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00:00:05.120Welcome to the Dr.
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00:00:06.63950 Something Podcast.
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00:00:07.759I'm your host, Dr.
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00:00:08.880Nicole Norris.
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00:00:17.519Whether you are in the midst of midlife or you want to prevent the physical and mental signs of aging that occur in midlife, this is the podcast for you.
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00:00:29.679This is a show where I share my knowledge gleaned in family practice, preventative medicine, and aesthetic medicine to shed light on aging, or better yet, how not to feel or look like you are aging.
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00:00:34.640We should be taking an active role in how we age from an early age.
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00:00:39.679We should not settle with growing old gracefully or letting nature take its course.
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00:00:46.159How we age directly affects our confidence, which impacts all of our relationships with those around us.
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00:00:56.479The length of time in our lives that we feel really good in terms of energy, aches and pains, and thought clarity has a definite impact on the mark we can leave on this world.
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00:01:03.920My wish for my listeners is to always be mistaken for being 50-something or less in mind, action, and appearance.
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00:01:05.040Let's go.
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00:01:16.560I missed you all.
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00:01:18.879I can see some of you shaking your heads.
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00:01:19.920I had you worried.
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00:01:22.239You wondered if I fell off the face of the earth.
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00:01:22.799Nope.
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00:01:24.799I was just busy having fun.
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00:01:26.719Summer is just so fun.
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00:01:31.439There is always something to do outside, and I am like a chicken when it stays light later.
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00:01:38.959For me and my chickens, it is just so hard not to enjoy every minute of the outdoors until it gets almost dark.
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00:01:45.280Did you know that chickens will not go in their coop until their natural instinct of fear tells them to?
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00:01:48.480Yes, chickens are actually quite chicken.
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00:01:51.599The reason is that chickens have very poor night vision.
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00:01:54.400Like little old lady driving at night blindness.
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00:01:59.120They will actually freeze in place when the sun goes down because they cannot see where they are going.
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00:02:12.800Their circadian rhythms are affected by changes in the light outside, and when the light starts to fade, this triggers a strong urge to find a high, safe spot huddled with their chicken friends to freeze in place from potential predators.
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00:02:21.439So me staying outside, having fun on long summer evenings, on the positive side is fresh air, exercise, and bonding with my family, dogs, and chickens.
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00:02:27.520On the negative side is no podcast writing and eating dinner later and getting to bed later than I would like.
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00:02:33.759So I am very grateful that you are still listening to my podcast after that little hiatus.
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00:02:39.520In this episode, I will try to make it up to you for waiting patiently for my next podcast.
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00:02:46.879You are going to absolutely love learning about peptides that affect your metabolism and therefore your body composition.
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00:02:53.120Body composition is losing body fat and gaining muscle.
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00:03:07.759These are the peptides that I like to use to improve my patients' results when they're on GLP1s for fat loss, or in some cases, I use these peptides instead of GLP1s for fat loss.
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00:03:12.400GLP1s are definitely the most famous peptides for changing body composition.
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00:03:16.080However, I'm not going to talk about them specifically in this podcast.
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00:03:18.479They may deserve their own podcast down the road.
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00:03:32.560I actually have thought to myself more than once that a little cocktail of hormone optimization, a whisper of GLP1, and a splash of growth hormone peptide may cure just about anything that ails you.
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00:03:39.120Well, probably not anything, but this combo sure can transform your body composition, especially after 30.
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00:03:39.840Think about it.
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00:03:43.680Hormones make it possible for you to lose fat and build muscle.
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00:03:48.800GLP1s make you not think about food, eat less, and decrease inflammation.
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00:03:55.520And then growth hormone peptides help you build muscle, which most people lose on GLP1s.
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00:04:02.560In our office, we do in-body body composition measurements at all of our weight loss, hormone, and peptide visits.
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00:04:16.959Patients on this trifecta of optimal hormones, a whisper of GLP1, and a cycling of a peptide that increases their natural growth hormone, they have the most significant transformations occur right in front of their eyes.
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00:04:21.120Our in-body device Bluetooth your body composition to an app on your phone.
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00:04:25.920So this shows you trends in your percentage body fat and your lean muscle mass.
