRBs. We can do studies, investigational studies, which is what's lacking from the FDA perspective. And if we can create those studies on a large enough population and essentially demonstrating at least safety, then there's no reason to say, "Well, you can't have access to them." But ultimately, yeah. Oh, go ahead. How do they do that? Like, how do they get around doing studies when it's not supposed to be used? Yeah. Because every every drug right now that's not approved yet by the FDA is being studied under an IRB for potential use in humans. Okay. So, there's they can do it in Okay. I just didn't know the leg. Yeah. The reason we most of these peptides or one reason most of these peptides have not been studied in human trials is this very expensive. Yep. And most of them aren't patentable. Meaning, right, whoever does the research and proves that BPC57 perhaps preserves cartilage. Whoever does that research can sell BPC57, but they can't prohibit anybody else from selling BPC either. So the and look, I'm pharmaceutical companies. I I'm not making a statement about them one way or the other. They have their business model to make money, but they're they're not necessarily interested in spending the tens of millions of dollars to run a trial for

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millions of dollars to run a trial for they don't prove the effectiveness of something that all their competitors can just easily manufacture and sell as well. No, it makes sense. And so that's what's limited. But a company whose all future business model is we're going to become the global peptide supplier and that's how we're going to make money has a strong interest in actually seeing to it that the um restrictions on the availability of these things are reduced. Well, please let me know if they actually move forward. I would love to I will. Yeah, it'll yeah they're getting set up. It's just a question of being able to get get the studies done. the current regulatory environment I think is a little less um a little less obstructive to to this type of work. I've already said things in on this uh particular recording that I probably wouldn't have said um a couple years ago right when the um and I'm not making a statement about politics or anything there. I'm talking about the environment of health care and where we stand right now is that it's a little more friendly to physicians exploring novel therapeutics and utilizing right well I mean even what we've seen over the last which has been amazing over the last 10 to 15 years with uh psychedelic therapy I never thought I'd see it and you know it's it's amazing though it is amazing um okay that's that's awesome so um I guess we could dive into I mean I know well actually you know I think the big thing like you said is is just be smart do your research um because I think

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do your research um because I think there's this thought out there obviously like the way I look at it is if I can get something via compound like tzepide um and it's no more expensive than research why would I go research I'm going to get the compound you know what I mean it just I agree from my perspective if I can prescribe it through a licensed pharmacy. Even if I have it available as a research peptide, I'm going to go that route. Yeah. I mean, yeah. So, yeah, but um I just, you know, the the view of all gray is bad or all research is bad or obviously you don't want to go to maidenchina. com and buy peptides. You know what I mean? And there are people doing it. It's crazy out there. But, um, you know, I think it's kind of like a spectrum. If you do your research and you make sure it's a quality company, I can't imagine there's there's all that much to be concerned about. But yeah, and the dosing protocols, which again is do your research for these days, you can pick almost any peptide and do just a standard Google search on dosing and there are people who would like to sell you that peptide or other clinics where they've already like written out the researchbased dosing protocols. Yeah. Um, and so it's very easy to find out what are the dosing parameters, but it's important that you follow those. And most of these peptides, not all, but most of them are going to be uh the most safe and effective when you're using the appropriate pulse doses

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you're using the appropriate pulse doses of them over time. And and some of those that's very important with like immune peptides. Um there are some that you could dose daily at low doses and be fine, but you definitely want to make sure that you um have reviewed those protocols and and follow those protocols if you're going to do this. Yeah. we've gotten uh I use a lot and I try to get not just for peptides but um I mean I've used chat GBT for years but it's it's taken it to a next level with like going through my blood work and you know talking about peptides and do any of these you know interfere with others and am I taking too many you know I literally give it like a list of all my supplements and it's like oh you're missing this or you're taking too much of this not that it's the end all but it's so fast you know what I mean you can feed it all this info and it's been so helpful So, all right. So, um I guess we could talk about uh I mean we could start with what I like to call the Morlands. Um if you want to go down that road. Now, I'm I'm taking Simorland. Um I do want to move over at some point after a break to CJC IPA. Um I have heard a Morland can make you hungry. I'm not sure about that what your thoughts are, but um unless you take it at night, then I guess it wouldn't really matter, but um I'd love to because I know the the biggest benefit for me with some is I sleep better. It really does help my sleep,

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better. It really does help my sleep, but other things could help my sleep, too. So, it's like I want I definitely want more benefits than that, but I also haven't been on it. You know, this is only my second cycle of it. So, um I'd love to hear your thoughts on that. And then Tessa Morland, too. So, yeah. So when we get into the growth hormone secrets again peptides that are essentially um designed to increase pituitary production of growth hormone and they and then that growth hormone is if it works for you and it's increased as it passes through the liver there's conversion to IGF-1 which is a biometric that's stable and can be measured so that you can know you're not wasting your money. Um, and if somebody is going to work with the uh the moral, I do recommend that if they can ask your doctor. It's not an expensive blood test for an IGF-1 level baseline. There are some people who come into my program and their first labs, they're already 98% on IGF-1 and they're like, "Hey, my friend told me about testim." And I'm like, "You don't need it." Um, you know, we don't need to go to 300% of what's the normal level with these things. Um, so you you know, first you assess your own level and then we'll talk about, you know, the different ones, but typically after you've done a anywhere from 30 to 60 day pulse, whatever you determine to do, you want to repeat a level because what I've seen in clinical practice um is honestly back with simorin which I used initially years ago, I didn't necess I mean some

