This may be the most controversial thing we have on this table.
This is a peptide that absolutely torches belly that at a disproportionate rate.
And what we found is not only do patients lose an incredible amount of weight,
but they also get the best improvements we've ever seen in their liver health. It's absolutely wild.
“And I think this is going to be a trillion dollar drug when it comes out.”
I've pulled you here because you were an expert in this subject, but I know it's worth saying that there was some significant news about this. Correct. From the FDA saying that in July, they are going to consider legalizing seven peptides.
And by far as estimate, it might be the most dangerous thing to their entire business model. So do you think it is plausible? That big farmer didn't want these in the hands of regular people because they can't pay to this. And it's powerful. 110%.
Because the question isn't what can peptides do? It's what can't they do? And we've got several peptides here in front of us. I'm going to go through all of them. Let's do it.
So this is probably the most well-known peptide for skin complexion. And it improves quality of hair and nails. And then epithalon is maybe maybe not going to be the fountain of you. But I'm very skeptical as far as that goes. Next, we've got this.
“And if you injected that at night, it would improve your quality of your sleep.”
Next, melanotan too. And this will actually end up giving you a deep tan in response to just a little bit of UV sun exposed. It will also give you some of the most impressive erections you've ever had in your life. So be warned when what else have we got. Oh my gosh.
But there's Medley and Blue where people take it and they think it's going to make them live forever. Don't take this. It literally will stain your nails blue and your hair blue. These two here stimulate the building muscle. This one can aid with healing after an injury.
And then this, this, this, this, this, this. It's crazy. It's wild. So why don't I take it? Well, we need to talk about that.
Because they're trade-offs.
But also outside of the world of peptides for a second.
I've got these three vials. Do you know what those are? Yeah. This is, unfortunately, our future for not careful. Explain.
So what we've got here is representing the fertility trajectory for young men. I'm so scared. Guys, I've got a favor to ask before this episode begins. The algorithm, if you follow a show, deliver you. The best episodes from that show, very prominently in your feed.
So when we have our best episodes on this show, the most shared episodes, the most rated episodes. I would love you to know. And the simple way for you to know that is to hit that follow button. But also, it's the simple, easy, free thing that you can do to help us make this show better. And I would be hugely grateful if you could take a minute on the app you're listening to this one right now.
And hit that follow button. Thank you so, so, so, so much. Dr. Alex Tatum, there's this word that has exploded in society in recent times. In fact, when I look at the data, people searching this word has increased by 400% just recently.
And that word is peptides. I have no idea what peptides are. I'm someone that wants to be healthy, that wants to optimize my health, wants to live long, doesn't love aging. Yeah.
And I'm told that this word peptides is somewhat linked to it. So I've brought you here because you're an expert in this subject, when I have watched your videos on YouTube, to start at the very beginning, Dr. Alex. Sure. What the hell is a peptide?
Peptides are a structural class of medications.
“The best way to think about peptides is that just like we have”
small molecules, which are drugs that are very small, taken in a pill, and have a wide ranging effect throughout the body, peptides are derived from little pieces of amino acids, which think of them as the legos that make up the human body, the legos that make up proteins. These are fragments of proteins that are designed to specifically target certain receptors and affect cells in a very targeted fashion.
Or a best way to think about it is a very specific targeted key to unlock a very specific lock. So instead of a small molecule that may have a wide ranging effect throughout the body, peptides are much, much more focused. So you've got different types of lego cubes here.
Would they be different types of peptides or are they different types of amino acids that come together to make a peptide? The best way to think about it is my son loves legos, which is why I'm glad that we have these here. He can take the same set of legos, and he can build a rocket ship.
And then just a few minutes later, he can build a pirate ship, and then he builds a race car. And he's using the same legos, but he's creating very, very different things that all do very, very different things. And so peptides have become incredibly popular, because yes, we have some really fascinating peptides that can help with anti-aging, with healing, and with tissue repair.
I'm going to talk about some of those, hopefully, but they can do so much more than that.
The first peptide that was actually isolated and used in medicine was insulin back in 1921.
And then all the way in 1985, in the world of urology, which is where I was trained, we had loop relied, which is a different peptide that, again, also a peptide like insulin,
Instead of having wide ranging metabolic effects, it had an endocrine effect.
It was designed to shut down the production of testosterone for prostate cancer patients
that needed to have their testosterone taken away. Interesting. But insulin's a peptide, because it's a series of amino acids that are put together.
“OK, so you said that the combination of amino acids forms a key.”
So what is the lock? The lock could be a cellular receptor. It could actually be regulating a certain pathway within the cell. OK, so let me repeat this back to you to make sure I understand it. So peptides are like a key, which you can make by configuring amino acids in a certain way.
And there's different locks in our body that these keys can go into. So if I take, we've got some peptides on the right, in front of us here. So a good way to think about it is this. If you've got a hammer, which is what a lot of small molecules are. You can do a lot with that, you can hammer in a nail.
But if you try to use that hammer when you're trying to put in a screw or you're trying
to put together a table that you got from IKEA, it may not always end the way that you want
to. And that's the problem that we have a lot of small molecules. It's not that they don't do what we want them to. They do a lot of other things while they're at that job.
“That can have significant negative side effects, which is why a lot of these small molecules”
actually don't make it all the way through the FDA approval process. Because we find something, it does what we want to do, but it has significant safety concerns down the line. Right? Now, what we see with peptides, for example, I've got, in my hand right now, a little
vial labeled BPC157, this is probably one of the most popular peptides that we're talking about right now, because BPC157 is a synthetic version of a naturally found peptide in the gut.
But what this actually does is it enhances blood vessel growth in areas of injury.
And it kind of makes sense, because if you think about it, our gut, our stomach is really just, this bag of acid that sits inside of our abdomen, and yet somehow you and I are here talking to each other and our bodies are eating themselves. Well, how does that work? Well, it's because we've developed a lot of really robust systems to encourage healing
of the gastric lining. And so the idea is, well, if this is one of the compounds that can help do that, it's been proven in multiple animal models. For example, they have completely transected the Achilles tendon in rats, and then they did transected, so they've cut across the Achilles tendon.
So not just a small injury that you are, I might experience in the gym where we pull it or strain it, but actually surgically cut the Achilles tendon, and then they administer it to rats, and they are healing spontaneously with administration of BPC157. If you have an Achilles tendon injury and you're a rat, BPC157 is one of the best things that you can ever have.
Now, that is not a one-to-one translation to what we might see in humans, but as we talked about earlier with our point on safety, when they are studying BPC157, we try to look for something called the LD1 or the LD50. How much can I give this to someone until 50% of the population that receives that dose doesn't do well or dies, okay?
That's called the LD50 dose. We have yet to figure out what the LD1 dose is for this, which is the amount that it would take to hurt even 1% of the population, because it is so incredibly well tolerated. So just giving you an example of this is a compound that can have profound healing effects at least in our animal models that we've seen so far, but so far we haven't seen any precipitous
“negative effects in human patients when taking this, okay?”
But we need more data. I am mind-blown, and I'm very, very excited. We've got all the several peptides here in front of us. I want to go through all of that and understand which ones do which things. Sure, there's a bigger question here, which is why now, why have the subject of peptide
suddenly exploded into society's consciousness? What's going on? What's the big picture? So this is really interesting, in 2013, there was actually a court case in the United States.
It was the sort of, it was called myriadgenetics case. This was the company that actually patented the Broker One and Broker Two genes. They discovered the genes that caused breast cancer, all right? This was mind-blowing, they identified the specific genes that would predispose patients to developing both breast, ovarian, and since we've learned also prostate cancer.
It was a fantastic discovery, but they patented it and they said, "We now own this illinital property." And then everyone else said, "Dinner, oh, that's the human body. You can't paten that." And the Supreme Court actually cited the argument, saying that if something is natural,
it's found within us, okay? I can't paten, you know, your muscle cells, right? Which is a wonderful thing, but the unintentioned, unintentional byproduct of that is all of a sudden, Barma had no incentive whatsoever to pursue really promising compounds that they could not monetize.
So that happens in 2013. At the same time, I believe it was around 2012, 2013, there was a terrible event that happened
In New England where there was a compounding pharmacy that was not doing the ...
And they ended up having a bunch of contaminated specimens that caused a fungal meningitis. Bunch of patients got really sick. It was a huge scandal. And all of a sudden, the FDA's stepped in and said, "Hey, historically, all right, states have been allowed to regulate compounding pharmacies themselves, but we need some federal
oversight here, because this is not acceptable. It's completely agree with that." And they introduced a new set of regulations on top of compounding pharmacies, basically saying, "What you can and cannot make." And what they eventually said is, "Well, the only, you can only make three things.
You can make things that are in the USP, United States, Pharmacopeia, okay? Things that have been, you know, well described, already published. Things are already in drugs that are already on the market. Or three things that are on a very specific list that we're going to give you, okay?" And in that list, they actually included a lot of these very promising compounds that
are stuck in drug development, you know, limbo. And you say compounding pharmacies, you've got a few times. What is a compounding pharmacy, just so I'm carrying the definition? Back in the 1800s or early 1900s, if you ever needed a medication, you'd go see the pharmacist who had a shop down the road and he would actually make your medication in front of you.
And he would do that custom for every single patient that came by. It was only since the advent of modern factories that we had, the modern pharmaceutical industry come about.
“But the truth is, is that, again, that's kind of paint by numbers.”
