WEBVTT
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Hey, it's the Second Opinion Podcast with Dr.
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Paul Kolodzik, where we talk about anything and everything medical, from a sore throat to the future of AI medicine.
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Dr.
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Paul is an ER doc and certified in addiction medicine and metabolic health, as well as a best-selling Amazon author.
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You can learn more about Dr.
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Paul at his website, dr Paul Kalodzik.com.
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Dr.
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Paul, how are you doing?
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I'm doing great, Terry.
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How are you?
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I'm doing fine.
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So we're back here again for another episode of the Second Opinion Podcast with Dr.
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Paul Kalazic.
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On a rainy Wednesday morning.
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Yesterday.
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I worked yesterday.
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It's crazy.
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In the emergency department.
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And I guess yesterday was record rainfall in Dayton, Ohio.
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Like over two inches of rain, I guess the highest ever in a single 24-hour period.
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It was crazy.
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It's still crazy today if you look out there.
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It's all black.
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Yeah.
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So we're as we're in mid-August, heading down into September.
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Um is there anything that we should know before we jump into this podcast about things that change?
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The the the seasons change.
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Does that bring on any kind of flues or why is that?
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Well, the flu season is always the cold the colder season.
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Yeah.
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So as we get into the fall, not quite yet though.
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That's why you get your flu shots in the fall.
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Yeah, but is it is it because we're inside?
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Is that what it is?
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Yeah, I think it's inside.
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Yeah, it's people are closer together and because you're back in school.
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So something new on this podcast for our our continued listers out there, we're going to be taking questions from you all.
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Uh, instead of us talking and bantering back and forth, we thought we'd open this up and let you guys send us an email with a question that you might have related to any ER-related medicine, addiction medicine, metabolic health.
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Have I forgotten anything?
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No, just I mean health system issues.
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If some you had a healthcare experience and you wondered why it was handled this way, we might be able to offer some insight.
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Okay.
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So what we're going to do is we're going to have anybody out there who's interested in some.
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Can we call this not free advice?
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What do we want to call this?
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Just You know, free advice is usually worth what you pay for it, right?
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Yeah.
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So let's not call it.
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No, we're just topics of discussion based on people's experiences or questions.
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So Okay.
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And I guess we're asking them to send this to info at dr colo.com.
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I N F O I N N O D O C T O R K O L O dot com.
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Yeah.
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And we'll try and answer these questions on the air, so to speak, I guess.
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On the air has a little red lights flashing at us.
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Yeah.
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Uh hey, so uh one of the things I wanted to talk about today is three weeks ago, uh I went and I took my first dose of GLP one.
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I'm in I'm in diabetic, I've been on insulin for a number of years, long acting in the morning, and then you take a shot with every meal.
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And my healthcare provider and my pharmacist suggested that I try maybe a low dose GLP one to see if that would smooth things out and quit going low at night.
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Because you had a previous bad experience with GLP1s way back in the day, right?
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When it first came out, I had the worst experience ever.
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I took the shot.
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There wasn't a small dose, you took just one dose, whatever that dose was, I can't remember.
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And I felt awful for days.
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I couldn't wait for that week to be uh sick, nausea.
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The whole nine yards, I said, I'll never do that again.
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Yeah.
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I did it again, and this time the experience is so much better.
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Uh you know, I take uh 0.25 milligram, which is the starting dose.
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Sure.
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Yeah.
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And I've been able to kind of cut back or eliminate completely my mealtime insulin.
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See, so that's a big deal.
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So you're basically saying, correct me if I'm wrong, but you went from four shots a day to one or two shots a day, right?
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Most likely one.
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Yeah, that's what I'm saying.
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If I'm eating something crazy, do I say, well, maybe I should give myself a shot just to kind of overcome anything.
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That's not the way you're supposed to use insulin.
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You know, eat what you want and then give yourself a shot to compensate.
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You aren't supposed to do that.
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I know, I don't.
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I really don't.
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But sometimes if you see like that Milano sub in the bread, you go, Oh shit, that's really gonna cause me an issue there.
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Okay.
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So but anyway, my numbers have been really good.
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I mean, my uh I'm I'm really impressed with it.
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And I haven't had much side effects, a little bit, but not much.
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And I'm hoping just to stay on this really, really low dose.
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Yeah.
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Would they call that micro dosing?
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It'd be microdosey.
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Yeah.
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And is that a thing?
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Yeah, yeah, it's a big thing to try and stay at the lowest dose you can, uh, you know, indefinitely, and hopefully you're accompanying that with the lifestyle changes we've always talked about.
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I I'm trying to.
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Yeah.
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No, um my only question would be uh do I go up one dose and maybe try to cut back on my long acting?
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Do I I just don't want to lose weight?
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Talk talk to your doctor, Terry.
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You are my doctor.
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Yeah, so get no, I'm not your doctor.
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I am not your doctor.
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Okay.
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Um just make sure you're getting your protein and doing your strength training.
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I'm doing both.
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Good.
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All right, so you have a bunch of GLP breaking news, as we're gonna call it.
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Yeah, so this is uh I'm just gonna run through this stuff.
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This is just based on my news feeds over the last couple weeks.
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So I guess this is pretty much the GLP1 Miracle Network now.
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So I mean, it's just amazing.
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The genie is out of the bottle on these medicines.
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They're gonna become the most prescribed medicines in the history of the world.
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And uh, you know, there's some a little bit more news over the course of the last couple weeks that we can bring up.
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You know, the the big one is that later this year or early in 27, Retitrutide will be here, which is the triple acting GLP1.
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Is this a lily product?
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I don't think it has a brand name yet.
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Um, but you know, this is the one where people uh have lost up to like 28% of their body weight for people with high BMIs to start.
