Not So Taboo Podcast: Peptides, Part 1

Not So Taboo Peptides Part 1
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 Dr Nick: Hey everyone. Welcome back to the podcast. Joining me today as is Becoming the usual is Alexis Clark, our PA at Rejuvenated Medical Spa and Maverick Male Medical. Hello. Happy to be here. We’ve got a lot to talk about today and a, a series coming up. Well, I’m pretty excited about today’s topic because peptides are getting a lot of attention in the media and online, and we’re starting to get a lot of inquiries about ’em, but I do have to get up on my soapbox for just a second. We’ve been doing peptides for like six years at Rejuvenated Medical Spa and Maverick, and unfortunately, everybody in their brother thinks they’re a peptide expert now.

And so all of these. Wellness clinics are coming out and they’re, they’re doing peptides. And some of them are even using research purposes only peptides in a clinic, which I think is wrong, abysmal, just terrible. So I want to, I wanna start with a disclaimer that while some peptides have extensive human studies and some even have FDA approved forms, many of these peptides are really more a research or experimental phase.

A lot of the research is animal studies, please. Only obtain peptides after consulting a healthcare provider that is an expert in these. Please don’t order your peptides online. Don’t be dumb. You gonna, please don’t take the advice of your favorite TikTok influencer. Yes. Because they are everywhere. You know, if your personal trainer is advising you on peptides, get a new per personal trainer.

So these online sources, they, they literally say for research purposes only. Or not for human use. And to illustrate this point, I want to, I want to cite a study. So, you know, the biggest, most common peptide are, are the GLP ones. So this university did a study where they ordered six types of [GLPs] online that did not require a prescription, and three of them never showed up.

They just took their money. And didn’t send them. And then out of the three that did show up, I wanna show you how scary this is. So the three that did show up actually claimed 99% purity on the product label. Their purity was between 7.7% and 14.37%. Yikes. So, pretty much crap. Uh, it gets worse. Number one.

None of their concentrations were right. None of their purities were right. Some of them were mislabeled. Two of the three didn’t even have any instructions on how to reconstitute or how to inject them or any dosages. So then people are just guessing on what to dose them, right? So you either paid for something that you’re not gonna get benefit out of, or you’re going to potentially overdose yourself and cause massive side effects.

Oh, it gets, it’s not good either way. It, it gets worse. So all three had bacterial endotoxins in them. And for our listeners there, there were no living bacteria in these vials. However, bacterial endotoxins are one of the main mechanisms of how people go into septic shock. So bacteria such as e coli, which is a nasty bug, the cell wall of gram-negative bacteria have something called endotoxins that is a very potent immune stimulator.

Uh, or rather gets a very potent immune response against and can cause you to feel very bad, such as fever, headaches, that kind of stuff. And it can also kill you and cause you to go into multi-organ failure. So let’s, let’s not get our peptides from these places online that are research purposes only.

And I’m now stepping off of the soapbox. So what are we gonna talk about today? What peptides are out there that we’re gonna discuss? So since we’re doing a two part series on this, and we’ll probably actually end up doing more, more because there are so many peptides, but the, the ones that have a lot of research and a lot of interests, I think let’s do episode one of.

Like body composition peptides. Right. And, and we’re not gonna talk about the GLP today. We’ve had separate episodes on the GLP ones, but specifically we’re gonna talk about peptides that help with lean body mass. So either reducing abdominal or visceral fat, or boosting lean muscle. And these pair so beautifully with the GLP ones.

I have been loving them. Standalone of course, but really loving them paired with the GLP ones. Yes, and I am not on a GLP one, but I am on on some of these. So the biggest one that I like is probably Sir Morlan. Me too. I’m personally on that one, and I love it. Yeah, I love it too. I’m, I’m, I’ve been on Samor for years and I, sometimes I’ll take breaks, but not really intentionally.