We're creating this one pill and, you know, it always seemed kind of crazy that the adult
dose is once standardized dose for all adults. Like, if you look at what your body composition is versus some of my patients, why is the dose in your blood pressure medicine the exact same? Like, that doesn't seem to be quite right. But it is what it is.
So when patients fall outside of that and they need custom medication, we still have those people who make custom formulations of medications. But instead of it being just your local pharmacist who's using a mortar and pestle and, you know, is creating something in his back office. These are now large sophisticated industrial operations that can make custom formulations
for patients. All right. I think the important context for people that don't understand how drug development occurs is that to get chemicals like the ones we have in front of us on the table through FDA approval, you've got to spend millions and millions and millions of dollars.
Tens, if not hundreds and millions of dollars. Sometimes hundreds and millions of dollars. Yeah.
An incredible amount of money.
And if you know you can't protect it once you spent a hundred million dollars, you have no incentive to just do charity work. Absolutely not. Okay.
“Because you have shareholders and you have to make payroll.”
And so because drug development is so expensive, there is no incentive for commercial pharmaceutical companies to pursue the development of these compounds. And then on the other side of that, what we have compounding pharmacies that, for them it makes sense. What if we could just make these compounds and then sell them directly to patients?
We make a small margin. We sell it. This makes sense for us. They could do that starting in about 2014 whenever that legislation finished, all right? What did it do?
Essentially what it did is it gave a assignment to each one of these compounds. It was either going to be category one, which is you can compound this. This is on our specific list of approved, compoundable drug ingredients. Number two was, hey, we see some negative safety signals here. You cannot make this.
Okay. So, something goes in category two. It's forbidden. And then we have category three, which is we just need more information. And all of these original compounds, these peptides that were so interested in, now we're
originally on that first list category one, all right? And so they were able to be compounded. We could prescribe them in patients. I prescribed them to patients, all right? From 2014 onward.
But then in 2023, in the FDA at that time, switched all of those peptides, 19 of them that were popular to category two, and then they were banned. Over night, we got notifications in our email inboxes from our compounding pharmacy partner saying, hey, we can. Can't make this anymore.
We're sorry. So, I've got two questions that. Yes. The first is, when you were prescribing these peptides to your patient, yes.
What are you saying incredible results?
Very much so. Very much.
“Again, you have to use the right key for the right lock, okay?”
But I think a really good example, all right? So there is a compound that is not technically a peptide. It is a small molecule, but it was lumped in with all of these and was the victim to the same process, something called mk677, also known as ibudamorin. So this is a small molecule, but when a patient takes it, it's overly available.
It binds to this receptor called growlin, and it actually stimulates the release of significant growth hormone. But what was really interesting is that it would actually stimulate hunger a profound amount. And all of a sudden, patients that were struggling with cacaxia, okay? So being very, very thin, very malnourished, maybe they're going through cancer treatment.
Relens the thing that makes us feel hungry. Absolutely. Yeah, so they were able to stimulate the hunger response, and patients were actually able to eat more to meet caloric goals. And so this was a medication that was fantastically effective at that.
Again, it had gone through some clinical trials, but was never taken all the ...
And so it was never going to be available from CVS or Walgreens, but you could get it
from a compounding pharmacy. And so that was one that made a big difference for us. We also had other peptides. So GHRP2 and GHRP6 for some of the ones we were using at that time. Those are growth hormone releasing peptides that stimulate the release of your body's natural
growth hormone, which can help with tissue repair, can also help with fat loss and with building muscle. We also had BPC-157, and we had derivatives like thymus and beta-4. These are also compounds that can help stimulate angiogenesis, so making new blood vessels and tissue repair.
So if we have a patient that's injured themselves, maybe we could help them get back at life faster. These were all things that were used very commonplace for many years, and truthfully, they weren't super popular at the time. We were just using them, and then they were banned overnight.
And they were working. And they were working.
“And we were not seeing adverse events, which is the most important thing.”
What's an adverse event? An adverse event is a patient has a terrible side effect. They call you, they have an allergic reaction to something, they call, they've got shortness of breath, and it's a direct result of the medication that you gave them. It was working.
It was working, and by all accounts, seemed to be incredibly safe. And then they banned it. And then they banned it. Why? That's a great question.
So officially, what happened is there is a meeting where they brought together the experts at the time, and they said there is insufficient data for us to say that these are safe, because again, they had not gone through the full FDA approval process. And so, as a result of lacking that data, we're going to say that they're too dangerous. Now there wasn't any evidence of any of that in the population.
These were widely used at the time. Potentially, we had commercial pharmaceutical companies saying, well, hey, this is people spending money on a compound, on something that isn't coming to us. So, hey, we love medicine, but maybe only when it's our medicine. And so there's concern that that was at play as well.
And so there is not a great paper trail, and there's not a great explanation why. And that's something that's been iterated by our current administration from RFK-Mself. You know, he himself has characterized that, moved on in 2023, is being illegal. With everything you know about the medical industry, do you think it is plausible that big farmer, 110%, didn't 111%, 110%.
These in the hands of regular people, because they can't pay to this, and it's powerful.
So ultimately, the way to think about it is this, farmer may not have a compound that directly competes for BBC-157, BBC-157. So this is the medication or the peptide that can aid with healing after an injury, okay? So it's not necessarily there's direct competition, but at the end of the day, your average patient going throughout their daily life only has so much money that they can spend on medicine.
And $10, $15, however much money that goes to this, doesn't go to a prescription drug from a commercial pharmaceutical company. And so there is real concern that potentially that was at play during that decision. And $10,000. Yeah.
Well, you know, it's interesting because, you know, I try to walk a very fine line between what I can prove versus what I suspect after being in this space for a long time. And, you know, ultimately, you know, I don't think it's accurate to characterize farmer
“a suitable company or really any other entity as being, you know, evil or bad, and the truth is,”
maybe a little bit more ominous.
The truth is is that they are these large machines that are designed to prioritize profit
over everything. Yeah. And that's everything. I think this is one of the really interesting observations I've had, the higher I've gone in my career, is that oftentimes, yeah, we had about the illuminati.
Like when I was growing up, I was like, oh, there's the illuminati. Yeah. And you think of it as these like shadow-hitted people that get together and decide evil things. But the further I've gone in business, the more I've realized that the illuminati or these evil forces are actually just machines that were designed to optimize for profit.
Correct. Correct. So, like corporations are illuminati. Yeah. And so, I don't actually think that there is necessarily, you know, a group of maniacal individuals,
you know, the legion of doom, you know, plotting to, like, take away your health.
“But at the same time, I think that there are these large organizations that really couldn't”
care less about your health. You know, they are prioritizing what's important for them. And a regular people just get caught up in the mix. And what's challenging is that, as a physician, you know, I took a Hippocratic oath. You know, I care about my patients.
And so, those are the people that are in front of me every single day that are seeking to improve their lives, to recover from injury. I have, you know, fertility patients that are just dying to start their family. And I have patients that are suffering from hormonal imbalances that have them full right in the years.
I treat erectile dysfunction and men that have been struggling for years after prostate cancer treatment. People that are broken and hurting, you want to be able to help them. And so, I feel that as a very strong personal calling that I have to be the advocate for
That patient, both in the room, whenever I'm treating them and taking care of...
But also when I'm talking to others, and, you know, speaking out about these issues, like, I want access to these medications because I care about the patients who benefit from them. So, they banned these peptides that we have here. Correct.
“And with that, here, two years after the ban, I believe the refugee is after that ban.”
Yeah. Finally, everybody's talking about peptides again. Yes. Why? What's going on?
So, I think what we're seeing is the forbidden fruit effect because this was banned and all of a sudden, oh, well, why they ban it? Well, they wouldn't abandon it if it weren't working, right? And we're also seeing the effect of TikTok and short-form content being spread very rapidly, very virally.
And that's been going on for two years now combined with new emphasis from administration leadership and the HHS and RFK.
What is the most incredible impact that you've seen peptides create in a patient?
Oh, my gosh. I have a best story for you. So, one of the most frustrating things about my practice is treating infertility in young men that have significant metabolic dysfunction.
“These are young men that have a low sperm count, right?”
So, they can't get pregnant because they just don't have the numbers to make it happen. And you're looking at them and they're morbidly obese, okay? They have high insulin resistance and their endocrine system has been damaged by that obesity. So they don't have low testosterone levels and their brain is not making enough of the signals to stimulate their testicles.
Now, we have medications that we can use to help stimulate that to make more of that signals stimulate the testicles, right? But really, what is eating at them, what is causing this is not that chemical imbalance. That's the symptom. It's not the problem, okay?
And treating symptoms doesn't really get you very far.
And so, I would have patients that I would take care of and we would never see a significant
improvement in their numbers because losing weight is really, really hard. You know, regardless of all of the education and resources I try to give them. But now we have peptides in the form of GOP 1 drugs, like some agluidide and trisepotide. And I just saw a patient last week who increased his sperm count 10 times over and is now in a normal range because he's lost 100 pounds.
He's using trisepotide, exercising and improving his diet. He has totally changed his life. And that started with a peptide, I struggle with a peptide. So we've got lots of peptides on the table in front of us. We will go to them individually, but just can you give me a high level view of the types
of areas in our health and life that these peptides can help with. So we've talked there about infertility as a downstream consequence of the weight loss and fixing the metabolic health, what are the parts of the body de peptides touch?
