Safety and Physician-Led Peptide Use

People are now stacking their GLP1 as their insulin sensitivity tool, their growth hormone or their GHRH, and their androgen modulation therapies as this Trinity stack. Trinity stack. To get very fit, very healthy, quic.kly So a lot of these transformations you see in CEOs and celebrities and stuff is using a combination of those three things, you know, your TRT plus terzeptide or retrotrutide, whatever it may be, and then using a growth hormone modulation with your if you can afford growth hormone or test hormoral apomorlin and you're seeing people lose a lot of fat, gain a lot of muscle in short amounts of time. Is that healthy? We'll find out. But that is like the celebrity protocol. Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Abud Bakri, an internal medicine physician who is also extremely knowledgeable on the science and use of peptides. When I say peptides, I mean both FDA-approved peptides, such as the GLP agonists, you probably know these as things like the Ozempic, Monjaro, and Retitrutide, as well as peptides such as Body Protection Compound 157, or BPC157, which, as you'll learn today, has a very long history of being used in humans for gut health and tissue repair, and many interesting studies in animals supporting its potential use in humans, but a minimum of formal studies in humans , meaning one. We discuss BPC157, what it does, and how, as well as things like growth hormone secretagogs, like tesimerellin, MK677, and others. And we talk about things like GHK copper, which nowadays many people are using to promote collagen synthesis and repair for aesthetic reasons, like improving skin, hair, and so on. We also talk about peptides that have been studied for the purpose of DNA repair and longevity, like epithalin and pinealin, which also have been touted to improve REM sleep and for improving cognitive function. You'll also learn what is known and what is not known about these peptides, both in terms of function and safety. During today's episode, you will come to appreciate that Dr. Bakri has truly encyclopedic knowledge about these peptides. He is also formally trained as a physician, and as a consequence, you will learn how to think about peptides based on whether or not they have known receptors or not, that turns out to be very important, and what their real safety profiles are, as well as what particular concerns you ought to have if you are considering using peptides of any kind. As a formally trained board certified physician, he comes at this topic through the lens of a physician, but also somebody who is very interested in the current status and future of peptide medicine. Today's discussion, thanks to Dr. Bachry, is a true masterclass on peptides. By the end of today's discussion, I promise you, again, thanks to him, that you will be among the most informed, doctor or otherwise, about peptides from the GLPs to BPC one five seven and all the others that I mentioned, including some that I didn't mention here in the introduction. So it is a real gift and honor to have this knowledge presented to all of us. So buckle up, you're about to learn a lot about peptides. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public. In keeping with that, theme today's episode does include sponsors. And now for my discussion with Dr. Abud Bakri. Dr. Abud Bakri, welcome. Good to be here. Peptides. Huge topic and huge category of biology and medicine. So we should start off by breaking this into categories so that people can wrap their minds around it because that word peptides has come to mean stuff people buy and take and maybe should or shouldn't buy and take, but there's a lot of important and quite simple biology to understand before anyone should even be thinking about any of that. So if I just push the word peptides towards you, how do you carve that up in terms of thinking about it as an MD, as a clinician? And maybe also put yourself into the mind of uh interested, let's call it a peptide cu rious person out there. So scientifically, I would say it's one of the languages of the human body, right? So the body likes these different languages to communicate between cells, going from DNA to RNA to proteins, which are can be broken down as polypeptides and peptides. And peptides are one of these languages. Steroid hormones are another language. And then peptides can be broken down further into subcategories, whether or not they have receptors or they have no receptor. And that kind of changes the clinical effects that we'll see, like the GLP ones, which have a very strong clinical effect. Compared to these obscure peptides like BPC-157, TB500, TB4, that don't have a clear target. They have receptors, but they just have many of them, or they don't even have receptors. We don't have a receptor identified for BPC-157 or TB4. There's a very interesting distinction. I don't think anyone else has described peptides this way. Let's take BPC one five seven for the moment. We're going to talk a lot about it today. If it doesn't have a receptor, what are some ways that it could impact cells and organs and so forth? Or is it that there are receptors we just don't know what they are. It could be that, the latter, that maybe the receptor is still elusive, or it could be that it's modifying certain proteins that already exist or linking different peptide uh proteins together in a more favorable fashion for gene transcription. The Russian peptides are all epigenetic modifiers that they bind into the groove of the DNA in certain spots that either open up or close the chromatin to certain areas of genetic expression. And they've modeled this out. Like a steroid hormone. So steroid hormones bind uh they bind to a like the androgen receptor binds DHT or testosterone, goes into the nucleus, turns on all the androgenic genes. Yes, exactly, exactly. So like Pinellion that we've talked about, uh shuttles uh heat shock proteins with androgen receptors.. Got it So if I just pause us for a second, we should think about this word peptides in two major categories at least. