Episode 393: Dr. Tyna Moore: Why Ozempic Should Be Microdosed, HRT Tips, Peptides for Metabolic Health + More
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So these are magic mind shots. They're like keeping you, it's basically we do, since you are a doctor, I have doctor, by the way, we have Dr. Tina Moore on the podcast today, who is fascinating. We're going to get into so many fun things that you guys are going to love. But given the fact that you are a doctor, I figured we should do this healthy shot. And it's for being alert, focused, stress-free.

energy, and look at the ingredients. It's all natural. It's like a neurotropic. You have adaptogens in there. You have turmeric in there. You have a little bit of matcha. Oh, nice. Yeah. I need my phone to zoom in because I'm that wild. Trust me, I'm in the same boat, baby.

I'm in the same. Oh, lovely. This looks nice. It is good. It's got some rhodiola. Yeah, it has some rhodiola. Lion's mane and cordyceps. Let's do it. Okay. Yeah, it's very good. Okay. Although, I'm not even sure if I should even take another one. I've had like four today. So I'll just do this. Are we going to spaz out? Well, I might. You're not going to. You've only had one. I'll save mine. Just so you can do it. Because I've had four. I think they told me I shouldn't have that many. Oh.

Oh, that's pretty good. It's good, right? They told you you should have them. I literally asked them like, how many are like technically am I allowed to have? And they're like, you know, probably two would be like a max. And so it's only like...

12, 20, and I have had like three. I love it. Yeah, it's good, right? Okay, that's good. Now you're going to be super alert. Now I can ask you these questions and you're going to be super focused and super sharp. Okay, so let me just, we have like a whole other intro, but let's just say who you are. So I think the way I really know you as, like Dr. Tina, that's how, people call you Dr. Tina, right? Yeah. Okay.

I feel like you've become like the maven expert on GLP-1, Ozempic, all that, that whole area. Would you not say that's who you've become? Kind of like very, very well known for speaking up or speaking about all the different things like that, like Ozempic, Manjaro, etc.

I say Ozempic because it's like, I feel like everyone just knows the name. Yeah. Right? Yeah, yeah. But now, like, you were telling me all these things offline that were so crazy, and I wanted to save it for the podcast because Dr. Tina was just canceled off of Metta, Facebook, Instagram, which I think is crazy. So before, you know, I cut you off before. Do you want to just tell everybody, like, what the hell's going on and why did you get canceled? Yeah, so September 1st, I woke up and...

I opened my app, my Instagram app, and I was at 232,000 followers. And it said, your account has been suspended. And I hit the appeal button and it said, thank you. We will be reviewing your account. And then an hour later, it said, I logged back in and it said, your account has been suspended and there's nothing else you can do. And so I contacted every single human I knew that might know someone. And I mean, I've

have exhausted almost every resource and nothing. I have heard nothing. I can't get a human on the line. I had the blue checkmark, the meta verified blue checkmark. But why? Why was someone who's a doctor, who's talking about GLP-1, who's talking about like peptides, metabolic health? I mean, why of all people would you get canceled?

Because I think that the conversation I was having around GLP-1s is really about using them in extremely low doses compared to the standard starting dose. And the brand name pharmaceuticals come in pre-filled pens that have a standard starting

dosage that you can't dial down below the first starting dose. And I was talking about compounded versions. Oh, so they feel, big pharma feels, that you're taking business away from them because you can do all of these compounding versions that they're not making money off of. Potentially. And interestingly, a day later, a couple other people who talk about

GLP-1s, microdosing GLP-1s and peptides were also suspended. And when one of them was able to appeal and look into it, she was told that

It was Big Pharma, one of the big pharma companies that was who reported her. So I'm suspecting I was on the same. It was, you know, the three of us and maybe more. I don't know. But that particular weekend. Interestingly, a week earlier, one of the big pharma companies came out and said that they're going to start dispensing one of these via a vial form. The cool thing about compounded is it comes in a vial. So you can really, really individualize the dosage for the person. It's not a pre-filled pen. Mm-hmm.

And they are coming out with a vial version, not a pen, pre-filled pen version. And they're going to be selling direct to consumer with a prescription in these vials. And they've been on a rampage sending cease and desist letters to doctors and different compounding pharmacies. And this has all been in different telemedicine companies. We were talking about one earlier that you know that you like. And so they have all been targeted. Yeah.

Something's going on. I think this was kind of a, I'm guessing I was part of this. I can't confirm anything because nobody will get on the phone with me. And again, I have the MetaVerified, which I've been paying for, which is supposed to get you through to someone, but you can only get through the account you're paying for it with. So I can't log in to find out. So then can we just go back a second? Because there's so much controversy over this.

Right. Like most people are like, oh, you know what? Like it's a it it's like the easy way out. You're not learning, you know, how behavioral differences or habits. You're just kind of taking a shot to lose weight. And you are on the opposite side of the fence. Right. You actually you're a big proponent of using weight.

these drugs? Well, I'm talking... I was originally, about a year ago, I found all this data and literature, like 20 years of studies showing that this class of... They're peptides, for one. They just happen to be owned by Big Pharma. Can you talk about what it is? Like, what is...

Because I think no one really understands, like, is it a peptide? Is it a drug? Like, let's start with what GLP-1 is. It's a peptide. So it's a string of amino acids linked together by peptide bonds. So it's a peptide. We make GLP-1 in our bodies naturally, in our brain and in our guts. We have receptors for GLP-1s all over our body that do a whole lot of different things. It just was serendipitous that it got figured out for type 2 diabetes. It does a whole

whole lot of other things in the body. And this was really interesting to me when I started studying it. It's a peptide in that it's in and out of the body very quickly. So the body produces it and the half-life is very short. The pharmaceutical version has been tinkered with so that the half-life is much longer. So the half-life is maybe four to seven days. So that's it. It's bioidentical, at least Ozempic, which is semaclutide, is bioidentical to our own GLP-1 for the most part.

And about a year ago, I started finding literature outside of what most people understand it for. Most people understand it for reducing appetite because it plays on the centers of our brain that control appetite, for slowing gut motility so you feel fuller longer. And that's kind of where the story ends. That's kind of where people understood how it works. And that's why it's a weight loss drug. And that's why it's for type 2 diabetes. It has multiple impacts on our metabolic health in a myriad of ways that have a lot more to do than just that.

And there are receptors in our brains, in our heart, in our pancreas, in our immune cells. And I started finding literature that was really, really interesting about this. And I started going on podcasts and sharing about it and finding information. Like recent studies have come out showing significant reduction in all-cause mortality for those who are on it, reduction in different types of cancers.

With cancers. Colon cancer specifically, this was correlative, not causative, but they were finding, they were comparing people on somaclutide versus, or even some of the other GLP ones for a period of time versus I think insulin and not a great comparison.

I mean, it's not a super clear comparison because insulin is pro-growth, so insulin can cause problems in and of itself. But interesting data coming out there recently, 13 different types of potentially reducing 13 different types of obesity-related cancers. And then I was finding data and sharing out about potential protection against COVID.

and upper respiratory illness. And I was sharing about it on podcast thinking, well, if anything, I'm helping big pharma sell their peptides. So they'll probably leave me alone. Like I didn't think I was a threat there, you know? And honestly, the microdose is completely independent to the individual sitting in front of me. And that person for that person, it might be the standard starting dose. Like that might be their microdose, right? So I have no idea. But then I started a second account a few days later and it grew to 15,000 followers pretty quickly. And

It was shut down within 36 hours. And that's when I realized like, oh, somebody wants me to shut up. Right, right, right. Well, I mean, if you're trying to take business away, who makes Ozempic? Who's the company that makes Ozempic? Novo Nordisk. And then Monjoro is Terzepatide and that's Eli Lilly. And so I, but I mean, I have no interest in

keeping people away from the standard. I don't care. What's interesting is when I started talking about this, I was like, you guys, I'm finding all this amazing literature supporting GLP-1s for neuroregeneration and decreases in inflammation and neural inflammation, which I think is really cool. That's where I got most interested. And potential, there's studies being done right now on potential improvements in Alzheimer's and Parkinson's. And like, this is super exciting, guys. And the

My followers, so many of them turned on me and they're like, when did you get... They were like, when did you get bought out by Big Pharma? When did you become a Big Pharma shill? So they're screaming at me in my comment section, accusing me of being a Big Pharma shill. And I'm like, no, I'm talking about compounded versions, you guys. I'm not even talking about the standard brand name. But if you want to use the standard...