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And what's different about this drug is that it has a third mechanism of action, which I was really not um familiar with previously.
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Um but the the third mechanism, remember uh Wagovi, the standard Ozambic, had a single mechanism of action primarily uh based on its hormonal influence.
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The uh um and then um Monjuro came out, ZEP bound, uh, which has a couple uh ways that it acts.
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But the third way that retitretite acts is this is the first GLP one that has what is called a glucocon receptor agonist.
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So what that means is it acts like the hormone glucagon in your system.
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And I wasn't aware of this, but apparently glucocon helps you burn more energy.
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It's a natural hormone, um, and it helps you burn more energy.
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It does two things uh that that does many things, but one of the two things that this this third mechanism action does is it promotes thermogenesis.
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What the heck does that mean, Terry?
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You've used a lot of terms, but I'm really not quite go ahead.
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What does that mean?
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It means you burn more energy, you know?
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Thermogenesis.
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Thermogenesis, you know, it just means that your metabolism is geared up.
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So apparently a glucagon agonist, a glucagon is a natural hormone in your system, so it helps you burn more energy and specifically causes here we go again, hepatic fat oxidation.
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But I mean, that's not that hard to figure out.
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Hepatic is liver.
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Most people I think know that.
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And it means you burn more fat in your liver, so it helps you reduce fatty liver disease.
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So retotrutide is going to be a big deal.
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I don't know what the brand name's gonna be, um, but this is the more the most effective GLP one that is coming out to date.
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Um, and and I'm sure you know, for some people, especially that don't get great responses from the other GLP ones, it's gonna be an option that they might look at.
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Is it do they think this will bring extra weight loss?
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Yeah, I mean it it for it shows it has showed the highest percentage of weight loss.
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Which was how much did it say?
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I I think from the studies I've seen, 20 uh uh it can be at 28 percent.
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Think about that.
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Think about that.
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Yeah.
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If you're 200 pounds, that's that's 40 percent.
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Yeah, you know, one of the things we're gonna talk about is a couple other things related to GLP1 news, and I guess you you know, the theme that I would like people to continue to remember is please don't get into the mode.
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What two things.
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Number one, please don't get into the mode where you you know you're taking a shot, you're taking a miracle drug, and you don't have to do anything else.
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You know, you don't have to do the the diety dietary issues, you don't have to work out.
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You remember as part of that 28%, a lot of that is muscle mass.
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So you've got to be doing other things, protein and strength training primarily.
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Wow.
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So that's just that's crazy numbers.
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And then um and then in addition to that, Pfizer is getting into the game.
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Uh Pf I Z E R, another you know, pharmaceutical company, um, and they are working on barabenatide.
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Oh my god.
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I don't um and and that will probably be out next year.
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And is that triple acting?
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No, I I it's not as powerful as what we just discussed.
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I think it's more in the vein of uh Wagovi and it, Ozambek, um, with the weight loss more in the you know 13 to 15 percent range.
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But it I mean the reason I bring this up primarily is because it means another pharmaceutical company is getting into the game.
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The good thing about that for everybody is that means competition.
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Right.
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And competition brings down prices.
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Right.
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So it's gonna provide access to more and more people.
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Um, and uh and and so uh again, and I I'm sure this is you know, this is the third pharmaceutical company that I'm aware of that is gonna have a product, and I'm sure there's more on the way.
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I mean, when you said triple acting, I I first thing that came to my mind was a toothpaste.
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Just triple acting.
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Oh, is that right?
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Yeah, so I'm sure there'll be some advertisements like that.
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So let's talk about, you know, uh I mean, again, the GLP1 Miracle Network here, but just but just a couple uh a couple other things that just on my news feeds in the last week.
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Um one is you know, something that's near and dear to my heart is decreasing alcohol use, a study published in the Journal of Addiction Medicine.
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Um we talked about this before.
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I've prescribed GLP1s to patients on microdosing approach to help them reduce their alcohol use and just confirmation um that alcohol use has significantly reduced a prospective study, which means we just didn't look at what happened to people when they took the drug.
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It means we enrolled people in a study and monitored their alcohol use and significant reductions in alcohol use.
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Yeah, the the my experience is generally it's in the 60 to 70 percent range.
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That's crazy.
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Yeah, it brings up the issue of you know, this is not often not an abstinence approach, it's a harm reduction approach.
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And I'm a big believer in harm reduction, which is you know, you don't necessarily have to quit right out of the gate.
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Yeah, abstinence is not the only way.
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Let's cause some harm reduction to have you reduce the amount of alcohol you're using, and then you can decide if you want to uh if you want to quit or not.
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Um, and some people just want to reduce the amount of alcohol they're drinking significantly, and other people want to quit.
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And of course, in my in my uh addiction medicine practice, I've used the combination of naltrexone, time-tested medicine to help reduce alcohol use.
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Um, and then you microdose GLP1s with it, and the result can be really quite remarkable.
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Wow.
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Yeah.
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That's crazy.
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So, and just other other things.
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So, this one I didn't expect.
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This is a British study that looked at people that started GLP ones, obese people that started GLP ones for weight loss, and they looked at the nine-month period before they started the GLP one and subsequent to the time they started the GLP one, and they found that work absences were reduced 40 to 50 percent.
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People not taking off work.
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Yeah, people not taking off work.
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What were they calling in for before?
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Do we know?
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Is it just well, I I think obesity is associated with many maladies, with many sicknesses, uh, not to mention fatigue and depression.
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Um and uh and so there was just a dramatic decrease in people from uh in in time off work.
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So, you know, it's a little bit counterintuitive to me because you would think, oh, people starting GLP ones, they're gonna have nausea, they're gonna maybe not be even feeling well.