“The best way to think about it is like this.”
So peptides are almost like an app on your phone. So imagine before we had apps, like I'm old enough to remember trying to log on and do my banking online before we had apps and gosh it was so painful, right? Like there are ways to accomplish things, but they were very inconvenient and around about way.
And now all of a sudden we have these apps on our phone that can do just about anything acceptable during laundry, right? You know, there are some limits to it, but I mean, really the skies of the limit from an electronic standpoint. And really, that's what peptides are.
So the thing is is that we have peptides that can help you lose weight, like the GLP1 drugs. We have peptides that can improve skin quality, like GHKCU. We have peptides that can help heal your gut, like BPC-157, particularly effective in all sort of colitis, which is something that's being investigated with the FDA's planned upcoming meeting on it.
We also have peptides that can help with sleep and with recovering the gland in your brain that's responsible for melatonin and regulating your sleep weight cycles. So the question isn't, you know, what can peptides do? It's kind of, well, what can't they do? And if they can't do that, yet, can we develop a peptide that can accomplish that task?
And the answer is probably, and simultaneously, while there may be resistance from pharmaceutical
industry in these peptides, the ones that were most interested right now, they have signed multi-billion dollar deals with other pharmaceutical companies that are involved in peptide development, aided by AI, to try and fast-track their own peptide products. Interesting. And so we are going to see exponentially more of these products come down the pipeline from
pharmaceutical companies in the form of commercial products. And it's worth saying that there was some significant news today. Correct. What happened today? But also what's going on?
And just for anyone that doesn't know, it's April the 15th. Yes. So today, we got a, well, press release from the FDA, saying that in July, they are going to consider seven peptides for removing from category two, back to category one. We need to realize them, legalizing them, okay?
And some of the heavy hitters from that list include BPC-157, which is the one we talked about to do with, like, repairing industry, absolutely, okay. And then we have the brother to that, which is TV500, this vial over here.
This improves blood flow to an injured area.
You could think of this sending the soldiers as sending the cells that were required for rebuilding that tissue matrix that was damaged by a tear or a cut, all right. On top of that, we're also getting something called KPV may not have it here. But that is another peptide that has been linked to angiogenesis and tissue repair. We're also getting MOTC and, you know, some patients will call it exercise in a vial.
It improves your VO2 max in your exercise tolerance and by up regulating the energy pathway.
Basically, making more ATP, the energy that we all used to move, it makes more of that available.
All right. We're also going to get D-SIP, epithalon, and C-Max, which are all peptides that affect cognitive function. So improving thinking, like, C-Max is a great option for that. And then D-SIP and epithalon both have roles in regulating sleep and recovery.
Wow. Pretty wild. And I've got to say, how does, so, some of them are becoming legalized, but even the ones that aren't legal right now, a lot of people are taking them anyway. Great.
So my question is, how are people getting them? Listen, I don't want to promote a legal drugs here. This is not that I'm going to show. No, I just want to know what's going on.
“No, this is, well, this is important to talk about, right?”
We have to understand, like, what's going on in the marketplace.
The moment that these drugs were banned, or these medications were banned in 2023, it was kind of like the United States experimented at banning alcohol. I didn't go very well, right? All of a sudden, you know, the mob came around and we started, you know, seeing unregulated saloons and unregulated alcohol production, and it was contaminated with all the stuff
that you didn't want. So we're like, "People are traveling." Yeah, exactly. It's just, it's not a good idea, right? And so what happened is we banned these and the grey market stepped in.
And so these are companies that will sell peptides that have on the label for research use only. And the idea is that that takes them out of the FDA's jurisdiction because they're not selling it for people to inject into themselves, out of the FDA's hands. I'm just creating a vial of this magical juice that you can use for your rat, okay?
That's the idea. We all know that's not what's really happening. But because there isn't any quality control, it's kind of like getting gas stations sushi. Like, yeah, you can do it, but you don't really know if it's sushi, and it may not in very well for you.
Yeah. Not saying that there aren't some people who have gotten good results with a research use only peptides, but again, it's not standardized, which is why I think moving this
“back into the 503A compounding world is the best thing for everyone, which is the legal”
framework. Okay, so how does one take a peptide? That's a great question. So what's interesting is that, as we mentioned, your peptides are just made up of building blocks of amino acids.
And if you were to go make yourself a protein shake, what does that kind of look like from a lego standpoint? It just looks like this. It's a handful of lego's in your hand, right? Oh, sort of ground up individual pieces, right?
The thing is, is that your gut is designed to break up any sort of protein that you ingest orally into these little pieces. And so if you were to say, I don't know, drink some of this TB500, your body wouldn't be able to tell the difference between that and a piece of chicken because it would break it all apart.
Now, there are some very unique exceptions to that. There's a form of BPC-157 that actually is tolerated in the gut. But by and large, overwhelming majority of these have to be injected, either subcutaneously or into the muscle. And that's usually a preference.
Subcutaneous being my body, just underneath the skin. As I tell patients, just pinch an inch and inject under the skin. We do that for a lot of other medications as well. Is that what this is? Yeah, so this is a prescription mungioro pen.
So mungioro is the brand name for trisepatide. All right, trisepatide being the leading GLP1 product right now from Lily. So this produces more weight loss per milligrams than any other product that we've got out right now. Is this the mechanism in which people inject peptides, a little bit different from it?
This is an auto injector pen. And so what you do is you're able to actually ratchet the dose there on the right side. And then you pinch an inch and you're skin and then push it up against it and it'll auto deploy.
“And so there's nothing that you need to do.”
You don't have to learn how to drop medication and inject. Whenever you're administering peptides at home, especially for patients that have obtained them from research use only markets, they usually come in just little vials that need to be drawn up with a needle, okay? Now the benefit of that is that you can do custom dosing, all right.
But the drawback is that well, you have to know how to calculate that and put it together. This may be the most controversial thing we have on this table. And by pharma's estimate, it might be the most dangerous thing to their entire business model. Because this is trisepatide, the exact same thing that you had in that pen. But this is made by a high quality 503A compounding pharmacy.
And the reason why this is so controversial right now is because it offers an incredible
amount of flexibility because what you have in your hand there is very standardized and you administer it once a week because that's what's approved by inches.
This is what the ZMPech thing everyone's been talking about exactly, right?
But think of that as paint by numbers, okay?
“You or this section is this color, this section is that color, all right?”
Think of this as the thing you've got in your hand right now. Yeah, exactly, just a vial of trisepatide as being having infinite permutations and dosing ability. Because you can draw this up with a small syringe and do micro dosing. So instead of one large dose once a week, because what many patients will experience, is they'll have a return of their hunger by the end of the week.
And they end up losing ground. You can actually instead of doing a full dose once a week, you could do multiple many doses throughout the week with this formulation and with this presentation of medication, all right? But the challenge is that that is the benefit that allows this to be compounded by compounding pharmacies because they are able to provide something that is similar to
what's in your hand, all right? But it offers more flexibility that maybe the right choice for some patients.
So personalization of medicine, okay?
But the challenge is that if you spend however much money on this, you're not giving it to Lily. And so as a result, we have seen an unprecedented crackdown in the United States from the FDA and trying to shut down compounding pharmacies and prevent them from making these medications. Even though that ability to customize the fact that this is not an exact copy of what's in your hand right now, should protect it under current legislation.
But there is now enough pressure from the powers that be. And from lobbyists from both Lily and Nova Nordisk, that which are the two companies that make the GOP-1 medications that we're seeing Marty McRee, the FDA commissioner, has now tweeted more about cracking down on compounding GOP-1 medications than he's tweeted about diabetes or heart disease and his entire time in office.
And just what I understand, I want to play this back to you to make sure I understand. Sure. In my hand here, I have "Try Zepatide" and this is made by Lily, which is a corporate company
who are patented at it so they can make lots of money from it.
In my right hand, I have "Try Zepatide" with nice cinema and this is not patentable. So Lily has a patent on the "Try Zepatide" molecule in that formulation in your hand.
“And if anyone violates a patent, that can be pursued in US court, patent law, right?”
But what's interesting is that Lily and Nova Nordisk know that that's different in your right hand. It doesn't look the same, you can dose it differently. And they know that if they were going to fight that in court, it would cost a lot of money and take a lot of time.
So you know what's a lot easier? Calling your friend at the FDA and getting him to step on the competition so you don't have to. And then who's paying for that enforcement? It's not the lawyers that the farmer company is paying for, it's the taxpayer of paying
for the FDA through taxes. And you seem to employ this was actually better because you could take it in a more flexible dose, you could take a little bit a lot, you can take it when you want, whereas this is kind of once a week. Well, I mean, you know, what is better, right?
So I like this option for many of my patients because it's flexible, all right? So that is something that works for most patients, all right? But then again, this works great for patients, too, but what you want is you want an ecosystem where you have choice, so you can make the right choice for the right patient. For a lot of patients, they're going to do exceedingly well on this and there is so much
data to support that. But I also have a lot of patients who get really ill after they do a large dose of mungioro or of GLP1 men, and if we take that same dose and we just cut it into multiple doses within a week, we can avoid those side effects. So you've told me that these peptides we have on the table in front of us can improve
your skin, weight loss, muscle, energy, chronic illnesses, you talked about the cognitive upsides, and you talk about it very passionately. Yeah. So one should ask you, presumably you're taking some peptides. I am.
