December 11, 2025 • 66 mins
Episode Summary
Peptides are everywhere right now — online, in wellness clinics, and all over TikTok. But what’s real? What’s risky? And what actually supports longevity? In this episode, Dr. Nisha and Dr. Vikas break down the hype vs. the science, explain why the Five Pillars of Longevity (Lift, Move, Sleep, Fuel, Connect) always come first, and walk through the peptides patients ask about most.
Key TakeawaysThe Five Pillars come first.
No peptide replaces strength training, daily movement, sleep, nutrition, or connection. Peptides amplify biology — they don’t repair a broken foundation.
GLP-1 is the only peptide with strong human data.
Semaglutide and tirzepatide have large trials, years of safety data, and real cardiometabolic benefits — but they do not protect muscle, so lifting and protein matter.
Growth hormone secretagogues (CJC-1295, Ipamorelin, Tesamorelin) carry higher uncertainty.
Only tesamorelin is FDA-approved. Long-term data in healthy adults is lacking. There are theoretical cancer risks and concerns around worsening insulin resistance.
Fat-burning peptides are mostly hype.
AOD-9604 has minimal human benefit. 5-Amino-1MQ has no human trials.
If fat loss is the goal: Lift, Move, Sleep, Fuel.
Healing peptides (BPC-157, TB-500) are interesting but early.
Most data is rodent-based, purity varies widely, and angiogenesis pathways carry theoretical risks.
Cognitive peptides (Semax, Selank) are not approved in the US/EU.
Human data is weak. Possible side effects exist. They won’t override poor metabolic health.
Cosmetic peptides like GHK-Cu have some human data.
But sunscreen still outperforms everything.
MOTS-c is promising but very early in humans.
Rodent data is strong — human data is sparse.
NAD is not a peptide.
It plays a key cellular role but has limited clear measurable benefit when supplemented.
The TikTok peptide culture is unsafe.
If your peptide has no certificate of analysis or arrives with a free sticker, it’s not longevity — it’s roulette with a needle.
Peptides are tools, not shortcuts. GLP-1s have real evidence; most others range from early to uncertain. The Five Pillars determine your healthspan — and peptides only work when those fundamentals are solid.
Cliff NotesLift for longevity.
Move for metabolism.
Sleep to repair.
Fuel your cells.
Connect with real humans.
Peptides don’t replace the pillars — ever.
This episode is for educational and informational purposes only. It is not medical advice, does not establish a doctor–patient relationship, and should not be used as a substitute for individualized medical guidance.
Follow us on social @MDLongevityLab
Sign up for our newsletter at www.MDLongevityLab.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome to MD Longevity Lab, where we're playing the long
game. This is a podcast where science
meets real life, with expert insights, practical tips, and
real world tools to not only live longer, but live better.
Our aim is to radically change the way medicine is practiced
and enable individuals to age gracefully, maintaining health,
(00:24):
span and vitality well into their later years.
We're your hosts, Dr. Nisha and Dr. Vikas Patel, physicians,
partners in life, and parents, balancing work, Wellness, and
everything in between. Let's dive in.
(00:44):
Welcome back to the MD LongevityLab podcast where we are playing
the long game. I'm Doctor Nisha.
And I'm not for Vikas. Today we are going to get into a
topic that we've been asked quite a been about lately and
that is peptides. The miracle injections, the
shortcuts, the bio hacks, the stuff that is on TikTok all the
(01:07):
time. Hopefully we can kind of dispel
some myths and get you some accurate information about what
these things are or what their use cases are and what they can
and can't do. Yep.
So before we even get into peptides, we have to ground this
conversation in what actually drives health span.
(01:28):
The five pillars of longevity, lift, move, sleep, fuel,
connect. That pretty much constitutes 98%
of what makes up health span, and these are the levers that
actually work. These are the levers that are
going to restore metabolism, energy, cognitive function,
hormones, mood and vitality. When we talked about longevity,
(01:52):
it always comes back to these five pillars, just like Nisha
said, lift, move, sleep, fuel, and connect.
Lift because maintaining muscle is one of our strongest
predictors of how long you'll stay independent and how long
you're going to be functional. Move because your daily
activity, not just your workouts, it's what keeps your
(02:14):
metabolism, your mitochondria and your cardiovascular system
functioning well. Sleep, because when your brain
is resting, when we go to bed, that is when it is cleaning
house. This is when our hormones
rebalance. This is when our body actually
takes the time to repair itself,fuel properly because what we
(02:35):
put on our plate directly shapeshow much inflammation we have in
our body, what our metabolic help is, and what our long term
disease risk is. Connect because humans are wired
for connection and for relationships, right?
We talked about this in our lastepisode.
I believe isolation is absolutely dangerous.
(02:55):
It's as dangerous for us as smoking a pack of cigarettes a
day. These five pillars are not
optional and they are honestly non negotiable when it comes to
lifespan and more importantly health span.
Everything else, including peptides, is kind of secondary.
Since we've seen so many patients, we've taken care of so
(03:16):
many patients across every age and every background.
Every single patient has room toimprove in one of those five
pillars. And every single patient, when
they make improvements on one ofthose five pillars, notices the
benefit of them. Yeah, it never fails, right?
Someone gets serious about strength training, their labs
(03:37):
are going to improve. Someone cleans up their sleep,
their hunger normalizes. Someone stabilizes their
nutrition and actually gets their protein intake that's
required. Their energy is restored and
someone reconnects with the people that they love.
Their stress markers and inflammatory markers drop and we
(03:57):
have our patients that they shoot for 8 to 10,000 steps.
When they actually hit that goal, their glucose stabilizes.
So I think kind of the moral this is that we don't jump
straight into peptides. We also don't jump straight into
medications. We don't jump straight into
supplements trying to patch a hole in the sinking ship.
(04:18):
Yeah, PSA for the people in the back, there is no quick fix.
Not for longevity, not for metabolism, not for aging.
And anyone that's promising thatis really just probably trying
to sell something. Peptides are tools.
They just can't be the foundation, and the foundation
(04:39):
has to be those five pillars of lifting, sleeping, moving,
fueling, and connecting. Doing the peptides without
working on those pillars is kindof like installing chandeliers
in the house, but there's no solid foundation.
It may look fancy, but a strong gust of wind is going to knock
it over. With that said, let's get into
(05:00):
peptides. Today we're going to talk about
the science of peptides, the hype, the misinformation, the
risks associated with peptides, as well as the potential
benefits and the reality in realworld use.
And I, I want to be honest aboutthis.
Like to be fair, peptides are exciting.
We're talking about molecules that can influence metabolism.
(05:23):
They can enhance our repair mechanisms, improve
mitochondrial function, reduce inflammation recovery.
There is a reason why the scientific community is paying
attention. There's a reason that athletes,
clinicians, researchers, and longevity physicians are
interested. The potential upside is pretty
(05:45):
huge. Exactly.
Some peptides are showing incredibly promising signals,
right Improvements with insulin sensitivity, fat loss, muscle
preservation, wound healing, immune modulation.
The early data is really interesting.
The mechanistic rationale is strong and we definitely want
(06:05):
these tools in our toolbox Eventually.
We also want more research, we want more FDA grade options and
we want the field to mature. I'd say, you know, the
excitement doesn't erase Physiology.
Some peptides work on growth repair and angiogenesis
pathways, and that's a part of what makes them potentially
(06:28):
really powerful. Those same pathways are also
involved in the growth of thingslike existing cancers or
microscopic lesions. We're not talking about causing
cancer. There's no specific evidence for
that, but we are talking about the possibility of accelerating
something that's already there. It's that double edged sword of
(06:52):
regenerative medicine, right? Anything that can help tissue
grow, repair or regenerate couldtheoretically help the wrong
tissue grow too. And so it's not about fear, it's
about respect for the biology. And that's why screening
matters. Our family history matters.
Hormonal history, imaging your labs, biomarkers, personal risk
(07:14):
factors, all of this should go into decision making when it
comes to peptides because peptides aren't dangerous by
definition. They're dangerous when it's used
in the wrong patient with no no legwork, without contacts, or
without supervision. And I think here's part of the
positive when they're used responsibly with proper
(07:38):
screening, pharmaceutical grade sourcing and in the right
clinical setting, peptides can probably be incredible tools.
They can definitely accelerate progress, enhance your baseline,
complement your current regimen and they can help patients and
breakthrough points. We've seen real benefits in our
(07:59):
own patients, improvement in energy levels, recovery,
strength, metabolic health. It's just we got to pay close
attention to who's a good candidate.
And those peptides only work well when that foundation is
strong, right? Lift, move, sleep, fuel,
connect. Without those five pillars,
you're taking a risk for minimalreturn.
(08:20):
So yes, be excited. Peptides are one of the most
promising emerging tools in geoscience.
Use them intentionally, safely, and with respect for the
pathways you're actually manipulating.
All right, so let's get into thescience.
What are peptides? Peptides are short chains of
(08:41):
amino acids, which are tiny little proteins that act as
signaling molecules. These signaling molecules tell
cells what to do, They regulate pathways, and they also
influence metabolism, healing, inflammation, mood, and pretty
much every system in our body. But in online Wellness spaces,
peptides now include a lot of things, right?
(09:03):
They include growth hormone boosters, fat burning compounds,
cognitive enhancers, mitochondrial peptides, cosmetic
peptides, random things sold on websites, Amazon like anything
an influencer Tiktok and inject into their thigh for views.
And it's really kind of criticalto understand most of the
(09:24):
peptides people are using are not FDA approved, they're not
standardized, there's no long term testing involved and
there's no regulation of purity of these things either.
If you're buying an injectable compound from a website with no
storefront address, no phone number, buy 2.
(09:45):
Get one free on Black Friday. Like you're not really
practicing longevity, you're basically just gambling.
So let's talk about the one peptide that we have robust
human data for and this peptide,pretty much all of you I'm sure
have heard of them. These are the GLP 1 agonist so
(10:07):
the GOP ones are a class of medication and this is literally
the only peptide in the entire peptide universe with FDA
approval. Large multi site randomized
human clinical trials, cardiovascular outcome data,
years of long term safety data, real world data from millions of
(10:29):
patients who have used this and pharmaceutical grade purity and
manufacturing standards. And there is actual oversight
from regulators, pharmacists andphysicians with the GLP one.
Everything else we're going to talk about today.
Great mechanisms, interesting Physiology, promising signals,
but nothing comes close to the data we have on GLP 1 peptides.
(10:54):
OK, So what is AGLP? One, it is a hormone that our
body already makes in our gut. It's GLP is short for Glucagon
like peptide. One, you've heard of some of the
names of these drugs, probably the most popular ones are some
in glutide and tirzepatide. These are drugs that are
(11:15):
available at this time. Some in glutide is a GLP
wagonist, meaning basically is just like Glucagon, like
peptide. Tirzepatide is a GOP one
agonist, but it's also a GIP agonist and that is a little bit
different. It has a second target which is
(11:35):
glucose dependent insulinotropicpolypeptide.
And so this adds an extra metabolic effect and we believe
This is why tirzepatide is a little bit more effective in the
weight loss category and reducing some of the bad
diabetes numbers that we see in patients who have diabetes.
(11:56):
So these medications work by in the body the same way that those
peptides that our body naturallyproduces and they do a few
different functions. They slow down gastric emptying,
which keeps us fuller longer. They reduce cravings and
compulsive eating. That is an effect that occurs in
(12:18):
the central nervous system in the brain.
It helps them modulate our hunger.
They improved insulin sensitivity.
This is partially how they're actually lowering patients blood
glucose and hemoglobin A1C. They suppress Glucagon which
helps to increase our blood sugar.
They calm down inflammatory markers, they lower post meal
(12:42):
glucose spikes, and ultimately they help to reduce our visceral
fat. And really that was that toxic
fat that lives surrounding all of our organs in our guts.
So mechanistically, these medications or these peptides
are very elegant physiologically, they just make
sense for a large, large amount of the American population right
(13:05):
now. Yeah.