Sometimes I’m like, oh, I don’t wanna keep paying for that and I’ll stop it. And then like two weeks later I’m like, ah, just kidding. I’m going back on it. So, so Morlin actually is, or has rather, rather been FDA approved for pediatric growth hormone deficiencies. However, it didn’t work great for that population and, and the reason why is the mechanism.

So I’m kind of surprised that they tried to, to do it like that. But I do think it works very well for adult growth hormone deficiency as well as just for general anti-aging stuff. And that’s been around since the nineties, correct? Yeah, about 30, 30 plus years it’s been around. So that’s a pretty steady state.

Amount of research. Yeah, there is a mean, that’s fantastic. There’s a significant amount of research on it, and that’s one of the reasons that I feel so comfortable with it. And again, I’ve been prescribing smolin for at least six years. So Smolin is a growth hormone releasing hormone analog. And for our listeners, what that means is.

One part of your brain releases a hormone called GHRH or growth hormone releasing Hormone that tells another part of your brain to release human growth hormone. So smolin is an amino acid sequence that is similar to GHRH, and it basically tells your pituitary gland to release more human growth hormone.

Well, the reason it didn’t work. Great in those kids is it’s their pituitary that is dysfunctional. And so it’s like stepping on a gas pedal, that doesn’t work very well. Right? So, but if [00:06:00] your brain is functioning normally and your pituitary is healthy, then these actually do work very well. And I guess I should probably mention what peptides are.

Peptides are just an amino acid sequence that is shorter than what a protein is, and, and different people classify ’em as different definitions, but most people accept that A, any amino acid sequence longer than a hundred is a protein, and shorter than a hundred is a peptide. So it’s really just semantics as far as classification.

Some of these that we’re gonna talk about are, you know, endogenous to the body, meaning the body creates them themselves, or some of these are synthetic versions that are similar to something that the body creates, right? And most of them are altered in some way. And so, for instance, they’ll alter like the tail of the am amino acid chain.

With a more stable amino acid so that it still structurally has the same shape and binds to the same receptor, but it doesn’t get broken down as fast, for instance. [00:07:00] Smolin is fantastic and, and really the, the reason that I like Smolin so much is number one, because it works. Number two, because it’s safe.

But you know, it’s, it’s very extensively studied. And so there are some studies that show that it, it has a, a human growth hormone spike within about 10 minutes that lasts for up to a couple of hours. And then that leads to increased insulin-like growth factor, which can help with blood sugar and lean muscle mass certainly helps muscle tissue growth.

Uh, and I think over time it can also help with, um, with fat loss. Although I found one study that, uh, that did not show any body weight. Change. However, it did show a reduction in fat and an increase in muscle. And so that’s even better than losing weight and for most people Right, right. Not necessarily a weight change, but just re comping is what the goal always is.

Adding muscle, removing fat. You know, I will mention that, uh, one caveat to, to Sir Moreland is some of the studies that I [00:08:00] found. They had significantly better effects than men, than in women. Sorry. As as is everything. Yeah. Sorry about that. Unfortunately. Um, but, so for instance, in this particular study they did, uh, 16 weeks of smolin.

And there again, there was no change in body weight, but there was a change in body composition. But men also reported an improvement in general wellbeing and libido, but women did not, which is interesting too, and I’ll talk about this a little bit later, but low IGF, which is insulin-like growth factor is correlated with sexual dysfunction in men and women.

And when you treat it, the sexual dysfunction in men seems to improve, but it doesn’t in women. I’m not sure why that is. So the the reason we measure IGF one. Instead of measuring human growth hormone is because HGH is pulsatile in nature. So you get these big spikes of human growth hormone, and then they go down within just a few minutes.

So human growth hormone stimulates the [00:09:00] production of IGF one. Which is a much more stable protein, and so it is circulating in your bloodstream for longer periods. And so we basically use IGF one as a measurement of human growth hormone because otherwise you would have to do like 24 hour sampling or multiple times a day sampling to get any.