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00:04:31.199We use this way more than a scale to determine health success.
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00:04:40.800If patients are losing muscle instead of fat when they're on a GLP 1, it is typically because they are not following the HENS rules.
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00:04:52.240As providers, we have to have a responsible conversation with these patients that if they're losing too much muscle mass, a GLP 1 may be hurting them, not helping them.
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00:05:02.560Of course, even though it has been a little while since my last podcast, I am sure you all remember the hens rule that I have drilled in your heads.
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00:05:08.240None of these glorious peptides will do much for you unless you are following my hens rule.
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00:05:21.279For those of you who are in need of some memory and brain optimization peptides, hens stands for hormone optimization, exercise, good nutrition, healthy sleep patterns, and stress management.
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00:05:26.000I think maybe I'll talk about optimizing brain function in one of my next podcasts.
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00:05:29.759I'm headed to Nashville soon for a three-day course on that very subject.
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00:05:35.439Let's begin with peptides that stimulate your body to secrete growth hormone.
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00:05:41.839Growth hormone is a hormone that we all have, of course, in order to grow as a child.
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00:05:47.439The levels are normally high while we are growing and then they level off in our 30s.
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00:05:53.360After that, they naturally start declining gradually with age, just like all of our other hormones.
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00:05:59.680But there are many other factors that can lower growth hormone levels more than age itself.
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00:06:01.920High levels of visceral fat.
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00:06:07.680That's the fat we can't pinch, but it hides on our organs and can lower growth hormone.
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00:06:10.800Physical and emotional stress lowers growth hormone.
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00:06:30.959Factors that can increase growth hormone naturally include high-intensity interval training, resistance training, good sleep, short-term fasting, and having adequate levels of T3, which is our active thyroid metabolite that rarely gets measured, but does also decline with age.
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00:06:34.720I check growth hormone levels in my patients over 30.
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00:06:40.639The lab test that you want to follow to monitor your growth hormone is called IGF1.
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00:06:48.399If this is low, I typically use a class of peptides called growth hormone releasing hormone analogs.
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00:06:52.160Shortened is GHRH analogs.
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00:06:59.519These are peptides that stimulate release of growth hormone from our pituitary gland located in the brain.
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00:07:10.160Some common GHRH analogs are surmerelin, CJC1295 ipimerelin, and tesimerelin.
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00:07:16.319They are going to be the ones we discuss today, and by and large are the most common.
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00:07:23.600They can be used alone or in combination to maximize the amount of growth hormone being released into the body.
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00:07:33.600They do this with minimal effects on other hormones, such as ghrelin, which causes hunger, and prolactin, ACTH, and cortisol.
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00:07:38.959This is actually why we don't use straight-up growth hormone to replace growth hormone.
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00:07:52.720Using straight-up growth hormone, marketed as omnitrope, affects these other hormones adversely and so is actually just limited to use in children who have short stature syndromes or head trauma that affects the pituitary.
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00:07:58.319The beneficial effects of GHRH analogs are many.
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00:08:01.600And there are some nuances to each of them, which I will touch on.
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00:08:09.439So, first of all, this is the laundry list of possible benefits to getting your growth hormone back up to where it should be.
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00:08:10.399Okay, here we go.
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00:08:17.600Increased muscle mass, improved physical performance, and rightfully so, they are outlawed in some competitive sports.
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00:08:32.240Weight loss support by increased metabolism to burn fat, improved recovery from exercise and injury, increased bone density, cardiovascular support, improved sex drive, brain protection, improved cognition and memory.
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00:08:37.120They have healing properties for burns and significant soft tissue injury.
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00:08:39.759You can have improved energy levels on them.
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00:08:42.960They promote deep wave REM sleep.
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00:08:50.559They can lower LDL cholesterol, and these are just to name the most common reasons that they are prescribed.
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00:09:05.279Possible adverse side effects of GHRH analogs include flushing after receiving a dose, injection site reactions, yes, this is a shot, folks, rash, edema, and joint and muscle pain if the levels are too high.
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00:09:14.639So very important when you are on GHRH analogs that you are under the care of a physician and someone is ordering your labs to monitor the level.