And many of the people that I talked to in my following have said, you know, I could only get a hold of the standard brand name through my regular doctor, through regular pharmacy, and it's changed my life. So I'm like, cool. You know, I don't have any favoritism either way. Right. I'm just saying that if for someone like you, as lean as you are and metabolically optimized as you are, if you had maybe cardiovascular disease in your family or you were dealing with some kind of neurodegenerative condition, we would need tiny, tiny doses for you. So wait, like, so...

So yeah, that's what's interesting. So in your opinion, should everybody be on one of these GLP-1, like an anoxempic form for their metabolic health? I think I get asked that a lot. I think that's kind of a bold statement to make, and I wouldn't say yes to that. I think the way that I've always practiced medicine is I'm just trying to treat the person in front of me, and I'm trying... I don't use this in isolation. It's not a monotherapy. It's...

part of a comprehensive protocol. So I'm a big fan of bioidentical hormone replacement. I've been using it in practice for a long time. My background was actually as a regenerative medicine doctor. So I was doing prolotherapy, PRP, stem cells, exosomes, regenerative therapies in my clinic for decades. So to me, peptides are just...

part of that. And this is just another peptide. So where did peptides even come from? I feel like the word peptide has become very popular, very trendy in the only in the last few years, like before, like five years ago, I never even heard of a peptide. Most of my friends never heard of a peptide. And then in the last four or five years, it's

There's lots of peptides that people are taking, the BPC-157, the CJC-1290, whatever it is. There's so many. And I think, number one, it's inconclusive from what I've heard. And so people don't, there's not much, but most people don't know much about them. And so it's scary.

And I don't even think people that mass, and I only say that for people who are in my world, who are in the health and wellness space or longevity space or the fitness space. If I'm like confused, I can only imagine how people who are just layman's like, you know, an accountant working at, you know what I mean? Or someone in the marketing department at like Hasbro. Yeah.

How do you even, like, I feel like, can you start from the beginning? Like, where did it even, how did it become even something that was even to be taken for optimizing your health or for your longevity? Well, these started popping up in the regenerative medicine space, at least in my, you know, when I caught wind of them, I would say 2017, 2018. And we were, we use them short term and we use them, we cycle them. So say you injured your shoulder.

We'd put you on a stack of peptides to optimize your shoulder. I would probably do some regenerative injections. You can even inject these locally to the injured areas. Yeah, you could do however you want. They seem quite safe. They're strings of amino acids, and they insert themselves in. Many of them have anti-inflammatory properties. Many of them have regenerative properties. And when I say regenerative, I think people get confused. It's not like...

we're going to drop some BPC-157 on a heart cell in a Petri dish or some GLP-1 and it's going to make new heart cells. What I mean when I say regenerative in the regenerative medicine world is that often we're just abating pathology. So when you hurt yourself, there's a whole downstream...

process of cytokines and inflammatory molecules that happen as the body's trying to heal itself. And sometimes the body gets caught in a loop. So a herniated disc is a great example. The nucleus pulposa will squish out of the disc, and it's called the annulus, the protective coating of the intervertebral disc. And it's not supposed to be on the outside. And once it's on the outside, the body freaks out and sends in everything. And that's why the initial injury hurts. And then two days later, you're like,

good God, I'm really in a lot of pain. It's because of that inflammatory process. Your body's trying to wall it off, control it, contain it, and heal it. But sometimes people's systems go berserk and it's a horrible mess. And that horrible mess can actually damage the tissues worse. And so...

We are trying to get in there with something that's going to be anti-inflammatory healing and abate that pathological process and slow the roll, if you will. And that's where I think peptides really shine. And so we have a variety of different peptides. In November, I believe it was, of 2023, all of a sudden there was a meeting at the FDA. And I know people that usually are in on these meetings, and they told me...

like pretty secret meeting just happened. And many of those peptides got wiped from the, from, for those of us who are licensed, we can only prescribe them. So I can only speak to the ones I'm still allowed to prescribe. So that's what I'm going to ask you. So like a lot of them, you can't even get in California anymore, but you can get them in other States.

Well, prescription versions, I'm not sure about. And I know that there are places that sell peptides online still, and I can't speak to those because they're research labs for research purposes and not for human consumption. And I know that's where people are buying a lot of them, but I can't speak to that because I'm licensed to prescribe. So in Oregon, I can prescribe, there's a couple growth hormone supporting peptides that we still have left, like

Tessamorelin, Cermorelin, we still have the GLP-1s available to us via prescription, via compounding pharmacies. But even those pharmacies are getting in trouble. And for what? Well, other compounding pharmacies are turning on them and turning them in. It's really crazy what's happening right now. Like it's,

really crazy what's happening. And I'm somehow caught up in all of this and my name seems to be circulating everywhere because I was just trying to introduce a new way of using these GLP-1s that might be outside of what we know them for. That was all I was trying to get at. Like, everyone's obsessed with weight loss and they've really vilified it and polarized it. And I'm over here like, okay, can we forget about that conversation for a minute? I mean, that's awesome. And I actually will support that because...

not without the lifestyle factors, not as a substitute, but in conjunction with, adjunctively, I'm going to give a patient every tool I have available to get them on the path, right? And there are actually metabolic healing properties to these GLP-1s that people don't understand. But over here, I'm like, look at this whole buffet of other impacts that I found data on.

Are you telling me that GLP-1 and, let's say, a samoralin peptide, they're not the same peptide, but they're both in the same class? They're both peptides? They're both peptides, but they're not at all the same. They don't do the same things in the body. No. They both may have some anti-inflammatory and some regenerative impacts, but they have different mechanisms. What does samoralin do? That's a growth hormone, I believe, releasing hormone peptide. So that'll help you. Your growth hormone declines as you age, and

And

Back when I was starting practice, you could still prescribe patients growth hormone, but they would get all pink and puffy, and we don't want to crank growth hormone. So a lot of people, I think, probably in their maybe 50s and 60s, if they've been going to longevity doctors for a long time, probably got some growth hormone at some point. But the FDA put a snafu on that. And so when I got into practice, I was licensed as a naturopathic doctor in 2008, and my mentor was like, do not prescribe growth hormone. You will get in trouble with the FDA. So I never prescribed it.

But I knew people that still were, and I knew doctors that were still taking it or putting their patients on it. And those people would get pink and puffy. And then came peptides many years later, which would help support your natural pulse of growth hormone at the appropriate times. GLP-1s support natural growth.

pulsing of insulin at the appropriate times. They actually work on your pancreas to help heal the pancreas and support natural release of insulin when needed. And also on the cellular level, they help the cells, if you will, in the kindergarten version, hear it better. They help the tissues respond to insulin better. And that's just but one mechanism. So when would someone take some Oralin?

If they've had an injury, I'll use it when someone's really burned out. I'll use it when someone's trying to alter body composition and they just can't get up on it. So this is a great time, I think, as we hit middle age, you know, when people are like, okay, I'm lifting weights, I'm doing all the things, but I'm just not having that anabolic response to the work I'm putting in anymore.

We can put them on bioidentical hormone replacement and estrogen and testosterone are going to be supportive to muscle protein synthesis. But sometimes we need to get that growth hormone up a little bit. And so there might be a myriad of reasons. Somebody may have gone through a terrible illness and they're just

fried on the other side of it. Long COVID, I'm not saying it's a specific treatment for that, but I think of these post-viral syndromes and people coming out the other side of a big womp with a virus. That might be a time to give them a leg up, but we cycle them and we pulse them. We aren't just putting people on them forever and saying, hey, good luck. We're using it as part of a comprehensive protocol and we're making sure that we're checking off all the boxes and we are making sure that we aren't

and cranking them up on especially one thing alone. I mean, imagine going on just estrogen or just testosterone or just progesterone only. You'd mess up the whole system, right? But I think this is what people are doing. They're going just on testosterone and or the samoralin. The reason why I'm asking about samoralin was I've heard a lot of people be, a lot of people are prescribed samoralin in my world. You said another one,

Tresamorlin. Tesamorlin. Are they different also? They're a little bit different, yeah. But they both work similarly in that we're trying to get a good pulse and activity out of some growth hormone. Most people... And I feel like it doesn't work for some people. It works for other people. Is that with every peptide? But then GLP-1 seems to work for everybody. It doesn't unless... So what's happening is...