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years ago, I didn't necess I mean some people got a really great response, but it was really hit or miss and there are a lot of people who we couldn't really measure any change and they couldn't detect any change. And then CJC1295 which is a separate one commonly combined with epomoralin. Epomoralin can be used as a solo agent but usually it's combined was you know theoretically more powerful and would work better and not that expensive similar cost really. And same thing you would inject it at night uh you know and you could either there there's a there's different way approaches to doing this. Some people say do it five nights out of seven. So you take two nights off over a period of time. You can also do like straight 30-day pulses and then take time off. So there's different ways kind of figuring out how you're responding. But with that one, I could definitely measure differences. And this isn't something based in research. This is just an observation for me in my clinic and that may not extrapolate to the whole population. Women specifically typically get very good responses to CK1295 andorin. And so that and men I get variable responses with CJC1295 epipomorin. Sometimes we see a nice response sometimes we don't. And then you go up the ladder to tessimorin which is commonly combined with epipomorin. Now tessimorin is available through compoundingies because it was actually expensive. Yeah. It's very expensive. Very. It was an FDA approved therapeutic specifically for a condition called lipodistrophe in HIV patients. So

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called lipodistrophe in HIV patients. So HIV patients who had AIDS would get this fat accumulation even though they were actually becoming malnourished and thin. They would get this fat deposition right around their stomach and tessammoralin was found to be effective at reducing that fat. So when it comes to reducing belly fat, tessamorin does have an impact only if you're also exercising and eating a nutri with a nutritional program. Like if you uh don't go in a calorie deficit and just use Tessa Morlin, you're not going to just magically burn off belly fat. Now, when you say belly fat, is it probably more visceral fat? Yeah. Or is it Okay. Yeah. And so, and it does and it works great and it's really powerful and almost universally men or women. We see major increases in IGF-1 when we use tessimorin and npmoralin. So, if if cost was not an issue, I would that would be where I would go to first. Okay. Even as a woman, yeah, it's cost not an issue because it it works and also usually it's also a little better tolerated. CJC1 1295, not always, but it can cause some itching and burning. It also will cause flushing and people will feel kind of hot after injection for like 30 minutes. Sometimes that can be make it a little harder to get to sleep. And so, but again, a lot of my uh patients are successfully using CJC 1295 in the morning. Um most of the male patients that work with me are electing to use tessamorin uh combined with epomoralin and you know and there are other in this

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and you know and there are other in this category there's something called a grlin mimedic but those really increase hunger so those are for people who want anabolic drive right okay now what what happens when we increase IGF-1 a lot of people think it's a muscle building peptide and it does facilitate muscle building but it's not necessarily a direct ly anabolic agent the way say testosterone is you know it's not growth hormone does a lot of things it is involved in repair of all tissues especially overnight while we're sleeping like rebuilding of tissue but repair recovery of the body it um for some people for it will also deepen sleep a higher level of IGF-1 will help them improve their deep sleep so generally if someone's is getting a good response. What they're experiencing is that they sleep more deeply. Their energy is better. Also, if they're invested in a fitness protocol, they're actually able to train a little harder longer and recover faster and increase their frequency of training. And then combined with perhaps during that time a modestly low calorie diet, they're able to actually strip some fat while they're actually maintaining, preserving, or even building muscle. And mo a lot of people also just note an improvement in general energy. Not everybody, but some people do. So, you know, as you age, your IGF-1 levels are going to naturally drop. And there's a debate about this

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drop. And there's a debate about this because some people are concerned that maintaining uh within the normal range, staying on the higher end, they say the top quartile, the normal range, is there an increased risk of cancer? Well, that hasn't been proven to be true. Um and so you know there's this sort of fa like for some they would advocate oh you don't want higher growth hormone because that's going to increase your risk of cancer. On the other hand low growth hormone increases your risk of sarcopenia muscle loss osteoporosis bone loss uh increased frail dability right which is a major major health risk for all causes of death associated with aging. So based on the totality of the research right now, I would favor for healthy aging, you at least want to be over the 50 percentile mark for your age. You'll get a a range specific to your age, and that range could be 70 to 220, you know, and we'll do make let's make the math easy. It wouldn't be this, but maybe it's 100 to 250. Well, what you'd like to see is that you're somewhere between 175 and 250 at baseline as you're aging. And if you're not there, then you know you you're on the lower side. Now, some of the people who come to see me who have been deconditioned and they're not healthy will have measurably low growth hormone levels. A lot of times that's just they're not eating enough protein and who's sedentary and their sleep is disturbed because these are the factors that affect IGF-1 naturally. Exercise is a major increaser of IGF-1 production.

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a major increaser of IGF-1 production. Sauna increases IGF-1 production or growth hormone production. Deep sleep improves growth hormone production. Uh, eating a higher protein diet improves IGF-1. So, these are like the natural approaches to improving your own uh, growth hormone IGF-1 levels. And I I do think that aging with a in the higher portion of the range probably has its advantages. It's an opinion, but but I I do believe that. And if you're in the lower portion of the range and you successfully use one of these growth hormone secrets and you measure, okay, that just took me from the 25th percentile to the 75th percentile. And then you use an appropriate sort of press pulse dosing cycle. So you did, let's just say, and I'm just throwing this out there, you did 30 days on, 30 days off, Right now what the research suggests is that instead of downregulating your own IGF-1 which is often the case when you augment hormones as you begin to suppress the actual glandular function that you increase baseline IGF-1. Now again the this is based on observation in my clinic and so it doesn't prove anything. What I've observed is that people who did have uh say were on the lower side of the range when we've used these peptides press pulse over time, you know, that typically their new baseline IGF-1 a year later when they're not using the peptide is significantly improved from where it started. Now