And unlike the rest of the peptide world GLP ones, the
research is not subtle, right, 15 to 20% of total body weight
loss in large clinical trials. There's reduced cardiovascular
risk, lower heart failure mortality, improved fatty liver
(13:26):
markers. So patients with Nafil D or
Nash, it's great for those patients, lower inflammation, C
reactive protein numbers, we seedramatic improvements in blood
sugar. And I know for many of our
patients when we've done a full body DEXA scan before they start
GLP ones and after we see significantly lower visceral
(13:48):
fat. And there's evidence for
appetite regulation and reward pathway changes.
So a lot of people notice reductions in their cravings in
food, alcohol and substances that they normally really have a
craving for like sugar. So this this is real biology
with the GLP ones. This is not influencer biology
that you see on TikTok. But there is a cashier, right?
(14:11):
And this is where we can kind ofget loud about it.
GLP ones do not fix lifestyle issues.
So we've definitely seen patients who have lost 20 lbs,
right? But they've also simultaneously
accidentally lost 7 to 9 lbs of muscle while they lost 20 lbs of
(14:32):
total body weight. This is simply because they're
not controlling the things that they should be controlling,
which is their protein intake and whether they're doing any
sort of resistance training to maintain muscle.
So GOP ones will put you into a calorie deficit and it's upon
the patient to then tell it their body that what type of
(14:57):
weight they want to lose. While they're in that catabolic
zone where their body is in a calorie deficit, they should
preferentially be losing fat, not muscle.
Muscle is more expensive for us to maintain and our body
basically says, well, if I'm in a calorie deficit, I'm going to
(15:17):
get rid of the stuff that's mostexpensive for me to maintain.
Fat is not that expensive to maintain.
So if you're not using the muscle, you will lose muscle.
In addition to losing fat, patients have to prioritize
being very cognizant about how much protein intake they're
taking. They have, they have to be at
the upper end right when we've, we've spoken previously about
(15:41):
getting close to 2G per kilogram, if not 2.2g per
kilogram if you're trying to actively lose weight on the GOP.
And then they have to give theirmuscles the training stimulus
that I'm actually using muscles on a daily basis by doing
resistance training, then their body will preserve the muscle
(16:01):
and just lose the fat. So the GOP 1 does not know the
difference between losing fat and losing muscle.
You do. Your habits are going to dictate
what you actually retain and what you lose.
And training matters a lot here.And this is the part that the
Internet forgets. GOP 1 is a tool.
(16:22):
It's not that transformation. It's a helper, not a healer.
It's a support, not a substitute.
It cannot replace the heavy lifting, the moving, the
sleeping, fueling, and connecting with real humans.
Those five pillars that we talked about, and those are the
things that are going to move the needle with your health
span. And certainly GOP ones are a
(16:44):
tool and we love them for many of our patients.
But we do emphasize you have to prioritize the five pillars
before jumping into that GOP one.
And here's another important truth, everything we talked
about after GOP ones, it's much thinner data, much smaller
studies, much more uncertainty, much, much, much less safety
(17:07):
monitoring. So we know so much about GOP
ones and in a lot of ways, GOP ones have become kind of the new
Staten where there's so many benefits coming out of the
research of GOP ones that there's almost, there's very few
side effects to GOP ones where we can say, OK, this is a reason
(17:31):
why someone should not be takingthis medication or this peptide.
All the rest of the things that we're even talking about today
just don't fall into that category.
Like there is very little data to support.
Most of the stuff that we'll talk about has anecdotal
evidence, which is basically thecomplete opposite of randomized
(17:51):
control trial data, where we know without a doubt that this
thing does this and we can repeat it over and over again
and get the same exact results. Yeah, GLP one is the only
peptide where we get to actuallyspeak confidently because we're
standing on decades of biology data, huge trials and real world
(18:12):
outcomes, Everything, every single peptide that we're going
to talk about now, right? We're back into potential
mechanism and interesting but early scientific data, which is
why those five pillars matter, whether it's with GLP ones or
other peptides, you really have to prioritize that five pillars.
(18:35):
So let's get into kind of this Gray area of peptides and let's
start with the growth hormone secreted guides, secreted dives.
That sounds like a demigod. It's like Greek.
It is, yeah. So we're going to talk about, I
guess, arguably some of the mostpopular ones first.
(18:56):
So CJC 1295 IPA, Morellan, Tasmarellan, Spermarellan, these
are growth hormone analogs, and there's a lot to like here, but
there's also some points of caution.
Yeah, growth hormone secreted eggs are one of the most
misunderstood and overhyped categories of peptides online.
(19:21):
Mechanistically, they stimulate your pituitary gland to release
your own growth hormone by acting on that GHRH receptor
like CJC 1295 or Tasmarellan or mimicking ghrelin which is that
hormone that our body naturally secrets and that will trigger a
brief growth hormone pulse whichincreases IGF one.
(19:47):
Exactly. So some of these like CJC are
directly impacting the growth hormone secretion and then the
others like ipromarolin are mimicking that ghrelin, which is
something our body makes naturally and it will end up
triggering a salsa of growth hormone, but it's also
(20:09):
increasing insulin like growth factor one, IGF 1, so.
This is, you know, the science and not like the TikTok version
of it. Tasmaron is the only growth
hormone Secretagog that's FDA approved and that's only for HIV
(20:29):
associated lipid dystrophy. And most of us don't know what
that is like. The physicians probably do, and
anybody who has HIV who's been on some of the older generation
HIV meds might know. But literally what this
lipodystrophy does is it it'll 'cause that gaunt phase, you'll
lose the muscle tissue in your feet or sorry, the fat tissue in
(20:52):
your face and your arms and legs.
But you add it in the not very safe places.
So you'll add it in your trunk, breast tissue enlargement, back
fat tissue enlargement and then the the not good inside of our
intra abdominal space where thatvisceral adipose tissue is,
it'll increase that. So basically Telnarolin can help
(21:16):
to reduce some of that visceral fat, but the effect is
temporary. When you stop it, the visceral
fat does return. CJC plus it from rollin reliably
increases growth hormone and IGFtransiently.
But we don't have any long term studies in healthy adults.
We don't have any 10 year outcomes, we don't have any
(21:38):
cancer data, we don't have any anti aging data.
So this is really where all of the theoretical risks come in.
Yeah. And that's where we have to be
cautious. Chronically elevated levels of
IGF one has been associated, again correlation, not causation
with prostate, breast and colorectal cancers.
(22:00):
That doesn't mean these peptidescause cancer, but the biology is
enough to say don't play with this casually, right?
We have to think twice about this.
And we need to say this clearly but responsibly.
There have been reports of some serious adverse events,
including at least one death temporally associated with
(22:21):
growth hormone related peptides used outside of medical
supervision. We cannot say that the peptide
caused it. There were some confounders, but
the point is these compounds modify existing hormonal
pathways and we 100% lack any sort of long term safety data.
(22:43):
So let's talk about why aging matters.
So growth hormone is not neutralin older adults.
Growth hormone is highest in childhood, believe it or not,
and it peaks between the ages of14 to 19 when we're teenagers.
And this is when we're growing at the fastest rate in our
lives, right? We see that in our kids.
After that, growth hormone levels naturally drop about 10
(23:06):
to 15% per decade, and this decline is protective.
When we're young, our immune system is excellent at catching
abnormal cells early and destroying them.
As we age, that surveillance weakens, which is why cancer
incidence rises with age. So raising growth hormone at age
45 or 55 carries different implications.
(23:29):
And raising growth hormone at age 15.
That's an excellent point. On top of that, for people who
already have some evidence of impaired glucose tolerance or
diabetes, growth hormone can raise our blood sugar and worsen
insulin resistance. You must be metabolically stable
(23:50):
before even considering these peptides.
And remember, in our previous episode, we talked about over
90% of our US population is metabolically unhealthy, right?
So there's very few people that would be a good candidate for
this without proper supervision.Absolutely agree.
(24:12):
So let's take a little bit of a deeper dive into CJC 1295
because I think it is kind of a misunderstood peptide.
Mechanistically, CJC 1295 is fascinating.
It's engineered to have a longerhalf life and instead of
overwhelming your system like synthetic growth hormone, it
(24:33):
kind of nudges your pituitary torelease growth hormone in a more
physiologic pulsatile pattern, and that's the way your body is
designed to release it. And This is why people get
excited about CJC, because when it's used appropriately in the
right patient and with pharmaceutical grade sourcing,
(24:54):
it can support a bunch of things, right?
So it can help improve our deep slow wave sleep, improved
exercise recovery, better muscular repair, collagen
production and skin quality, mild improvements in body
composition, and increase vitality and energy.
These aren't magic effects, but they are real physiologic
(25:18):
changes, and patients often really do feel better on it.
But the excitement doesn't erasethe biology.
CJC still works on that growth repair and angiogenesis
pathways, which is that development of new blood
vessels. And those are the same pathways
that help tissues heal and the same pathways that could
(25:39):
theoretically accelerate the growth of an existing cancer or
a microscopic lesion. And again, there's not a causal
relationship with cancer that weknow of, but it potentially
could speed up something that's already there.
And the metabolic effects mattertoo, right?
So a growth hormone opposes insulin, it can raise blood
(25:59):
sugar. So if a patient has insulin
resistance, metabolic syndrome, diabetes, CJC can worsen all of
that. This is why screening is not
optional. This is why you can't just
decide on your own that I'm going to go online to some
sketchy online pharmacy. Order CJC from some Jim bro.
(26:20):
Yeah, there's a lot of that. Most gyms have some guy, usually
a guy, usually not a gal, who's like the supplier of like all
the steroids and peptides like that ever on all the IT.
Used to be steroids, now it's peptides.
There's still a lot of steroids used to, but like I said, This
is why screening is not optional, right?
(26:41):
Family history, personal history, hormonal history,
metabolic labs, IGF levels, cancer risk.
All this stuff matters before you decide that this is the
right compound for you. CJC is a tool and it's only
useful in the right environment.Right?
That metabolically healthy patient which is really only 10%
(27:01):
of us. Someone who's consistently
strength training. Someone with good sleep hygiene,
optimize nutrition. Basically someone who's already
optimized those five pillars. In that context, CJC can be a
meaningful adjunct. It can be a multiplier to what a
healthy system is already doing.But it honestly it can't
(27:22):
compensate for poor sleep, no exercise, inconsistent
nutrition, or metabolic dysfunction.
You just can't hack your way around biology with a syringe.
All right, let's move on to the mitochondrial peptide that
everyone's heard of, Mott C. Mott C is a mitochondrial
(27:43):
derived peptide, which already makes it unique compared to
everything else that we've discussed.
It's encoded in mitochondrial DNA and appears, at least in
rodent studies, to activate AMPKand improve metabolic
flexibility. It enhances exercise tolerance
(28:04):
and it helps counteract high fatdiet effects.
But here's the key point In humans again, the data is
extremely limited. We do not have large trials.
We do not have safety data. We do not have long term
outcomes. Monty is honestly, it's
scientifically interesting. It might one day play a pretty
(28:28):
big role in metabolic health, but right now it belongs in the
early research category. Not something that we, you know,
would ever wholeheartedly recommend.
Not something that we use routinely and definitely not
something to self inject Becausea YouTube told you that this is
the new or next GLP one. Right.
(28:50):
Since when were we taking advicefrom these influencers and tic
tacers? It's insane.
We're influencers now. Yeah, I don't.
Know. We have patients that come to
me. I'm like, what's your
profession? I'm a or a, what do they call
it, a lifestyle Blogger? Like what does that mean?
(29:11):
I want to be a lifestyle Bloggerwhen I grow up.
It's like our kids say I want tobe a YouTube when I grow up.
Like we went into the wrong field with our with our tuition,
our debt, so much debt coming into marriage.
Anyway, until we understand longterm safety, dosing, target
populations and the downstream effects, this stays firmly in
(29:31):
the not quite ready for prime time like the GOP ones category.
I think most people who take Motsie, like the reported
effects are that they feel like they've got more energy, right?
That their exercise tolerance isbetter.
There is interesting anecdotal evidence about what it can do
for someone. But again, I feel like this is
(29:54):
one of those things where we don't have a lot of data, right?
So if you're going to take it like the idea is, let me take
this to get the ball rolling so that I can get back into a
healthier lifestyle and then cycle off of it because who the
heck knows what happens if you take this for six years.
Right. And I don't want to be the
(30:15):
Guinea pig to find out exactly. All right, So we are going to
cover NAD, but NAD is not a peptide.