People are cranking the dose into crazy high levels in the standard dosing. In the standard, you know, big pharma pen version, people are going up to these really high... And some people need that, though. Are you talking about GLP-1? Yeah. I'm talking about the samoralin and the other one. Right. Well, peptides are going to work or not. I mean, it's all individualized. Not everything works for everyone. But also...

you get much better results when somebody's metabolically optimized. So if you were to come in and take a peptide, we would be able to likely keep, or hormone for that matter, any hormone. If you walked into my office, I'd be like, oh, this is going to be easy. This is like, you've got good muscle mass. I can tell you're doing all the things. Your skin's glowing. You have good vitality. Wow. Yeah.

Oh my gosh, I pay you? That was for free. I didn't pay her to say anything. Well, you take care of yourself, you know? I try. So a little bit of hormone, a little bit of peptide is likely going to have a really powerful impact on you. And there's other people who are really not very well metabolically optimized and peptides don't work as well on them. Do we still use them? Yes, we probably need a higher dose and it gets a little muckier. It

It's not as clean and easy on my end. Can you take too many? Can you take, if someone's taking the testosterone, the samorilin, or do people take samorilin instead of testosterone? Or like, my question is like, if someone wants to like change their body composition, I'm going to ask the most basic one that most people want to know about. They want to like get lean, lose weight, change their body composition. What would be the cocktail that you would prescribe?

That gets tricky because I don't want to get in trouble with my board or anyone else. But I'll tell you what I do. I'll tell you what I do. First, I'm going to run labs, obviously, and see where we're at with everything. Second, I'm going to do a very in-depth analysis of what their lifestyle is like because if they're fucking around with a bunch of alcohol and they're eating not the right foods that are conducive to longevity and we're dealing – or honestly, in my world, I can't tell you the amount of people who came in who were just –

balls of stress, like high-level CEOs that were just burning the candle at all ends. Then we're just trying to supplement to keep up. We're not even getting any headway. You're not getting any headway, yeah. So it really depends on a lot of factors. And then lifestyle factors, how well-muscled they are matters a lot. And then I'm not going to ever put anybody on anything forever. I think that that's the problem is...

All of these potentially are pro-grow. And I'm conservative in my opinion, taking something like PPC-157 even all the time every day, I think that's a bit of a danger. I think we want to cycle those, right? We want to...

go on them and come off of them. We want to use them as we need and come off of them, but I'm conservative with use. And I'm also concerned about all of these, including GLP-1s, about receptor sensitivity. Are we going to basically, any cell that gets bombarded with a peptide or hormone or anything for that matter is going to start cleaving off receptors. And so you're going to start, the cells are no longer going to hear what we're doing for it.

They're not going to hear the hormone in the system anymore. And so we have to start using higher and higher doses. I don't like that cycle. I think that gets really messy. And so I'm looking for folks who are really well optimized. Those are much better candidates, I think, for peptides. Do the other folks out there need it? I mean, the argument I get all the time when I say this for people is, well, you know, 70% of Americans are obese or overweight. And, you know, 94% at 2018 data show close to 94% were cardiometabolically busted.

So what about them? And I'm like, here's what I say. We use peptides whilst they're getting their lifestyle in order because it does give you a leg up and some people need a leg up. So that's where I come back to this obesity conversation and, oh, is it the easy way out? Well, why wouldn't we give somebody a leg up?

Why wouldn't we give somebody the opportunity to have a window open where it's actually inducing some neuroplasticity and they can make the appropriate lifestyle changes with good counseling, right? With actually good guidance from their physicians or their health coach or whatnot. And they can start to rewire different pathways with good lifestyle habits. I'm all for giving people a leg up. So I use peptides differently for different categories of patients.

Okay, so let's just say, let's just get back to the Ozempic because there's so many questions I have for it. So the microdosing or the doses, can everybody microdose it and get a benefit from it?

I suppose it would matter on what their personal history is, what their family history is. So I've got a patient who's got a pretty severe family history of cardiovascular disease, history themselves of high blood pressure. They're just using it at a very low dose to keep their blood pressure mitigated. And it does seem to have some impact, but only if they're doing all the other things, right? If they start messing around...

And we're doing other things in there as well. I'm using different herbs, different nutrients, different supplements, different lifestyle interventions. But it is one of many in a toolkit. I've got people on it who have found it to be really spectacular for boosting their mood and their neurocognition and allowed them to go off antidepressants and allowed them to discontinue some of the things they were doing. It's really... I think this is the problem and I think this is maybe what got me in trouble is...

the need for a lot of other pharmaceuticals may go by the wayside in certain people, depending on how impactful this GLP-1 is in their body, because it not only potentially is abating some of the pathology, I mean, we have hard data showing its impacts on the cardiovascular system

as well as what it's doing to the cardiovascular cells, the cells of the heart. Actually, the damage that's done when there's pathology is being abated and potentially reversed, and mitochondrial function is returning. And we're seeing this in different organ systems of the body. So this is where I'm like,

Who has something to lose? Which industries have something to lose? Who turned off my Instagram? Was it Big Food? Was it Big Food? Because Big Food has a lot to lose. And they've come out recently and like different CEOs have come out flat out and said, go look it up on Forbes. They're concerned. Like their snack food sales are down. McDonald's fast food sales are down. Big...

Pharma might have something to lose because those big pharma companies who don't have a patent on a GLP-1, who are doling out lifestyle drugs like high blood pressure medications and statin drugs, that's their bread and butter. Type 2 diabetes and obesity is very profitable to a lot of industries. So

Maybe people aren't needing those medications anymore that are on GLP-1s. The companies that make the joint replacements are concerned because hip and knee replacements are a massive, massive industry right now because the obesity problem is really causing havoc on these joints. I mean, most people in our age group, I don't know how old you are, but I'm guessing we're somewhere in there. 29. 29.

Oh, wait. Forever. I'm 28 forever. Fine, 39. Go on. I mean, hip replacements are a thing, right? Coming down the chute. Dialysis clinics potentially have something to lose. They're popping up on every corner because long-term metabolic dysfunction is, you know, a 15, 20-year process. You get to type 2 diabetes.

And they're like, oh, you've hit the magic number. But the damage has been being incurred to the microvasculature, to our joints, to our brains, to everything else, to our kidneys for that entire time. And so now they're at type 2 diabetes. The path beyond that is dialysis. If you make it, if the cardiovascular disease doesn't take you out, it's dementia and Alzheimer's, right? Like that's the path that most Americans are headed down because of diabetes.

our system. And I'm with everyone who's like, right now we see Callie and Casey Means, and they are banging the drum on that fact that we need to change the systems. And I completely agree. And I know Dr. Mark Hyman has been trying to change the systems for a long, long time. I totally agree with that. And that has been my platform as well for decades. But I'm over here like, okay, the house is on fire for a lot of people in this country and the world. And

We can talk all we want about how the drywall is flammable and the wood's flammable and the foundation's not built right. We can go on and on and we need to change all that. I completely got to make it earthquake proof. Totally agree. But there's a freaking fire right now on this individual and I need a fire extinguisher. Yeah, no, totally true. So I'm like, can we do both? We can do, I mean, it's true. Like, I feel like it's, you just see, like, I think,

how the, how you just describe it is so true, right? Like if all these snack food companies are seeing their sales are down, McDonald's sales are down because so many people are on these things now, like literally like there's,

There was such a shortage in... People who actually were diabetic could not even get these drugs forever because half have lost more than half. Like three quarters of Los Angeles were on them over here. And, you know, I met this man who was like 70-something years old who had diabetes who was on what? Mongero? Mongero? They were on such back order because people are getting it. Which then brings me to this other question. Are people...

People are abusing it. Of course. And are there people who actually shouldn't be on it because of potential risks to their health, like people who have bad thyroids? Is there any group of people who should be exceptionally cautious before they just jump on the bandwagon? Well, I actually think it has such an enormous impact on the immune system in a positive way when it's not being overdosed that...