Yes. Which ones do you take? So I will tell you that, as of right now, the only peptide I am taking is a small dose of therizapatide, right? Which is the one we were just talking about.
Yeah. So back a couple of months ago, I was probably close to about 240 or so, and I was into powerlifting, you know, I still am. But you know, it's really great to be able to deadlift 500 pounds, but then stares become really hard when you're trying to walk up.
And I'm like, I don't know. I kind of like being able to not take a break after two or three flights of stares. And so I was like, okay, all right, longevity is a priority of mine. I'm going to slim down a little bit. I'm like, let me just try this for a little bit.
And what I found is that it is incredibly potent and at a very low dose, very, very tolerable. Why didn't you take some of the others? Honestly, because right now, there is not a legal framework for me to obtain them.
“And the truth is, is that I want to be an example for my patients.”
And that's why I'm out here advocating that we get access to these peptides and a legal safe way again, all right? And because it's the best thing for everyone. If they were legal, which ones might you consider?
Oh, man, I would tell you this, as some, like, I don't know how old you are, ...
I'm in my three. 33. God bless you.
“I will tell you, once you get over 35, man, that is brutal.”
All right.
I sleep on my neck in a wrong way, and I need like a freaking brace for like two weeks.
And so, as someone who spends a lot of time in the gym, you know, working out, like you start to accumulate all these little aches and pains. And so the idea of, for example, I have a very finicky right shoulder. If I try to do a really heavy bench and I haven't warmed up, I can tweak this and it takes me out of the fight for at least a month, okay?
And I have to do other things. Now, I would have killed at various points in time, or the past two years, to have had BPC and TB500 to hopefully speed that sort of healing. All right. Also, for example, I suffer from really bad a rosacea, it flares constantly.
What's that? So, just a redness of the face, okay, that, you know, it makes me look like I'm sunburned. And then I come in on the office on like a Tuesday, and then my staff's like, oh, my gosh, you go out in the yard and do some work this week.
I'm like, it's just my face. For example, that's something that the lot of people have reported benefits from GHKCU from. So, again, another compound, another peptide that could be beneficial for a patient like myself.
What about muscle mass and maintaining muscle? Yeah. So, that is an interesting misnomer, because that has been a common selling point. You'll see on social media, but as of right now, the only peptide that you might
“construe that way would be this guy right here in my hand, IGF1, LR3, okay?”
Now, IGF1, LR3 is basically the longer lasting version of IGF1, which is the downstream
effect of growth hormone. I'm sure you've heard of bodybuilders taking growth hormone to increase size and, you know, lose fat. And higher doses, it can't help contribute to muscle mass, right? But, truthfully, if you're trying to gain significant muscle mass, this is, this is not
the way to do it. And so, the right now, one of the things that peptides can't do for you is independently put on significant amounts of lean mass. You still have to get to the gym. You still have to get to the gym.
Believe it or not. And guess what? Well, back to the podcast. Yeah. But something that blows my mind is that I have so many patients that think that they can just
take testosterone and just put on muscle naturally, and it doesn't work that way.
You might get a tiny little bit, but you still have to have stimulus.
You still have to get in the gym. You still have to put the work in. And so, I tell patients that I am not a replacement for a personal trainer. I'm your doctor. You also need your personal trainer.
And most of you need a nutritionist, man. And so, I've lucky to work with some great people in the community who partner with me on that. But, you know, it's a full court press when you're trying to get people to, you know, live the highest quality life.
What about some of these metabolic disorders and diseases in terms of, like, insulin? Yeah. Resistance. People on the diet of the sea, the audience are very interested to learn about insulin. I see that a lot in the comments section and a lot of the data.
Yeah. So, how can if someone's struggling with their insulin levels or their glucose response, how does these peptides help? Honestly, the best peptides for that right now are the GOP one drugs. Okay, hands down, because what you're doing is you are slowing gastric emptying.
And so, you have a slower absorption of that bolsa foody of it. So, your glucose doesn't spike. And so, as a result, that increases insulin sensitivity significantly.
“Now, again, you have to be careful about what peptide you're using for what?”
A lot of these peptides that boost growth hormone and boost, let's say, IGF1, those can actually increase serum glucose. And that may not be what you want if you are someone that is trying to work on your insulin sensitivity. And to any of these peptides come as like creams or as pills or anything like that.
If you look online, you can probably find a version of everything. But if we're talking about actual legitimate formulations, the best example of a topical cream is going to be GHKCU. And this is interesting, because this is a copper tripe peptide that has been found to decrease in expression and concentration as we age.
But when it is applied topically, it's highly, effectively, so putting on a cream on your face. All right. It's been found to be extremely beneficial in regenerating the quality of skin. So, complexion, all right, increasing the amount of collagen and elastin, the things that
we need to keep our faces taught in youthful. The things that people will pay, lots of money to go get laser to get improvements. Not that it's a road of replacement for that. But that's a topical form that believe it or not, you could go out and buy today because topical GHKCU is regulated very differently than the injectable form.
Is it expensive? Usually. You know, growing up, I thought all these sort of anti-aging creams were bullshit. But you were telling me that this has actually been associated with improving signs of aging. I will tell you this, when I was going through college and medical school, I was the
biggest skeptic. I did not believe any of the health or wellness claims that we saw coming out at the time. But again, you know, that was at a time where we were getting bombarded with stuff about the acnes diet and this side of the other. But then all of a sudden, you start having patients come back to you and they're testifying
as the benefits they've seen from these things. You start to actually look at the biochemistry behind them. You're like, there's a lot of science backing this up.
This isn't just mumbo jumbo.
And so, believe it or not, yeah, there are creams that can slow the process of aging, at least
from a visual standpoint, when it comes to your skin. I have yet to figure out anything that makes me as energetic as I was in my early twenties, but you know, I'm working on it. But on that point of energy and cognition, if I wanted to become a better podcaster, yeah, and you know, I sit here sometimes, sometimes you do tune a day, which means I might
“see if I was once, I think a couple of times you've done three in a day.”
That's brutal. Just 12 hours of recording. Yeah. But what would you recommend if I was trying to improve my cognitive performance? So again, as a physician, I like keeping my license.
I would say necessarily recommend, but I would say if we're looking at how these medications had been used and potentially one that may be legal again, coming this July, depending on what the FDA says, intranaisal CMAX. And this was one that was originally studied actually in Russia many years ago.
And what they found is that this seven amino acid peptide, when it was administered after
a TBI, so a traumatic brain injury, our acute injury, that patients tended to bounce back faster. Also, they saw evidence of improving outcomes after stroke. And it also seems to upregulate the same sort of factors that help with cognition and with connecting sentences and bits of data in your brain.
And so it's also one of the interesting enough, one of the ones that is available intranaisely because it goes through the mucus membranes and gets right where you need it. And so that's going to be a really, really fascinating compound to see back on the market. And then we can actually get more data regarding efficacy and across a wide population. It's so interesting and you sniff back through your nose.
Like you would for any nasal de-conjustant, right? And if you have allergies or something like that, also for someone like yourself, you travel a lot. You're going in between different time zones, you're balancing multiple obligations at different odd times of the day.
I shuttered to think what your circadian rhythm looks like my friend. But that is what we have some of these other compounds that are going to be available for. So if we look at a decip, that has been shown to be helpful with regulating your circadian rhythm. That is one of the ones that's going to be approved hopefully here soon, again, in July.
And then on top of that, you've got things like Selenk, which is another one that can help calm you as you're going to sleep about an hour ahead of time. And again, help those deep delta way brain waves that are so restorative whenever you actually are resting. How will we be able to buy these when and if they are legalised?
So from 503A compounders here in the United States with a prescription from a physician. So you still need a prescription. Still need a prescription. Correct. It's going to be quite crazy world when everybody is going to be injecting themselves
every day. I mean, we're already getting to that point now with a Zempack. Yeah. I've got loads of people in my friendship group that are. Yeah.
And they're doing great. Yeah. They're doing great.
“And that's what I like about the advent of these GLP ones is they're removing the”
stigma of an needle. And I look at some of my friends who have been on it. I can't recognize them. They look awesome. Are you concerned with any of them?
You know, I've got a couple of friends in my circle where I'm a little bit concerned. I don't even know if I should be concerned. But it's just when you see someone you know change so dramatically, so quickly. Yeah. I think there's something in us, which something prehistoric in us, which goes, oh, my
got this a problem. Yeah. I'm concerned about is the rapid weight loss with GLP one medications.
Because the problem is that when you go into such a radical caloric deficit, your body
goes into metabolism, which is breaking down tissue. And you want to break down fat, right? But your body isn't that judicious. It's going to break down muscle. And muscle is the most metabolically important tissue that any of us have.
And so if you really want to optimize your insulin sensitivity, we need to maintain your muscle. And right now, really, the only compounds that we have that are really good at preserving
“muscle with resistance training is testosterone, right?”
But that isn't going to be a good option for our male patients that want to get pregnant because testosterone turns off fertility in men, all right? It's also not a great idea for our female patients, all right, depending on their age. testosterone, TRT, is a thing an older, you know, a women, menopausal won't go into that. But truthfully, testosterone is not the right answer for everybody.
And so what we are going to see come down the pipe very soon is kind of the older brother of peptides, the more complex form biologics called monoclonal antibodies that are specifically designed to inhibit the enzymes that break down muscle. So these are specifically called miastatin inhibitors. There are three that are coming down the pipeline.