Accuracy for human growth hormone and just from a practical standpoint, your levels are highest at night during sleep and so, right. It’s not like we’re going to your house to draw your blood. Right. And that’s something too, with some morelin that I like is when you know we’re taking this medication at night and causing that pulse tile release, some people do get some benefit of.

Better sleep quality, so deeper sleep, maybe not longer sleep per se, but their quality of sleep can improve. Yes, I do notice that I don’t notice it at lower doses of like 200 micrograms, but if I’m 300 micrograms and above. I get just kind of like warm and fuzzy and go right to sleep. Love it. That’s amazing.[00:10:00]

Yeah, and so many people struggle with sleep. So anything that can help with sleep is just a huge plus. Um, the only side effects that I have seen with Smolin is itching at the injection site. I get that when I inject into my abdomen, but for whatever reason, if I do my, my hip or my thigh, I don’t get it.

And that doesn’t really make sense to me. It’s happened over and over. Uh, there are some reports of increased cholesterol with some morelin that was transient, but otherwise, really no significant side effects. I do think it stimulates appetite if you take it earlier in the day. And it, and then the sleepiness.

But again, that’s very short-lived for me and for, for most of my patients. But if you have trouble sleeping, it’s great to take it bedtime. And this one is dosed nightly. Just so everyone knows. Yes, there is a, a troche form that is a dissolvable like sublingual. But I prefer the injectable, and it is a nightly dose.

It’s not a big deal if you miss, but I try to take it every day. Unfortunately, last night I fell asleep before I took it. But anyway. So [00:11:00] let’s talk about why some of these peptides are better to boost your own growth hormone as opposed to taking human growth hormone. Well, one human growth hormone is stupid Expensive.

Yeah, like three, four grand a month. Stupid expensive. Not that it doesn’t have benefits, it certainly does, but really I think the only population that human growth hormone is better is pediatric growth hormone deficiency. So like very, very small stature children, um, that have severe growth hormone deficiency, they, they need HGH.

Right. And then perhaps if you’ve had, you know, like. Severe debilitating injury, you know, right Brain, terrible trauma, car crash, brain trauma, something like that. But the problem with human growth hormone is it has what we call square pharmacodynamics. And, and, and what that means is the level goes up, it stays up for a very long time and then comes down.

So you do get benefits from that, but over a prolonged period, you can get [00:12:00] changes in your cholesterol. You can get perhaps liver damage, you can get abnormal bone growth. And so we don’t want those side effects. And so, as I mentioned before, human growth hormone is, is released in a pulsatile manner. So Lin Tesamorelin, CJC 1295 Ipamorelin RP two, they all actually maintain the normal pulsatile release of human growth hormone.

So it mimics what you’re getting. Physiologically, it just improves it right? So instead of getting those big square levels where it stays up for a long time, you get the, the natural spikes. And so that’s, that’s really why I, I like it much better. And then the other thing is that human growth hormone is highly regulated.

In fact, I know a physician who got his licensed temporary suspended for prescribing Too much of it. I mean, this was like 10, 20 years ago. But, so explain some of the differences for [00:13:00] our listeners, you know, between these major. Growth hormone releasing hormone peptides? Is it the length of time that they last?

Is one stronger than the other? Is there one you reason you would choose one over the other depending upon the patient? Yes. So my favorite to stay on year round is Smolin, just because it has the longest safety data and it’s. More physiologic, I believe CJC 1295 has this exact same mechanism of action, but it has a longer half-life.

And just for those of you that are considering buying stuff online, again, don’t. But you will see CJC with something called DAC and DAC is an addition to the CJC where they. Increase the HALFLIFE from 30 to 120 minutes up to eight days. So I think that that is probably a very bad idea. But I do regular CJC 1295 more often in sort of cycles [00:14:00] similar to ’cause.