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improved from where it started. Now they're now producing more IGF-1. But if they've been working with me, they've also optimized protein and they've gotten into fitness and there are other things and their sleep quality has improved. There are other factors that could have influenced that. Yeah. But I do like this class of peptides. I think there's a lot of potential benefits. It's another one that will get thrown in for repair from surgery, right? Because Yeah. And I was taking it after after my first surgery at least. So when I start back in December, my IGF, my range is 65 to 216 and I was at 114. All right. So what was the r say the range again? 65 to 216. So definitely below the 50%. Yes. Um, and now I'm at 127 five months later. So, I didn't go up much, but I've only been taking some Orland, but I've improved other things, too. So, you know, maybe maybe next round I'll try. If I were you, I would uplevel to to my first next move would be just CJC 1295 combined with IPA Morland. Okay. Not Tessa Morland. Go ahead and try. You need to go there yet because if you're a really good responder because CJC to IPA typically is onethird the cost of Tessa. Okay. I I think you scared me more about the side effects than anything, but not scary. It's not there's it's not dangerous, but there's No, I didn't mean that way. Yeah. But there's definitely a potential for like a flush, like a warm sensation that Well, no does that to me. Exactly. Almost every time I take your vitamin, Vic, I Dr. So like because then you formulate it's still it's weird and I don't not actually not every time. It's weird. It's random, but it probably

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It's weird. It's random, but it probably depends on how much food I have in my stomach with appetite. Yeah, you're unusually sensitive. Ever since I shifted the ratios of nicotinic acid nyinomide, we have not had flushing reported. But clearly Oh, has that happened already? Yeah, the new batches I mean the only the first batch that I had the first bottles had the 50 milligram split. Now it's a 7525 25 acid which is also split into twice a day. So the actual dose on any given day of any portion is 12. 5 milligrams, which theoretically shouldn't cause a flush, but it could for you. Well, and it it I think the times it did, I took two instead of one because sometimes I'll Okay, there you go. So that's probably it. And if you did have more food in your stomach, you'd probably Yes. Yeah. Now, um even though it's not, um Samorland, I know it's related. What are your thoughts on um it's kind of related on AOD 9604 because there's a ton of people who are interested in it that use it for stalls, they use it for visceral fat, but it sounds like Tessa Morland, if you can afford it, is basically gonna do the same thing again. Yeah, it's a popular one. I have used it in a lot of patients. I haven't used it over really probably the past year just because I didn't we never saw a lot of results. Now that doesn't mean that there aren't results and that there aren't you know but I

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and that there aren't you know but I never really was able to measure improvements the patients didn't experience improvements and if we were you if we identified which of the growth hormones crits really did work well for them when we got those improvements we just went ahead. So, I've I've kind of and I might need to revisit it and there might be data that shows up that says, "Oh, no. This works great." And I it was just kind of a a weird population or maybe at the time the compounding pharmacy wasn't making good quality. I don't know. But I never really was able to see much of a response to it and okay I was treating but pretty much Tessa Morland's doing the same but more or but better. Yeah. I mean, if you want to augment IGF-1 and you can afford it, Tessa Moralin is your best, I think, your most powerful option. Yeah. Okay. Which also has FDA approval and you can actually get it from a compounding pharmacy. Yeah. But it's even more expensive that way. I will tell you that. Yeah. That's one that's like just for the cost alone. I probably would not go that route. I'd go Yeah. And real quickly, just just some some understandings around timing of dosing. So typically the dosing is going to be prior to bedtime and that's because you're going to produce most of your growth hormone when you enter into deep sleep. So we're trying to add a catalyst to that. Now if you it's critical though that if you've had alcohol or food that you don't actually dose it uh you're wasting a dose because well what two hours at least right of two hours that you've had no alcohol, no calories if you want to make sure you're going to get your best

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make sure you're going to get your best response. Otherwise you're interfering potentially. you've got other things on board that are going to actually interfere with growth hormone release and you could be wasting your money. Now, there are some people who will wake up and inject it in the morning prior to exercise fasting because exercise is another stimulus and and some who like exercise and then get in a sauna and they'll go ahead and inject in the morning and not necessarily inject at night and that can be quite effective as well. Yeah. um like fasted exercise, use a shot of your growth hormone secret at that time for people who perhaps would rather not inject at night. Yeah. I know with AODD most people do it in the morning fasted. Yes. So, but I mean I know that's different but um and then with if you were doing te say now that's with Tessa say with CJC or even with Tessa and IPA do the people that do it in the morning do they tend to do IPA with it in the morning or do they do it? Usually most of people you can buy Tessa Morland solo but it's not that much more expensive just to buy combo of Tessa IPA and so most of the time people are on the combination. Same thing with CJC1 1295 and Morland. I mean it's very very rare that we have these split up almost universally whichever one our patient is using that it's combined with eporalin. Okay. Awesome. Well, that's that'll be my next uh we'll see and then I'll get my blood work done again. And so I really want to try to get that that number up above that 50% mark, whatever it would be is

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that 50% mark, whatever it would be is what you're thinking. Yeah. No, you would. And ideally if you can get it up to the 70th or Yeah. 75th percentile. And then is it something that you just continuously use or does your body eventually start kind of producing it on its own and you can back off? like what yeah it varies from individual individual of course and that's somewhat dependent on all the other aspects or variables that are influencing someone's overall health picture again in my experience uh if if we see positive re-entrainment of INGF-1 you can some of my patients will no longer use cycles and their ba baseline level is uh you know somewhere in that top half possibly top quartortile and it might it'll fluctuate it's supposed to fluctuate they may have, you know, but um most of the people who utilize it who are also uh definitely into fitness, always wanting to improve fitness, um they will usually continue to press pulse it. They just they like the impact, they like how they feel, they like the results they get. We monitor the levels, we make sure we're not like pushing them up to uh too high of a level of IGF-1 over time. So most people will just end up sticking with it if they get a good response. They may reduce the frequency like they may go from instead of a 30 on 30 off they might go to a 30 on 60 off. Yeah. All right. Um I know one of the other really big uh areas of