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Um, but this study found the opposite, a significant redu reduction in time off work.
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That's great to hear.
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And I'm gonna keep going here.
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Okay, the hits keep on rolling.
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The hit keeps going.
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This is the last one.
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Um but I think very important, there's long been an association with of breast cancer risk in women with obesity.
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Okay, if if you're obese, your risk of breast cancer is higher.
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Okay.
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And one of the reasons for that is in postmenopausal women, once the ovaries reduce the amount or uh of estrogen they're producing, um, fat in the body takes over and fat produces estrogen.
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And if you reduce the amount of fat in the body, um that has resulted in a decrease in estrogen levels in postmenopausal women, which then results in um a decreased risk of breast cancer.
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And the study showed um overall in women a decrease in breast cancer from 2.2% in postmenopausal women to 1.66%, which equates to about a 30% reduction in the risk of breast cancer.
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Uh the study even went so far as to suggest, and this was an observational study.
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Um, so it was a study that really just looked at women that were on GLP1s and not on GP GLP1s.
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It wasn't a study that enrolled patients.
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It just kind of looked at uh an observational study, looked at it across.
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Um but then they went so far also as saying, and I'm not I want to back off and say I'm not advocating this.
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If you you know, if you have breast cancer or you're at high risk for breast cancer, I I am Dr.
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Kaladzik is not saying that this reduces your risk.
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This is a single study, but these are in the press now, so you can go and find this information yourself and review it.
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So I'm not I'm not an OB gen doctor, I'm not an oncologist, I'm just telling you that I came across this article that showed this.
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But it even went so far as saying that in patients that had breast cancer, um, that the risk of recurrence could be diminished as well.
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So it's crazy.
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I mean, I on my TikTok feed, I I get a lot of stuff popping in just because.
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There you go.
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Uh is that where you get all your useful information?
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Actually, that's where I got my degree in my TikTok information.
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Okay.
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Uh but there's a couple of people coming on there just telling you about Alzheimer's decrease and all kinds of other cancer decreases by use of GLP1s.
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So it's I that's one reason I went on it.
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It wasn't because I I I I was concerned about my blood sugar, but I went on there because of the other benefits.
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The other benefits.
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Well, it applies to you because of the risk of a second cardiac event, which has been proven.
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Exactly.
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So that's a true indication for a GLP one.
00:14:21.440 --> 00:14:25.360
If you've had a cardiac event, they can decrease the risk of second cardiac events.
00:14:25.519 --> 00:14:28.000
That might have been in people that were obese, I'm not certain.
00:14:28.240 --> 00:14:29.440
It might have been in diabetics.
00:14:30.080 --> 00:14:32.240
I'll take any ch any advantage I can get.
00:14:32.480 --> 00:14:32.720
Yeah.
00:14:32.960 --> 00:14:33.840
So yeah, okay.
00:14:34.159 --> 00:14:38.320
But this whole thing is just absolutely stunning how every day we turn around, something else is coming up.
00:14:38.559 --> 00:14:50.879
The way the world has changed in the last five years from when I sort first started my metabolic health practice with an exclusive focus on continuous glucose monitoring and stabilizing blood sugar, and then the GLP ones came in and have really taken the world by storm.
00:14:51.200 --> 00:14:54.000
Yeah, this is like our 135th or something like that podcast.
00:14:54.080 --> 00:14:55.679
We go back three or four years.
00:14:55.919 --> 00:15:00.799
If you go back and listen to them where we were talking about this as like the early stages, the early world, right?
00:15:00.879 --> 00:15:03.360
We didn't have any idea that this was going to be like this.
00:15:03.679 --> 00:15:04.080
Yeah.
00:15:04.399 --> 00:15:07.840
So uh again, this is just information for people to consider.
00:15:08.000 --> 00:15:12.080
I'm not advocating that you know everybody needs to go out and get on a GLP one.
00:15:12.320 --> 00:15:20.559
I think there are certainly many, many people who should not be on a GLP one, but in terms of the different conditions that seem to be effective, there's just additional news.
00:15:20.639 --> 00:15:23.759
And yeah, you know, this is what pharmaceutical companies do as well.
00:15:23.919 --> 00:15:30.159
All these studies were um, you know, I'm sure sponsored by pharmaceutical companies or the majority of them.
00:15:30.240 --> 00:15:42.000
Uh, but once they have a medication and they've invested a lot of time in uh you know researching that medication, going through the FDA process and getting it to market, what they then do is look for what's called new indications.
00:15:42.159 --> 00:15:44.720
So what's the new indication for a GLP one?
00:15:44.960 --> 00:16:01.919
So it started as it started as diabetes only, then it got an indication for obesity, then they have gotten indications for sleep apnea, fatty liver disease, second cardiac event, and now there's all these other things out there that are being uh they're being considered useful for.
00:16:02.240 --> 00:16:05.759
Yeah, well, I look forward to the the more news you bring like this.
00:16:05.840 --> 00:16:06.799
This is fantastic stuff.
00:16:07.039 --> 00:16:17.919
Yeah, I I want to be I'm a little bit hesitant because I don't want to, you know, again, we joke about the the miracle, you know, nature of these drugs, but I'm just trying to make people conscious of what's going on.
00:16:18.080 --> 00:16:35.840
So again, I'm gonna come back to the fact that we're gonna change the format a little bit or at least add uh a format approach here of uh letting people, having people please give us your questions at INFO uh at D-O-C-T-O-R-K-O-L-O.com.
00:16:36.320 --> 00:16:39.919
And uh we won't won't identify people, you know.
00:16:40.080 --> 00:16:49.279
And but but if you have pertinent questions that you think other people might want to hear the answer to, then uh go ahead and send us some questions and uh and we'll see if we can answer them.