And also you can get CJC 1295 mixed with ipamorelin. So Ipamorelin Boost growth hormone by mimicking a hormone called ghrelin. Uh, as does GH RRP two, and so often I would combine one of those with Tessa Morlin or CJC 1295 for like an eight week cycle to stimulate healing after an injury or surgery. Or to improve body composition in someone who’s, you know, training for something.

Right. And those are ones that you know, also don’t have to be taken every single day because of their longer half-life? Yeah, those are typically four times a week or so. Right now I’m on an eight week cycle of a four times blend that has Testim Molin, GH rrp two. Morelin and mechanical growth factor, and I’m doing that because following back surgery, I’m just trying to, to get some muscle back on.

So I’ll do an eight week cycle of that and then go back to just smolin. I kind of consider those [00:15:00] like a, not necessarily a step up from Smolin, but when I’m talking to my patients about it, like Smolins a really great. Entry level peptide because it is so safe and well researched and you do it every single night, there’s not this concept of like having to cycle it or not cycle it or whatever.

And then for people who have done some orlin and loved it, but want a little bit more, that’s when I usually go to, you know, these blends that are, you know, quote unquote, maybe a little bit more, take a little bit more knowledge or education to. To inject, right? And so I did find a study on CJC 1295 that had, um, healthy subjects in between 21 and 61 years old, and they did escalating doses that were either two or three times weekly.

And, uh, basically they looked at the IGF one levels. And even after a single injection of CJC 1295, there were dose dependent increases in. IGF one, they also were [00:16:00] actually able to measure human growth hormone because they kept an IV in and just took serial samples, but up to a, a two to tenfold increase for six days or more in the plasma IGF one levels, and then up to nine to 11 days, it was 1.5 to three times the level of IGF one.

So it works fast and actually the levels remained, uh, above baseline for 28 days after cessation. So it stimulates your body to keep making the growth hormone for a while. Again, that’s, that’s nice to reiterate all of these, maintain your normal pulsatile. Release Ilin is a little bit different. It mimics a hormone called ghrelin, but it’s not nearly as potent in releasing human growth hormone as the others that we talked about.

But kind of nice when you pair ’em together, ’cause then you get two different mechanism of action. So you know, you are getting maybe not twice as much, but you know, stimulating it from both sides of the coin. Right, and so that’s why I [00:17:00] like the CJC mixed with Ipamorelin because then you’re getting two different mechanisms.

I do wanna mention a different peptide that we, we talked about a little bit here called Tessa Morlin. So Tessa Morlin has this same mechanism of action as Smolin and CJC 1295. It actually. Is an FDA approved medication and it’s used for lipodystrophy in HIV patients. So HIV and AIDS patients that take antiretroviral therapy get an increased production of fat around their organs or visceral fat, and that can be detrimental to their health, uh, leading to increases of heart disease, et cetera.

So for those patients, you actually do a really pretty high dose. So normally I recommend 500 micrograms of Teslin, and those patients, they were doing two milligrams, so four times the dose. And that medication is stupid expensive, by the way. But I did find a trial and there’s a lot of research on [00:18:00] Teslin because it was FDA approved.

They did a, uh, a 26 week randomized placebo controlled primary intervention followed by a 26 week safety extension. So they had 806 HIV patients that were on antiretroviral therapy and they had excess abdominal fat and visceral fat. And so they actually did show a significant reduction in visceral adipose tissue after the 26 weeks.

No real significant. Adverse effects, uh, mostly injection site irritation. And then they did have a, actually a reduction in triglycerides and an improvement in your total cholesterol to HDL ratio. And so it’s interesting that it seemed to improve their lipids where some of the studies on Summer Orleans showed, it showed a, showed a brief reduction in quality of your lipid panel.

Hmm. So after a a year, these patients didn’t really show anything [00:19:00] significant, and they did also show a reduction in waist circumference after a year. Um, and these are some of, you know, the sickest patients Yes. HIV aids patients. So that’s really even more impressive. Yeah. That all of these biomarkers are moving in the right direction.