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one of the other really big uh areas of course is the healing and inflammation and all of that. Um there's a lot of people I mean obviously I'm I talk about BPC and TV500 all the time and you know if you're recovering from surgery your dosing is probably going to be different than your maybe have a tennis elbow or something like that. I know people that have used it for plantar fasciitis all kinds of stuff. And then you also have a lot of people using um these combinations like glow. It also adds G GHCU which helps the skin but it has BPC and TB500. And then there's another one that has the keep KPV which I've been looking into that one looks pretty pretty awesome too. I don't know if you've you know but what what do you want to talk about in terms of those? Yeah, I mean just so KPV sort of falls in its own little category. Um it it is specifically you know it's the best option we have right now for people have what is called mass cell activation. Mass cell activation syndrome is a really challenging immune problem trigger. There's all kinds of different triggers people have. Mass mass cells release histamine and other inflammatory modulators and they'll end up having these really terrible reactions. Um, a lot there's a lot of gut work you have to do and a lot of immune system you have to work and KPV is one of the peptides that often can help bring that under control. It's also really good for gut inflammation, right? So, it improves gut integrity, reduces gut level inflammation. KPV can be taken orally. It's only three amino acids long. So you can take it orally and get, you know, positive benefits. As far as

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you know, positive benefits. As far as like repairing tendons, ligaments, cartilage, recovering from injuries. Um KPV is not one that I've put into that box yet. Um so that it doesn't it might eventually we might see some benefit there, but I've almost again anything I'm doing doesn't mean that's the only way to do it. just one physician working in their clinic observing results and kind of working with what they have and also trying to be conservative to some extent with our patients resources. And so with KBV where I've primarily uh targeted that is people with gut level inflammatory issues, gut integrity issues and mass cell activation. So I'll bring it in. It's safe and it can work really well. Now, BPC157, which is my favorite peptide, and maybe everybody's favorite peptide. It's my desert island peptide. Meaning, again, you know, earlier we had the supplements. Yes. Oh, yeah. I want your desert island peptide. You're gonna put me on a desert island. And you say, "You can only have one peptide for the rest of your life, but you can have an endless supply." That's BPC157. Wow. The the number of, you know, at least so there are enormous number of mechanistic studies where you're just looking at what does it do in this type of tissue or cell. That doesn't always mean that it's backed up by a full human trial of measuring response over time. And then there are a lot of times animal studies which I I personally I I sometimes get challenged by using animals as you know our basis of research and stuff but that's where a lot of the studies are done. And so from a mechanistic standpoint it there it's

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a mechanistic standpoint it there it's there's so many impacts on human systems. Everything from sensitizing growth hormone receptors, meaning possibly improving the response you get to that higher level of IGF-1 in terms of repair recovery, uh protecting from deterioration cartilage and connective tissue and activating repair uh you know c like repair um synthesis cascades that where your body is beginning to actually build back collagen and repair things to um tamping down inflammatory cytoines. universally across all tissues including the brain potentially increasing uh BDNF which is brain derived doatropic factor like you know basically our growth hormone for our brain and then you go into the gut and it's like the most phenomenal gut anti-inflammatory peptide ever right and it's actually original site of secretion in the body is the gastric juices that's where we make BPC-157 and what the theory is we don't know if it's true or not was that probably ancestral diets where we were actually eating like t raw tubers and roots and herbs and also possibly grinding bone and getting like we were probably creating micro tears in our gut as these things would traverse through there and BPC57 would have been one of the signaling molecules to help accelerate repair of that tissue. Again, that's a theory, but it does make some sense to me of why it's such an effective gut healer. And so, um, you know, it's one of those that for just

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know, it's one of those that for just about any particular reason that a person has inflammation, whether it's the gut, it's the body, other health issues, brain fog, anything, I am going to try BBC57. Nice concussion recovery, traumatic brain injury recovery, surgery recovery. So there is a difference in dosing between say just maintenance and a guy like me who's 55 who wants to keep lifting weights and doing all these things and wants to minimize the deterioration of my body. You know somebody like me I'm I'm likely I'm not saying I am just but I'm likely to go ahead and use like an oral dose of BPC every day as a maintenance strategy for both gut and body. But then if I overdo it in the gym and I'm starting to get some rotator cuff tendonitis, I'm going to switch to a highdosese injectable version, okay, for a period of time, maybe 30 days until I get that settled down. And so I'll kind of rotate back and forth. Um, there are some very rare but possible risk associated with BPC57. So everybody still has to pay attention to how they're responding. The other thing, and I know you've already experienced this, but uh one of my daughters, I have twin daughters, and this was a couple years ago, but she had during her sophomore year of high school blew out her ankle, tore the ligaments, tore tendons. Uh did not it did not heal. Six months later, she's taken to surgery. They sew up all of her ligaments and do a really nice job of restoring structural integrity, but ultimately the two main extensor tendons that also had tears were not

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tendons that also had tears were not addressed. The orthopedic surgeon did an amazing job. I'm grateful forever that what he did because it was really complicated. It just the tendons they weren't thinking about. And so afterwards, she's healing, but then she's still got this weakness and this pain. Her her ankle is stable. And a brilliant foot and ankle specialist out of Atlanta is on his way through uh to go do a TED talk and he stopped by my clinic with his ultrasound. He ultrasounds her ankle. this is now a year out from the and he's like, "Yeah, the ligaments look great, but these two tendons have massive tears in them." And they and it was the identical to what was seen on the MRI a year ago. So, you're a year out, they have not healed, right? It means they're not going to heal. Like, the tissue is not good. You're going to need to go back to surgery. But, he had already prepared for that and I had to. So, under ultrasound guidance, he did a nerve block and then I watched as he injected BPC57 into each of those tendon sheets, like directly into the tend directly. Wow. Yeah. And then six weeks later, we drive back to his clinic and he reultrasounds her ankle and the tendons are 100% healed naturally. Crazy. Yeah. So, is there something then too? Um, like I did not inject near my knees. I wasn't willing to like, you know, knee infections. Yeah. I mean, I understand this is a different situation, but do you think there's something to injecting near your injury site? Does No. People go back and forth with that. So truthfully when you inject so in her case obviously they they went right into the tendon she's under ultrasound guidance but otherwise wherever you