It often gets thrown into this category of peptides because
it's kind of in the same stratosphere as everything that
we're talking about. I think it's important for
people to understand NAD is something that our body makes
(30:37):
naturally. Essentially it's a coenzyme
that's involved without getting into the Krebs cycle, like
there's a lot of intense biochemistry that we have to
learn when we find Med school. And without getting into all of
that, it's essentially A coenzyme factor that is used in
(30:58):
mitochondrial energy production,DNA repair and metabolic
regulation. It helps us deal with oxidative
stress. So the by product of a lot of
the processes in our body ends up causing oxidative stress
which is damage damaging free radicals, free radical oxygen
(31:20):
species. NAD is one of these compounds
that helps to neutralize that damage.
And so the theory is, is that aswe age, our ability to deal with
oxidative stress decreases. And if we load ourselves with
more NAD because we can't produce it as efficiently, we
(31:40):
know that people as they age have lower levels of NAD than
kids do. And so if we give more through
an IV or through an IM injection, that we're going to
improve people's health. Do the oral NAD precursors work?
OK. So uniformly the data on that is
(32:02):
basically they don't do anything.
So it's. Just an expensive like sure.
Yeah. So NMN is another NAD precursor
that got very popularized and you take it orally, they can try
to absorb it orally. Basically, the data on all of
that has so far been this doesn't do anything.
(32:22):
If you're going to take NAD, youhave to take it either
intravenously or as an injection.
That's the only way that it is bioavailable to your body.
Then the question becomes, can you get enough of it to make a
difference in some of these processes?
And then the next question is how do you measure an effect,
(32:45):
right? So this is where we've
completely failed in being able to ascertain does NAD actually
do something? We have no idea.
There are no randomized control trials with NAD that span enough
of a time frame to be able to say that NAD is anti aging or
NAD helps with muscle repair or NAD helps our skin look better.
(33:10):
We just don't have any studies that that will tell tell us
anything like that. Anecdotally, we have patients
that tell us they have improved cognitive function, right, They
have a little more mental clarity, better energy, improved
sleep, so does show some promising effects.
(33:32):
But again, how much of this is placebo?
How much of this is actually from the NAD?
It's really hard to kind of. There's no.
Any way to to tell? I mean, I have met plenty of
patients who say NAD 100% has made a difference in my life and
I'm not going to stop taking it.It's hard to argue with that
when people keep saying that we just don't have the data to back
(33:56):
it up. In theory and AB should help and
there are some die hard bench scientists who say yes, this
should help, you should take it hard for me to take that
position because there's no dataout there that says yes, it does
help. In theory it should, and there
are a lot of patients who self report that I've taken this and
(34:20):
I know that I feel better on it,so it is what it is.
So we've covered the growth hormones, we've covered GLP
ones. Let's move into some of these
newer fat burning peptides. Yeah, this section is going to
be really short because honestlywe've got better stuff with more
(34:41):
data. So the ones that we hear about
frequently are AOD 96 O four andfive amino one MQ.
These are honestly they're, they're billed as these fat
burning peptides, but we don't have good human studies.
The studies that we do have are underwhelming, inconsistent
(35:01):
without a ton of good effects. The reality is, is that we
already have GLP ones and GIP drugs.
We have so much data on those that I would so much rather put
a patient on one of those compounds then put somebody on
one of these unproven fat burning peptides.
(35:21):
There's some studies to show that yes, there could be a
benefit here, but time will tell.
Like this is nowhere near ready from mainstream.
This is nowhere near the level that of data that we have even
for the growth hormone analogs. So I say we just move on from
this topic Sounds. Good to me, right?
(35:42):
Let's move into some of the healing peptides.
Many of you have heard of BP157 or TV500, and these are the
TikTok darlings, right? They're all over social media
and people swear by them for tendon healing, gut healing,
joint pain, pretty much every over 40 injury that you can
(36:03):
think of. Yeah.
So BPC 157 and TB500 combined, you will hear them called The
Wolverine Compound online. You know if you're a fan of
Marvel Comics right? Wolverine can like infinitely
heal himself and that's why thisis called The Wolverine Combo.
(36:25):
You were Wolverine for Halloweenone year before we had kids.
I was, yeah. And I know Wolverine doesn't age
just like me. Yeah, you look the exact same I
did. I was storm.
Yes, you were Storm in the bodysuit.
I. Yeah, go to.
I loved Halloween. That's when you can wear stuff
that you couldn't. It's not socially acceptable.
(36:46):
Pantily clad for sure. So OK, some of the science on on
this, right. So this peptide is a synthetic
version of a naturally occurringcompound that is made in our
gastric juices inside of our gut.
So, you know, our stomach liningregenerates itself like every
(37:10):
three days and it has to becauseit's constantly being attacked
by our stomach acids and all thefoods and everything unhealthy
that we put into our our GI tract.
And so these compounds are derived from those same peptides
that essentially we make in our body.
(37:30):
Unfortunately, most of the data is really based on rodent
models. There are no real high quality
human trials here. You want to talk about the
mechanisms a little bit. Yeah.
So mechanism of action, it comesfrom in vitro mouse or mice
models, basically no human studies.
And it's one of the reasons why our ligaments and tendons take a
(37:54):
long time to heal is that they don't really have vasculature,
which is a blood supply to support them.
They rely on nutrients, inflammatory and immune cells
migrating to these from areas ofricher blood supply to make
their way over to these injured sites.
And this is not an efficient process.
And it gets even worse as we age, which is why many of us, if
(38:17):
we have a joint injury, it takesway longer for us to heal than
it would a 12 year old. But this is where these peptides
are supposed to exert their effect, right?
By increasing angiogenesis, or blood flow and fibroblast
migration. And these are the cells that
help regrow that tissue. Yeah.
So I think it's worth noting a little bit about this, right.
(38:38):
So we've all had kind of the experience of exercising and we
get soreness in our muscles, right?
Our muscle soreness will go awayin a matter of a couple days,
even if we haven't exercised in a long time.
And we go to the gym for the very first time and our muscles
get sore, they repair themselveswithin two or three days and the
(38:59):
soreness completely evaporates. Why is that, right?
Well, our muscle tissue has veryrich blood supply.
Our ligaments and tendons do not.
And so that is why when somebodygets tennis elbow, as I had this
last summer, right? I was on three months of tennis
elbow pain with, with trying to do appropriate rehab and it did
(39:23):
not resolve. I ended up needing to get a
steroid injection before it actually finally resolved
itself. It's because our bodies can't
send. Did I do your steroid injection?
I actually did it myself in the mirror.
I numbed you. No, you did not do any of the
steroid injection. I we've done multiple
unsanctioned medical procedure for each other.
(39:44):
PRPI did, yeah. I tried PRP 1st and that did not
work as well. Platelet rich plasma, but I
didn't do it properly because you're supposed to do multiple
rounds of it. Yeah.
And I had a work related golf tournament that I need to be
ready for so. Is this one of those things?
Do not try at home. Oh, absolutely, do that.
(40:07):
We're medical professionals. I know I so when we were I think
we were engaged. So this must have been 16 years,
1617 years ago. I had to drain a chalazion,
which is an eye cyst, like one of those little bumps on your
eyelids, a sign in the eye, and you refused to go to the doctor
(40:28):
or to the ophthalmologist. I did give it to the doctor I
want to see. You, well, you refused to go to
an ophthalmologist who was qualified to do it.
I was not qualified to do it. And you're like, yeah, so I did
what I do as super orbital black.
We were idiots. We were residents.
We were working 100 hours a week, yeah.
So I know my sister is an ophthalmologist and she was
like, you did what? You're blind.
(40:49):
You're not now you're blind because you're old.
Anyway, you know, the legality is complicated as these
compounds have been on again, off again for use by the FDA and
currently you're able to obtain BP157, right?
But again, there's so many mixedpharmacies sources getting it
(41:11):
from overseas, completely unregulated industry.
Yeah. I think it's worth noting.
So one of the other things that I, I think we did not talk about
earlier was, you know, the growth hormone analogs of this
Wolverine blend. These are all things that have
been banned by basically every sports federation, all the
international sports federations, all the domestic
(41:34):
ones. These are not legal, which tells
you that they probably do have areal world effect, right?
Part of the reason that they're not legal is that we don't have
good data. But part of the reason that
they're not legal is because people keep reporting that
they're that they work and so. People don't want athletes have
(41:55):
this unfair advantage they wanted.
A fair advantage, correct? So I, I have never taken any of
this stuff. I know people who have and I
would say by and large, most people that take them are like,
I suffered from this tendonitis or this ligament injury and I
suffered for four months with noimprovement.
(42:16):
And then I went on The Wolverineshot and in the next month it
resolves and I got better. Again, this is completely
anecdotal, right? It's like, oh this one person
took it and and did fine one. Percent anecdotal.
Yeah, this is, there's no human studies for this again, which is
why this is that cautionary talewe're giving you guys
(42:37):
information. Definitely not recommend
necessarily recommending this. This is a case by case kind of
risk benefits now, now. I've seen mainstream medicine.
I mean, we're addressing this, these topics because people keep
asking us. People keep asking because they
don't want to do the five pillars and that's my dent every
(42:57):
single time. Everyone wants a shortcut.
Correct. Sorry, guys.
So this one does again carry some risks, right?
And I would say that the main risk falls under that, under
that kind of cancer propagation again, right.
So if you have some understanding of cancer, cancer,
(43:18):
cancer is an unregulated growth of cells in the body that our
DNA codes and tells all of our cells how they're supposed to
grow when they're supposed to die.
Cancer does not follow that action plan and it is
(43:39):
unregulated. Eventually cancer spreads
because it's unregulated and it is competing for energy with us.
So with a compound like DPC 157,if it is truly causing
angiogenesis, the growth of new blood vessels to repair damaged
(44:00):
tissue, right, It could also cause growth of new blood cells
in cancer cells that are alreadyexistent and cause the cancer to
grow more quickly. So there are wiser ways to use
something like this, right? Like if you're only cycling for
a few weeks at a time, you're not just on this stuff for a
(44:22):
year or two, right? Safer ways to do this to
minimize your risk. But this again falls into the
category of like you need to be making sure all of your pillars
are correct, that you're maximizing all of that stuff
before you go to this as the answer all.
Right, let's move into some of the cognitive peptides, the
(44:42):
peptides that affect your brain chemistry.
C Max C Link. What is it?
Is that how you say it? Yeah, I think.
So and all of these, the pronunciation, it's ridiculous.
These both were developed in Russia and the most proposed
mechanisms involved BDMF, dopamine and serotonin
modulation. And these are used in patients
(45:04):
who have suffered brain injury from things like strokes.
And C Max is used for treatment for things like anxiety and
there's several neurological conditions.
And these are being used primarily in Russia, right?
Yeah, so these are awesome because they're they were
developed in Russia. They're only really used in
(45:26):
Russia legally and everywhere else they're, you know, like not
approved, basically illegal. So C Max does increase BDNF
brain Dr. neurotrophic factor. It can also increase dopamine
levels and serotonin levels. C link does is treated is used
(45:49):
for generalized anxiety disorder.
There's a third one called Cerebro Lysine, which which is
kind of like this catch all for all types of neurologic
conditions, but that one probably has the weakest
evidence out of all all three ofthem.
I It's hard to know anything about these because all the data
comes out of Russia and. Our kids.
(46:12):
Our kids aren't the biggest fan because we have put them in
something called the Russian School of Math for years and
years. All those teachers I thought
were on this, They were. So smart.
That's why there's that's right.So the European Union and the
FDA in the US has not approved CMax or C Lane.
(46:37):
So I don't really know what to make of these.
I would never suggest anybody take these because there's not
any real good evidence. Like I'd say we have gotten
better anecdotal evidence for some of the other things that
we've talked about than we do for any of these things.
Yeah. All right.
So let's move on to some of the cosmetic peptides, GHKCU.
(47:00):
So this has some cosmetic human data.
Topical forms might support collagen and wound healing, but
sunscreen still outperforms everything, right?
Any of these beauty peptides? I think so.
I mean, I you're a little bit more in the cosmetic space than
I am. I think there's better data and
(47:22):
evidence for a lot of the treatments that you guys do,
everything from laser resurfacing to so the injections
in the face that are actually beneficial for helping collagen.