Most thyroid issues are Hashimoto's driven. They're immune driven, autoimmune driven. So I think if at least what I'm seeing, what I'm hearing from my colleagues, people are having really great results from them and needing reductions in their thyroid medication when they're on the GLP-1s. But to get back to your

shortage point, from what I understand, the shortage is in the pens, not the dispensing pens, not the actual substance. That's why this pharmaceutical company is coming out with vials. There's plenty of the medication. It's the pens. Yeah. And there's plenty of compounding pharmacies that dispense it. So there's plenty of it around. And in fact, the compounded version is a couple, maybe at some of the doses I'm doing are $30 a month up to $200 a month

That's it? For ozempic, or for, I'm not, I'm sorry, I misspoke. For semaglutide. Is that, you mean semiglutide, right? Yeah. Okay. And then terzepatide is more expensive. But yeah, it's really, really affordable in the compounded form. I think the

The question always was, you don't know where you're getting it. That's the argument, right? Like, well, you don't know what compounding pharmacy is and what they're really doing there. And people have a lot of skepticism. Right. Just how they would online. You don't know who these people are. You think it's more safe, right? If you use a big pharma company. Sure. Right. So how do people know who to choose and where to go? Is it more about just...

trusting the person who is prescribing it? Is that really the only way? I didn't realize until I opened this can of worms a year ago that people didn't use compounding pharmacies. Like I've always used compounding pharmacies. My mentors always use compounding pharmacies. I wouldn't even know how to practice without a compounding pharmacy. And I do know, I know many compounding pharmacists and I know that they are probably the most punk rock

crew in medicine period, like if anyone's being witch hunted, it is the compounding pharmacists, especially now, the ones that are dispensing the GLP-1s. They've got really stringent boundaries and safety protocols that they have to subscribe to. I'm not a compounding pharmacist. I don't know all the details, but I know that they're not looking to get in trouble and having their whole organization shut down, right? They're not looking to be dispensing garbage. And I

Everyone I know is extremely diligent about safety standards, especially if they're making injectables. If they're making injectables, I know there's a whole rigmarole. They have to go through special kind of safety rooms and vents and, you know, they're going in there with like full hazmat gear on making their injectables. And so there was years and years ago, there was a compounding pharmacy that I used to

send patients medication from and they had a bit of a fungal issue in some of their vials of something and that caused a whole lot of trouble and I mean it's just a mess you know so and I'm not anti-pharma either like medication

medications have saved my life and my family's life. And thank God for big pharma when I'm in the ER with a major problem. But when it comes to taking care of yourself every day, I think longevity medicine doctors, the functional medicine doctors that really are on the tip of regenerative medicine, like those are the cutting edge doctors doing the really cool work. And the

you get better faster. So I'm always trying to get people better faster. Like if you were to come in to me and say, you know, I just had a massive mold exposure, I'm super sick, blah, blah, blah. I'm going to bring peptides on board to get you that leg up. What peptide would you use for that? Well, actually, what peptide would you use for that or for heavy metal? I can't get into specifics because then I'm giving medical advice and I don't want to get any more trouble. Yeah, exactly. You're in enough hot water as it is. You're right. I know. That's fine. That's okay. I'll be easy on you today. Well, I'll say this.

I even with the GLP ones, I'm never telling people to take them for this reason. What I try to share is that I am looking at mechanisms of action of how they work. And if it makes sense that in that individual dealing with those symptoms, that that mechanism of action would be helpful, then I'm going to apply it.

Does that make sense? So it's kind of a different way of looking at things. So people say, well, can I take GLP-1s for this condition? Or can I take GLP-1s for this condition? And I'm like, that's kind of missing the big picture. The big picture is who's Jen sitting in front of me? What are her symptoms? What is she dealing with? What's her health history? What can I bring on board to help mitigate? First of all,

bring you comfort and try to mitigate some of those symptoms. But more importantly, what's the root cause and how can I impact that? And so it's a little different way of looking. That's naturopathic medicine in my head. That's a different way. I understand what you mean though. But how about this? Can people get, can your body just get acclimated to it? Are you supposed to cycle these medications too, these Ozempics?

I think so. You know, the studies are showing and what the allopathic community is doing is saying, just put them on it. Some people need to be on it forever. There are studies coming out showing that those who exercise and actually have lifestyle changes during the process of being on them are able to potentially come off of them. And I think the medical industry is starting to wake up a little bit to what I'm saying, which is maybe we should start talking about individualized dosing. Maybe we

maybe the person taking them, even somebody who's got a lot of weight to lose may not tolerate a high dose. And we don't have to just ramp them up according to protocol. Protocol says double the dose every four weeks and ramp them up. So semaclutide starts at 0.25 milligrams and they ramp them up to 2.5 milligrams, 10 times the dose in a period of 16 weeks.

And people just are so sick and can't tolerate it and feel awful. And then they just continue it. And it's like throwing out the baby with the bathwater when maybe back here they were doing great and they were having really, really good impacts and they were tolerating it well and they weren't having any side effects. Yeah. Or maybe even lower than that 0.25 is something that they could start on and get them acclimated and they could feel good. I'm not a big fan of this like...

crank everybody... And this is for any medication or supplement. I'm just not a big fan of cranking up the dose. We titrate until we get minimal efficacy. And then...

How do you cycle that, though? Do you do four weeks on, one week off? It depends on the patient and it depends on how they're responding and it depends on what they need. Or do you expand, like extend? Like I said, I'm taking it every week. You could take it every two weeks. Is that microdosing? That's a potential way of doing it. It really depends on the person and what we're trying to do it for. So for me, I can give you me as an example. Okay.

I have psoriasis and I have psoriatic arthritis. I have psoriasis. If I go, which is crazy, so many people have psoriasis right now. And I never watch regular television. And the weird times that I do, like if I'm at my parents' house, every other ad on the TV is for psoriasis. And I'm like, what is going on? It's crazy, right? Do we have a psoriasis epidemic happening? I have a really bad eczema now. It's terrible. I don't know. It just really just ruptured. I don't know if it's because of the heat. I don't stress. It's happening to a lot of people I know. So...

I would say, and so psoriasis actually is an autoimmune condition that impacts your brain. It gives you brain fog. It impacts your joints and your spine. And people don't want to hear that. They just look at the skin presentation and say, oh, you have a skin lesion. And I'm like, no, this is a whole body lesion.

system thing happening. And when it hits me, I don't just get skin lesions. I get terrible brain fog, terrible depression. I almost can't work some days. I just, my team hates me because they're like, we just told you the same thing 10 times. Where's your brain? I'm like, I'm so forgetful. Well, that and, you know, estrogen helps too. Okay. That's it. That's a whole other thing altogether. But yeah, I mean, as we go through that transition of midlife, our brains really take a

a whomping. And in fact, Dr. Mary Claire was just talking about a study that just came out showing, you know, really severe impacts on depression. And she was on here. She actually said to me that if you take in combination, HRT, you know, medication, HRT, if you take therapy, what do you call it? If you take HRT, but is that what you call it? HRT with a GLP-1, you have a 30% reduction though in fat loss. Yeah.

That was a really small study, really, really small. And it was cool, but what they looked at was they looked at people who were on HRT and semaclutide. Yeah. And they found that those who were on HRT did have a better reduction in fat. So they did have better fat loss.

But again, it was correlative, not causative. They were just looking at people's chart notes. And so it just happened to correlate. There just happened to be these people were on this. And so, and it was very, very small. I think it was like, I want to say like 100 and something people, maybe 300. So that's cool, but it's not, I mean, we would need more studies, but it's cool. And it's, it's interesting. And that's kind of the cancer study they did too. It was like these, they happened to be on this and we're looking at chart notes. That study that just came out that everyone's roaring about on the internet saying, I don't

ozempic causes suicide. No, it doesn't. They looked at 36 million chart notes over 23 years, and they found a signal. And that signal, I think, was 107 in the semactitide group and I think 100 in the loraclitide group. They also happen to be on antidepressants and benzodiazepines. Oh, wow.

So it was a signal. And all they did was find like these people happen to be on this. And even the authors of the study listed like 10 different limitations to the study saying this is just this is just a blip. Pay attention. This is a signal. This is not causative. Please do not run out and assume that this causes this. And they even said in the conclusion that really what we found here is that we just need to be screening our patients for mental emotional health.