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guidance but otherwise wherever you inject on the body if it's subcutaneous it's entering the capillaries. Yeah. And so it's going to go into the capillaries and then it's going to circulate through the bloodstream. Most peptides are metabolized very quickly. I they're going to run through your circulation a few times and then boom they're gone. They sent their signal done. They're not lingering the way hormones do. And so theor, you know, from the standpoint of like what's likely, it's likely that wherever you put it in, you're getting the same impact. Some people have speculated that if you're closer, maybe it'll go into Yeah. You'll get a slight like a less of a dilution effect. Yeah. I have had times where somebody had a a very mild anterior ankle sprain. Yeah. And I would actually I wouldn't inject the tendon, but I would inject right over where that area was. So like because that's a if you're looking at it from your ankle, it's kind of a shallow area of skin, right? So yeah, you can reach down there and actually kind of feel the tendon attachment and that's where they're painful. And in those cases, I would take that little insulin syringe. I would just run it right down to where I'm maybe just on top of the tendon and inject there. And that that definitely seemed to be helpful. But that's I was able to get very close to that when I injected it. Yeah. Interesting. And then I also heard that if you're if your primary focus, for instance, is gut inflammation, you're better doing the pill versus oral. Absolutely. Oral. Okay. Yeah, I take a pill every day. I don't inject much right now, you know, because my knees are healing well. Um, but is BPC one of

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are healing well. Um, but is BPC one of those that if you do you still need to, you know, do some type of cycle or is it a little if you're doing a small enough amount? You know, a lot of if you go and you do your research, a lot of people being responsible will say, you know, yes, you should cycle BPC. And I think for young people especially, yeah, they should. I think you get to my age and maybe the answer is yes, you should cycle. I'm not. Yeah. Right. Okay. Yeah. It's a very safe peptide and yes, I take it routinely. Uh and I think it does a lot of good. Now TB500 is another one and it used to be thymus and beta 4. So this is an immune peptide. It's like a first cousin to thyus alpha but it works differently. So it does actually have immune system modulating impacts but also has substantial uh influences on general inflammation and as well as body repair. And so there are a lot of uh a lot of studies looking at it from the standpoint of like corial ulcerations, burn wounds. So there's so many different things where they've looked at TB500, it also has a significant impact on chronic central nervous system inflammation. And so for people who've had a chronic CNS inflammatory disorder, which will typically cause fatigue and brain fog, this could be like chronic lime uh Epstein bar like chronic mono, these types of things, plus many others or concussions. TB500 can be really long

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or concussions. TB500 can be really long COVID as well. Again, 2500 often gave substantial relief to people when they would use pulses of it. It definitely needs to be pulse dosed and it can because of its immune effects. Some people will have kind of reactions to I broke out in hives and had to go I'm pretty sure that's what it was. But, you know, I experimented, I lowered it, I took a break, all of that. But I think it was just a a reaction. Yeah. So it can cause reactions and some people will have a lot of side effects headaches and itchy like and it's just so in those cases what we do and it really has to do with something that that could be identified on what's called a lymphosy map with the T - helpper cell balance but in those cases we can reduce it to the fragment it's the TB500 17 through 23 fragment right there's a much smaller snip of the peptide and most of the time somebody who didn't tolerate TB500 will actually tolerate the fragment Yeah. And and still get a good response. But it's uh it's always that's been part of my standard post surgical uh uh protocols for a long time now is a pretty a relatively high dose. Uh not it's higher than a maintenance dose, PV500 and BPC-157. And when I first started doing this, just like you experienced with your PT, the the first couple of times they were both shoulder cases. The orthopedic surgeon about six weeks out called me and said, "Hey, I want to talk to you about so and so." I did their shoulder. I said, "Oh, yeah, I know, no,

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shoulder. I said, "Oh, yeah, I know, no." And they were like, "Hey, they said you had them on these couple of like peptide things. Like, what was that?" And then I'm sitting there getting nervous like, "Uh oh, you know, what happened?" And I'm like, "Yeah, I did. Why?" And they're like, "Because this I want to know more about it because this healing is remarkable." Like, that's amazing quickly. like and I would get these calls from surgeons who had no idea anything about it but were like there's something difference about some difference about the way this person is healing and again postconussion traumatic brain injury there is a potential for reduction in cardiac inflammation so possibly cardiac remodeling and healing I mean the there's an enormous number of potential benefits what we need are human trials where we can prove yes yes we do exactly and and then the other immune peptide which is really not a body repair peptide It's more about improving immune system balance, reducing uh strengthening the immune system for people who are susceptible to frequent infections or say frequent herpes outbreaks or something like that. We want to boost their immune system. Then we'll use cycles of thymus and alpha 1. Also really good at and for individuals who uh potentially again I'm not one more time not telling anybody to use any of these peptides. You talk to your doctor, you know, make your own decisions. I'm not advocating for you to use them, but for autoimmune diseases, we almost automatically reflects to TA1 as one of the treatments we're going to do. But again, there's reasons for the autoimmunity. Um, and there are genetic factors as well, but there's a lot of

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factors as well, but there's a lot of times a gut interface that's going on. There's dysregulation and particular cell functions. So, I'm not just throwing TA1 at them. I'm actually getting those assessments, looking at what's going on in their body and their gut and their immune system and we're building a comprehensive plan uh to and then we're layering the TA1 in to see if we can kind of catalyze a faster shift and change. Yeah, it's a I I have some just in case, you know what I mean? I'm like, well, I have I know someone in particular that got COVID and immediately started taking it, knocked it out. Yeah. you know, and that was where the uh when it started showing up back in 2021. I lost you. You lost me. Can you hear me? Hello? I can't hear you. Can you hear me? I can hear you. Yeah, I can't hear you. Check your microphone maybe. No, it's it looks good. I'm here. Can you hear me here? Let me So, yeah, you mentioned like with the COVID thing. Yeah. And actually that was when thyosin alpha which made sense to me if there was a viral pathogen that based on the previous research we had on thyus and alpha that that would be a possible smart peptide to use to fortify your system but not that it would mean you wouldn't go and pursue any really solid treatments for that pathogen right it wasn't like don't do anything else just use this but you know that was also around the time that ivormectin became a hot topic and hydroxychloricquin Quinn