00:16:49.519 --> 00:16:50.159
All right, Dr.
00:16:50.320 --> 00:16:54.720
Paul, thanks for joining us on today's podcast, the second opinion podcast with Dr.
00:16:54.799 --> 00:16:55.840
Paul Kalazik.
00:16:56.080 --> 00:16:59.039
We'll hear you, see you, be with you all very soon.
00:00:05.040 --> 00:00:07.120
Hey, it's the Second Opinion Podcast with Dr.
00:00:07.200 --> 00:00:13.759
Paul Kolodzik, where we talk about anything and everything medical, from a sore throat to the future of AI medicine.
00:00:14.160 --> 00:00:14.400
Dr.
00:00:14.560 --> 00:00:20.800
Paul is an ER doc and certified in addiction medicine and metabolic health, as well as a best-selling Amazon author.
00:00:21.039 --> 00:00:22.160
You can learn more about Dr.
00:00:22.239 --> 00:00:25.039
Paul at his website, dr Paul Kalodzik.com.
00:00:26.960 --> 00:00:27.280
Dr.
00:00:27.440 --> 00:00:28.320
Paul, how are you doing?
00:00:28.559 --> 00:00:29.440
I'm doing great, Terry.
00:00:29.519 --> 00:00:29.839
How are you?
00:00:30.079 --> 00:00:30.879
I'm doing fine.
00:00:31.120 --> 00:00:35.119
So we're back here again for another episode of the Second Opinion Podcast with Dr.
00:00:35.200 --> 00:00:35.920
Paul Kalazic.
00:00:36.159 --> 00:00:37.520
On a rainy Wednesday morning.
00:00:37.679 --> 00:00:38.159
Yesterday.
00:00:38.719 --> 00:00:39.520
I worked yesterday.
00:00:39.759 --> 00:00:40.240
It's crazy.
00:00:40.640 --> 00:00:41.920
In the emergency department.
00:00:42.000 --> 00:00:45.920
And I guess yesterday was record rainfall in Dayton, Ohio.
00:00:46.159 --> 00:00:49.359
Like over two inches of rain, I guess the highest ever in a single 24-hour period.
00:00:49.600 --> 00:00:49.920
It was crazy.
00:00:50.000 --> 00:00:51.280
It's still crazy today if you look out there.
00:00:51.520 --> 00:00:51.920
It's all black.
00:00:52.000 --> 00:00:52.159
Yeah.
00:00:52.320 --> 00:00:56.240
So we're as we're in mid-August, heading down into September.
00:00:56.719 --> 00:01:01.920
Um is there anything that we should know before we jump into this podcast about things that change?
00:01:02.159 --> 00:01:03.520
The the the seasons change.
00:01:03.759 --> 00:01:06.560
Does that bring on any kind of flues or why is that?
00:01:06.719 --> 00:01:09.200
Well, the flu season is always the cold the colder season.
00:01:09.280 --> 00:01:09.519
Yeah.
00:01:09.599 --> 00:01:11.599
So as we get into the fall, not quite yet though.
00:01:11.760 --> 00:01:13.120
That's why you get your flu shots in the fall.
00:01:13.359 --> 00:01:14.959
Yeah, but is it is it because we're inside?
00:01:15.040 --> 00:01:15.599
Is that what it is?
00:01:15.920 --> 00:01:16.959
Yeah, I think it's inside.
00:01:17.040 --> 00:01:20.799
Yeah, it's people are closer together and because you're back in school.
00:01:21.040 --> 00:01:27.120
So something new on this podcast for our our continued listers out there, we're going to be taking questions from you all.
00:01:27.280 --> 00:01:38.480
Uh, instead of us talking and bantering back and forth, we thought we'd open this up and let you guys send us an email with a question that you might have related to any ER-related medicine, addiction medicine, metabolic health.
00:01:38.560 --> 00:01:39.359
Have I forgotten anything?
00:01:39.680 --> 00:01:41.359
No, just I mean health system issues.
00:01:41.439 --> 00:01:46.319
If some you had a healthcare experience and you wondered why it was handled this way, we might be able to offer some insight.
00:01:46.560 --> 00:01:46.719
Okay.
00:01:46.799 --> 00:01:49.760
So what we're going to do is we're going to have anybody out there who's interested in some.
00:01:50.079 --> 00:01:52.319
Can we call this not free advice?
00:01:52.400 --> 00:01:53.359
What do we want to call this?
00:01:53.439 --> 00:01:57.040
Just You know, free advice is usually worth what you pay for it, right?
00:01:57.359 --> 00:01:57.519
Yeah.
00:01:57.760 --> 00:01:58.480
So let's not call it.
00:01:58.640 --> 00:02:02.640
No, we're just topics of discussion based on people's experiences or questions.
00:02:02.719 --> 00:02:03.439
So Okay.
00:02:03.680 --> 00:02:08.319
And I guess we're asking them to send this to info at dr colo.com.
00:02:08.719 --> 00:02:12.879
I N F O I N N O D O C T O R K O L O dot com.
00:02:13.039 --> 00:02:13.120
Yeah.
00:02:13.280 --> 00:02:15.680
And we'll try and answer these questions on the air, so to speak, I guess.
00:02:16.240 --> 00:02:18.479
On the air has a little red lights flashing at us.
00:02:18.639 --> 00:02:18.719
Yeah.
00:02:18.879 --> 00:02:26.400
Uh hey, so uh one of the things I wanted to talk about today is three weeks ago, uh I went and I took my first dose of GLP one.
00:02:26.560 --> 00:02:33.120
I'm in I'm in diabetic, I've been on insulin for a number of years, long acting in the morning, and then you take a shot with every meal.