Yeah, so the average waste reduction was 3.4 inches after a year. Wow. That’s huge. That’s, yeah, that’s huge. That’s a big deal. And this is a pretty big study too. I’m gonna say eight. Yeah, 806 patients. It’s really pretty, pretty powerful study there. Um, and that, that was all statistically significant. So I’m, I’m very happy with that.

One other one that I kind of wanted to mention. Along the same body composition type peptides is called LR three. IGF one, and so as we mentioned, IGF one is produced in response to human growth hormone production. So LR three is a long arginine three attachment to the IGF one. [00:20:00] Basically, it doesn’t get broken down as quickly.

It just has much longer action. So by improving or by mimicking IGF one naturally in your body, it stimulates healing. It stimulates reduction in glucose and also muscle hypertrophy. And so for my patients that are trying to increase muscle and loose fat, I do really, really like this peptide as well. It is also one that I cycle.

On and off of for patients, so maybe on for eight weeks and then off for a while. So it’s, it’s pretty interesting. I, I found a study where they had 32 people in the untreated group and 51 in the treated group. These were all patients with adult growth hormone deficiency. And as I’m, this was the study I mentioned earlier where there was an improvement in libido for erectile dysfunction and libido for men, but for women, it, it didn’t really seem to help them, which is unfortunate they even looked at the men.

It was the improvement in the [00:21:00] IGF one levels was not related to their changes in testosterone. So their sexual function improved even when you took out. The testosterone levels. So there could be a, a benefit from sexual function as well. But I usually use these more for like healing and for body composition is, is what I would consider those for.

So it’s, these are anabolic, anabolic peptides. So again, I, I would typically use those for. Cycles to improve healing after surgery to, uh, improve body composition. Right. Something kind of, you know, similar but not the same. Um, that’s getting a lot more talk lately too, is gonna be the mots C peptide. So I wanted to bring this one up because it is also big when we’re talking about specifically like reducing visceral fat.

However, this one works completely different than anything we’ve talked about. So with these being growth hormone releasing hormones, this one does not work like that. So this one is actually a [00:22:00] mitochondrial. Derived peptide. Um, so it specifically, you know, has those metabolic capabilities, but working right at the source, which is the mitochondria.

So really, really interesting. It actually helps optimize the way that mitochondria produce energy, the way they use nutrients, and how you can respond to stress. So this one is really cool because yes, it does help with reducing visceral fat, which we talked about is, you know, the most dangerous fat around the abdomen, and that can be linked as we know, to heart disease, to insulin resistance to diabetes, inflammation.

So this one does do that. However, it’s really interesting because it also works on the insulin, on improving insulin sensitivity, and it does that through modulating key pathways like A MPK or SIR two and one, uh, which are really essential for metabolic health. So this one has some kind of added benefits because you’re essentially helping boost [00:23:00] mitochondrial function.

But you’re also working to improve insulin sensitivity and reducing that ab abdominal fat. So it’s kind of a mixture because you’re like supporting that healthy aging biohacking, you know, component there, but you’re also improving your metabolic flexibility, working to even enhance some physical performance in the sense of dropping that body fat.

So I’m, I’m really interested to see, um, how this one, this one. How we utilize it, because I think it’s gonna be great paired with GLP ones really too, because, you know, with those people we are always looking to, you know, maintain muscle, but drop body fat again, all of these kind of pair well with GLP ones.

But Motc is interesting just because it, it works totally different than the ones that we have spoken about so far, but, you know, has that healthy aging support to it. So I’m excited about that one. Yeah, I like that too. And, and to your point, these pair great with GLP ones. You know, [00:24:00] if, if someone comes in and they are.

Strongly pre-diabetic or diabetic and significantly overweight. I’m gonna reach for the GLP one, right? That that’s what I’m gonna reach for because it’s super effective. I, I am not someone that keeps most of my patients on high doses of GLP ones indefinitely. I do try to deescalate that dose and titrate them down, uh, or rather taper them down.