There is one called Bamagramab, which is owned by Lily. That is going to bind to the peanut butter to miastatin's jelly, which is called active in. And then you have hereto's map and Trovogumab, which are two other compounds owned by different pharmaceutical companies that are all designed to maintain muscle even in a significant
caloric deficit. This is getting interesting now. Yeah, yeah. So you'll tell me I'm going to be able to inject myself with his impact to lose the
Fire and then inject myself with something else to keep the muscle.
It's wild, it's wild and I'll tell you, you know, one of the hardest things that I'm sure you've heard being on the receiving end of this is just the complexity of it. And there are so many levers that are moving at once and trying to get your head around it and balance it all. It requires nuance and requires thoughtful discussion with your doctor who is well-educated
on them. And that's one of the challenges is that there isn't broad, great education on these products right now in the medical space. And so that's something that I'm very passionate about is improving education across my colleagues so that they're not afraid of these anymore.
What you say to people about listening to this now, you're fucking out, why don't you just like eat your greens and go to the gym and just be more human and you'll be fine. I love that.
“I love eating your greens and going to the gym, okay?”
But the unfortunate reality is that here in the United States, it depends on what database you look at.
But obesity rates are estimated to be 40 to 70 percent, okay, whether you're depending
on what BMI cut off you're using, okay, BMI is not perfect, but it is what it is. And so the thing is is that, well, eating greens and going to the gym are not working for us as a society. And we could talk about how we don't have real food anymore, we have food deserts, but we have this numerically dense but nutritionally poor food, I'll tell you the most disturbing
thing I see as a surgeon is I'll see a patient come in the door and they're morbidly obese, they're a large individual, but I have to do surgery on them, but the connective tissue, the stuff that's made of a protein that makes them them that literally holds them together is paper, paper, thin because they're eating an incredible amount of calories they're gaining fat, but they don't have any protein in their diet and that's not something
that's rare. I see that on a daily basis.
“And so the truth is is that we're talking about this from the angle of biohackers and”
people that are super engaged in our health, but the truth is is that this is going
to be able to be used to help our population at large and, you know, ultimately hopefully avoid a lot of the terrible disease states that we're seeing overwhelmed the medical system right now. How big is the peptide industry right now? If we look at the top four large language models companies, all right, so all the heavy
hitters and how much revenue they're generating, it's estimated between 50, 8 billion up to maybe 62 billion. Yet the income in the revenue from just some agluedide and terizepatide alone is going to be over 55 billion this year. And so what we have is peptides without even considering all of this happening in the research
space, well, or the research use only space, without even considering the peptides that we'll see come from compounding pharmacies, we're already approaching parity with what we're seeing in AI as far as revenue goes. That is the demand that we're seeing in the marketplace. Iron multiple companies that have multiple sales teams, and one of the things as a founder
of a company that's often confusing is you find it hard to figure out where sales are. So about 10 years ago, I started using pipe drive in my former company, and it's also the reason why I switched over all of my commercial teams in my current media company called Steven.com to use pipe drive as well, not only do they want to this show, but they've been an incredibly effective way of scaling our sales engine over the years.
Pipedrive is an easy to use intelligence CRM, and at its very core, it makes your sales process visible through one dashboard, a visual pipeline showing every deal, what stage it's in, what needs to happen next, and it's all in real time with no delay. It doesn't magically close the deal for you, of course, but it does replace complexity with clarity.
“If you want to join over 100,000 companies, already using pipe drive, you can use my link”
for a 30 day free trial with no credit card payment needed, head to pipedrive.com/ceo to get started. That's pipedrive.com/ceo. When your patients come and see you, Dr. Alex, what are they asking you most frequently? As it relates to peptides, what are like the top three questions you get asked the most?
The first thing I get asked is what peptides do I need, and then I just look at them
and I'm like, what's your problem? What's bothering you? What did they say? Then they'll come in and they'll start talking about energy, sex drive, and that sort of things, and I'm like, okay, if that's it, we need to take it to software levels, so instead
of looking for peptides, you don't walk into a Home Depot or a Lose, but what tools do I need? What are you trying to do, right? Then you start to talk to someone there, like, well, I'm trying to build this. Okay, you need a saw, you need a screwdriver, you need this, and some of those tools might
be peptides, but some of them may be hormones, you know, some of it may be diet and exercise. And so peptides are just another type of tool that we can use. We all want a shortcut, though, Dr.'s. We all want a quick way to be better, yeah, and ideally not to have to do hard work. That's like what most, you know, the average person is looking for, and we hear about
these peptides, we hear other people are taking them, we hear the infantastic results and skin, hair, muscle, yeah, and we go, I can, what about me? You know what I tell patients, I'm like, me too, man, you know, but my alarm still went off at 445 this morning, so I could hit the gym before I made it to clinic because there
Are no real shortcuts, there are things that can help, right, GLP ones of the...
of that, right? Okay, this is the closest thing that you'll shortcut, you're going to get.
“But the truth is, is that this isn't going to go to the gym for you, and it's not going”
to lift the weight so you can maintain that muscle mass so you get the best post a result and try to hold on to your muscle while losing the fat. One thing I've learned from doing this podcast, that is really grown with me every time. People ask me what the time like, what's the one thing you've learned from the podcast?
One of the answers that I've never given that I'm going to give now, is that I've learned
that there's no such thing in life as a free lunch. No, absolutely not. And what I mean by that is like, everything is a trade-off. And if you ever here on a podcast or in any medium, that something has tremendous upsides, the first question one should ask is what's the trade, and like just with everything, you
can apply this to having a relationship with a partner, huge upsides, also trade-off, trade-off. Yeah, kids, like, I love my children, I have slept in years, you know, like this is just this is life, right? They're trade-offs, and even with great tools, they're trade-offs. So what are the trade-offs of these peptides?
The biggest trade-off right now is you don't know if you're even getting what you want, right? Because you're ordering this from some research, you know, compound only, you don't know whether or not they've gotten out all the appropriate endotoxins, you don't know if you're getting what you actually paid for.
So that's the biggest thing. And also, the thing is, is that, well, all right, these have a good example of, okay, preventing or helping heal injury. But the thing is that, well, we've got other compounds over here, you know, let's go ahead and, like, let's just pull Tesla Moreland as an example.
So this is actually interesting, it's a peptide that is commercially available right now.
“I could write the script for you, you could go pick it up from CVS or Walgreens, okay?”
This is available as a commercial product, and people really like it because it'll help boost growth hormone, and it happens to be uniquely good at stripping abdominal fat, okay, or visceral fat. But the thing is, is that, you know, the moment you start taking it for a brief period of time, well, if you haven't changed anything about your lifestyle, you're going to write
back to where you were. It's good at stripping abdominal fat, belly fat, you belly fat. This is what it's known for. Yeah. It's good at stripping belly fat, stripping belly fat specifically.
So bodybuilders actually really like it for that particular application. I had no idea that there was a peptide for stripping belly fat. There you go, man. Yep. And, like, for example here, we've got another one.
So this is melanotan2, right? So this is a melanocorten receptor agonist. So melanocortens this what makes you tan, right? So you could administer this, all right? And it will actually end up giving you a deep tan in response to just a little bit of
UV sun exposure, all right? Now, I know, right? Listen, I've embraced my pastie whiteness, so I'm not, you know, not necessarily my bag, but it's real. Now, again, there are some safety concerns with this because, again, could that potentially
stimulate a melanoma or something like that, but this is something, again, as a peptide
“that gives a wildly different result than Tesla Moreland, right?”
Because it's a different aspect. It does. Yeah. It does. It will also give you some of the most impressive erections you've ever had in your
life, so be warned. Wait, it's literally timing you're into a black guy. (laughing) Finally. Yeah, right?
And it's wild. So there's actually, and there's even a derivative, a melanotan2, called PT141, a Bremelanotide, that is a commercial product right now that you can write as a prescription, okay? But that doesn't have the tanning benefit, but has the sexual benefits.
Oh, wow. Yeah. Keep that as a TV. Yeah. We have to talk about this.
Another really interesting thing, the phenomenon that we've seen, right, is that now we've got all of these companies that are making these research-use-only compounds, right? It used to be that you would have a compound that's in drug development, and you're seeing all the advertisements for it, you know, maybe if you follow these sorts of things, like I do, 'cause I'm a nerd, right?
You get excited about it, but you don't get access to it, right? Well, believe it or not, the next blockbuster drug that Lily is going to come out with probably in the next couple of months, is this guy called Retitroutide, all right?
And Retitroutide is fantastic, and that is the first three receptor agonist GLP1 drug.
So the GLP1 drugs, okay? Whenever you're talking about semigluedide and trisepotide, they have slightly different profiles. This is the exempted category, correct, right? So GLP1 is the primary receptor that they work on, and what that will do is it slows gastric emptying, and it limits caloric intake, all right?
But then, in trisepotide, not semigluedide, but trisepotide is a dual agonist, so it has effect on GIP, which is a different receptor. Well, Retitroutide adds in Lukagon receptor activation, and so believe it or not, your liver actually acts like a repository of energy, where it stores glycogen and fat that your body can use as energy.
But that's a problem, right? If you get too much fat there, if you have a caloric excess, then you could end up having what's called Nash Cerosis, but non-alcoholic state of hepatitis, basically inflammation of your liver due to accumulating too much fat. It's a problem.