And FDA approved and I know welland it starts like I love the
cosmetic stuff, right? I love sunscreen, treknowin,
(47:43):
some of the skin care treatmentsthat are actually proven.
But I also tell patients back tothe five pillars.
You can spend all the money on those treatments, but if your
five pillars aren't in place, that's actually worse for your
outside look too. And I think we'll do an episode
also about all the kind of available FDA approved
(48:07):
procedures that that we do know that are helpful for from the
standpoint of cosmetics and skinaging.
But for now, stay away from the cosmetic peptides, stick to
sunscreen tretinoins and you'll be good.
All right, so let's summarize. We need to say this loudly
(48:28):
because apparently it's not obvious on the Internet.
The peptide world is a disaster zone right now.
I think that's safe to say. TikTok is full of people
injecting unregulated compounds on camera like it's just another
part of their morning skin care routine.
Pray. Hey guys, welcome back to my
YouTube channel while I inject something into my butt that I
(48:50):
bought at 2:00 AM from God knowswhere.
Yeah, And I think people are ordering research peptides from
websites that are not super reputable.
You know, there's no independentagency that is making sure that
what is being sold is actually accurately what you're getting.
(49:12):
There's no batch testing. There's no oversight.
So honestly, like if your peptide is shipping and like
just a padded envelope, that's acoupon for some dog antibiotics,
like we need to talk. Let's be clear.
You're injecting these things into your body.
It's a needle into your actual tissue.
(49:35):
It is not a gummy. It's not a serum.
It's not. Let me try this appetizer or
aroma therapy. It's an actual injection.
Yeah, that is an important thingthat I think we didn't talk
about before. All of these for the most part
have to be taken and as an injection they are not
bioavailable to us as a pill or powder that we can swallow
(50:01):
because our gut enzymes basically neutralize them so.
So all the oral peptides are basically garbage.
Yeah, there. There's none that.
I'm sorry, that's not entirely true.
Now, there are some that are meant to be absorbed through
your oral mucosa, so you're not swallowing them.
Anything you swallow does not work, but they'll come as a film
(50:25):
that you that you'll put inside of your cheek or under your
tongue, or a tablet that dissolves under your.
Tongue again, but none of these are FDA the.
Secondary mechanism, it's not the preferred mechanism because
let's face it, like we don't know the true bioavailability of
these through the subcu mucosa or through the cheap mucosa.
(50:47):
We don't know that. What we know is, I should say
what we anecdote anecdotally know is that there is a pretty
consistent effect when they're injected.
But we don't know because it's so new now, like these are the
latest in the last couple years.We're just starting to see these
oral formulations that are not meant to be swallowed but
(51:10):
absorbed through the oral mucosa.
And that is a different dosing for sure.
Patients are going to get some sort of effect from it.
But is it as reliable as what they were getting through
shooting yourself in subcutaneous tissue?
Definitely not. And again, no human trials, no
studies. So just be weary.
(51:32):
I would say be cautious. I hate that do your own research
thing because it's that Dunning career effect.
You don't know what you don't know.
Everyone thinks they're an expert in everything.
You have to like, if you're going to go do one of these
things, you have to go to somebody who actually has some
experience prescribing it. They know what the common things
(51:54):
are that people complain of, what the side effect profiles
are. They're doing your labs, yeah,
to be sure you don't have risk factors for cancer.
All patients need to be appropriately screened before
they go on this, and any doctor,physician, EA, nurse
practitioner, anybody who's doing this needs to have done
(52:16):
some baseline medical evaluationbefore they're agreed to give
you this stuff. I think a great example of that
was the silicone boom, right? Everyone 30 years ago was
injecting silicone right into their lips, their face, because
it was this permanent filler that was building collagen.
And we saw how that played. Album, I'm not going to name any
(52:39):
names, but those giant duck lipsthat now I feel so bad.
Some of those patients need literally regular steroid
injections just to reduce the inflammatory effect of those
silicone injections that they had 20-30 years ago.
So this is where that cautionarytale comes in.
Like just because it's new, justbecause it's hyped up right now,
(53:02):
we don't have the 10/20/30 year studies to back this stuff up.
So it's just one of those thingsyou got to think through this.
It's not a Willy nilly approach to just I'm going to buy this
thing and inject it into my body.
I could not agree more. So, and here's the part that
truly blows my mind, The sheer Olympic level kind of irony of
(53:27):
it all. Some of the same people who
spent months saying I'm not putting that in my body and so I
see the data are now injecting this mystery liquid from some
website with some sketchy logo that was designed on like
Myspace or something. It's kind of ridiculous when a
patient will say that I'm not going to inject this FDA
(53:50):
regulated vaccine that has been proven with literally millions
of doses given, sometimes literally billions of doses
delivered, but they're willing to inject themselves with CJC,
right? Or Tasner on these are just.
(54:12):
But the cognitive dissonance of like, well, this makes sense,
but this doesn't. When one has tons and tons of
data, we know what it does cause, what it does not cause,
and the other one we have a theoretical knowledge of what it
does. Yeah, those same people are out
here, like, yeah, I'll inject this unlabeled vial with this
(54:36):
needle that came from some random warehouse in Wuhan
because a guy on TikTok with a really good ring light and
lighting said it gave him crazy muscles.
Yeah, this isn't really like biohacking.
It's not cutting edge. This is just right.
(54:58):
There's a big difference betweensomething that's gone through
the FDA approval process becauseeven if the FDA got it wrong and
the drug manufacturer got it wrong, we have an entire system
in place that allows us to refine the recommendations based
on what happens once hundreds, thousands, millions of that
(55:20):
compound have been delivered to a patient.
If we start noticing that there's some sort of trend,
there's a whole system in place for re evaluating and the FDA
stepping in and saying, whoa, whoa, whoa.
We're noticing that patients whotake this get a heart attack.
Like we need to put a black box warning on this that these are
the risk factors that might, that might cause a patient to
(55:43):
have that side effect, right? There's a whole process.
The system is designed for us being as safe as possible.
There are downsides to that also, because then things don't
get developed as rapidly as people want them to get
developed. So there's definitely a downside
to the way the FDA does things. There's a lot of red tapes.
(56:04):
There's a lot of things that that I think we think should get
expedited, that should get proper funding for research that
does not including some of thesecompounds, right, these peptides
that we're talking about. But the system exists in such a
way to promote safety. Right.
(56:27):
And let's remind our listeners of the bigger issue.
People are using peptides instead of working on their five
pillars, lift, move, sleep, fuel, connect.
Like peptides are going to magically compensate for those
things and all those things thatthey're not actually doing that
they're supposed to be doing. I think peptides can enhance
(56:50):
biology, but they can't resurrect a lifestyle.
They won't fix chronic sleep deprivation. 0 muscle mass, like
you can take growth hormone, You're not just going to
magically get muscles, right? You would still have to actually
go to the gym and do resistance training.
So there's this calculus I thinkthat needs to be done on why
(57:14):
you're going to use a peptide and what you're going to do when
you're on the peptide. It's not just let me take this
pill and I'm just going to magically feel better and
everything in my life is going to be better.
Doing those peptides without thepillars, the analogies.
I love frosting a cake that you forgot to bake right?
Or pouring premium fuel into a car with no engine like that.
(57:37):
All of us understand that that just doesn't make sense.
And I think the same argument wecan make for peptides, right,
without actually implementing those five pillars and taking
those more seriously. I I think that hits the nail on
the head. So if you're skipping the
fundamentals, thanks for that, peptides are going to save you.
(57:58):
That's just not longevity medicine.
It's really just wishful thinking with needles.
So while the peptide world is exploding in popularity, we need
to separate the hype from reality, right?
Peptides do have some solid evidence.
The one the GOP ones that we talked about, for example, have
years of safety data, large randomized clinical trials,
(58:22):
cardiometabolic outcomes, real world evidence of millions of
patients having tried them. And there are other peptides
with promising early research, right?
Improvements in metabolic markers, inflammation, body
composition, mitochondrial function and tissue repair.
It's our exciting space. The potential is huge.
(58:44):
But promising doesn't equal proven, and it's still too early
to recommend to many of our patients across the board,
especially when we don't have that long term data, right to
understand the safety over decades, which is what longevity
medicine is all about, right? We are playing the long game.
We're not just going to sell this quick fix to a patient
(59:07):
without understanding what the real world implications are.
One decade, 2 decades, 3 decadesfrom now.
We're excited about peptide technology.
We really are. Any advancement in the
geoscience of longevity space isa win.
New tools, new pathways, new ways to enhance health span.
(59:27):
This is going to be one of the new frontiers of medicine and it
is all fascinating. But the excitement does not mean
that we should be reckless. We can be optimistic about
peptides and still be evidence based.
We can be curious without being careless.
And I think we can find a way tointegrate peptides thoughtfully.
(59:50):
When the rest of your foundationright, the lift, move, sleep,
fuel, connect, when all of that is solid and it's actually
working for you, that might be the right time that these
peptides are actually useful. Because peptides aren't the
plan, right? They're supplementary to the
plan. And once those fundamentals are
(01:00:11):
already doing their job, many times you don't need those
peptides. I don't think we've had a
patient in two years that has not had a work up that has
revealed something that they could be working on one of those
five pillars, right. Everyone has room for
improvement in those five pillars, and that's really what
(01:00:31):
we want to emphasize. So the way to think about this
is really from a risk benefit standpoint.
And that's the only framework that honestly ends up mattering,
right? Everything in life is some sort
of risk benefit and it doesn't matter whether it's a
medication, a therapy, a supplement, lifestyle choice.
(01:00:52):
Every decision in our healthcarejourney has a trade off of some
sort and pretending otherwise ishow people get in trouble.
I mean literally like deciding to go to the gym.
You're giving up something else in your life, right?
You're dedicating some time to exercise when you might that
time might be better off spending with your kids and
(01:01:14):
building a better relationship with them.
There's always some sort of trade off, no matter how good
the potential thing is that you want to do.
Exactly. And when we talk about risk
benefit, I always think of it this way.
Would I get on a Boeing airplanethat hasn't been safety tested,
flown, inspected, simulated, andstress tested?
(01:01:37):
Absolutely not right, Even if ithad the comfiest seeds, first
class, the good logo, free drinks.
I'm not boarding anything that hasn't been proven that it can
fly safely in the air. And it's kind of like, would we
want to swim with sharks in the open water, right?
I mean, I guess we have. We have damn it twice.
(01:02:00):
Twice, but in that case, right? We pushed our we pushed our kids
in. Remember from the boat.
Throwing two of our three children in the water and.
Then the the third was like, yeah, let's go, yeah.
Oh, but there's a risk benefit calculation, right?
We were something with nurse shows, not controlled
environment safety protocols, reward of a once in a lifetime
(01:02:23):
experience, right? That is an informed risk.
The problem with some of these things that we see online is
that there's an uninformed risk.Yeah, and risk that I said is
deeply personal, but it also hasto be grounded in reality and it
has to be discussed with your doctor.
(01:02:44):
Not the TikTok, not Reddit threads written at 3:00 AM.
Not a guy whose entire medical education came from ChatGPT.
Right. Everyone is a self appointed
expert these days. Yeah, and I think here's a part
that people forget. Like if you do choose to take
the peptide, even the more well studied ones, then the five
(01:03:07):
pillars matter even more becausepeptides just aren't going to
replace biology. They amplify it, right?
So if you're doing the lift, move, sleep, fuel, connect, then
then systems are primed for working correctly with the
peptides and it isn't the peptides trying to work around
(01:03:27):
your bad. Habits, right?
Peptides without the lifestyle is just taking a risk without
that benefit. It's like boarding that on
tested airplane while forgettingyour parachute.
Or swimming with sharks but deciding that that cage is
optional with white great white sharks, which we haven't done
(01:03:48):
yet. That's on my bucket list too.
Perfect, can't wait and I'm suretwo of our three kids can't wait
either. So you know, I I think in
closing, we hope you guys learned a thing or two after
listening to this episode. If you didn't pay attention to
anything else, listen up. Now here's a flip notes.
We have to ground everything in those five pillars of lift, new
(01:04:11):
sleep, fuel and connect. You lift because muscle is the
organ of longevity. You move because your body hates
sitting still and it was built for motion, not office chairs.