Which of course we do. Like, of course we should be talking. Maybe these people were already suicidal. Maybe they would have tried to commit suicide without the semaclutide. Right. Who's to say? But 36 million people over 23 years, and we have 107 in the Ozempic group, and suddenly that's front page news all over Twitter. And I'm like, do you guys know how to read a fridge?

and study. But this is social media. There's so many... There's meta-analysis. There's so many different studies and people don't know what they're... They don't know what they don't know. And by the way, I'm a victim of that too. You can get really wrapped up in... Look what I just said, right? I spouted some...

that Dr. Mary was saying to me, and you just said it was a smaller study than I thought. Meanwhile, everyone now on the internet thinks that that's the Bible, right? But you were saying something about you before we went. Okay, so if I go more than...

It depends on how clean I'm eating. It depends on how well I'm living. It depends on how consistent I am with my workouts, how my sleep is doing, how my stress level is doing, how my mental emotional state is doing. I can go off of the GLP-1s for a period of time and then I start to get my itchies back. I start to see little lesions popping up.

And I usually get them in my hairline. And I'm like, oh, I'm itchy. Now that might have something to do with how many workouts did I do and how many times did I sauna without washing my head as well. But I have noticed that there's a significant reduction in my psoriasis and my psoriatic arthritis symptoms when I'm on a GLP-1. So I cycle depending, and it depends on the season, and it depends on all those other factors, how long I can go off. How long can you go off now? For me personally, probably a couple weeks. Okay.

So you go, like, so you take it once every couple of weeks. Yeah. Generally speaking. Okay. Now. It depends though. Like right now my stress is super high because of all this BS and I've been traveling a lot with these podcasts. And so I'm eating outside of my house. I'm eating a lot of foods I don't normally eat. Yeah. So I have to be more on.

I have to be on it more consistently. And this is why I say it's not a substitute and it's not a band-aid. It actually, I just did a podcast on my own show of seven different mechanisms that GLP-1s actually heal your metabolism. And it gets nerdy and it gets into biochemistry, but they ignite different pathways that are really, really, really beneficial to your mitochondrial health and to your metabolic health overall. And so it's not just a band-aid. It's healing the body while the person's on it.

People are using it, I think, at very high doses as a crutch, and they're not implementing any other lifestyle changes. That's not my problem. That's not the pharmaceutical industry's problem. That's not the doctor's problem even. I, as a physician, try to get everyone to strength train and try to get everybody to live better habits, and it's like pulling teeth. I know. So this is basically, I know, this is like one component of a bigger plan, or one tool in the toolbox. It's not the toolbox by itself. Yes, exactly.

So wait, so I want to ask you a bunch of questions, but the first question is, which do you prefer? The Ozempic, the Monjaro, Wagovi, like in all the different generics, like I would say trizepatide, semiglutide. It depends on the patient.

Because I heard that Ozempic makes people super nauseous. It gets people really tired. They lose a lot of muscle mass. I don't have any of those problems happening. Really? At all. No, because it's the dose. The dose makes the poison on that.

So we have GLP-1 receptors in the nausea and vomiting centers of our brain. And I do think some people have a bigger bed of those potentially. And so GLP-1s probably impact them more significantly on that nausea front. But we keep the dose this side of nausea. So I don't run into that at all. And the muscle mass issue is...

an issue of severe caloric restriction. It's just, literally, these peptides have a really cool impact on muscle. They actually help support angiogenesis into, so blood perfusion into the muscle. They're healing and regenerative to the muscle in almost an anabolic way. So the muscle loss is due to the caloric restriction. People are starving because they're on too high a dose and their appetite is being crushed and they're not...

protecting their muscle mass by strength training and they're not eating their protein macros, they're not hitting their goals there, and so they're wasting away because they're being, I believe, being overdosed in many cases. And then they're not being counseled or they're not being compliant or who knows, but it's not the muscle. The peptide itself does not, from what I can find, induce any muscle loss specifically as a mechanism. In fact, it might do the opposite. It might help induce muscle protein synthesis.

Really, because I also heard that people just don't have the energy to go and do the workouts that they used to do because they were just exhausted. I think the dose is too high. And a lot of people are saying they're microdosing, and a lot of doctors are saying they're offering microdosing now since I've started talking about this. And every single – I'm not kidding. Knock on wood, I'm wrong. But every single time I've talked to somebody and I said, oh, great, you're a doctor, you're microdosing. What dose are you using? They're all just starting at the standard starting dose. Right.

And then they're bumping them up. They're doubling the dose within four weeks, which is insane. Like, that's insane to me. I'm like, I'm talking about a fraction of that dose. And that fraction is different for each person. So a lot of doctors out there saying they're offering microdosing are simply just offering standard low dose and keeping patients on that dose and just not ramping them up that much.

fast tier, those tiered levels I told you about. So they're not going as fast and they're not going as high and they're calling that microdosing. That's not it. I'm talking about using a fraction of that dose for someone who needs it. So it totally depends on the person that is utilizing the peptide. As far as what my favorite is, it depends on the patient. Simaclutide is a lot less expensive, even compounded. Well, I think with the brand names, trizepatide and simaclutide are about on par for cost. For compounded, simaclutide's less expensive.

maybe sometimes four times less expensive. So it might be a cost issue for people. That's what they can afford. And so I meet them where they're at. That's important that we consider that. We don't want to put something on someone they can't sustain, something they can't afford to sustain, right? Yeah. Trisepatide has a different profile and it has...

a GIP agonist in it. So if someone's got more of that metabolic dysfunction or that insulin resistance that comes with middle age, I might think that that would be one to try. But I've also heard from people that are using it just for autoimmune disease that the semaclutide is better. They're liking that better. It really depends on the person. My husband does not like trisepatide. I love it. I do not like semaclutide. He loves it. Many of my patients love one or the other. So...

Can one work on one person in terms of the efficacy, in terms of the effects? Like, you know, one may make you nauseous, but it actually gets the job done. While the other one... I don't want anyone nauseous, though. Well, no, what I'm saying is, my point is, is there... Oh, I see what you're saying. You know what I'm saying? Yeah. But one just doesn't work on the body. Like, it just doesn't react. Well, we just have to try. And same thing, like you were saying earlier, that, you know, people that, you know, the Sir Moreland's not working on. And...

If it doesn't work, it doesn't work. There are issues. You asked me who should not take it. People who have biliary issues. Like if you have a history of biliary disease, gallbladder issues, it has been shown to have some problems there. I think part of that problem, if you just want to get down to the physiology of it, is that people are going on high doses regularly.

They're crushing their appetite. They stop eating. When someone stops eating, the gastrointestinal tract slows down. It also slows down because of the peptides. So we've got double duty there. And then their bile gets sludgy. People who tend to need to lose weight and who tend to be in that type 2 diabetes obesity group also tend to have sludgy gallbladders, as is. They're already sitting on the edge of that. And so...

We slow all that down and sludge up the gallbladder and we're going to have more potential for a stone. You throw the stone into the pancreas, now you've got pancreatitis. That's a big issue. But the peptide itself does not actually cause pancreatitis. It's actually healing to the pancreas. It's a secondary issue from biliary stone. The other main cause of pancreatitis is fatty pancreas. So when somebody is in a metabolically compromised state for a long period of time and they're dealing with obesity and or type 2 diabetes or and or just metabolic dysfunction and they're on that path...

They're going to get fatty liver and they're going to get fatty pancreas. And so we're talking about people who are already sitting on the edge of a lot of these concerns. They're already sitting on the edge of gastroparesis. Type 2 diabetics are probably the highest risk group for gastroparesis because their vagus nerve gets hypersugared and destroyed. They're already sitting on the edge of pancreatitis and gallbladder issues. They're also...

a high risk group for that. And so people are getting slammed with high doses of this peptide and getting thrown over the edge of something they're already at high risk for, or maybe, maybe again, sitting on the edge of. So it's just being all sensationalized and people aren't thinking, and they're not stopping to look at physiology and pathophysiology and how these things work and how the body works. And they're like, oh, it's bad. Right? Yeah. I mean, the other thing is like, how do you maximize the benefits, right? Like

If you're just doing all the lifestyle things that we spoke about, like strength training, eating the amount of protein you should be eating daily, microdosing it or taking a dose that just kind of like helps you, like don't overdose. Right. The appropriate dose for the patient. The appropriate dose for the patient. What other ways are we able to maximize the benefits of that?