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00:09:19.840Also, as the name implies, growth hormone may increase cell multiplication.
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00:09:28.720And so it makes sense it is not recommended to take GHRH analogs in patients prone to cancer or who have active cancer.
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00:09:39.279Patients who want to take growth hormone in my office, we screen to make sure they're up to date with their routine cancer screening tests, like colonoscopies and mammograms.
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00:09:46.399And most of my patients have more advanced cancer screening called a gallery early detection test once a year.
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00:09:54.799This is an innovative blood test that tests for 40 different types of DNA fragments that are released from the onset of cancer cell multiplication.
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00:09:56.159So, what does this mean?
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00:10:09.279It means that this test is incredible for picking up early stage one and stage two cancers that most people would not have symptoms of until they were probably stage three or four, when the prognosis, of course, is much poorer.
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00:10:14.799So let's talk about the nuances of each growth hormone releasing hormone analog.
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00:10:18.639I kind of like to think of them in terms of good, better, best.
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00:10:24.960So SURMARELAN is my favorite starter growth hormone releasing hormone analog.
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00:10:27.919It is an FDA-approved peptide.
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00:10:30.080Yes, it's actually FDA approved.
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00:10:33.679It has great safety data and it has been used in kids.
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00:10:41.279In one interesting study I read, IgF-1 levels were checked in a group of younger men and older men.
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00:10:55.519When the older men on Cermorelin had the exact same IGF-1 levels as the younger man did naturally, the older man on Cermorelin had higher percentage muscle mass and higher strength.
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00:11:05.440So there is actually something beneficial about sermelin itself, not just the fact that it stimulates the pituitary to make more growth hormone in terms of muscle production.
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00:11:13.919I love to use sermelin on my GLP1 patients who are stalled despite hormone optimization or who are losing too much muscle mass.
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00:11:20.399I also like to use sermelin in my longevity patients whose interest lies in staying healthy as long as possible.
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00:11:23.759Remember, muscle is the currency of aging.
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00:11:34.080My patients who want to maintain the elasticity of their skin love sermorelin, and I have seen improvements in LDL cholesterol when patients are on this peptide.
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00:11:39.039So the next one is CJC1295 Ipamerelin.
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00:11:47.519This is a combination of two GHRH analogs and so can get IGF-1 levels up a little more robustly.
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00:11:56.799I like to use this combination after sermorelin if patients don't get the results I'm expecting, or if IgF1 levels don't improve as much as I would like.
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00:12:03.039CJC 1295 Ipamarelin is not FDA approved and it's more expensive than Cermorelin.
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00:12:12.080The third one, Tesimarelin, does increase muscle mass, but it is also really impressive for decreasing visceral fat.
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00:12:16.080This one also not FDA approved and it is the most pricey.
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00:12:28.480It is ideal for my hormone optimized patient on a GLP1, but despite that, he or she still has obvious visceral fat, signs of insulin resistance, or even sleep apnea.
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00:12:37.519All of these GHRH analogs ideally are dosed at night at least two hours after you eat, and then you should not eat again at least 30 minutes after dosing.
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00:12:42.720One downside is that the vial it comes in needs to be refrigerated, so it's hard to travel with.
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00:12:47.840The injection is easy and very tolerable, typically in your belly with a small needle.
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00:12:50.799This peptide, like most others, is cycled.
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00:12:54.879You take it for approximately two months and then you take a one-month break.
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00:13:02.240It is also unique in that most providers recommend dosing five nights of the week and then two nights off.
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00:13:11.600The reason for this partial week dosing seems to be to decrease the risk of becoming allergic or having histamine reactions in the form of flushing.
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00:13:18.639If you have flushing with a GHRH analog, that is not an allergic reaction and it may or may not happen again.
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00:13:26.320If you have actual hives after a GHRH analog injection, this is a true allergic reaction.
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00:13:31.440And it is contraindicated to use any GHRH analog ever again.
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00:13:37.200Trust me, anyone that has ever been on a GHRH analog does not want to become allergic to it.
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00:13:39.120Patients typically feel great.
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00:13:42.240They get amazing sleep and better results at the gym.