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hot topic and hydroxychloricquin Quinn and really became a target of health authorities that you know people are being and again I'm not going to assign any bad motive here or whatso but you know the idea was that people are being um uh misinformed and they're going to use these treatments and then they're going to end up really sick and they're believing that they're safe and all these kinds of things. Um but essentially um some of the people who were putting out lists for things for people to consider in COVID which was all at that time were all just trying stuff right because who knows we don't have any at that point any we don't have whether we like it or not yet we don't have a vaccine yet we don't have hacks of it or anything of that sort and some and thyus and alpha 1 would show up on that list and it suddenly all I know is from that point forward the compoundingy's got to cease and desist on thy Yeah. Wow. I know. That's interesting. Yeah. So, thyos and alpha one was again to me an indispensable peptide because a lot of people who come to me have autoimmune issues and chronic immune dysfunction and it can really help. But uh you know some people and again my disclaimers but you know might use this uh and possibly in also on their like say their children at lower doses every fall as a way of potentially improving immune function and potentially reducing risk of infections. Yeah, that's amazing. Um I have a couple

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Yeah, that's amazing. Um I have a couple other topics. Um I definitely want to we can end with like the NAD stuff but what are your thoughts on um obviously there are things like retatrin and tide that are available in research you know a lot of people there was a whole thing going around well it's not real there's no way it can be real so I did the research absolutely it is it's the API is public anyone can get the recipe so to speak you know you still want to get a test all that so it's not like It's fake red tide. Um, unless you're depends on where you're getting it, I guess. Yeah. But, you know, I know there's obviously somewhat of a risk because it's still in studies. You know, we don't know. You know, I know they found some things. I mean, be smart, start low. That's always the But, you know, what is that kind of your thinking too that you know, it's you're obviously running more of a risk because we don't fully have the studies done yet. Okay. Phase three studies are underway but not completed yet. So clearly they saw pretty strong efficacy in phase two. But the what part of the point of phase three is to actually prove it is safe across a population of people and to identify in what ways it may not be safe and who it may not be safe for. You looking at it mechanistically. Um it is interesting to me because obviously when you activate GLP1 you're you're downregulating glucagon and in this particular case we've now added a glucagon agonist. Yeah. which does have from the perspective of what's going on in your

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perspective of what's going on in your body during that time potential advantages. It does, but it is also kind of like it's one it's the only one of the three G the GLP1 GLP gip that's actually bringing in an element that is different than how the body is naturally programmed. And anytime we start to vary from the original script of the design of the body, there's a little bit of nervousness for me because the body is so brilliant, right? And it's so complex and there's so many compensating mechanisms. And so I'm like, well, there's a reason why when we activate GLP-1, we suppress glucagon. And obviously, it has a lot to do with insulin release and moving things moving, you know, and now we're going to activate glucagon. And I can absolutely see where that could be beneficial and further reduce appetite and energy mobilization, but I have a hesitation there. I suspect it's going to be found to be safe. Um, and you know, and probably very powerful, but you know, at this point, um, you know, if it's not through phase three trial, of course, a lot of the peptides we just discussed, they've never been trial, right? You know, um, you know, it is proceed with caution. you know the studies that 1 milligram was sort of the lowest dose studied and there was some effectiveness and then it got better at 2 milligrams and even better at six milligrams if I wanted to if I had already so let's just say I tried some glutide and just the nausea was unbearable and then I tried tzipotide and it was somewhat effective

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tzipotide and it was somewhat effective for me but possibly I had some side effects or I just wasn't getting a great result and this and for my health these were something that I wanted to be able to use then you know would I consider red tide yeah I would and but I start at that lowest dose and go really slow and be very careful with my system. And again, I'm not advocating anybody actually do that. I'm just saying that that's what I do. Currill tide, you know, is a different mechanism altogether. Amalin and I like this. I think this is going to be great to have additional tools because I think if we can activate say MLN and GLP-1, then we could actually possibly use lower doses. And yeah, it's a it's apparently a phenomenal suppressant. Yeah. Work two pathways. Once again, the it's it's in those final phase of trials. The actual you can go online and pull up some of the studies from the original phase two and you can identify what doses they were using that they saw effectiveness and you can through uh research manufacturers get cucidide and when it comes out commercially it's going to be with the semaglutide m you know the it is which I don't think is actually the best mix for that particular wine. Yeah, I would agree. I'd love to see it with Tzepide to be honest. Yes. I actually think based on mechanisms that retatride and krillitide will be the most powerful comp. So basically a GLP4 quadruple agonist. Yes. Um, and I always thought too that retoa might be a really

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thought too that retoa might be a really interesting one for maintenance just because it I guess the glucagon can help with fatigue, things like that, you know, and if you're into the body composition phase, it might help. I know a lot of gym guys that are on True Tide, so no judgment. I mean, I get it, you know, it's it's helping. Um, okay. So before we'll get into the last subject about the NAD stuff, my friend Eric wanted me to ask you what your thoughts were on hydrogen water. You have any? Yeah. So I mean if any of the all these biohacks interventions that we have that has pretty solid data across a wide variety of different studies that there's positive impacts. Hydrogen rich water is one of those. Yeah. So free hydrogen ions in the mitochondria they it's really a backdoor mechanism to cleaning up mitochondrial exhaust and improving mitochondrial efficiency and it does I mean it can vary everybody has different things going on in their body but it probably for most people is quite effective I you the where we get stuck is you've got either the tablets or that you dissolve in the water and so it is debatable I mean it it turns into a foam and you have to drink the foam before it evaporates and hydrogen ions are incredibly volatile, right? So, they're just floating out. So, how much are you actually getting? But the study suggests you are increasing. Uh, you know, it's going into the gut. It's passing into the bloodstream. It's passing into your cells. People can measure an impact. I keep the hydrogen tablets around. I