I do microdose, as we talked about on another episode for some patients, but I really think either. The Mot Sea and some of these other peptides pair very well or. Once the patient has reached, you know, their, their goal weight or gotten close to their goal weight, I think these work very well to help maintain that healthy body composition.

I also, I use the, the growth hormone boosting once a lot after surgery, after tendon or muscle injury. You know, I, I think that the, they have a lot of uses. You know, I, again, we, we talked about [00:25:00] smolin. I think just taking it year round for just general anti-aging effects. Mm-hmm. I, I found some studies that actually show can improve skin thickness as well.

Right. And so for our aging population, you know, we all want thicker skin as we get older so that we don’t have that crepeness. Exactly. And so that’s just one of the many reasons that I like them. The Mott Sea is interesting. I haven’t tried that one yet, but I probably will. Because, uh, it’s on my list.

Yeah. The insulin sensitivity is especially for you. Yeah, and, and, but you know, interestingly, my fasting insulin levels are super low. It’s like 3.6, but my blood sugar tends to get higher than I would like, so I probably will try a lot. CI just. When I’m on these different cycles, I try to only do a couple of things at once, so that way I know how I’m responding, right?

And so, for instance, I’m gonna take labs at the end of my eight week cycle of the, uh, the four X blend that I’m on to see what happens to my A1C. And see what my IGF one looks like. And that’s what we’d look, we’d, you know, [00:26:00] recommend for our patients as well is, you know, we, a lot of people talk about stacking these peptides, which can be really beneficial.

But I think, you know, initially we, you, you may be good to just start with one and then maybe add something in as time goes on. But I mean, gosh, you see people out there on. Social media or whatever that are on 5, 6, 7 peptides at a time and like, woo. Right. It’s kind and it’s kind of overkill. Well, and eventually that’s okay.

But the problem is, is that, you know, if you look at, and, and again, this is, this is the problem with the talkers and social media influencers, you know, advising you on health things. Don’t listen to them. They don’t know what they’re talking about most of the time. But with the peptides, I usually will do.

Some short cycles of particular peptides get feedback from the patient with labs and or, um, symptom resolution. And quality of life questions. And then after a period of time say, okay, this is the protocol that I want you to be on. Because the problem is if you start five different peptides at one time and you start having an [00:27:00] adverse effect, you don’t know which one’s causing it.

Then if you take five different peptides and you do great, you might be paying for five peptides, but only three of ’em are benefiting you. Right? And so you just get, you know, you go to basic research, you want as few variables as you can to make a good controlled experiment. And that’s, that’s what really a lot of these are.

And to, to reiterate, you know, a lot of these are really still in the research phase. There’s not. Other than Smolin and Tessa Molin, there’s not a tremendous amount of human research. There’s some, but those two have a lot of of human research. So go to a knowledgeable healthcare provider and talk about.

What your goals are. You know, a lot of people that are doing peptides. I, I would ask the question, how long have you been prescribing peptides? That’s that. I would absolutely ask that question. Do you have any extra training in them? And how long have you been prescribing them? And if that answer is, is, you know, a short period of time, like, [00:28:00] you know, months to a year or something, I would find somebody else.

Not that we’re perfect by any means, but like I said, we’ve been prescribing these peptides for about six years. And so I think that in our area we’re sort of looked at as the, the expert clinic for peptides and, and I’m proud of that. So if you guys have any questions about peptides. Reach out to us at Rejuvenated Medical Spa or Maverick Male Medical and uh, we’re gonna move on to part two,

not so Taboo, longevity, aesthetics, and Sexual Health with Dr. Nick, produced by me Brock with Brock Entertainment. For more information on Dr. Nick, or to ask him a question, find him on Instagram at Dr. Nick Gentry, or go to his website, rejuvenated med spa.com.