And we know that if you don't move it, you're going to lose
it. You sleep because you can't out
hustle biology. Your body needs to repair and
(01:04:33):
nothing works when you're exhausted.
You fuel because you can't out train a crappy diet.
Your cells literally run on whatyou feed them.
You are what you eat, right? And we connect because humans do
not thrive on isolation. We know that community is
medicine. So dial in these five pillars
(01:04:54):
and you've already won most of the game.
GLP ones are the only peptide with really strong evidence
based human data. Every other peptide we talked
about rank is from interesting early science to we've really
have no idea. A lot of them do have good
(01:05:16):
anecdotal evidence and likely dohave a fair amount of benefit,
but again, no real true data that we can reliably used to
prescribe these. So not one of these is ever
going to replace one of the fivepillars of longevity.
(01:05:36):
Thanks for listening and remember guys, keep playing the
long game. Thank you for playing the long
game with MD Longevity Lab. You can visit us at
www.mdlongevitylab.com to learn more about how we can support
you on your dream. Stay connected with us on social
(01:05:56):
media at MD Longevity Lab for tips, updates, and behind the
scenes insights. If you enjoyed today's episode,
we'd love it if you subscribe, left us a rating, or shared it
with someone you know who's alsoplaying the long game.
Thanks for listening, We'll see you next time.
Welcome to MD Longevity Lab, where we're playing the long
game. This is a podcast where science
meets real life, with expert insights, practical tips, and
real world tools to not only live longer, but live better.
Our aim is to radically change the way medicine is practiced
and enable individuals to age gracefully, maintaining health,
(00:24):
span and vitality well into their later years.
We're your hosts, Dr. Nisha and Dr. Vikas Patel, physicians,
partners in life, and parents, balancing work, Wellness, and
everything in between. Let's dive in.
(00:44):
Welcome back to the MD LongevityLab podcast where we are playing
the long game. I'm Doctor Nisha.
And I'm not for Vikas. Today we are going to get into a
topic that we've been asked quite a been about lately and
that is peptides. The miracle injections, the
shortcuts, the bio hacks, the stuff that is on TikTok all the
(01:07):
time. Hopefully we can kind of dispel
some myths and get you some accurate information about what
these things are or what their use cases are and what they can
and can't do. Yep.
So before we even get into peptides, we have to ground this
conversation in what actually drives health span.
(01:28):
The five pillars of longevity, lift, move, sleep, fuel,
connect. That pretty much constitutes 98%
of what makes up health span, and these are the levers that
actually work. These are the levers that are
going to restore metabolism, energy, cognitive function,
hormones, mood and vitality. When we talked about longevity,
(01:52):
it always comes back to these five pillars, just like Nisha
said, lift, move, sleep, fuel, and connect.
Lift because maintaining muscle is one of our strongest
predictors of how long you'll stay independent and how long
you're going to be functional. Move because your daily
activity, not just your workouts, it's what keeps your
(02:14):
metabolism, your mitochondria and your cardiovascular system
functioning well. Sleep, because when your brain
is resting, when we go to bed, that is when it is cleaning
house. This is when our hormones
rebalance. This is when our body actually
takes the time to repair itself,fuel properly because what we
(02:35):
put on our plate directly shapeshow much inflammation we have in
our body, what our metabolic help is, and what our long term
disease risk is. Connect because humans are wired
for connection and for relationships, right?
We talked about this in our lastepisode.
I believe isolation is absolutely dangerous.
(02:55):
It's as dangerous for us as smoking a pack of cigarettes a
day. These five pillars are not
optional and they are honestly non negotiable when it comes to
lifespan and more importantly health span.
Everything else, including peptides, is kind of secondary.
Since we've seen so many patients, we've taken care of so
(03:16):
many patients across every age and every background.
Every single patient has room toimprove in one of those five
pillars. And every single patient, when
they make improvements on one ofthose five pillars, notices the
benefit of them. Yeah, it never fails, right?
Someone gets serious about strength training, their labs
(03:37):
are going to improve. Someone cleans up their sleep,
their hunger normalizes. Someone stabilizes their
nutrition and actually gets their protein intake that's
required. Their energy is restored and
someone reconnects with the people that they love.
Their stress markers and inflammatory markers drop and we
(03:57):
have our patients that they shoot for 8 to 10,000 steps.
When they actually hit that goal, their glucose stabilizes.
So I think kind of the moral this is that we don't jump
straight into peptides. We also don't jump straight into
medications. We don't jump straight into
supplements trying to patch a hole in the sinking ship.
(04:18):
Yeah, PSA for the people in the back, there is no quick fix.
Not for longevity, not for metabolism, not for aging.
And anyone that's promising thatis really just probably trying
to sell something. Peptides are tools.
They just can't be the foundation, and the foundation
(04:39):
has to be those five pillars of lifting, sleeping, moving,
fueling, and connecting. Doing the peptides without
working on those pillars is kindof like installing chandeliers
in the house, but there's no solid foundation.
It may look fancy, but a strong gust of wind is going to knock
it over. With that said, let's get into
(05:00):
peptides. Today we're going to talk about
the science of peptides, the hype, the misinformation, the
risks associated with peptides, as well as the potential
benefits and the reality in realworld use.
And I, I want to be honest aboutthis.
Like to be fair, peptides are exciting.
We're talking about molecules that can influence metabolism.
(05:23):
They can enhance our repair mechanisms, improve
mitochondrial function, reduce inflammation recovery.
There is a reason why the scientific community is paying
attention. There's a reason that athletes,
clinicians, researchers, and longevity physicians are
interested. The potential upside is pretty
(05:45):
huge. Exactly.
Some peptides are showing incredibly promising signals,
right Improvements with insulin sensitivity, fat loss, muscle
preservation, wound healing, immune modulation.
The early data is really interesting.
The mechanistic rationale is strong and we definitely want
(06:05):
these tools in our toolbox Eventually.
We also want more research, we want more FDA grade options and
we want the field to mature. I'd say, you know, the
excitement doesn't erase Physiology.
Some peptides work on growth repair and angiogenesis
pathways, and that's a part of what makes them potentially
(06:28):
really powerful. Those same pathways are also
involved in the growth of thingslike existing cancers or
microscopic lesions. We're not talking about causing
cancer. There's no specific evidence for
that, but we are talking about the possibility of accelerating
something that's already there. It's that double edged sword of
(06:52):
regenerative medicine, right? Anything that can help tissue
grow, repair or regenerate couldtheoretically help the wrong
tissue grow too. And so it's not about fear, it's
about respect for the biology. And that's why screening
matters. Our family history matters.
Hormonal history, imaging your labs, biomarkers, personal risk
(07:14):
factors, all of this should go into decision making when it
comes to peptides because peptides aren't dangerous by
definition. They're dangerous when it's used
in the wrong patient with no no legwork, without contacts, or
without supervision. And I think here's part of the
positive when they're used responsibly with proper
(07:38):
screening, pharmaceutical grade sourcing and in the right
clinical setting, peptides can probably be incredible tools.
They can definitely accelerate progress, enhance your baseline,
complement your current regimen and they can help patients and
breakthrough points. We've seen real benefits in our
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own patients, improvement in energy levels, recovery,
strength, metabolic health. It's just we got to pay close
attention to who's a good candidate.
And those peptides only work well when that foundation is
strong, right? Lift, move, sleep, fuel,
connect. Without those five pillars,
you're taking a risk for minimalreturn.
(08:20):
So yes, be excited. Peptides are one of the most
promising emerging tools in geoscience.
Use them intentionally, safely, and with respect for the
pathways you're actually manipulating.
All right, so let's get into thescience.
What are peptides? Peptides are short chains of
(08:41):
amino acids, which are tiny little proteins that act as
signaling molecules. These signaling molecules tell
cells what to do, They regulate pathways, and they also
influence metabolism, healing, inflammation, mood, and pretty
much every system in our body. But in online Wellness spaces,
peptides now include a lot of things, right?
(09:03):
They include growth hormone boosters, fat burning compounds,
cognitive enhancers, mitochondrial peptides, cosmetic
peptides, random things sold on websites, Amazon like anything
an influencer Tiktok and inject into their thigh for views.
And it's really kind of criticalto understand most of the
(09:24):
peptides people are using are not FDA approved, they're not
standardized, there's no long term testing involved and
there's no regulation of purity of these things either.
If you're buying an injectable compound from a website with no
storefront address, no phone number, buy 2.
(09:45):
Get one free on Black Friday. Like you're not really
practicing longevity, you're basically just gambling.
So let's talk about the one peptide that we have robust
human data for and this peptide,pretty much all of you I'm sure
have heard of them. These are the GLP 1 agonist so
(10:07):
the GOP ones are a class of medication and this is literally
the only peptide in the entire peptide universe with FDA
approval. Large multi site randomized
human clinical trials, cardiovascular outcome data,
years of long term safety data, real world data from millions of
(10:29):
patients who have used this and pharmaceutical grade purity and
manufacturing standards. And there is actual oversight
from regulators, pharmacists andphysicians with the GLP one.
Everything else we're going to talk about today.
Great mechanisms, interesting Physiology, promising signals,
but nothing comes close to the data we have on GLP 1 peptides.
(10:54):
OK, So what is AGLP? One, it is a hormone that our
body already makes in our gut. It's GLP is short for Glucagon
like peptide. One, you've heard of some of the
names of these drugs, probably the most popular ones are some
in glutide and tirzepatide. These are drugs that are
(11:15):
available at this time. Some in glutide is a GLP
wagonist, meaning basically is just like Glucagon, like
peptide. Tirzepatide is a GOP one
agonist, but it's also a GIP agonist and that is a little bit
different. It has a second target which is
(11:35):
glucose dependent insulinotropicpolypeptide.
And so this adds an extra metabolic effect and we believe
This is why tirzepatide is a little bit more effective in the
weight loss category and reducing some of the bad
diabetes numbers that we see in patients who have diabetes.
(11:56):
So these medications work by in the body the same way that those
peptides that our body naturallyproduces and they do a few
different functions. They slow down gastric emptying,
which keeps us fuller longer. They reduce cravings and
compulsive eating. That is an effect that occurs in
(12:18):
the central nervous system in the brain.
It helps them modulate our hunger.
They improved insulin sensitivity.
This is partially how they're actually lowering patients blood
glucose and hemoglobin A1C. They suppress Glucagon which
helps to increase our blood sugar.
They calm down inflammatory markers, they lower post meal
(12:42):
glucose spikes, and ultimately they help to reduce our visceral
fat. And really that was that toxic
fat that lives surrounding all of our organs in our guts.
So mechanistically, these medications or these peptides
are very elegant physiologically, they just make
sense for a large, large amount of the American population right
(13:05):
now. Yeah.
And unlike the rest of the peptide world GLP ones, the
research is not subtle, right, 15 to 20% of total body weight
loss in large clinical trials. There's reduced cardiovascular
risk, lower heart failure mortality, improved fatty liver
(13:26):
markers. So patients with Nafil D or
Nash, it's great for those patients, lower inflammation, C
reactive protein numbers, we seedramatic improvements in blood
sugar. And I know for many of our
patients when we've done a full body DEXA scan before they start
GLP ones and after we see significantly lower visceral
(13:48):
fat. And there's evidence for
appetite regulation and reward pathway changes.
So a lot of people notice reductions in their cravings in
food, alcohol and substances that they normally really have a
craving for like sugar. So this this is real biology
with the GLP ones. This is not influencer biology
that you see on TikTok. But there is a cashier, right?
(14:11):
And this is where we can kind ofget loud about it.
GLP ones do not fix lifestyle issues.
So we've definitely seen patients who have lost 20 lbs,
right? But they've also simultaneously
accidentally lost 7 to 9 lbs of muscle while they lost 20 lbs of
(14:32):
total body weight. This is simply because they're
not controlling the things that they should be controlling,
which is their protein intake and whether they're doing any
sort of resistance training to maintain muscle.
So GOP ones will put you into a calorie deficit and it's upon
the patient to then tell it their body that what type of
(14:57):
weight they want to lose. While they're in that catabolic
zone where their body is in a calorie deficit, they should
preferentially be losing fat, not muscle.
Muscle is more expensive for us to maintain and our body
basically says, well, if I'm in a calorie deficit, I'm going to
(15:17):
get rid of the stuff that's mostexpensive for me to maintain.