00:02:34.080 --> 00:02:41.919
And my healthcare provider and my pharmacist suggested that I try maybe a low dose GLP one to see if that would smooth things out and quit going low at night.
00:02:42.240 --> 00:02:45.280
Because you had a previous bad experience with GLP1s way back in the day, right?
00:02:45.599 --> 00:02:47.520
When it first came out, I had the worst experience ever.
00:02:47.680 --> 00:02:48.400
I took the shot.
00:02:48.560 --> 00:02:53.039
There wasn't a small dose, you took just one dose, whatever that dose was, I can't remember.
00:02:53.439 --> 00:02:55.520
And I felt awful for days.
00:02:55.840 --> 00:02:58.400
I couldn't wait for that week to be uh sick, nausea.
00:02:59.039 --> 00:03:01.280
The whole nine yards, I said, I'll never do that again.
00:03:01.680 --> 00:03:01.840
Yeah.
00:03:02.159 --> 00:03:05.520
I did it again, and this time the experience is so much better.
00:03:06.479 --> 00:03:10.560
Uh you know, I take uh 0.25 milligram, which is the starting dose.
00:03:10.800 --> 00:03:10.960
Sure.
00:03:11.199 --> 00:03:11.439
Yeah.
00:03:11.759 --> 00:03:16.960
And I've been able to kind of cut back or eliminate completely my mealtime insulin.
00:03:17.360 --> 00:03:18.400
See, so that's a big deal.
00:03:18.479 --> 00:03:25.599
So you're basically saying, correct me if I'm wrong, but you went from four shots a day to one or two shots a day, right?
00:03:26.000 --> 00:03:26.719
Most likely one.
00:03:27.039 --> 00:03:27.360
Yeah, that's what I'm saying.
00:03:27.919 --> 00:03:31.759
If I'm eating something crazy, do I say, well, maybe I should give myself a shot just to kind of overcome anything.
00:03:32.080 --> 00:03:33.680
That's not the way you're supposed to use insulin.
00:03:34.080 --> 00:03:36.960
You know, eat what you want and then give yourself a shot to compensate.
00:03:37.039 --> 00:03:37.840
You aren't supposed to do that.
00:03:38.080 --> 00:03:38.719
I know, I don't.
00:03:38.960 --> 00:03:39.360
I really don't.
00:03:39.599 --> 00:03:44.560
But sometimes if you see like that Milano sub in the bread, you go, Oh shit, that's really gonna cause me an issue there.
00:03:44.879 --> 00:03:45.199
Okay.
00:03:45.520 --> 00:03:48.319
So but anyway, my numbers have been really good.
00:03:48.719 --> 00:03:50.879
I mean, my uh I'm I'm really impressed with it.
00:03:50.960 --> 00:03:54.319
And I haven't had much side effects, a little bit, but not much.
00:03:54.560 --> 00:03:57.199
And I'm hoping just to stay on this really, really low dose.
00:03:57.360 --> 00:03:57.520
Yeah.
00:03:57.919 --> 00:03:58.960
Would they call that micro dosing?
00:03:59.199 --> 00:04:00.080
It'd be microdosey.
00:04:00.159 --> 00:04:00.319
Yeah.
00:04:00.479 --> 00:04:01.120
And is that a thing?
00:04:01.360 --> 00:04:09.599
Yeah, yeah, it's a big thing to try and stay at the lowest dose you can, uh, you know, indefinitely, and hopefully you're accompanying that with the lifestyle changes we've always talked about.
00:04:09.919 --> 00:04:10.879
I I'm trying to.
00:04:10.960 --> 00:04:11.120
Yeah.
00:04:11.280 --> 00:04:16.480
No, um my only question would be uh do I go up one dose and maybe try to cut back on my long acting?
00:04:16.720 --> 00:04:18.560
Do I I just don't want to lose weight?
00:04:18.879 --> 00:04:20.160
Talk talk to your doctor, Terry.
00:04:20.240 --> 00:04:20.720
You are my doctor.
00:04:20.959 --> 00:04:22.480
Yeah, so get no, I'm not your doctor.
00:04:22.639 --> 00:04:23.680
I am not your doctor.
00:04:24.480 --> 00:04:24.720
Okay.
00:04:25.279 --> 00:04:28.160
Um just make sure you're getting your protein and doing your strength training.
00:04:28.319 --> 00:04:29.120
I'm doing both.
00:04:29.279 --> 00:04:29.600
Good.
00:04:29.759 --> 00:04:32.800
All right, so you have a bunch of GLP breaking news, as we're gonna call it.
00:04:33.199 --> 00:04:35.519
Yeah, so this is uh I'm just gonna run through this stuff.
00:04:35.600 --> 00:04:38.079
This is just based on my news feeds over the last couple weeks.
00:04:38.160 --> 00:04:42.079
So I guess this is pretty much the GLP1 Miracle Network now.
00:04:42.399 --> 00:04:44.399
So I mean, it's just amazing.
00:04:44.480 --> 00:04:47.040
The genie is out of the bottle on these medicines.
00:04:47.199 --> 00:04:50.720
They're gonna become the most prescribed medicines in the history of the world.
00:04:50.959 --> 00:04:56.480
And uh, you know, there's some a little bit more news over the course of the last couple weeks that we can bring up.
00:04:56.560 --> 00:05:05.439
You know, the the big one is that later this year or early in 27, Retitrutide will be here, which is the triple acting GLP1.
00:05:05.680 --> 00:05:07.279
Is this a lily product?
00:05:07.360 --> 00:05:09.680
I don't think it has a brand name yet.
00:05:09.839 --> 00:05:20.079
Um, but you know, this is the one where people uh have lost up to like 28% of their body weight for people with high BMIs to start.