So we see the returns long-term. Strength train, build muscle, focus on muscle. In fact, I just told my husband the other day, I'm like, you're just wasting all these peptides I'm spending money on because you're not in the gym. Like, you know, don't waste the opportunity. Like strength train, build the muscle, eat the good food. Like I said, there is a potential, well, not a potential, they have that.

piles of studies on this. There is a neuroplasticity that occurs on the GLP-1s, meaning your brain is wiring new pathways and learning new behaviors and hardwiring it in. So why not take that opportunity while you're having a little bit of appetite suppression? There's also this

Onus of responsibility goes, it goes, people get back in the driver's seat. They, a lot of people describe it as like, oh, I feel in control again. And I'm not just in control of my eating. They're in control of their alcohol. They're in control of their smoking. They're in control of all these vices. Those are some other big industries that maybe turned off my Instagram.

Yeah, yeah, yeah, yeah. Honestly, it could be anybody at this point. It could be Ed over here who turned off your Instagram. They're studying it for alcohol cessation, alcohol abuse syndrome. It shuts off the noise in your brain. That's what I've heard. The hedonic noise. It shuts off the noise. So all these things that are your vices or your addictions, because food can be a massive addiction, right? Just how alcohol or drugs.

And if it's shutting, it quiets your brain, actually it can, it can really save somebody's like mental health in that way itself. Yes. Right. My only thing I'm curious about is can your body become acclimated? And then like, cause I've also seen friends of mine who it was great in

And then after now six months of using it, they're eating again how they used to eat. Yeah. Not because they're necessary. It's habitual. Because eventually you go back to your habits of what you used to do, right? You can chew through it, as I call it. You can definitely override. Yeah. And if you...

take those higher and higher doses and that's that cellular receptor I was talking about, and you get acclimated at those higher doses, then where do you go from there? I'm really concerned about the people that are on the super high doses, especially if they're not strength training, especially if they're not using that opportunity to change all their lifestyle habits because taking the peptide away, they're just going to crash and burn, and then they are going to have muscle loss.

There is real muscle loss happening. I'm not saying it's not happening. And there is real side effects happening. I'm not negating that. I just think it's a dosing and management issue. It's dosing and management. Yeah, I think so. Then let's talk about you were saying middle age, right? Like you're saying...

like how can we use the GLP-1s to really maximize what's happening in perimetopause or even menopause for people who are going through that? I know we kind of mentioned with Dr. Mary that study. Are there any other tips and tricks or things that we can do, in your opinion, to really kind of get us the biggest bang for our buck? Well, I think HRT is critical. And I've

been using it in my patients for decades. And when that Women's Health Initiative study came out decades ago saying estrogen was dangerous, those of us who actually read the study, again, people aren't reading studies before they start vilifying everything. That study showed estrogen and progestins. Progestins are fake progesterone, and they will sit on the cell, and they will not have the same impact as progesterone. And that's really dangerous. So we use progesterone, natural, real, bioidentical progesterone, to offset any issues with estrogen.

So I don't like using unmitigated estrogen alone. I like having a progesterone on board. So anyway, those of us who read the study 20 years ago were like, we're going to keep using it. And we've been prescribing it ever since. And our patients are very happy on their hormone replacement therapy. I feel terrible because there's a whole generation of women who got severely screwed over. And this is why. As we go into those years and our estrogen starts to wane, not even talking about progesterone, which is a neurohormone and we need it. But as our estrogen starts to wane, a couple of things happen that are

really, really bad. Number one, we start to become more insulin resistant and we start to become more metabolically compromised, period. It's going to happen to all of us as our estrogen wanes. Number two, our fat cells start to act differently. Our stem cells start preferentially turning into adipose tissue, which is fat tissue. And our fat tissue starts to redistribute itself into weird places. That's why we all turn into the sort of, they call it the gynoid shape, which is that belly with the skinny legs and arms. Whereas we used to have the butts and hips.

We start to get more of a male figure, which is that middle section, the middle-aged middle, and the skinnier arms and legs. And estrogen also helps with, to some degree, there's a mechanism where it helps with muscle protein synthesis. So we start to lose muscle even with our best efforts. Our tendons and ligaments, that was my world, was regenerative organics.

orthopedics, our tendons and ligaments start to become brittle and friable. And they, they, I started getting, that's how I really knew I needed to double down on the estrogen. I just kept getting injured and injured and injured in all of my workouts. And I was like, what the hell is going on here? So it's, this is a disaster. And,

I've always told my patients, stay on this side of the curve, meaning start the hormones, test the hormones and start the hormones way before you think you need them. Because once you're on the other side of it, it's looking like from the studies that I've been reading, I've been really diving into the musculoskeletal component because like, again, that's my world. The pain component, there's a whole arsenal of impacts that estrogen has on our pain that they're just discovering and putting together, which is so cool. Because I've known this for decades with patients and I just...

didn't have the data to put my finger on it. I just had patient outcomes to prove it, you know? Yeah. Estrogen on the other side, especially after all the adipose tissue has laid itself down, because women will become, as I said, more insulin resistant, more metabolically compromised, and usually more obese. It just adds up, right? Like,

60 some percent of postmenopausal women are obese. So in this country, I don't know where that stat came from, but I heard somebody say it, who's an obesity doctor and it's some, and I looked it up and there is some version of that. I found like close percentages on either side, but it's a pretty significant number.

Anyway, on the other side of that estrogen, over here, estrogen's protective. It's got protective benefits to our cardiovascular system. It's got protective benefits to our joints even. Over here, it might actually harm. Once people are over that hump, it's going to be a lot more effective.

especially if they've laid down a lot of fat and they're metabolically pretty severely compromised. And I've seen this in patients. Estrogen just can go rogue. So it actually, over here, it causes vasodilation and it helps your vessels stay open and patent. Over here, it can cause vasoconstriction. Just by waiting too long to start taking it. Dementia, over here, it's protective against dementia. Over here, it might actually cause dementia to get worse. Over here, it's protective to your knee joints. Over here, it might make your knees worse.

So, this whole generation of women who got bamboozled by this stupid Women's Health Initiative study 20 years ago have completely been screwed over. Whereas I've been taking estrogen since, I've been taking progesterone since I was in my 30s. I've been taking estrogen since I was in my mid-40s.

Like, I'm not messing around. I know what my mentors have all taught me, that I've all been doing hormone replacement forever and ever in practice. And you get too, and I've seen this clinically, you get too far on the other side, and I would put those women on hormone replacement therapy, and it just, all bets are off how it's going to go.

It really sucks. Over here, like if you started gaining belly fat, estrogen can really help with that because that's, again, that's where the fat wants to redistribute when you start losing estrogen. Over here, you might have a real problem. This is why I think GLP-1s are such a wonderful tool in this tool belt because these women need help over here. And I think the

adipose tissue and the metabolic dysfunction is what's driving the potential deleterious effects of estrogen. And we need to clean it up. And what's going to clean it up? Yes, lifestyle, of course. But also, can we bring something in that might actually really help reset that metabolic health and really get them dialed in and get that inflammatory adipose tissue off of their bodies so we can apply the hormones they need? This is where I think GLP-1s are like a

Yeah.

I think as long as the patient doesn't have any outstanding contraindications, I am probably going to suggest it. And then it's a risk tolerance thing. And then we dose appropriately so we don't induce any side effects. So it's not a miserable existence on it. There's no need to be miserable on urozempic. Wow.

So what about when people are starting to play around, like they take the testosterone but not the estrogen? Testosterone is awesome. It's really awesome. I've done a whole series of educational content around testosterone, and it's great for pain too. So is estrogen. But some people are going to aromatize. You have this aromatase enzyme that lives in your belly fat specifically, and oxytocin

I am one of those people. If I take too much testosterone, it aromatizes into estrogen. And in the fat, that aromatase enzyme causes testosterone to convert into estrone, not estradiol. And in the brain, it converts into estradiol from what I understand. And so depending on how your aromatase enzyme is behaving, and some people just have a lot of it, then it's going to potentially turn it into estrone. Estrone is the estrogen that's highest in menopausal women. And

I don't have any great data on this, but something, this is what I have been like engrossed in the past three months is trying to figure out, I think estrone is what is potentially causing a lot of these, you know, your menopausal issues. I don't think estrone's the most favorable type of estrogen, but I don't have any data to support that yet. But I,

What I have found when I'm looking at estrogen and adipocytes, those are your fat cells, how it behaves in your fat, estrone maybe isn't the best. So I used to rely on testosterone to convert into estrogen for women. And a lot of doctors believe that and I believed that. But I'm starting to wonder, depending on their belly fat situation, that might not be the best answer. Now, if you don't have any belly fat, it's probably not as problematic. But for me, when I first went on testosterone, I got really lean in the midsection and my abs looked great. And I was like, woo!