Fat is not that expensive to maintain.
So if you're not using the muscle, you will lose muscle.
In addition to losing fat, patients have to prioritize
being very cognizant about how much protein intake they're
taking. They have, they have to be at
the upper end right when we've, we've spoken previously about
(15:41):
getting close to 2G per kilogram, if not 2.2g per
kilogram if you're trying to actively lose weight on the GOP.
And then they have to give theirmuscles the training stimulus
that I'm actually using muscles on a daily basis by doing
resistance training, then their body will preserve the muscle
(16:01):
and just lose the fat. So the GOP 1 does not know the
difference between losing fat and losing muscle.
You do. Your habits are going to dictate
what you actually retain and what you lose.
And training matters a lot here.And this is the part that the
Internet forgets. GOP 1 is a tool.
(16:22):
It's not that transformation. It's a helper, not a healer.
It's a support, not a substitute.
It cannot replace the heavy lifting, the moving, the
sleeping, fueling, and connecting with real humans.
Those five pillars that we talked about, and those are the
things that are going to move the needle with your health
span. And certainly GOP ones are a
(16:44):
tool and we love them for many of our patients.
But we do emphasize you have to prioritize the five pillars
before jumping into that GOP one.
And here's another important truth, everything we talked
about after GOP ones, it's much thinner data, much smaller
studies, much more uncertainty, much, much, much less safety
(17:07):
monitoring. So we know so much about GOP
ones and in a lot of ways, GOP ones have become kind of the new
Staten where there's so many benefits coming out of the
research of GOP ones that there's almost, there's very few
side effects to GOP ones where we can say, OK, this is a reason
(17:31):
why someone should not be takingthis medication or this peptide.
All the rest of the things that we're even talking about today
just don't fall into that category.
Like there is very little data to support.
Most of the stuff that we'll talk about has anecdotal
evidence, which is basically thecomplete opposite of randomized
(17:51):
control trial data, where we know without a doubt that this
thing does this and we can repeat it over and over again
and get the same exact results. Yeah, GLP one is the only
peptide where we get to actuallyspeak confidently because we're
standing on decades of biology data, huge trials and real world
(18:12):
outcomes, Everything, every single peptide that we're going
to talk about now, right? We're back into potential
mechanism and interesting but early scientific data, which is
why those five pillars matter, whether it's with GLP ones or
other peptides, you really have to prioritize that five pillars.
(18:35):
So let's get into kind of this Gray area of peptides and let's
start with the growth hormone secreted guides, secreted dives.
That sounds like a demigod. It's like Greek.
It is, yeah. So we're going to talk about, I
guess, arguably some of the mostpopular ones first.
(18:56):
So CJC 1295 IPA, Morellan, Tasmarellan, Spermarellan, these
are growth hormone analogs, and there's a lot to like here, but
there's also some points of caution.
Yeah, growth hormone secreted eggs are one of the most
misunderstood and overhyped categories of peptides online.
(19:21):
Mechanistically, they stimulate your pituitary gland to release
your own growth hormone by acting on that GHRH receptor
like CJC 1295 or Tasmarellan or mimicking ghrelin which is that
hormone that our body naturally secrets and that will trigger a
brief growth hormone pulse whichincreases IGF one.
(19:47):
Exactly. So some of these like CJC are
directly impacting the growth hormone secretion and then the
others like ipromarolin are mimicking that ghrelin, which is
something our body makes naturally and it will end up
triggering a salsa of growth hormone, but it's also
(20:09):
increasing insulin like growth factor one, IGF 1, so.
This is, you know, the science and not like the TikTok version
of it. Tasmaron is the only growth
hormone Secretagog that's FDA approved and that's only for HIV
(20:29):
associated lipid dystrophy. And most of us don't know what
that is like. The physicians probably do, and
anybody who has HIV who's been on some of the older generation
HIV meds might know. But literally what this
lipodystrophy does is it it'll 'cause that gaunt phase, you'll
lose the muscle tissue in your feet or sorry, the fat tissue in
(20:52):
your face and your arms and legs.
But you add it in the not very safe places.
So you'll add it in your trunk, breast tissue enlargement, back
fat tissue enlargement and then the the not good inside of our
intra abdominal space where thatvisceral adipose tissue is,
it'll increase that. So basically Telnarolin can help
(21:16):
to reduce some of that visceral fat, but the effect is
temporary. When you stop it, the visceral
fat does return. CJC plus it from rollin reliably
increases growth hormone and IGFtransiently.
But we don't have any long term studies in healthy adults.
We don't have any 10 year outcomes, we don't have any
(21:38):
cancer data, we don't have any anti aging data.
So this is really where all of the theoretical risks come in.
Yeah. And that's where we have to be
cautious. Chronically elevated levels of
IGF one has been associated, again correlation, not causation
with prostate, breast and colorectal cancers.
(22:00):
That doesn't mean these peptidescause cancer, but the biology is
enough to say don't play with this casually, right?
We have to think twice about this.
And we need to say this clearly but responsibly.
There have been reports of some serious adverse events,
including at least one death temporally associated with
(22:21):
growth hormone related peptides used outside of medical
supervision. We cannot say that the peptide
caused it. There were some confounders, but
the point is these compounds modify existing hormonal
pathways and we 100% lack any sort of long term safety data.
(22:43):
So let's talk about why aging matters.
So growth hormone is not neutralin older adults.
Growth hormone is highest in childhood, believe it or not,
and it peaks between the ages of14 to 19 when we're teenagers.
And this is when we're growing at the fastest rate in our
lives, right? We see that in our kids.
After that, growth hormone levels naturally drop about 10
(23:06):
to 15% per decade, and this decline is protective.
When we're young, our immune system is excellent at catching
abnormal cells early and destroying them.
As we age, that surveillance weakens, which is why cancer
incidence rises with age. So raising growth hormone at age
45 or 55 carries different implications.
(23:29):
And raising growth hormone at age 15.
That's an excellent point. On top of that, for people who
already have some evidence of impaired glucose tolerance or
diabetes, growth hormone can raise our blood sugar and worsen
insulin resistance. You must be metabolically stable
(23:50):
before even considering these peptides.
And remember, in our previous episode, we talked about over
90% of our US population is metabolically unhealthy, right?
So there's very few people that would be a good candidate for
this without proper supervision.Absolutely agree.
(24:12):
So let's take a little bit of a deeper dive into CJC 1295
because I think it is kind of a misunderstood peptide.
Mechanistically, CJC 1295 is fascinating.
It's engineered to have a longerhalf life and instead of
overwhelming your system like synthetic growth hormone, it
(24:33):
kind of nudges your pituitary torelease growth hormone in a more
physiologic pulsatile pattern, and that's the way your body is
designed to release it. And This is why people get
excited about CJC, because when it's used appropriately in the
right patient and with pharmaceutical grade sourcing,
(24:54):
it can support a bunch of things, right?
So it can help improve our deep slow wave sleep, improved
exercise recovery, better muscular repair, collagen
production and skin quality, mild improvements in body
composition, and increase vitality and energy.
These aren't magic effects, but they are real physiologic
(25:18):
changes, and patients often really do feel better on it.
But the excitement doesn't erasethe biology.
CJC still works on that growth repair and angiogenesis
pathways, which is that development of new blood
vessels. And those are the same pathways
that help tissues heal and the same pathways that could
(25:39):
theoretically accelerate the growth of an existing cancer or
a microscopic lesion. And again, there's not a causal
relationship with cancer that weknow of, but it potentially
could speed up something that's already there.
And the metabolic effects mattertoo, right?
So a growth hormone opposes insulin, it can raise blood
(25:59):
sugar. So if a patient has insulin
resistance, metabolic syndrome, diabetes, CJC can worsen all of
that. This is why screening is not
optional. This is why you can't just
decide on your own that I'm going to go online to some
sketchy online pharmacy. Order CJC from some Jim bro.
(26:20):
Yeah, there's a lot of that. Most gyms have some guy, usually
a guy, usually not a gal, who's like the supplier of like all
the steroids and peptides like that ever on all the IT.
Used to be steroids, now it's peptides.
There's still a lot of steroids used to, but like I said, This
is why screening is not optional, right?
(26:41):
Family history, personal history, hormonal history,
metabolic labs, IGF levels, cancer risk.
All this stuff matters before you decide that this is the
right compound for you. CJC is a tool and it's only
useful in the right environment.Right?
That metabolically healthy patient which is really only 10%
(27:01):
of us. Someone who's consistently
strength training. Someone with good sleep hygiene,
optimize nutrition. Basically someone who's already
optimized those five pillars. In that context, CJC can be a
meaningful adjunct. It can be a multiplier to what a
healthy system is already doing.But it honestly it can't
(27:22):
compensate for poor sleep, no exercise, inconsistent
nutrition, or metabolic dysfunction.
You just can't hack your way around biology with a syringe.
All right, let's move on to the mitochondrial peptide that
everyone's heard of, Mott C. Mott C is a mitochondrial
(27:43):
derived peptide, which already makes it unique compared to
everything else that we've discussed.
It's encoded in mitochondrial DNA and appears, at least in
rodent studies, to activate AMPKand improve metabolic
flexibility. It enhances exercise tolerance
(28:04):
and it helps counteract high fatdiet effects.
But here's the key point In humans again, the data is
extremely limited. We do not have large trials.
We do not have safety data. We do not have long term
outcomes. Monty is honestly, it's
scientifically interesting. It might one day play a pretty
(28:28):
big role in metabolic health, but right now it belongs in the
early research category. Not something that we, you know,
would ever wholeheartedly recommend.
Not something that we use routinely and definitely not
something to self inject Becausea YouTube told you that this is
the new or next GLP one. Right.
(28:50):
Since when were we taking advicefrom these influencers and tic
tacers? It's insane.
We're influencers now. Yeah, I don't.
Know. We have patients that come to
me. I'm like, what's your
profession? I'm a or a, what do they call
it, a lifestyle Blogger? Like what does that mean?
(29:11):
I want to be a lifestyle Bloggerwhen I grow up.
It's like our kids say I want tobe a YouTube when I grow up.
Like we went into the wrong field with our with our tuition,
our debt, so much debt coming into marriage.
Anyway, until we understand longterm safety, dosing, target
populations and the downstream effects, this stays firmly in
(29:31):
the not quite ready for prime time like the GOP ones category.
I think most people who take Motsie, like the reported
effects are that they feel like they've got more energy, right?
That their exercise tolerance isbetter.
There is interesting anecdotal evidence about what it can do
for someone. But again, I feel like this is
(29:54):
one of those things where we don't have a lot of data, right?
So if you're going to take it like the idea is, let me take
this to get the ball rolling so that I can get back into a
healthier lifestyle and then cycle off of it because who the
heck knows what happens if you take this for six years.
Right. And I don't want to be the
(30:15):
Guinea pig to find out exactly. All right, So we are going to
cover NAD, but NAD is not a peptide.
It often gets thrown into this category of peptides because
it's kind of in the same stratosphere as everything that
we're talking about. I think it's important for
people to understand NAD is something that our body makes
(30:37):
naturally. Essentially it's a coenzyme
that's involved without getting into the Krebs cycle, like
there's a lot of intense biochemistry that we have to
learn when we find Med school. And without getting into all of
that, it's essentially A coenzyme factor that is used in
(30:58):
mitochondrial energy production,DNA repair and metabolic
regulation. It helps us deal with oxidative
stress. So the by product of a lot of
the processes in our body ends up causing oxidative stress
which is damage damaging free radicals, free radical oxygen
(31:20):
species. NAD is one of these compounds
that helps to neutralize that damage.
And so the theory is, is that aswe age, our ability to deal with
oxidative stress decreases. And if we load ourselves with
more NAD because we can't produce it as efficiently, we
(31:40):
know that people as they age have lower levels of NAD than
kids do. And so if we give more through
an IV or through an IM injection, that we're going to
improve people's health. Do the oral NAD precursors work?
OK. So uniformly the data on that is
(32:02):
basically they don't do anything.
So it's. Just an expensive like sure.
Yeah. So NMN is another NAD precursor
that got very popularized and you take it orally, they can try
to absorb it orally. Basically, the data on all of
that has so far been this doesn't do anything.