00:05:20.240 --> 00:05:28.160
And what's different about this drug is that it has a third mechanism of action, which I was really not um familiar with previously.
00:05:28.399 --> 00:05:38.800
Um but the the third mechanism, remember uh Wagovi, the standard Ozambic, had a single mechanism of action primarily uh based on its hormonal influence.
00:05:39.040 --> 00:05:47.680
The uh um and then um Monjuro came out, ZEP bound, uh, which has a couple uh ways that it acts.
00:05:47.759 --> 00:05:56.079
But the third way that retitretite acts is this is the first GLP one that has what is called a glucocon receptor agonist.
00:05:56.319 --> 00:06:01.040
So what that means is it acts like the hormone glucagon in your system.
00:06:01.199 --> 00:06:05.759
And I wasn't aware of this, but apparently glucocon helps you burn more energy.
00:06:05.839 --> 00:06:09.680
It's a natural hormone, um, and it helps you burn more energy.
00:06:09.839 --> 00:06:19.360
It does two things uh that that does many things, but one of the two things that this this third mechanism action does is it promotes thermogenesis.
00:06:19.600 --> 00:06:21.199
What the heck does that mean, Terry?
00:06:21.600 --> 00:06:24.639
You've used a lot of terms, but I'm really not quite go ahead.
00:06:24.720 --> 00:06:25.199
What does that mean?
00:06:25.519 --> 00:06:27.199
It means you burn more energy, you know?
00:06:27.519 --> 00:06:28.240
Thermogenesis.
00:06:28.399 --> 00:06:31.600
Thermogenesis, you know, it just means that your metabolism is geared up.
00:06:31.759 --> 00:06:44.879
So apparently a glucagon agonist, a glucagon is a natural hormone in your system, so it helps you burn more energy and specifically causes here we go again, hepatic fat oxidation.
00:06:45.199 --> 00:06:46.879
But I mean, that's not that hard to figure out.
00:06:47.040 --> 00:06:48.240
Hepatic is liver.
00:06:48.399 --> 00:06:49.839
Most people I think know that.
00:06:50.000 --> 00:06:54.480
And it means you burn more fat in your liver, so it helps you reduce fatty liver disease.
00:06:54.720 --> 00:06:56.959
So retotrutide is going to be a big deal.
00:06:57.120 --> 00:07:05.040
I don't know what the brand name's gonna be, um, but this is the more the most effective GLP one that is coming out to date.
00:07:05.279 --> 00:07:13.759
Um, and and I'm sure you know, for some people, especially that don't get great responses from the other GLP ones, it's gonna be an option that they might look at.
00:07:14.000 --> 00:07:17.439
Is it do they think this will bring extra weight loss?
00:07:17.759 --> 00:07:21.199
Yeah, I mean it it for it shows it has showed the highest percentage of weight loss.
00:07:21.519 --> 00:07:22.639
Which was how much did it say?
00:07:22.800 --> 00:07:26.720
I I think from the studies I've seen, 20 uh uh it can be at 28 percent.
00:07:26.800 --> 00:07:27.199
Think about that.
00:07:27.519 --> 00:07:27.920
Think about that.
00:07:28.079 --> 00:07:28.240
Yeah.
00:07:28.480 --> 00:07:31.839
If you're 200 pounds, that's that's 40 percent.
00:07:32.000 --> 00:07:41.759
Yeah, you know, one of the things we're gonna talk about is a couple other things related to GLP1 news, and I guess you you know, the theme that I would like people to continue to remember is please don't get into the mode.
00:07:41.920 --> 00:07:42.720
What two things.
00:07:42.879 --> 00:07:49.839
Number one, please don't get into the mode where you you know you're taking a shot, you're taking a miracle drug, and you don't have to do anything else.
00:07:50.079 --> 00:07:54.720
You know, you don't have to do the the diety dietary issues, you don't have to work out.
00:07:54.800 --> 00:07:58.720
You remember as part of that 28%, a lot of that is muscle mass.
00:07:58.879 --> 00:08:02.800
So you've got to be doing other things, protein and strength training primarily.
00:08:02.959 --> 00:08:03.199
Wow.
00:08:03.360 --> 00:08:05.839
So that's just that's crazy numbers.
00:08:06.160 --> 00:08:11.600
And then um and then in addition to that, Pfizer is getting into the game.
00:08:11.759 --> 00:08:20.959
Uh Pf I Z E R, another you know, pharmaceutical company, um, and they are working on barabenatide.
00:08:21.199 --> 00:08:21.920
Oh my god.
00:08:22.480 --> 00:08:25.439
I don't um and and that will probably be out next year.
00:08:25.759 --> 00:08:27.279
And is that triple acting?
00:08:27.519 --> 00:08:30.399
No, I I it's not as powerful as what we just discussed.
00:08:30.560 --> 00:08:39.360
I think it's more in the vein of uh Wagovi and it, Ozambek, um, with the weight loss more in the you know 13 to 15 percent range.
00:08:39.519 --> 00:08:45.120
But it I mean the reason I bring this up primarily is because it means another pharmaceutical company is getting into the game.
00:08:45.279 --> 00:08:49.039
The good thing about that for everybody is that means competition.
00:08:49.120 --> 00:08:49.279
Right.
00:08:49.440 --> 00:08:51.279
And competition brings down prices.
00:08:51.440 --> 00:08:51.600
Right.
00:08:51.840 --> 00:08:55.039
So it's gonna provide access to more and more people.
00:08:55.360 --> 00:09:05.279
Um, and uh and and so uh again, and I I'm sure this is you know, this is the third pharmaceutical company that I'm aware of that is gonna have a product, and I'm sure there's more on the way.