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keep the hydrogen tablets around. I don't use them routinely, but if I have uh I come back like I've got to go speak at this conference in Sweden next week and I've got to fly I gota fly in be there two days fly back and it's gonna that's hard on me, right? So I'm going to come back I'm going to be worn out my circadian be torqued. I will come back and I'll I'll have like a mixture with like four of those hydrogen tablets. Okay. I've done this in the past. Within about 45 minutes, I can clearly feel like my body better. Yeah, it's it can really help. So, antioxidants, anti-inflammatory, mitochondrial efficiency. I think it's worth trying for anybody. It's not that expensive an intervention. It's completely safe. Um, you know, and so tablets the only way. Well, you can also get uh generators. So, okay. You can get machines that'll actually produce the hydrogen and they have these handheld ones like a water bottle that you can kind of turn on and it'll generate the hydrogen in the water and then you can just drink it. Those are better. The challenge is that the quality matters a lot and some of them are also producing heavy metals and things like that and so finding one. the original company that came out and really pushed the hydrogen. They came out with these like devices that were several thousand dollars that would generate the the hydrogen water and you could just then walk up, pour a cup and drink it. But then there turned out to be a big snafuyu with that company and what they were creating. But you can find reputable uh units that plug in that will offer it

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uh units that plug in that will offer it both via like water or through like nasal canula. you can actually inhale it and yeah and I think if I remember correctly it's been a while since I looked at this literature I think there may have been a study on using inhaled hydrogen like for stroke recovery and showing improvements and reductions in tissue damage in the brain. I think that don't hold me to that one but I feel like that may have been the case. So yeah, I'm a fan. It's not a everyday for me. For some people they may decide it is an everyday but it's definitely a go-to when I my body needs more help. Are you a fan of like mitochondrial peptides like Matzi or anything like that? Yeah, but they're expensive. Yes, they are. And not everybody like not everybody's going to benefit from them. People who are fatigued and have metabolic health issues and possibly have complex blocks that it's worth trying because they may get a really good result. But um somebody like me um who metabolically is pretty healthy um you know I I one time did do a course because I just wanted to this was years ago I could tell no difference whatsoever and it was expensive. Yeah. And so that doesn't mean it didn't do anything positive for me. But typically, if you actually have healthy mitochondria that the oxidation of glucose and and fats is is not is is going along smoothly and mitochondrial exhaust is being cleaned up. You're not necessarily going to see a whole lot of benefit there. But interesting enough, I was on a a teaching section session with

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was on a a teaching section session with a peptide specialist last night and he mentioned Matsi as a potential receptor salvaging peptide for people who've used higher doses of GLP1s for a long time and possibly down down regulated receptor availability that might see it. Uh it could be a peptide that could accelerate recovery of receptor availability. Interesting. That's it. Oh god, I can't wait till we can actually study these things. Yeah. If I had a chronic fatigue syndrome and I felt like it was a mitochondrial issue, one peptide I would definitely consider trying would be SS31. Yep. A lot of people do that first. Yes. Yeah. Now, do you is there a way to measure your mitochondria health? Like are there you know or is it there's a the metabolomics test that I use look at a lot of different metabolites involved in all aspects of mitochondrial function. There's also a functional test called a MEC screen meen sen where you actually send a blood spot and they take your blood the I know the the lead scientist who created this technology. He's amazing. He's also does like all the Joe Dispenser conferences. Measure does all the metrics. Oh yeah. He's a great guy. He's fascinating. He's at University of California San Diego. I toured his lab while I was out there. And essentially what they do is they take normal mitochondria and muscle culture cells. They take your blood, they drop it on, they observe the behavior of that mitochondria and they're able to reverse engineer what are your mitochondria

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engineer what are your mitochondria likely functioning like it's pretty cool. And so it looks at all these different domains of mitochondrial function including network domains efficiency under both resting and under stress. It's a I think it's like a $ 400 test, something like that. Done with a blood spot, but that will actually tell you what your mitochondrial function is like. That's cool. All right, we're gonna I guess we'll wrap it up with the whole NAD discussion just because a lot of people are on it taking it. Um, a couple questions I have and then we can you can just touch on whatever you want. um with you know I do NAD plus but I'm also looking into starting um one through um unless you sell one that you because I know you've got stuff to to tell me. I think it's the NMN it might be the NR whichever one's the more common. Um, so taking TMG as a supplementation, is that smart? And then what we talked about prior to starting the recording, is there an overlap by taking NAD Plus and NMN or NR? Um, is it good to do both? I know you already talked to me about it, but the audience didn't hear. So, yeah. No, you can definitely do both. And yeah. All right. So, back to this first and foremost that question. Can you do um a uh subcutaneous injection and use precursors nicoten monucleotide nicotine ribocide at the same time um the answer is yes right and so I'm going to break this down so that people kind of understand and there's a lot of this

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understand and there's a lot of this that's to some extent speculative meaning the research is speculative so you know when you inject NAD subcutaneously now up until recently There was the research did not suggest that you would actually get increases in in intracellular NAD which is what you're really trying to do by injecting NAD or getting it through NIV and that's because NAD is a a complex molecule and it doesn't just directly cross cell membranes and so it actually would have to be transported in across the cell membrane and as far as we knew there weren't any transporters to do that job and so that essentially NAD was the product of intracellular synthesis processes and that the only way to potentially catalyze an increase in NAD would be to preload those pathways i. e the niacin adequate doses of nasin which is always step one and a lot of people jump straight over to nicotenomide monucleotide or nicotenomide ribocide because they see an ad they've never status and they're actually nasin depleted right and nasin is more import more more important for other things too not just NAD so step one is you know you optimize nascin availability make sure that you're getting adequate nascin typically to some extent through a supplemental source and then you can you know experiment with the the two options options are the NR or the NMN and both are very safe and both of them have some data suggested that they are effective.