(32:22):
If you're going to take NAD, youhave to take it either
intravenously or as an injection.
That's the only way that it is bioavailable to your body.
Then the question becomes, can you get enough of it to make a
difference in some of these processes?
And then the next question is how do you measure an effect,
(32:45):
right? So this is where we've
completely failed in being able to ascertain does NAD actually
do something? We have no idea.
There are no randomized control trials with NAD that span enough
of a time frame to be able to say that NAD is anti aging or
NAD helps with muscle repair or NAD helps our skin look better.
(33:10):
We just don't have any studies that that will tell tell us
anything like that. Anecdotally, we have patients
that tell us they have improved cognitive function, right, They
have a little more mental clarity, better energy, improved
sleep, so does show some promising effects.
(33:32):
But again, how much of this is placebo?
How much of this is actually from the NAD?
It's really hard to kind of. There's no.
Any way to to tell? I mean, I have met plenty of
patients who say NAD 100% has made a difference in my life and
I'm not going to stop taking it.It's hard to argue with that
when people keep saying that we just don't have the data to back
(33:56):
it up. In theory and AB should help and
there are some die hard bench scientists who say yes, this
should help, you should take it hard for me to take that
position because there's no dataout there that says yes, it does
help. In theory it should, and there
are a lot of patients who self report that I've taken this and
(34:20):
I know that I feel better on it,so it is what it is.
So we've covered the growth hormones, we've covered GLP
ones. Let's move into some of these
newer fat burning peptides. Yeah, this section is going to
be really short because honestlywe've got better stuff with more
(34:41):
data. So the ones that we hear about
frequently are AOD 96 O four andfive amino one MQ.
These are honestly they're, they're billed as these fat
burning peptides, but we don't have good human studies.
The studies that we do have are underwhelming, inconsistent
(35:01):
without a ton of good effects. The reality is, is that we
already have GLP ones and GIP drugs.
We have so much data on those that I would so much rather put
a patient on one of those compounds then put somebody on
one of these unproven fat burning peptides.
(35:21):
There's some studies to show that yes, there could be a
benefit here, but time will tell.
Like this is nowhere near ready from mainstream.
This is nowhere near the level that of data that we have even
for the growth hormone analogs. So I say we just move on from
this topic Sounds. Good to me, right?
(35:42):
Let's move into some of the healing peptides.
Many of you have heard of BP157 or TV500, and these are the
TikTok darlings, right? They're all over social media
and people swear by them for tendon healing, gut healing,
joint pain, pretty much every over 40 injury that you can
(36:03):
think of. Yeah.
So BPC 157 and TB500 combined, you will hear them called The
Wolverine Compound online. You know if you're a fan of
Marvel Comics right? Wolverine can like infinitely
heal himself and that's why thisis called The Wolverine Combo.
(36:25):
You were Wolverine for Halloweenone year before we had kids.
I was, yeah. And I know Wolverine doesn't age
just like me. Yeah, you look the exact same I
did. I was storm.
Yes, you were Storm in the bodysuit.
I. Yeah, go to.
I loved Halloween. That's when you can wear stuff
that you couldn't. It's not socially acceptable.
(36:46):
Pantily clad for sure. So OK, some of the science on on
this, right. So this peptide is a synthetic
version of a naturally occurringcompound that is made in our
gastric juices inside of our gut.
So, you know, our stomach liningregenerates itself like every
(37:10):
three days and it has to becauseit's constantly being attacked
by our stomach acids and all thefoods and everything unhealthy
that we put into our our GI tract.
And so these compounds are derived from those same peptides
that essentially we make in our body.
(37:30):
Unfortunately, most of the data is really based on rodent
models. There are no real high quality
human trials here. You want to talk about the
mechanisms a little bit. Yeah.
So mechanism of action, it comesfrom in vitro mouse or mice
models, basically no human studies.
And it's one of the reasons why our ligaments and tendons take a
(37:54):
long time to heal is that they don't really have vasculature,
which is a blood supply to support them.
They rely on nutrients, inflammatory and immune cells
migrating to these from areas ofricher blood supply to make
their way over to these injured sites.
And this is not an efficient process.
And it gets even worse as we age, which is why many of us, if
(38:17):
we have a joint injury, it takesway longer for us to heal than
it would a 12 year old. But this is where these peptides
are supposed to exert their effect, right?
By increasing angiogenesis, or blood flow and fibroblast
migration. And these are the cells that
help regrow that tissue. Yeah.
So I think it's worth noting a little bit about this, right.
(38:38):
So we've all had kind of the experience of exercising and we
get soreness in our muscles, right?
Our muscle soreness will go awayin a matter of a couple days,
even if we haven't exercised in a long time.
And we go to the gym for the very first time and our muscles
get sore, they repair themselveswithin two or three days and the
(38:59):
soreness completely evaporates. Why is that, right?
Well, our muscle tissue has veryrich blood supply.
Our ligaments and tendons do not.
And so that is why when somebodygets tennis elbow, as I had this
last summer, right? I was on three months of tennis
elbow pain with, with trying to do appropriate rehab and it did
(39:23):
not resolve. I ended up needing to get a
steroid injection before it actually finally resolved
itself. It's because our bodies can't
send. Did I do your steroid injection?
I actually did it myself in the mirror.
I numbed you. No, you did not do any of the
steroid injection. I we've done multiple
unsanctioned medical procedure for each other.
(39:44):
PRPI did, yeah. I tried PRP 1st and that did not
work as well. Platelet rich plasma, but I
didn't do it properly because you're supposed to do multiple
rounds of it. Yeah.
And I had a work related golf tournament that I need to be
ready for so. Is this one of those things?
Do not try at home. Oh, absolutely, do that.
(40:07):
We're medical professionals. I know I so when we were I think
we were engaged. So this must have been 16 years,
1617 years ago. I had to drain a chalazion,
which is an eye cyst, like one of those little bumps on your
eyelids, a sign in the eye, and you refused to go to the doctor
(40:28):
or to the ophthalmologist. I did give it to the doctor I
want to see. You, well, you refused to go to
an ophthalmologist who was qualified to do it.
I was not qualified to do it. And you're like, yeah, so I did
what I do as super orbital black.
We were idiots. We were residents.
We were working 100 hours a week, yeah.
So I know my sister is an ophthalmologist and she was
like, you did what? You're blind.
(40:49):
You're not now you're blind because you're old.
Anyway, you know, the legality is complicated as these
compounds have been on again, off again for use by the FDA and
currently you're able to obtain BP157, right?
But again, there's so many mixedpharmacies sources getting it
(41:11):
from overseas, completely unregulated industry.
Yeah. I think it's worth noting.
So one of the other things that I, I think we did not talk about
earlier was, you know, the growth hormone analogs of this
Wolverine blend. These are all things that have
been banned by basically every sports federation, all the
international sports federations, all the domestic
(41:34):
ones. These are not legal, which tells
you that they probably do have areal world effect, right?
Part of the reason that they're not legal is that we don't have
good data. But part of the reason that
they're not legal is because people keep reporting that
they're that they work and so. People don't want athletes have
(41:55):
this unfair advantage they wanted.
A fair advantage, correct? So I, I have never taken any of
this stuff. I know people who have and I
would say by and large, most people that take them are like,
I suffered from this tendonitis or this ligament injury and I
suffered for four months with noimprovement.
(42:16):
And then I went on The Wolverineshot and in the next month it
resolves and I got better. Again, this is completely
anecdotal, right? It's like, oh this one person
took it and and did fine one. Percent anecdotal.
Yeah, this is, there's no human studies for this again, which is
why this is that cautionary talewe're giving you guys
(42:37):
information. Definitely not recommend
necessarily recommending this. This is a case by case kind of
risk benefits now, now. I've seen mainstream medicine.
I mean, we're addressing this, these topics because people keep
asking us. People keep asking because they
don't want to do the five pillars and that's my dent every
(42:57):
single time. Everyone wants a shortcut.
Correct. Sorry, guys.
So this one does again carry some risks, right?
And I would say that the main risk falls under that, under
that kind of cancer propagation again, right.
So if you have some understanding of cancer, cancer,
(43:18):
cancer is an unregulated growth of cells in the body that our
DNA codes and tells all of our cells how they're supposed to
grow when they're supposed to die.
Cancer does not follow that action plan and it is
(43:39):
unregulated. Eventually cancer spreads
because it's unregulated and it is competing for energy with us.
So with a compound like DPC 157,if it is truly causing
angiogenesis, the growth of new blood vessels to repair damaged
(44:00):
tissue, right, It could also cause growth of new blood cells
in cancer cells that are alreadyexistent and cause the cancer to
grow more quickly. So there are wiser ways to use
something like this, right? Like if you're only cycling for
a few weeks at a time, you're not just on this stuff for a
(44:22):
year or two, right? Safer ways to do this to
minimize your risk. But this again falls into the
category of like you need to be making sure all of your pillars
are correct, that you're maximizing all of that stuff
before you go to this as the answer all.
Right, let's move into some of the cognitive peptides, the
(44:42):
peptides that affect your brain chemistry.
C Max C Link. What is it?
Is that how you say it? Yeah, I think.
So and all of these, the pronunciation, it's ridiculous.
These both were developed in Russia and the most proposed
mechanisms involved BDMF, dopamine and serotonin
modulation. And these are used in patients
(45:04):
who have suffered brain injury from things like strokes.
And C Max is used for treatment for things like anxiety and
there's several neurological conditions.
And these are being used primarily in Russia, right?
Yeah, so these are awesome because they're they were
developed in Russia. They're only really used in
(45:26):
Russia legally and everywhere else they're, you know, like not
approved, basically illegal. So C Max does increase BDNF
brain Dr. neurotrophic factor. It can also increase dopamine
levels and serotonin levels. C link does is treated is used
(45:49):
for generalized anxiety disorder.
There's a third one called Cerebro Lysine, which which is
kind of like this catch all for all types of neurologic
conditions, but that one probably has the weakest
evidence out of all all three ofthem.
I It's hard to know anything about these because all the data
comes out of Russia and. Our kids.
(46:12):
Our kids aren't the biggest fan because we have put them in
something called the Russian School of Math for years and
years. All those teachers I thought
were on this, They were. So smart.
That's why there's that's right.So the European Union and the
FDA in the US has not approved CMax or C Lane.
(46:37):
So I don't really know what to make of these.
I would never suggest anybody take these because there's not
any real good evidence. Like I'd say we have gotten
better anecdotal evidence for some of the other things that
we've talked about than we do for any of these things.
Yeah. All right.
So let's move on to some of the cosmetic peptides, GHKCU.
(47:00):
So this has some cosmetic human data.
Topical forms might support collagen and wound healing, but
sunscreen still outperforms everything, right?
Any of these beauty peptides? I think so.
I mean, I you're a little bit more in the cosmetic space than
I am. I think there's better data and
(47:22):
evidence for a lot of the treatments that you guys do,
everything from laser resurfacing to so the injections
in the face that are actually beneficial for helping collagen.
And FDA approved and I know welland it starts like I love the
cosmetic stuff, right? I love sunscreen, treknowin,
(47:43):
some of the skin care treatmentsthat are actually proven.
But I also tell patients back tothe five pillars.
You can spend all the money on those treatments, but if your
five pillars aren't in place, that's actually worse for your
outside look too. And I think we'll do an episode
also about all the kind of available FDA approved
(48:07):
procedures that that we do know that are helpful for from the
standpoint of cosmetics and skinaging.
But for now, stay away from the cosmetic peptides, stick to
sunscreen tretinoins and you'll be good.
All right, so let's summarize. We need to say this loudly
(48:28):
because apparently it's not obvious on the Internet.
The peptide world is a disaster zone right now.
I think that's safe to say. TikTok is full of people
injecting unregulated compounds on camera like it's just another
part of their morning skin care routine.
Pray. Hey guys, welcome back to my
YouTube channel while I inject something into my butt that I
(48:50):
bought at 2:00 AM from God knowswhere.
Yeah, And I think people are ordering research peptides from
websites that are not super reputable.
You know, there's no independentagency that is making sure that
what is being sold is actually accurately what you're getting.
(49:12):
There's no batch testing. There's no oversight.