00:09:05.679 --> 00:09:10.080
I mean, when you said triple acting, I I first thing that came to my mind was a toothpaste.
00:09:10.559 --> 00:09:11.519
Just triple acting.
00:09:11.759 --> 00:09:12.240
Oh, is that right?
00:09:12.559 --> 00:09:15.039
Yeah, so I'm sure there'll be some advertisements like that.
00:09:15.440 --> 00:09:24.799
So let's talk about, you know, uh I mean, again, the GLP1 Miracle Network here, but just but just a couple uh a couple other things that just on my news feeds in the last week.
00:09:24.960 --> 00:09:33.679
Um one is you know, something that's near and dear to my heart is decreasing alcohol use, a study published in the Journal of Addiction Medicine.
00:09:33.840 --> 00:09:35.440
Um we talked about this before.
00:09:35.600 --> 00:09:51.360
I've prescribed GLP1s to patients on microdosing approach to help them reduce their alcohol use and just confirmation um that alcohol use has significantly reduced a prospective study, which means we just didn't look at what happened to people when they took the drug.
00:09:51.440 --> 00:09:56.960
It means we enrolled people in a study and monitored their alcohol use and significant reductions in alcohol use.
00:09:59.679 --> 00:10:03.840
Yeah, the the my experience is generally it's in the 60 to 70 percent range.
00:10:04.720 --> 00:10:05.200
That's crazy.
00:10:05.519 --> 00:10:11.200
Yeah, it brings up the issue of you know, this is not often not an abstinence approach, it's a harm reduction approach.
00:10:11.279 --> 00:10:17.519
And I'm a big believer in harm reduction, which is you know, you don't necessarily have to quit right out of the gate.
00:10:17.600 --> 00:10:19.679
Yeah, abstinence is not the only way.
00:10:19.840 --> 00:10:30.159
Let's cause some harm reduction to have you reduce the amount of alcohol you're using, and then you can decide if you want to uh if you want to quit or not.
00:10:30.320 --> 00:10:35.200
Um, and some people just want to reduce the amount of alcohol they're drinking significantly, and other people want to quit.
00:10:35.360 --> 00:10:44.000
And of course, in my in my uh addiction medicine practice, I've used the combination of naltrexone, time-tested medicine to help reduce alcohol use.
00:10:44.159 --> 00:10:48.879
Um, and then you microdose GLP1s with it, and the result can be really quite remarkable.
00:10:49.120 --> 00:10:49.440
Wow.
00:10:49.600 --> 00:10:49.840
Yeah.
00:10:50.080 --> 00:10:50.720
That's crazy.
00:10:50.960 --> 00:10:52.639
So, and just other other things.
00:10:52.799 --> 00:10:54.799
So, this one I didn't expect.
00:10:54.960 --> 00:11:15.600
This is a British study that looked at people that started GLP ones, obese people that started GLP ones for weight loss, and they looked at the nine-month period before they started the GLP one and subsequent to the time they started the GLP one, and they found that work absences were reduced 40 to 50 percent.
00:11:15.919 --> 00:11:16.879
People not taking off work.
00:11:17.120 --> 00:11:18.240
Yeah, people not taking off work.
00:11:18.799 --> 00:11:20.000
What were they calling in for before?
00:11:20.080 --> 00:11:20.399
Do we know?
00:11:20.559 --> 00:11:29.039
Is it just well, I I think obesity is associated with many maladies, with many sicknesses, uh, not to mention fatigue and depression.
00:11:29.279 --> 00:11:37.360
Um and uh and so there was just a dramatic decrease in people from uh in in time off work.
00:11:37.519 --> 00:11:44.720
So, you know, it's a little bit counterintuitive to me because you would think, oh, people starting GLP ones, they're gonna have nausea, they're gonna maybe not be even feeling well.
00:11:44.799 --> 00:11:49.840
Um, but this study found the opposite, a significant redu reduction in time off work.
00:11:50.639 --> 00:11:51.200
That's great to hear.
00:11:51.440 --> 00:11:52.399
And I'm gonna keep going here.
00:11:52.879 --> 00:11:54.399
Okay, the hits keep on rolling.
00:11:54.720 --> 00:11:55.519
The hit keeps going.
00:11:55.600 --> 00:11:56.799
This is the last one.
00:11:57.120 --> 00:12:05.600
Um but I think very important, there's long been an association with of breast cancer risk in women with obesity.
00:12:05.840 --> 00:12:08.879
Okay, if if you're obese, your risk of breast cancer is higher.
00:12:09.120 --> 00:12:09.279
Okay.
00:12:09.519 --> 00:12:21.840
And one of the reasons for that is in postmenopausal women, once the ovaries reduce the amount or uh of estrogen they're producing, um, fat in the body takes over and fat produces estrogen.
00:12:22.000 --> 00:12:34.960
And if you reduce the amount of fat in the body, um that has resulted in a decrease in estrogen levels in postmenopausal women, which then results in um a decreased risk of breast cancer.
00:12:35.200 --> 00:12:48.879
And the study showed um overall in women a decrease in breast cancer from 2.2% in postmenopausal women to 1.66%, which equates to about a 30% reduction in the risk of breast cancer.
00:12:49.440 --> 00:12:54.799
Uh the study even went so far as to suggest, and this was an observational study.
00:12:54.879 --> 00:13:02.000
Um, so it was a study that really just looked at women that were on GLP1s and not on GP GLP1s.
00:13:02.159 --> 00:13:03.840
It wasn't a study that enrolled patients.
00:13:04.240 --> 00:13:08.000
It just kind of looked at uh an observational study, looked at it across.
00:13:08.159 --> 00:13:13.759
Um but then they went so far also as saying, and I'm not I want to back off and say I'm not advocating this.