But by stimulating the Glucogon receptor, while simultaneously hitting GLP1 and GIP, what we
found is not only do patients lose an incredible amount of weight, but they also get the
best improvements we've ever seen in their liver health, we've ever seen.
People have been buying that from research use only websites and using it for...
years now.
And bodybuilders have already made this the standard in their protocol when it comes to cutting
for a shell. And it is wildly effective, and we're now seeing the population using a drug at scale that hasn't even made it through commercialization yet. Oh, you survived. You're using it.
No. I have not.
“I can honestly say I have not used Retta, but I find it fast.”
It's just fascinating, though. It's absolutely wild. Yeah. Talk about power to the people, right? What about these others then?
What else have we got here that you think is interesting? So, we've got these two here that I think are really interesting, so CJC1295 and Epomorollum. So the whole idea is that, you know, can we stimulate growth hormone? And there's an interesting story behind that, you know, actually growth hormone itself was very, very popular for many, many years as an anti-aging compound.
But then we changed some laws here in the 1990, okay? That made it a little dicey to prescribe growth hormone. And also, you know, it's kind of a blunt instrument. We wanted something to stimulate more natural growth hormone release. So we have this entire class of medications called secreticogs that help stimulate natural
growth hormone release. And these are two of the most potent ones that are often combined together. And when we say growth hormone, yes. What does growth hormone do? So growth hormone acts like a signal that tells your liver to make more of another compound
we talked about, IGF1.
“What growth hormone does is growth hormone actually stimulates the building muscle, okay?”
And it also strips fat, okay? And it's also been found to help with tissue healing, okay? And so there's a significant benefit in that regard. And so people want to boost their growth hormone, improves quality of skin, improves quality of hair, and nails, and that sort of thing.
And so these two compounds together are particularly potent. CJC1295, being a growth hormone releasing a hormone derivative. And then we have epimoralin, which is a growing receptor agonist. So again, release, improving the release of growth hormone through two different synergistic mechanisms.
And so that one is really, really interesting, or these two together. And then on top of that, so this one, somatotropin, another word for growth hormone, okay? So this is growth hormone, okay? Just a different word for it. So what would happen?
Let's just take this one. Tropen. Yeah. Somatotropin. Yeah.
If I bought this for research purposes, and my research purposes only, and I started injecting some of this into me. Yes. What would change? What would you do, and when you do it?
So the idea is that if you injected that at night, it would improve your quality of sleep, okay? You would get a boost in your quality of your hair, your skin, nails, theoretically, it would be easier for you to recover from injuries, hopefully put on a little bit more muscle a little bit easier, maybe lose a little bit of fat.
So why don't I take it? Well, because if you take a little bit too much, you can actually get insulin resistance
“because your glucose levels will go too high for too long, all right?”
You'd use too much for too long. You will actually get acromedogly, so that's development of your bones continue to grow, but not along only in certain junctures. And so there's a very specific look that bodybuilders who abuse growth hormone and high amounts will get to them, all right?
Which isn't your reversible change to the facial bone structure. You can also theoretically, if you had a cancer, maybe it could make it worse, all right?
We've never shown it that it causes new cancers, but that could be a concern.
And on top of that, it could give you insulin resistance because, you know, you're again. Yeah, exactly, right? And if you take too much, it could potentially make your hands numb in the morning because you get effusions into the joint space. And so bodybuilders will talk about lifting a dumbbell and having to drop it because
their hand goes numb temporarily if they're taking too much growth hormone too soon. And what else have we got here? Oh, my gosh. So epithalon. So this is the medication that is theoretically going to be available to us in July, okay?
And so the hope is that, you know, this is going to expand cell life. So epithalon, the purpose of it is it works to enhance telomeris. So at the end of yourselves, imagine it this way. You're trying to copy the genome, but the little copier that copies it, it takes up space enough itself.
So it's kind of like it cuts off the last couple of letters every single time. This is when you're aging when you're aging, you're creating new cells, right? cells divide through this process called mitosis where they split, all right? Well, if you've got to make an exact copy, we've got to read through all these lines of code,
but because of the way that we're built, we always end up cutting off the last little bit of code.
Now, how we age, which is how we age. It is one of the things that contributes to aging, all right? Now, that is considered to be, quote unquote, junk information. It's at the very end called the telomere, all right? But we know that shorter telomere is associated with aging, potentially worse health outcomes.
And there is an enzyme that can help heal or repair the telomere called telomerase. But that one helps encourage that. And so some people are looking at that as being one of the fountain of youth compounds. I'm very skeptical as far as that goes. But it does show some benefits when it comes to healing parts of your brain that are
associated with regulating your circadian rhythm.
The average person listening now, they've had a lot of stuff about a lot of t...
How do they know if they should pursue getting and taking peptides?
Like, how do they know? What are they looking for?
“So, what I will say is that think of peptides as falling into three categories, all right?”
If it category one, which are a peptides that you can prescribe right now, legal from a commercial pharmacy, that includes the GLP ones, PT-141, a Brimmelana Tide, I mentioned to you earlier, oxytocin is another one. We have these different compounds that are available. And then we have what we call category two.
Well, if you don't have anything in right now, but that will consist of the seven peptides that are hopefully going to be approved in July, whenever they get moved from category two, cannot compound to category one, can compound, all right?
And then everything else is kind of in this category three, where it's only available for research
you've sold me. And so my recommendation for patients is, don't go out and buy research you've sold me compounds, all right? You don't know what you're getting and you don't know if you're dosing it right, you don't know if it's contaminated. So really what the public should be doing is educating themselves on this, and then going and talking to their doctors about what problems they have, and then potentially when those options
become available, a peptide might be part of the answer for their problem. Okay, so speak to Dr. Yeah, consult with your doctor and make it a conversation with whoever your medical professional is about your symptoms and what might be useful and what the range the toolbox, the options are, correct, to attack those symptoms. Yes, absolutely, talk, collaborate with your doctor, your doctor should be your partner in you getting as healthy as humanly possible.
We talked about and tries appetite, as empathically tied. One of the questions that's front to mind for everybody, whether they're taking them or watching others take them, is what happens when you stop? We've looked at that, you actually regain the weight.
“And so, because the truth is, is that you have introduced something into your life”
that has moved the needle in one direction. But if you don't change anything else, well, you take that back out. Well, you're going to go back to where you were. And so, if you're going to maintain that weight loss, you have to make lifestyle changes associated with that. And what we found is that people do regain, if they do make lifestyle changes, they do regain some of the weight, but not necessarily all of the weight. And there's also data showing that you could
potentially stay on that medication, but at a much lower dose, and then maintain your weight. Okay. So, there are options to minimize your medication burden long term. And of all the things we've talked about today, if you have to just pick one thing that excites you the most, that's either coming down the pipe or here we're ready. Yeah, what is the thing and most excited about? I see your eyes wondering. Hands down, it's that one over there,
a reticurutide. Because the changes in body composition that we have seen, both in clinical trials. Okay. And in anecdotal reports from users who have obtained on their own are wild. We're talking losing one to you to 25% of total body weight within a relatively short period of time.
“And I think that this is going to be basically the Ferrari of GLP1 medications when it comes out.”
It's not for everybody, right? It's going to go faster than everything else, but it's going to change the game. I think this is going to be a trillion dollar drug when it comes out. And no one's going to ruin the patent, so everybody will be able to access it. Is that right? No, no, that is going to belong solely to Lily. And so you are going to see and they are going to enforce it, you know, as aggressively as they've ever enforced anything. But you will see
profound results in patients. People are referring to peptides as Silicon Valley's miracle drug. And I wonder why that was. Why it's been associated with Silicon Valley? Have you heard that at all? I have. And I'll tell you, I've seen some peptide stacks from Silicon Valley, you know, founders and, you know, individuals that blow my mind, I'm like, oh, man, even I think that's a lot. Why would people in Silicon Valley? Why would found us being interested in peptides?
Well, I think it's because we all want to live our, you know, best version of our own lives, right? We want to perform at the highest level. And so, you know, people will do whatever they can. They'll drink caffeine, you know, they'll, you know, pop a zinn in their mouth, you know, and they'll try to tweak whatever variable they possibly can to get the best possible performance. And the thing is, is that anabolic steroids come with, you know, significant side effects,
and that's not everybody's cup of tea, right? And the health consequences from high-dose androgens dwarf anything that you might experience with peptides. And so, peptides offer a lot of flexibility in pulling many different lovers that are interesting to, like, your regular average, you know, person. And honestly, you know, it requires a little bit of DIY right now because of the nature of these peptides. And I think you combine that with the kind of rogue, you know, a founder
spirit that is common in Silicon Valley. And I think it's a perfect fit.
I lost you a second ago. What are the three questions that people come to? And I'll
ask you as, as a doctor, the first one as a related to peptides was, which peptides should be taken? Yeah. Well, there are any other questions we haven't covered off that are common place in your practice. The second one is, you know, can you prescribe me? And then I have to explain to them
The regulatory environment, you know, surrounding peptides that, you know, as...
only peptides that I can prescribe, or the ones you can get from CVS for Walgreens, which is going to be your GLP-1 medications in a handful of others that usually aren't applying to the young men that I see in my practice. I've had so many founders speak to me and say, why didn't this particular ad that I ran on this platform work for me? Maybe the copy wasn't good, the creative wasn't strong,
but usually the problem is they're not having the right conversation because that ad never reached
the right person. And if you're in B2B marketing, that is much of the game. And this is where LinkedIn ads solve that problem for you. Their targeting is ridiculously specific. You can target by job title, seniority, company size, industry, and even someone's skill set. And then network includes over a billion professionals, about 130 million of them are decision makers. So when you use LinkedIn ads, you're putting your brand in front of the right people. And LinkedIn ads also
drive the highest speed to be returned on ad spend across all ad networks and my experience.