So honestly, like if your peptide is shipping and like
just a padded envelope, that's acoupon for some dog antibiotics,
like we need to talk. Let's be clear.
You're injecting these things into your body.
It's a needle into your actual tissue.
(49:35):
It is not a gummy. It's not a serum.
It's not. Let me try this appetizer or
aroma therapy. It's an actual injection.
Yeah, that is an important thingthat I think we didn't talk
about before. All of these for the most part
have to be taken and as an injection they are not
bioavailable to us as a pill or powder that we can swallow
(50:01):
because our gut enzymes basically neutralize them so.
So all the oral peptides are basically garbage.
Yeah, there. There's none that.
I'm sorry, that's not entirely true.
Now, there are some that are meant to be absorbed through
your oral mucosa, so you're not swallowing them.
Anything you swallow does not work, but they'll come as a film
(50:25):
that you that you'll put inside of your cheek or under your
tongue, or a tablet that dissolves under your.
Tongue again, but none of these are FDA the.
Secondary mechanism, it's not the preferred mechanism because
let's face it, like we don't know the true bioavailability of
these through the subcu mucosa or through the cheap mucosa.
(50:47):
We don't know that. What we know is, I should say
what we anecdote anecdotally know is that there is a pretty
consistent effect when they're injected.
But we don't know because it's so new now, like these are the
latest in the last couple years.We're just starting to see these
oral formulations that are not meant to be swallowed but
(51:10):
absorbed through the oral mucosa.
And that is a different dosing for sure.
Patients are going to get some sort of effect from it.
But is it as reliable as what they were getting through
shooting yourself in subcutaneous tissue?
Definitely not. And again, no human trials, no
studies. So just be weary.
(51:32):
I would say be cautious. I hate that do your own research
thing because it's that Dunning career effect.
You don't know what you don't know.
Everyone thinks they're an expert in everything.
You have to like, if you're going to go do one of these
things, you have to go to somebody who actually has some
experience prescribing it. They know what the common things
(51:54):
are that people complain of, what the side effect profiles
are. They're doing your labs, yeah,
to be sure you don't have risk factors for cancer.
All patients need to be appropriately screened before
they go on this, and any doctor,physician, EA, nurse
practitioner, anybody who's doing this needs to have done
(52:16):
some baseline medical evaluationbefore they're agreed to give
you this stuff. I think a great example of that
was the silicone boom, right? Everyone 30 years ago was
injecting silicone right into their lips, their face, because
it was this permanent filler that was building collagen.
And we saw how that played. Album, I'm not going to name any
(52:39):
names, but those giant duck lipsthat now I feel so bad.
Some of those patients need literally regular steroid
injections just to reduce the inflammatory effect of those
silicone injections that they had 20-30 years ago.
So this is where that cautionarytale comes in.
Like just because it's new, justbecause it's hyped up right now,
(53:02):
we don't have the 10/20/30 year studies to back this stuff up.
So it's just one of those thingsyou got to think through this.
It's not a Willy nilly approach to just I'm going to buy this
thing and inject it into my body.
I could not agree more. So, and here's the part that
truly blows my mind, The sheer Olympic level kind of irony of
(53:27):
it all. Some of the same people who
spent months saying I'm not putting that in my body and so I
see the data are now injecting this mystery liquid from some
website with some sketchy logo that was designed on like
Myspace or something. It's kind of ridiculous when a
patient will say that I'm not going to inject this FDA
(53:50):
regulated vaccine that has been proven with literally millions
of doses given, sometimes literally billions of doses
delivered, but they're willing to inject themselves with CJC,
right? Or Tasner on these are just.
(54:12):
But the cognitive dissonance of like, well, this makes sense,
but this doesn't. When one has tons and tons of
data, we know what it does cause, what it does not cause,
and the other one we have a theoretical knowledge of what it
does. Yeah, those same people are out
here, like, yeah, I'll inject this unlabeled vial with this
(54:36):
needle that came from some random warehouse in Wuhan
because a guy on TikTok with a really good ring light and
lighting said it gave him crazy muscles.
Yeah, this isn't really like biohacking.
It's not cutting edge. This is just right.
(54:58):
There's a big difference betweensomething that's gone through
the FDA approval process becauseeven if the FDA got it wrong and
the drug manufacturer got it wrong, we have an entire system
in place that allows us to refine the recommendations based
on what happens once hundreds, thousands, millions of that
(55:20):
compound have been delivered to a patient.
If we start noticing that there's some sort of trend,
there's a whole system in place for re evaluating and the FDA
stepping in and saying, whoa, whoa, whoa.
We're noticing that patients whotake this get a heart attack.
Like we need to put a black box warning on this that these are
the risk factors that might, that might cause a patient to
(55:43):
have that side effect, right? There's a whole process.
The system is designed for us being as safe as possible.
There are downsides to that also, because then things don't
get developed as rapidly as people want them to get
developed. So there's definitely a downside
to the way the FDA does things. There's a lot of red tapes.
(56:04):
There's a lot of things that that I think we think should get
expedited, that should get proper funding for research that
does not including some of thesecompounds, right, these peptides
that we're talking about. But the system exists in such a
way to promote safety. Right.
(56:27):
And let's remind our listeners of the bigger issue.
People are using peptides instead of working on their five
pillars, lift, move, sleep, fuel, connect.
Like peptides are going to magically compensate for those
things and all those things thatthey're not actually doing that
they're supposed to be doing. I think peptides can enhance
(56:50):
biology, but they can't resurrect a lifestyle.
They won't fix chronic sleep deprivation. 0 muscle mass, like
you can take growth hormone, You're not just going to
magically get muscles, right? You would still have to actually
go to the gym and do resistance training.
So there's this calculus I thinkthat needs to be done on why
(57:14):
you're going to use a peptide and what you're going to do when
you're on the peptide. It's not just let me take this
pill and I'm just going to magically feel better and
everything in my life is going to be better.
Doing those peptides without thepillars, the analogies.
I love frosting a cake that you forgot to bake right?
Or pouring premium fuel into a car with no engine like that.
(57:37):
All of us understand that that just doesn't make sense.
And I think the same argument wecan make for peptides, right,
without actually implementing those five pillars and taking
those more seriously. I I think that hits the nail on
the head. So if you're skipping the
fundamentals, thanks for that, peptides are going to save you.
(57:58):
That's just not longevity medicine.
It's really just wishful thinking with needles.
So while the peptide world is exploding in popularity, we need
to separate the hype from reality, right?
Peptides do have some solid evidence.
The one the GOP ones that we talked about, for example, have
years of safety data, large randomized clinical trials,
(58:22):
cardiometabolic outcomes, real world evidence of millions of
patients having tried them. And there are other peptides
with promising early research, right?
Improvements in metabolic markers, inflammation, body
composition, mitochondrial function and tissue repair.
It's our exciting space. The potential is huge.
(58:44):
But promising doesn't equal proven, and it's still too early
to recommend to many of our patients across the board,
especially when we don't have that long term data, right to
understand the safety over decades, which is what longevity
medicine is all about, right? We are playing the long game.
We're not just going to sell this quick fix to a patient
(59:07):
without understanding what the real world implications are.
One decade, 2 decades, 3 decadesfrom now.
We're excited about peptide technology.
We really are. Any advancement in the
geoscience of longevity space isa win.
New tools, new pathways, new ways to enhance health span.
(59:27):
This is going to be one of the new frontiers of medicine and it
is all fascinating. But the excitement does not mean
that we should be reckless. We can be optimistic about
peptides and still be evidence based.
We can be curious without being careless.
And I think we can find a way tointegrate peptides thoughtfully.
(59:50):
When the rest of your foundationright, the lift, move, sleep,
fuel, connect, when all of that is solid and it's actually
working for you, that might be the right time that these
peptides are actually useful. Because peptides aren't the
plan, right? They're supplementary to the
plan. And once those fundamentals are
(01:00:11):
already doing their job, many times you don't need those
peptides. I don't think we've had a
patient in two years that has not had a work up that has
revealed something that they could be working on one of those
five pillars, right. Everyone has room for
improvement in those five pillars, and that's really what
(01:00:31):
we want to emphasize. So the way to think about this
is really from a risk benefit standpoint.
And that's the only framework that honestly ends up mattering,
right? Everything in life is some sort
of risk benefit and it doesn't matter whether it's a
medication, a therapy, a supplement, lifestyle choice.
(01:00:52):
Every decision in our healthcarejourney has a trade off of some
sort and pretending otherwise ishow people get in trouble.
I mean literally like deciding to go to the gym.
You're giving up something else in your life, right?
You're dedicating some time to exercise when you might that
time might be better off spending with your kids and
(01:01:14):
building a better relationship with them.
There's always some sort of trade off, no matter how good
the potential thing is that you want to do.
Exactly. And when we talk about risk
benefit, I always think of it this way.
Would I get on a Boeing airplanethat hasn't been safety tested,
flown, inspected, simulated, andstress tested?
(01:01:37):
Absolutely not right, Even if ithad the comfiest seeds, first
class, the good logo, free drinks.
I'm not boarding anything that hasn't been proven that it can
fly safely in the air. And it's kind of like, would we
want to swim with sharks in the open water, right?
I mean, I guess we have. We have damn it twice.
(01:02:00):
Twice, but in that case, right? We pushed our we pushed our kids
in. Remember from the boat.
Throwing two of our three children in the water and.
Then the the third was like, yeah, let's go, yeah.
Oh, but there's a risk benefit calculation, right?
We were something with nurse shows, not controlled
environment safety protocols, reward of a once in a lifetime
(01:02:23):
experience, right? That is an informed risk.
The problem with some of these things that we see online is
that there's an uninformed risk.Yeah, and risk that I said is
deeply personal, but it also hasto be grounded in reality and it
has to be discussed with your doctor.
(01:02:44):
Not the TikTok, not Reddit threads written at 3:00 AM.
Not a guy whose entire medical education came from ChatGPT.
Right. Everyone is a self appointed
expert these days. Yeah, and I think here's a part
that people forget. Like if you do choose to take
the peptide, even the more well studied ones, then the five
(01:03:07):
pillars matter even more becausepeptides just aren't going to
replace biology. They amplify it, right?
So if you're doing the lift, move, sleep, fuel, connect, then
then systems are primed for working correctly with the
peptides and it isn't the peptides trying to work around
(01:03:27):
your bad. Habits, right?
Peptides without the lifestyle is just taking a risk without
that benefit. It's like boarding that on
tested airplane while forgettingyour parachute.
Or swimming with sharks but deciding that that cage is
optional with white great white sharks, which we haven't done
(01:03:48):
yet. That's on my bucket list too.
Perfect, can't wait and I'm suretwo of our three kids can't wait
either. So you know, I I think in
closing, we hope you guys learned a thing or two after
listening to this episode. If you didn't pay attention to
anything else, listen up. Now here's a flip notes.
We have to ground everything in those five pillars of lift, new
(01:04:11):
sleep, fuel and connect. You lift because muscle is the
organ of longevity. You move because your body hates
sitting still and it was built for motion, not office chairs.
And we know that if you don't move it, you're going to lose
it. You sleep because you can't out
hustle biology. Your body needs to repair and
(01:04:33):
nothing works when you're exhausted.
You fuel because you can't out train a crappy diet.
Your cells literally run on whatyou feed them.
You are what you eat, right? And we connect because humans do
not thrive on isolation. We know that community is
medicine. So dial in these five pillars
(01:04:54):
and you've already won most of the game.
GLP ones are the only peptide with really strong evidence
based human data. Every other peptide we talked
about rank is from interesting early science to we've really
have no idea. A lot of them do have good
(01:05:16):
anecdotal evidence and likely dohave a fair amount of benefit,
but again, no real true data that we can reliably used to
prescribe these. So not one of these is ever
going to replace one of the fivepillars of longevity.
(01:05:36):
Thanks for listening and remember guys, keep playing the
long game. Thank you for playing the long
game with MD Longevity Lab. You can visit us at
www.mdlongevitylab.com to learn more about how we can support
you on your dream. Stay connected with us on social
(01:05:56):
media at MD Longevity Lab for tips, updates, and behind the
scenes insights. If you enjoyed today's episode,
we'd love it if you subscribe, left us a rating, or shared it
with someone you know who's alsoplaying the long game.
Thanks for listening, We'll see you next time.
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