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data suggested that they are effective. Now there are again metabolomic reports that I use in my clinic that are getting into the biochemical pathways that can predict which of those is actually going to improve NAD and tell you that you should be using NMN and what dose you should be using or you should be using NR and what dose and also able to identify do you even need to boost NAD. Do you have issues with NAD and AADH balance? Now most people over 40 do and will benefit from boosting it for all the many reasons that NAD helps us. So recently though it was identified that injecting subcutaneously under certain conditions may improve intracellular NAD and that there are these little transport channels that could be upregulated that could move some of that NAD into the cell and but we don't know who what those conditions are you know and who's getting that benefit. So what you know has been reported to me by my patients uh with NAD that who would get it either IV or subcutaneously some of them felt like a clear improvement in energy you know after yes I do hello and you know and then some actually felt worse heard that yeah some felt nothing which is the category I had fallen into when I experiments okay so back My my understanding of this not long ago was though that what whatever response you're getting subjectively to injecting NAD, it's not based on an increase in

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NAD, it's not based on an increase in intracellular NAD. Now, that may not be true based on recent research. And so, at the time, what was speculated is that there's some other signaling activity. And the idea was that the only way times we would see higher concentrations of the actual NAD molecule in the bloodstream would be if cells were damaged and ruptured and they spill their contents out into the bloodstream. And so when that happens, if it happens to enough cells, it creates what's called a cell danger response which then mobilizes all these other responses because hey, there's tissue damage, there's danger. And for some individuals that end result of that could have been upregulating a pathways that helped them feel better. And usually if we did recommend it for people it would be a trial for people with severe chronic fatigue syndromes that we have not found answers for. We say why don't we try this and see. And some people uh getting routine like IVNAD salvaged it like it restored them. They they got better and of course other people didn't get much out of it. But now we understand that there are perhaps certain conditions in some people who do actually improve intracellular NAD when they inject that NAD. So what we're left with is one, it appears to be safe. Now I wouldn't inject high doses all the time because like we talked about there's this cell danger response signal and we're not wanting to activate that all the time. But and and you know a dosing protocol proposed to me by one of the owners of the peptide research manufacturers if you're going to do subq was once a month do 100 milligrams a day for seven days. As we talked about earlier 100

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As we talked about earlier 100 milligrams is higher than you can tolerate. I would fall over. Yeah. That yeah and and that a lot of people will experience you know clear benefits from that. Interesting. Yeah. And so you know the for anybody who if you again as long as you're not overdosing it and overrelying because you get energy so you think I'll just do this every day. No. Yeah. Three times a week 20 milligrams. Yeah. You're going to start creating problems if you do that. Yeah. But if you you know are mindful about these dosing ideas, it's generally safe for people to try and then you can see what what is it that I experience when I do this. And if there's a clear uptick in available energy, it's very well possible you are somebody who's getting an intracellular NAD boost and it might be these other mechanisms I mentioned earlier. Now at the same time uh and there's also some studies suggesting that that NAD might get broken down into components and then those components absorbed as preloaders for the NAD pathway synthesis pathway and then of course we can load in either nicotenom nicotenomide monucleotide or nicotenomide ribocide making sure we have a basis of adequate nascin and potentially catalyze that as well. But as the metabolomics report point out, for some people, one of those pathways may be robust and helpful and the other one not so much. And so you'd have to once again kind of try the different molecules and see how you respond. And quality is critical within MN especially. There's a lot of junky powders and stuff out there. Yeah. No, I think Thorn Thornne has a good one. I think there Reservatl or

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one. I think there Reservatl or something has it in it and then they have a separate one too. And then there are companies companies like Qualia Q AI Newer they make a like a comprehensive that has NASIN co-actors. Yeah. You know it puts it all together and you know they've got some Is that one on your list? Um on my list you know the ones that you sell. No we don't sell that at all. Okay. No call. Okay. Got it. Yes. But they have an NAD boosting supplement though. Okay. And then what about the the final question was the whole TMG supplement. What's what's that have to do with NAD and do people trimethyl glycine? Yeah. Um yeah. So that's something that I'm glad you brought it up because it's something I'm going to have to go research because the truth is I'm not actually aware of protocols for TMG. I can speculate biochemically what's going on. Trimethly, TMG or also often called betane is a methyl donor. It's three methyl groups attached to a glycine. So it's specifically good for people who have reduced MTHFR function. It it offers the alternative pathway to MTHFR for recycling homocyine into methionine creating methyl groups. So it's a methylation supporting drug and for people who have possibly uh lower level methylation function. It can be a nice booster for them. And so but it's used specifically alongside NAD. I don't know about that. And yeah, apparently it's a thing. So, I mean, it's it's several people ask me. I know people that are doing it. I haven't taken that. Yeah.

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doing it. I haven't taken that. Yeah. The people that either, but I'm interested to see the people that I other clinicians I know who use NAD, they haven't brought it up, but I'm really glad you did because now I'm gonna go find out and maybe maybe there is something really uh important about that combination boosted. And if so, I'd like to understand that. Well, if you find anything, let me know. Yes. And uh yeah, this has been great. I will link all your stuff in the comments like I always do or down in the description. And um I really appreciate your your time today. Yeah, I've enjoyed it. I enjoy my conversations with you, Kelly. Yeah, what a great interview, you guys. You can go into the description of this video and find all of Dr. Vicker's links, where to find them, his supplements, all the things. Until next time.