00:13:13.919 --> 00:13:19.039
If you you know, if you have breast cancer or you're at high risk for breast cancer, I I am Dr.
00:13:19.120 --> 00:13:21.840
Kaladzik is not saying that this reduces your risk.
00:13:22.000 --> 00:13:27.840
This is a single study, but these are in the press now, so you can go and find this information yourself and review it.
00:13:28.000 --> 00:13:33.840
So I'm not I'm not an OB gen doctor, I'm not an oncologist, I'm just telling you that I came across this article that showed this.
00:13:33.919 --> 00:13:43.759
But it even went so far as saying that in patients that had breast cancer, um, that the risk of recurrence could be diminished as well.
00:13:44.159 --> 00:13:45.360
So it's crazy.
00:13:45.440 --> 00:13:48.799
I mean, I on my TikTok feed, I I get a lot of stuff popping in just because.
00:13:49.440 --> 00:13:49.759
There you go.
00:13:49.919 --> 00:13:51.519
Uh is that where you get all your useful information?
00:13:52.000 --> 00:13:54.240
Actually, that's where I got my degree in my TikTok information.
00:13:54.639 --> 00:13:54.799
Okay.
00:13:55.120 --> 00:14:03.919
Uh but there's a couple of people coming on there just telling you about Alzheimer's decrease and all kinds of other cancer decreases by use of GLP1s.
00:14:04.399 --> 00:14:06.960
So it's I that's one reason I went on it.
00:14:07.039 --> 00:14:12.000
It wasn't because I I I I was concerned about my blood sugar, but I went on there because of the other benefits.
00:14:12.240 --> 00:14:12.720
The other benefits.
00:14:13.120 --> 00:14:18.559
Well, it applies to you because of the risk of a second cardiac event, which has been proven.
00:14:18.960 --> 00:14:19.120
Exactly.
00:14:19.440 --> 00:14:21.279
So that's a true indication for a GLP one.
00:14:21.440 --> 00:14:25.360
If you've had a cardiac event, they can decrease the risk of second cardiac events.
00:14:25.519 --> 00:14:28.000
That might have been in people that were obese, I'm not certain.
00:14:28.240 --> 00:14:29.440
It might have been in diabetics.
00:14:30.080 --> 00:14:32.240
I'll take any ch any advantage I can get.
00:14:32.480 --> 00:14:32.720
Yeah.
00:14:32.960 --> 00:14:33.840
So yeah, okay.
00:14:34.159 --> 00:14:38.320
But this whole thing is just absolutely stunning how every day we turn around, something else is coming up.
00:14:38.559 --> 00:14:50.879
The way the world has changed in the last five years from when I sort first started my metabolic health practice with an exclusive focus on continuous glucose monitoring and stabilizing blood sugar, and then the GLP ones came in and have really taken the world by storm.
00:14:51.200 --> 00:14:54.000
Yeah, this is like our 135th or something like that podcast.
00:14:54.080 --> 00:14:55.679
We go back three or four years.
00:14:55.919 --> 00:15:00.799
If you go back and listen to them where we were talking about this as like the early stages, the early world, right?
00:15:00.879 --> 00:15:03.360
We didn't have any idea that this was going to be like this.
00:15:03.679 --> 00:15:04.080
Yeah.
00:15:04.399 --> 00:15:07.840
So uh again, this is just information for people to consider.
00:15:08.000 --> 00:15:12.080
I'm not advocating that you know everybody needs to go out and get on a GLP one.
00:15:12.320 --> 00:15:20.559
I think there are certainly many, many people who should not be on a GLP one, but in terms of the different conditions that seem to be effective, there's just additional news.
00:15:20.639 --> 00:15:23.759
And yeah, you know, this is what pharmaceutical companies do as well.
00:15:23.919 --> 00:15:30.159
All these studies were um, you know, I'm sure sponsored by pharmaceutical companies or the majority of them.
00:15:30.240 --> 00:15:42.000
Uh, but once they have a medication and they've invested a lot of time in uh you know researching that medication, going through the FDA process and getting it to market, what they then do is look for what's called new indications.
00:15:42.159 --> 00:15:44.720
So what's the new indication for a GLP one?
00:15:44.960 --> 00:16:01.919
So it started as it started as diabetes only, then it got an indication for obesity, then they have gotten indications for sleep apnea, fatty liver disease, second cardiac event, and now there's all these other things out there that are being uh they're being considered useful for.
00:16:02.240 --> 00:16:05.759
Yeah, well, I look forward to the the more news you bring like this.
00:16:05.840 --> 00:16:06.799
This is fantastic stuff.
00:16:07.039 --> 00:16:17.919
Yeah, I I want to be I'm a little bit hesitant because I don't want to, you know, again, we joke about the the miracle, you know, nature of these drugs, but I'm just trying to make people conscious of what's going on.
00:16:18.080 --> 00:16:35.840
So again, I'm gonna come back to the fact that we're gonna change the format a little bit or at least add uh a format approach here of uh letting people, having people please give us your questions at INFO uh at D-O-C-T-O-R-K-O-L-O.com.
00:16:36.320 --> 00:16:39.919
And uh we won't won't identify people, you know.
00:16:40.080 --> 00:16:49.279
And but but if you have pertinent questions that you think other people might want to hear the answer to, then uh go ahead and send us some questions and uh and we'll see if we can answer them.
00:16:49.519 --> 00:16:50.159
All right, Dr.
00:16:50.320 --> 00:16:54.720
Paul, thanks for joining us on today's podcast, the second opinion podcast with Dr.
00:16:54.799 --> 00:16:55.840
Paul Kalazik.
00:16:56.080 --> 00:16:59.039
We'll hear you, see you, be with you all very soon.