“If you want to give them a try, head over to LinkedIn dot com slash diary. And when you spend”
$250 on your first LinkedIn ads campaign, you'll get an extra $250 credit for me for the next one. That's LinkedIn dot com slash diary. Terms and conditions apply. We have finally caved in. So many of you have asked us if we could bundle the conversation cards with the 1% diary. For those of you that don't know, every single time a guest sits here with me in the chair, they leave a question in the diary of a CEO. And then I ask that question to the next guest.
We don't release those questions in any environment other than on these incredible
conversation cards. These have become a fantastic tool for people in relationships, people in teams, in big corporations, and also family members to connect with each other. With that, we also have the 1% diary, which is this incredible tool to change habits in your life. So many of you have asked if it was possible to buy both at the same time, especially people in big companies. So what we've done is we've bundled them together and you can buy both at the same
“time. And if you want to drive connection and instill habit change in your company,”
head to the diary dot com to inquire and our team will be in touch. Is there a super peptide for anti-aging and skin and some of those issues? Oh, for skin, GHKQ. Yeah. So this is probably the most well-known peptide for use for skin complexion. And I mean, really, it may have some small benefits when it comes to hair. All right, but those reports are a little bit more spotty.
Is that clear? Yeah. And then outside of the world of peptides for a second. Yeah, I've got these three vials in my hand. I'm so scared. All right. Do you know what there's on? Yeah. This is unfortunately our future for not careful explain. So, you know, what we've got here is we have three different canisters containing water that has a little bit of coloring in it. And what you can see is that all the way back in 1973, this is pretty opaque. All right. Like,
“you know, this is not what you would. You can't see through it. And then 2026 has a little bit of color”
to it. And then we've got over here, 2045, which is totally clear. This unfortunately is actually representing the fertility trajectory for young men. Because what we're seeing is that back in 1973, total modal sperm count. So how many healthy swimming sperm do we have in each ejaculation is exponentially higher and more dense than what we're seeing today? And so what we're seeing is a progressive decline in male fertility over time. And that's been demonstrated in multiple studies.
We've debated this at multiple meetings. People tried to argue that it's a measuring difference. But as we give it more time and as we give it more scrutiny, this is real. We are experiencing a significant decline in sperm quality and motility and concentration. Why? So the leading culprits are going to be, yes, microplastics and environmental toxins. Okay, things that are put in our environment that we have been exposed to that we can't help. But again, the biggest
modifyable risk factor is insulin resistance and metabolic disease. It needs to be a city. And so a downstream effect that we may see from peptides like we discussed before is we may be able to help reverse this for the first time in history by trying to prevent the development of metabolic disease using some of the peptides we talked about. Exactly. I gave you the example of a patient that I saw on clinic this past week that increased a sperm count 10 times over. Imagine if we had given
that to him before he even got that obese when he just started to get a little bit overweight
and at a lower dose. Well, he may have never ended up in my office, right, because his primary
care doctor would have identified that treated it and he never would have needed the specialist. It's crazy. It's wild. So ultimately, you know, if you look at what are the ills that are affecting health care in, you know, any first world nation, the number one offender is metabolic
Disease and metabolic dysfunction.
by, you know, RFK whenever he was talking about root cause of disease. Well, yes, we have many,
“many diseases and many, many infections that don't stem necessarily from insulin resistance.”
But if we look at cardiac disease, if we look at issues with lack of perfusion, my, my specialty, erectile dysfunction, right? We look at cancer. All of this is related back to obesity and metabolic dysfunction. And so if we can eliminate that, you know, as a society,
or we can minimize it to as little as possible. Well, I mean, man, maybe I'd finally work
myself out of a job. You'll specialties erectile dysfunction. Yeah. So my specialty is this branch off of geology that we broadly call men's health, okay? And so what that incorporates for us is going to be low testosterone, advanced hormone management. I take that a little bit further than most people, that's totally cool. And then also erectile dysfunction, pyronies disease, which is damage to the penis that causes curvature. And then male fertility
on top of that. And I do a little other thing, treating leakage after prostate cancer treatment. And that's basically it. I treat like five things, maybe. And, you know, that's it. So I'm
very, very specialized because I was the kid that, you know, like to take my sandwiches apart
and eat it one at a time. I was very precise. And I figured, you know, you can do a lot of things in this world and be okay at them, or you can pick like, I don't know, four or five and get pretty good at them. So that seemed to work for me. I was looking at a photo of you five years ago and you were very different. Yeah. You've changed a lot. So I will tell you this. Medical training in the United States has gotten better, but it is grueling. It's absolutely grueling.
For five years, I worked anywhere from 80 to 100 hours a week in a hospital, no eating very little sleep, did not care for yourself at all. And again, we can argue whether or
“not that's necessary all day long. But the truth is, is that it really beat me down. It absolutely took”
me apart physically and psychologically. In part, it's designed to do that because the idea is that as a surgeon, you have to be able to perform when all the lights are on, when everything is against you, you have to be the one holding together in the operating room and command that ship, save that patient. And I remember being totally devastated towards the end of training. And I did a very challenging surgery on a very neat patient. Gentlemen was about to go into renal failure, did not have a lot of
kidney left. And he had a very challenging kidney tumor. That was in a very treacherous location. It was in a location where he should have lost that kidney by all measure. If we were going to take out that cancer. And he was at a county hospital, he had no insurance, you know, and we swung for the fences and did a very very challenging operation on him. And against our best efforts for having everybody there, he ended up having a bleed postoperatively that night. And I remember getting the call.
I was on call and that he is blood pressure dropped and that he did not look well. And I knew exactly what it was because again, this was a very treacherous surgery. And I went in the middle of the night with my attending who was a different attending than the one I did the initial surgery with. And I remember just opening him up and just being covered in blood that we were taking out of the abdominal field that we were evacuating, eventually identifying the area of the bleed. And there was
no way that it could have been avoided. I remember my attending yelling at me and we ultimately
had to take that guy's kidney. And I remember walking out of there, just being totally shattered,
“covered in blood, crying in a hallway by myself, wondering if, you know, like, what was the point?”
Like, is there going to be it? Is there a tomorrow after this? Like, I spent all this time this training, like, am I good enough? Am I going to be able to make this? And, you know, I wasn't well put together, wasn't healthy. And ended up spending a lot of time with that patient, literally held his hand throughout the rest of his hospital stay. And he ended up recovering, and against all odds. But, you know, afterwards, I took a strong interest in not only taking care
of my patients, but also practicing what I preach, taking care of myself and prioritizing my own health. I got evaluated. I was diagnosed with low testosterone myself. Turns out not eating or sleeping for five years to do a number on you, you know, through the roof, 24/7. I cannot even imagine what, you know, there's a part in the brain called the hippocampus that they, when they do MRIs on soldiers that come back from war, that'll be degenerated in them. I wonder if we did that in
Surgical trainees, what that would look like.
to take care of myself, and make that a priority. And to be, you know, simultaneously, the best doctor,
and, you know, the best father, and, you know, husband, I could be. Not perfect, made a lot of mistakes along the way. But, you know, what you're seeing from five years ago is where I was, you know, I've been in training for seven years, so it took a while to kind of recover from that. But what you're seeing is, you know, what focusing on health and wellness can potentially look like. The emotion in your is palpable when you talk about this, and I'm wondering where that comes from.
What is it? Because you're looking off into the distance at something. And I didn't know what you're looking at. Yeah. I mean, I, when I'm caring for my patients, and I see a young man that is struggling with his fertility,
and he wants to be a father, I was that guy. Me and my wife couldn't get pregnant when we first tried.
“We ended up having to do in vitro fertilization at IVF. I remember feeling like I wasn't a man,”
because I was sitting in that room holding her hand and not having an answer as to why things weren't working. When I see my patients who come in that are, you know, struggling because their hormones are out of whack, and no matter how they try to take care of themselves, something just isn't clicking, I've been that guy. And then when I see my other patients, you know, that are further on in life, and struggling with things like, you know, prostate cancer, or, right now, it's been for the case
maybe I see like, I see my my my father, my uncle, my grandfather, I like these, but and they are someone's father, grandfather, and uncle, like these are our brothers, and this is who I have been called to care for, and I care for my patients deeply, and it's because I care for my patients, and like this is a calling for me that I care about stuff like this, because I want my patients to have every tool physically possible to live their best quality of life, so that they
“can be whole, and they can be happy, and so that they can be the best version of themselves”
for their loved ones. Well, thank you for caring, because it matters, and a lot of this stuff is quite opaque and confusing to an average person like me, but it's clear that I'm so glad that we have people like there in the world, like you, that are deemystifying all of this for us, and explaining it in single terms, but also championing it, because, you know, one of the things I've learned from you in this podcast is solutions to problems, that a lot of people are suffering
way, they're watching right in front of us, but they need voices and educators like yourself out there leading the charge so that these types of things are available to everyone, not just the few. Absolutely, not just the billionaires who can get whatever they want straight away any day. Yeah, I mean, you know, it's a one thing I love is that I've been very blessed in my practice to take care of people that are much fancier than I am and sit in boardrooms and that sort of thing,
but, you know what, I love taking care of my regular patients who are farmers, iron workers, tradesmen, guys that, you know, truthfully, I have more in common with than anyone else. You know, I joke with my patients, I'm just an educated plumber at the end of the day, right, you're all just, and so it's a health is for everyone, not just for the fortunate. The last thing I wanted to talk to you about is linked but random. Yes.