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00:13:46.799Their labs usually reflect lower cholesterol levels and less insulin resistance.
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00:13:54.879In our office, we teach you how to give yourself the injection and then have the vial and needle shipped to your home from one of our vetted compounding pharmacies.
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00:14:00.559We do not and would never source peptides from a for research use only website.
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00:14:11.759Buyer beware, if there is no medical provider prescribing the peptide to you, or it is not shipped to your door with a return label that includes the word pharmacy, the hair on the back of your neck should be raised.
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00:14:24.320Please listen to my last episode on what it takes to produce a peptide in an FDA-cleared compounding pharmacy versus some guys in a garage putting them on sale on a research-only website.
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00:14:31.120What is going on out there is scary because of all this craze over GLP1s and peptides like these.
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00:14:38.240Next up in my armamentarian of body composition change peptides is OSO1.
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00:14:42.320OSO1 is a synthetic peptide developed by OneSkin.
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00:14:50.879OneSkin is a longevity biotech company started by four female Brazilian scientists specializing in immunology and cellular biology.
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00:15:01.919It is not FDA approved for any of the things I use it for, but it can be used topically for skin aging and it is under investigation for systemic benefits via an oral capsule.
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00:15:06.399The oral form can influence whole body aging markers in several ways.
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00:15:07.679Here's the science.
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00:15:12.240One, it increases glucose update, resulting in less fat.
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00:15:16.480Two, it downregulates a protein called mTOR.
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00:15:23.600MTOR, which stands for mechanistic target of rapamyosin, is a master regulator of protein kinase.
00:15:23.679 -->
00:15:27.600So mTOR1 is like the brain of our cells.
00:15:27.840 -->
00:15:30.879MTOR2 controls our cell survival.
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00:15:36.399When mTOR gets overactive, we lose muscle and it accelerates our aging.
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00:15:40.879Too much mTOR can also fuel proliferation of cancer cells.
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00:15:53.519So OSO1 downregulates mTOR, and that is a good thing in terms of increasing muscle mass, improving our body's cellular recycling system, and potentially reducing proliferation of cancer cells.
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00:16:01.519It can improve mitochondrial function by reducing oxidative stress, and it can decrease inflammation and help to heal connective tissue.
00:16:01.759 -->
00:16:05.600Are you saying stop with the science already and just tell me you should take it?
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00:16:06.879Okay, I'm getting to that.
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00:16:17.440We like to use OSL1 maybe for a patient who is in their, let's say, 60s, who just wants to lose five to ten pounds of fat but needs to gain muscle, not lose muscle.
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00:16:25.840I do love GLP1s for many reasons, but it is a fact that at least 30% of the body weight you lose on them is muscle mass.
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00:16:38.720OSL1 is also great for anyone who is looking for whole body anti-aging benefits at the cellular level on the inside, and they're looking for skin quality improvements on the outside.
00:16:39.039 -->
00:16:44.399It may improve the elasticity of the skin in both the oral and topical form.
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00:16:51.600And this, my friends, finding something that actually improves crepey skin is the holy grail of medical aesthetics.
00:16:51.759 -->
00:16:54.320So how do I prescribe OSO1?
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00:16:57.759I prescribe 100 milligram capsules from a compounding pharmacy.
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00:17:04.880I usually have patients take them one time a day, morning or night, with or without food, for approximately 45 days.
00:17:05.119 -->
00:17:11.839Then I have them take a 30-day break, and then I have them resume them again for 45 days.
00:17:12.079 -->
00:17:16.880So you could technically do this in a four-month regimen, one or two times a year.
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00:17:21.119The capsule does have to be refrigerated, so you can't travel with them easily.
00:17:21.359 -->
00:17:24.880The side effects reported so far can be mild GI upset.
00:17:25.039 -->
00:17:28.720However, there is lack of long-term safety data with oral use.
00:17:28.880 -->
00:17:34.720The topical form is available online without a prescription and once again only affects the skin.
00:17:34.799 -->
00:17:37.039You can find it on oneskin.com.
00:17:37.119 -->
00:17:38.960And you can read about the science there too.
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00:17:40.480It's it's worth looking into.