And then over time, I started turning into a little apple shape and my pain started roaring. And I was like, something is wrong. And my estrone was super high. And you think it was converted from the testosterone. So how do people find out if that's happening to them? You test. You can test. And there's different tests that are... There's blood tests. That's a standard of care. I know a lot of people poo-poo on the Dutch test, but the Dutch test shows pathways, which I think is cool and that's helpful. So it just depends. But relying solely on testosterone...

I think, I don't think is it. I think estrogen is wonderful. I think testosterone is wonderful. And I think progesterone is wonderful. And I think of all of these as like a symphony and we need all the instruments, right? And I think of peptides the same way. We don't just use GLP-1s at super high doses as a monotherapy and hope for the best. I think we use...

The symphony. But you know, you know what I'm getting from this podcast from you is that like, it's, it can be very complicated and overwhelming and, and it's really important to have somebody who you trust, who knows what the hell they're talking about, who you work with. Because I think there's so much information and that's like really, it's like information overload. It's a lot. Right? Because I'll talk to you and I'll get some, and I'm like, okay, this sounds great. And then

left to my own devices, I'm confused. And then I'll go to my doctor who's like, let's say a regular gynecologist. And she's like, what are you talking about? Your testosterone is fine or your estrogen is fine. And then they won't be able to properly balance me. Then I'll try to find someone like you. And more often than not, and you can be honest, you won't take me like, maybe you'll take me as a patient, but like the ones who seem to know the most are not taking patients. I'm not taking patients anymore. Right.

You're not taking patience because you're too busy writing books and doing the media tours and going on the podcast. And then like all the people who have all the knowledge or who are the, who are really good are like,

too big to they're they're now like media personalities they're not taking patients I know it's like a shitty situation that it leaves people in like what are people supposed to do we're left with like these mediocre doctors who don't know what the hell they're doing because people like you are too busy doing media

Well, it's not even that. It's just, I mean, I got out of practice in 2018 because I was burned out. I still take patients here and there by referral, but I don't have- You do? I don't have like an open- Door. Yeah, to the public. If I begged you, would you take me on? Yes, of course. Okay, please. And then, no, I'm serious. It's almost like- I have a course. So I made a course that-

because I really wanted to get my brain down into the internet in case anything ever happened to me. Because this deplatforming by Instagram. You know, you're very upset about it. Well, it wasn't the first. I mean, I've been getting targeted since 2020. And so I was like, I'm going to put my brain down. Like, how do I go about patient care from a comprehensive perspective?

point of view. And so I made a course for clinicians that I let the general public into. So if people are interested, they can find it on my website. And I have a free four-part video series that takes people through a lot of the information that we're kind of just touching on and leads them into that if they're interested in buying the course. And for now, the course is open to the public. I'm thinking about changing that to clinicians only soon. But I

I'm trying to at least that way train other clinicians to have a more comprehensive, holistic point of view because there's a lot to unpack here. And I didn't just learn all this stuff overnight. And the reason I got interested in GLP-1s was because I already was treating people this way for decades. And I was like, oh, look at this cool new tool. So you were using GLP-1s like 10 years ago? No, no, no. I just started utilizing them in the last year because I...

I, it just was this nice little tool to add to my toolbox. You know, I joke every year, my, this is the best advice, totally off topic, but the best advice I could give any dad. My dad bought me a new tool every year, like a tool to do something with and a toolbox when I was 18 or 17. And every year he bought me a new tool and taught me how to use it. And so I have a big toolbox now and I know how to use tools.

And I don't have to ask a dude when I need to drill a hole in the wall to hang something, right? Yeah. So I think of it that way. I'm like, oh, this is a cool peptide I'm going to add to my toolbox. This is like this year. This is a cool new thing. And, you know, there's talk like people, some people really love metformin and some people love this. Like I've been using

thyroid hormone for longevity over pathology. Let me explain this. I think this is really important to wrap this up. We're looking at medicine in this pathological medicalized state. And I think that's where most of the Ozempic and Monjoro use is. We're waiting until people are completely in disaster land. And once they hit that diabetes number, they have had 15 to 20 years of massive destruction in their body. They're metabolically and mitochondrially

trashed and we wait until then until we do something. And I'm over here trying to grab people and say, let's just tinker with a few things. Like you've done a pretty good job thus far. You're lifting weights, you're active, you're taking good care of yourself. Here's some longevity tools to clean this up. So microdosing really only works in those who are metabolically optimized.

And so do most of the peptides. That's not to say we can't use them over here. But again, as you heard with the estrogen, over here, once the dumpster fire started, we're doing emergency medicine, in my opinion. And we're trying to bring people back from the brink of severe pathology. And it's this medicalized use of

stuff I'm over here using like a paintbrush, where I'm just trying to optimize people, get them feeling better, just tinker with them. They're generally doing pretty good, and we just need a little bit of this and a little bit of that to sweeten the deal. It's an entirely different approach to medicine. How about men versus women? Men are actually always, they respond faster and better, and they're more compliant, always. Always. Men are easier to deal with. Yeah.

By far. You're preaching to the converter on that one. They're like, tell me what to do, doc. And they clean up nicely. And because they don't have such a soup of hormones and they don't have such a soup of autoimmune potential, they tend to do much, much better and much, much faster. And they just are a bit more resilient of the species for real. For 100%. And then how about in terms of regular things that people can do in terms of health optimization? Like besides the peptides, besides...

Is there any recommendations that you think people can do that can move the needle just even a little bit that they can just...

pick up naturally or do besides strength training? Well, the really unsexy stuff that we all talk about, which I would tell anyone interested, I have a whole video I made on my website of how to find a good doc. But even there, it's just ideas. Like, what do I look for in a good doctor? Because there's all this homework you have before you even call a doctor or you even think about spending the money. Because all of these, even if you can find them, they are cash pay and they are expensive.

Your insurance is not, you're generally not going to find these people through your insurance system. So do your homework and do your work, which is go for walks every single day. Set your circadian rhythm. Go out in the daylight like a mammal, not like a vampire. Yes.

Yes. Watch your blue light exposure as we sit under, you know. A hundred blue light, I know. Do the muscle building. Protect your muscle at all costs. It's your insurance as you move through life. I've been telling people for decades, like lift weights and eat meat long before it was popular, long before it got popularized. I'm like, dude, if you try to go through middle age and older age without muscle, it is the kiss of death.

Make sure you optimize your sleep and protect it. And anything that messes with your sleep, get out of your life. Get your TV out of your bedroom. Get your snoring husband out of your bedroom. Get your dogs out if you have to. I love my dogs, but man, if they're making too much noise, out. So the basics of being a human being and do them every day because as we age, I think they become more and more of a job.

it's kind of a full-time job. I know it's overwhelming, but I don't have any better answers. I'm just the messenger. No, I agree. I think that, I think what you said that was very important before about none of these things work unless you're already at a certain place doing certain things, right? Nothing is a magic pill, right? Like you can only band-aid something so much, right? If you're not sleeping properly, if you're not working out regularly, if you're not eating well. And then the one other thing you said, which I think is very important and I'm a believer in and people, again, it's, it's,

how there's even controversy around this to the level it is, but eating animal protein, I mean, there's no other source of protein that you can feel like that gives you the same bang for your buck. Yep, 100%. Honestly, my practice when it was open to the public was by application only, and I really would turn away most...

vegans and vegetarians, because I was doing regenerative injection therapies for the most part. And you can't regenerate tissues that when you don't have collagen coming into the body, I'm trying to induce collagen with these injections, right? So anybody out there who's looking to get stem cell therapies done, if you're not eating animal protein and you're not getting collagen into your body regularly, like your body can't be induced to make more. So it's- That's a really good point. It's really critical. I'm a big animal protein proponent. I was a vegetarian for 10 years and I about killed me. It was not-

It was not good for me. I know that some people thrive off of it. I've met very few who do, though. The only person, honestly, that I know who thrives off of it, he's a very close friend of mine, Darren Olean. Yep, I know Darren. Darren is like my brother. We're very, very good friends. And he looks that he's vital. He's the only vegan I know, honestly, that is doing a great job at it. A great job at it. Every other person I know who is a vegan, God bless them, they look tired. They look sad.