“It's the enhanced games. Let's do it. I am so excited about these. So do you know them?”
I do very well. So for those of you, or for those who may not know, the enhanced games is a project based off of the world anti-doping agencies own data, potentially up to 40% of athletes that are competing at the Olympic level, you have either are currently using or have used band substances at some point in time, all right. And also, we know that a lot of the compounds that are used for enhancement maybe aren't quite so dangerous if they're being administered
by a trained medical professional with proper oversight. And as of right now, that's not happening. Also, at the same time, we know that Olympic athletes aren't paid enough, right? These are the best of the best and they're not even making the poverty line a lot of years. And so the idea is this, well, what if we go ahead and we strip away those rules? Okay, we allow athletes to use medications that can enhance performance. We watch them very closely and we have a team of doctors
and medical professionals watching them. And then let's see what they can do at these traditional Olympic events and see if they smash world records. Oh, and they're going to give 250 grand to any
first place winners and a million dollars to anyone that hits a world record. And just for comparison,
how much you're Olympic athletes getting paid? They don't get paid to compete at all. Okay. So they don't get paid to be an Olympic athlete. They end up getting sponsorship deals. And that's potentially the money that they can make. So, yeah, interesting. So it's basically the dope
Olympics where everyone's allowed to dope.
trying to say that only FDA approved medications can be used. Okay, so you couldn't use something like trendblown, which is for veterinary use only. Or theoretically any of the compounds we've talked about today, because they're not FDA approved. But also at the same time, they've said that they're not going to test for those things. And one of their athletes, Magnusen, has openly
“admitted to taking BPC 157 and that's what I think. So I think we can kind of figure out that it”
may just be a wide open playing field. Maybe. So the international Olympic committee does not pay athletes a single cent for winning a gold medal. Yep, just crazy. How many billions do you think they make off of those without advertisement? So much money. Right? Yeah. And this is taking place in Las Vegas, May 21st of the 24th, I believe. Are you going to go? I'm going to be watching. That's
for sure. Do you all go? I would love to go. That would be incredible. Well, if you want to go,
I know a few people that are putting the event on. So do let me know. I'm there. I'm already interested. You got my, got my attention. Is there anything else we should have talked about that we didn't talk about as it relates to this subject we've discussed today? I mean, honestly, I think that we've gone pretty deep on peptides. And so I think we've, you know, covered that. But one thing that I did want to just leave with you because I think it's pretty humorous. And I think you've talked to
some of my colleagues about this before. But, you know, one of the things that I deal with as a surgical specialist is the end stage ofascular disease, the end stage of diabetes, which is going to be erectile dysfunction. And believe it or not, whenever we're dealing with that in male patients, they eventually get to a point where things like Viagrin, Cialis, do not work. And that is a dark place to be as a guy. And so you're taking these medications. All you're getting is a headache
and nothing else. And then maybe you have other options. There are actually injections you can do in the penis, which is about as appetizing as you might imagine. But men want a better solution
“and they'll come to us as a sexual medicine specialist. You know, seeking that. And that's what I do.”
So the bulk of my surgical practice is actually fixing erectile dysfunction with a procedure called implant placement. Okay. Oh, no. Absolutely. So now, I think did Reena show you one of these last time? She brought it and I didn't, I didn't ask her to do it. It makes me like, I get full body shutters when they talk about this stuff. Yeah, the thought of putting that up my penis. Well, so you can show me, you can show me. Well, I would tell you the good news is, if you don't have to,
okay, like that's, that's what we have a job for. Okay. But the way I explain to patients is like this. So take this out of the picture. Okay. Ultimately, like the male erection is just two inflatable tubes that start in the pelvis throughout the shaft of the penis. It makes sense, right? It is a hydraulic motion. What happens is you get stimulate, you get a rush of blood into those tubes, get a rigid erection, able to use that for intimacy. And then when you climax, pop off valve opens back
up and everything drains out. All right. So if you can understand breaks on a car, you can understand
directions. But the problem is that when you have long-term metabolic and vascular dysfunction,
the break lines, the blood vessels that feed those erections, they fail. And all of a sudden, you can't get enough blood flow for it to work. And believe it or not, you can actually get atrophy of the penis over time and you actually lose size, all right, which no man is eager to see. All right. But whenever the easy things like oral medications, if I grind sea owls don't work any more, the next best option, if we're looking at patient satisfaction, durability,
“concealability, is this little thing that I do, which is what if we took our own tubes, okay?”
And we put them inside your body's natural ones. It's invisible. Nobody looking at you could ever tell that you've ever had anything done. But all of a sudden, when you want to get an erection, stem hammer a lie on pills that don't work or putting a needle in there, right? You could reach down, and there's a small pump that we hide underneath the skin down in the scrotum. Okay. So I joke, it's like a third testicle, but again, nothing external, nothing you can see.
And all of a sudden, whenever you squeeze this, what it does is it moves saline that we hide
and a little reservoir that goes in the belly. You never feel that into the cylinders.
And all of a sudden, men are able to get a firm rigid erection that looks natural, feels natural, and they can use it as long as they want, or until they're partner sick of them. And then press a button and it goes back down. Do they still feel the same pleasure? Yeah. So it does not affect sensation. And so the nerves that affect sensation run along the top of the penis, if you're looking at a clock at the 12 o'clock position,
and we stay totally away from those. So this is surgically put inside the penis. All internal. And believe it or not, that takes me about 13 minutes to do. How many people have these? Well, I've put in about 11 or 1200 personally, but it's quite a lot of people. There'll be people listening now that have these. Well, you know, this is what's interesting. If you look at in the United States right now, okay, there are 30 million men with erectile dysfunction in
the United States right now. That's more than the population of Australia. All right. And if you look at statistics, the oral medications are going to fail in 15 to 40% of those men the first time they fail that. And so you're talking about millions and millions of men who aren't responding to oral medications and need a better option. So why is the button to get rid of the erection?
You see those two little bars right there?
it. Yeah. Do that. And then squeeze the from the end of the device back towards the palm.
So squeeze it. Yeah. Right there. There you go. It's down. And then you would have the weight of your natural tissue. Push things down. Okay. And then yeah. Okay. There you go. Okay. Okay. Well, you know, I'm happy people of the options because I can imagine what that would be like to not be able to get an erection. It would be devastating frankly. Well, I'll tell you this. I get more hugs and high fives than
anybody else in my practice. And that includes the guys that treat kidney stones and cancer. So I feel like you're doing some doing some good work here until peptides with the out of business.
“I think that's going to happen anytime soon. And you have a great YouTube channel.”
Thank you. I appreciate that. Which I think everybody should go check out because you really are great at explaining all this stuff in simple terms. So I'm going to link Dr. Alex's YouTube channel down below. We'll try and collab. So if you just click on the diversity icon now, you'll see Alex's channel. And I highly recommend you go check out his content because he's really really leading the charge on this subject of peptides. When I spoke to my
team and said, I want to have a conversation about peptides. They gave me lots of options of lots of different types of doctors. And you are by far in a way, our preference because of the very fact that you're very, very good at communicating. You understand people. And as you've demonstrated today, you have a very big heart. I appreciate that. And you're clearly, it was wonderful to see what's actually driving you. And you did that anyway, which is irrefutably authentic. So please
go check out Alex's channel. He's around 100,000 subscribers on my channel now. I'm so close. We're at like 98, 99, any minute now. Okay. So hopefully we can help push you over that milestone. Yeah. We have a closing tradition, Alex, on this podcast where the last guest leaves a question for the next. Not knowing who they're leaving it for. Okay. Question left for you is, if you could give
one billion dollars to one person, you don't know personally. Who is it? And what do they have to
“spend it on? Honestly, I would give it to Elon Musk. And it's not because I think that he's”
hurting for a billion dollars right now. But if you look at what he is working on to accomplish for us as a human race, right? He, I truly believe from what I've seen that he has a similar heart for humanity that I've seen when a lot of physicians. But on a macro scale as an engineer and an entrepreneur. He's trying to solve some of the greatest problems that are facing us today. And I think that what we are going to see hopefully coming from the Terra Fab down in Austin is going to be wild with
recursive feedback and engineering on AI chips that are going to get better and better in a short period of time and increasing independence when it comes to chip foundries for the United States.
“Like, it's wild. And I think that that billion dollars would go further and do more from more”
people than anywhere else I could put it. And he's also working on neural link, which is a really interesting company, which puts a sort of brain chip interfaces to allow people to
hear again, see again, allow paraplegics to walk again, which is really, really incredible.
Dr. Alex, thank you so much. It's so limiting. I can't wait to have you back again sometimes soon to talk about all the other things we could have talked about today. We focused on peptides predominantly, but I know that over on your YouTube channel you talk about a lot more than that. So highly recommend everybody to go check out Dr. Alex's YouTube channel. And it's been a pleasure. Thank you. Thanks, sir.
[MUSIC]