00:17:40.960 -->
00:17:45.680Lastly, we are going to discuss MOTC in this podcast.
00:17:45.920 -->
00:17:54.400MOTC, which is spelled M O T S hyphen C, is a peptide created naturally in our mitochondria of our cells.
00:17:54.559 -->
00:17:56.720Somebody asked me the other day what it stands for.
00:17:56.880 -->
00:17:58.880Well, I had no idea, but I did Google it.
00:17:59.039 -->
00:18:04.799It stands for mitochondria open reading frame of the 12S rRNA type C.
00:18:04.960 -->
00:18:06.000That is a mouthful.
00:18:06.160 -->
00:18:08.480I think of it as the hostess with the most.
00:18:09.119 -->
00:18:15.200Matsy is known as a mitochondrial derived peptide that has its positive benefits in the brain.
00:18:15.359 -->
00:18:23.200It crosses the blood-brain barrier and may decrease neuroinflammation, improve memory, and may prevent neurological aging.
00:18:23.440 -->
00:18:30.720But it also reduces insulin resistance and helps in regulation of metabolism, which is why it made the cut in this podcast.
00:18:30.960 -->
00:18:35.039Because it decreases insulin resistance, it is also anti-inflammatory.
00:18:35.279 -->
00:18:40.160This peptide also plays a role in mitochondrial function and may improve energy production.
00:18:40.240 -->
00:18:43.200It can reduce obesity and improve physical performance.
00:18:43.359 -->
00:18:48.880And in middle-aged mice, it has been shown to increase lifespan and physical abilities.
00:18:49.119 -->
00:18:49.440See?
00:18:49.680 -->
00:18:52.319Hostus with the most discond.
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00:18:59.440It is also an injection, dosed two times a week for four weeks, and then it can be given just once a week.
00:18:59.599 -->
00:19:04.319I typically recommend cycling this peptide for two months and then taking a month off.
00:19:04.480 -->
00:19:12.799There are few side effects as long as you are taking enough folate with it, which enough is about 1200 milligrams a day, and that's a lot.
00:19:13.039 -->
00:19:20.559So if you're not taking enough folate, it's important that your provider is monitoring something called homocysteine levels.
00:19:20.720 -->
00:19:28.079The reason for this is that MOTC blocks an enzyme in the folate cycle that helps to recycle homocysteine.
00:19:28.160 -->
00:19:32.880And homocysteine is a normal cellular waste product produced in our bodies.
00:19:33.119 -->
00:19:37.920So too much homocysteine can cause brain fog and low mood.
00:19:38.079 -->
00:19:43.920So some people refer to this possible side effect of MOTC as the MOTC hangover effect.
00:19:44.079 -->
00:19:50.960But once again, it is very preventable with enough folic acid supplementation, which will facilitate clearance of homocysteine.
00:19:51.200 -->
00:19:53.759Boy, aren't you glad you met this podcast?
00:19:53.920 -->
00:19:58.000All these peptides are so cool, but they are medications.
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00:20:00.960And all medications have possible side effects.
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00:20:21.759So if you need a little guidance and you are interested in having my team of longevity experts create a body composition peptide stack for you, or maybe you just want to get started in the right direction safely toward a longer, more fruitful life, all you have to do is fill out our eligibility form on our website and drop it off or mail it to us.
00:20:22.000 -->
00:20:29.440After I review it, my team will then do a discovery call to determine next best steps pending your health and body composition goals.
00:20:29.599 -->
00:20:34.319And I promise it will not be three months until the next Dr.
00:20:34.480 -->
00:20:36.31950 Something podcast.
00:20:37.200 -->
00:20:39.759Thank you for joining this episode of the Dr.
00:20:39.920 -->
00:20:41.20050 Something Show.
00:20:41.359 -->
00:20:45.920If you are intrigued by this show and never want to miss an episode, click follow.
00:20:46.079 -->
00:20:48.240If you are a really great friend, share it.
00:20:48.400 -->
00:20:54.640The content of this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
00:20:54.799 -->
00:21:02.079Always seek the advice of your physician or other qualified healthcare provider to answer any questions you may have about your personal medical conditions.
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00:21:04.160Until next time, get fit.