They look tired. They look weak. He's doing it properly. And I don't know how he does it, but it's amazing. I think, you know, this goes back to the Ozempic in that becoming malnourished is a really bad place to be. It's a really, really bad place for your immune system. And it's a really bad place for aging. And so anybody who's basically just starving themselves to death, whether they're choosing not to eat entire food groups or they're choosing to just not eat at all because they're taking so much of an appetite suppressant,

peptide, you're going to end up in malnourishment. And that's a really, really terrible place to be. You just, they all end up looking like melted candlesticks. That's exactly what it looks like. One other question, not about GLP-1, and then you can go to your, I know I've been like, I've got so many questions for you, is about the stem cells that you said that you, do you still do them? I don't.

No. You don't do them anyway? Why are they now illegal all in the U.S.? Because I have a guy, a doctor that I know who does them in Cabo and Dubai. He's not able to do them in the U.S. There's different rules, and I'm not up to date on all of them, but I don't think they've changed since I was doing them. So you can do fat-derived or bone marrow-derived from the patient on the same day. So if I were to take out your fat, which you don't have any of. I do. If we were to suck out your own bodily tissues. Yeah.

Process them in the lab right there and put them back into you. That is legal. But taking them out and banking them in hopes to grow more from that sample is not. But there's something called Muse cells. Have you heard of stem Muse cells? I haven't, but there's a lot of... Every year there's a new thing and these are...

If they are in the US, if someone's telling you- Not in the US. But if you're in the US, just for everyone to know, if you're in the US and your doctors are telling you they're giving you stem cells and it comes out of a vial, that's bullshit. Those are growth factors. Those are not stem cells. There's no living stem cell in something that's been processed and put into a vial. If it's been sterilized and cryofrozen, it is not alive anymore. You're not getting a stem cell out of that. You're getting growth factors from the stem cells. Not to say it's not going to have any impact and that it can't

be helpful, but it's not stem cells. And I'm seeing a lot of this right now in the online space of like, oh, so-and-so hooked me up with so-and-so's doctor and I'm getting stem cells. There are no stem cells that come out of a vial, people. If you go to another country, you might be getting something from an umbilical cord.

derived or a placental derived, and those are coming, maybe there's something that's still alive in there. And those are not allowed in the US. Why are they not? I don't know. It's such a sordid. I got out of... See, I was trying to stay out of trouble there too. So I got away from stem cells long ago. Really? I've honestly been trying to stay out of trouble. And there you are. I'm just like trying to help people and give them information that I have to help them. And then you get banned. So...

So you have no idea why they would be banned from here? Well, it's just logistics. Well, they're helpful. They're helpful. I mean... They're expensive. They're helpful. Anything that's helpful that's going to heal somebody and take money out of Big Pharma's pocket is a threat. They don't want that. Why are they so expensive, though?

I don't know. I got out of the stem cell world a while ago. Yeah. I got, I got a girl you could interview that is brilliant. And I'm going to ask, I'm very curious about this. If it can help, can it help like nerve damage stem cells? There's amazing. I mean, they're doing really cool stuff all over the world outside of this country. Yeah. It's crazy. That's why I thought you would. Really? Yeah. Really, really cool stuff. And if I needed that, I would probably leave the country and. Oh yeah. Yeah.

Of course. Go get it. But as you said, I mean, a lot of this stuff is cost prohibitive and not everybody can access it and afford it. And I realize that and I realize I'm sharing all this cool information and then people sometimes come back and say, well, where do I, I can't even afford this. Start with the basics. Go for a walk every day. Get your daylight cycles synthesized or, you know, in check.

Get your sleep dialed in. And we can't get our sleep dialed in if our hormones are a wreck. Totally. But a lot of these hormones, like bioidentical estrogen, the estradiol that Big Pharma provides in the patch or in injection form or in the pill form even, not that the pill's very, we don't want the pill going through the liver, but there are forms that you get at your regular pharmacy.

That is bioidentical. That's estradiol. So even the, like the, I love, I use the patch. I love the patch. You can get micronized progesterone from Big Pharma at your regular pharmacy. Really? Yes. And it's, you don't always have to go through compounding for this. And in fact, sometimes I prefer not to. Everything I take for my bioidentical, aside from my testosterone, comes from a traditional pharmacy and it's very inexpensive.

So you just have to find the doctor that'll give it to you. How about troches? The trochees? Yeah, trochees. Those are compounded. So the cost can get...

Costs can become an issue there. Are they expensive, the trochies? They can be. I think it depends on what you put in there. So it's just... Is it as, like, is it, are they as effective, like testosterone trochies? It just depends on what the patient likes. Some people swear by the pellets. Some people swear by the trochies. Some people, like, I really was not getting any bang for my buck with any estrogen delivery until I put a patch on. And then I was like, oh, this is what they're talking about. Like, the calm...

Zen Jedi powers. Really? Yes. Do you have an extra in your purse? All the pain went away. All the calm comes over you. And it's almost like a tranquilizer. It's amazing. So this is just from your regular pharmacy. So I just share that as hope because this isn't all just for us folks over here who can access these special doctors. I agree. That's what I like. I like giving people things that everyone can do versus just like the super, you know,

elite, rich, or people who are in the business or whatever. Because there's a whole world out there. Yeah, and people need help. And they need help. And I think that that's why it's really important. There's always alternatives. So it's important to give people those opportunities.

The options, yeah. And as for the GLP-1s, for those who really do have weight to lose and who are metabolically compromised, the standard starting dose in the pen may be very, very effective and well-tolerated. And even going up a little bit, like my dad, I'll use an example. My dad is just really severely overweight and very metabolically compromised. And for him...

All we did is use the standard dosing protocol, but we went very, very slow. And I only have him at half the maximal dose and he's doing great there. And he's having really nice weight loss and it's slow and he's not wasting away and he's having a tremendous impact on his blood sugars and his metabolism. And...

It's proof that it took me a year to get them up to that dose. That's how slow I went, right? So there's a way to do this. So for folks who really do want to use GLP-1s, I would just say from the regular doctor, just ask them to go slow and low. There's no doctor out there that's going to be opposed to going slow and low on medication. Most doctors have a brain and are going to be like, great, you want to use less? Yeah, 100%. That's much safer. I've been using, have you ever heard of this thing? It's like a

that's called a lumen and you breathe into it. Oh yeah. And it's like a metabolic test. Yeah, I use that. You do? Yeah, I have one. Really? And it tells me what I'm burning, if I'm burning fat, well, you know, fat, carbs. Is that a good indication of where your metabolism is in terms of your health?

I think it's helpful, but I use it in conjunction with other things. So I like a DEXA scan to see what your body composition is. And I like strength testing. Like, can you do pushups? Can you do pull-ups? Can you deadlift your body weight? This is just another tool. I'm not like everything else. I think it's great in conjunction with labs. Like I don't ever, or even those, you know, in-body body composition. I never use anything alone and put my hat on it. It's like,

How does this fit into a comprehensive analysis? Yeah. Okay, good. Yeah. All right. Well, I guess you can go now. I don't know how long this will take. Well, you have my cell phone. Yes, and I'm going to use it. Dr. Tina, I would say everyone follow her on Instagram, but now I won't say that. Well, I have one Instagram there. It's the Dr. Tina Show. It's my podcast. And that account for now is still standing. Perfect. And I'm going over to TikTok and my website. I think...

in this day of censorship, get on my email list and go to my website and get on my email list. And that's a really good point. I think that's what everyone should be doing that anyway. Yeah. And I have a free course there called Ozempic Uncovered. And I saw that. It's informative and it's helpful. It's really good. Yes, I did see that. Thank you so much for being on the show. Yeah. Thanks for having me. Of course. Bye. Bye.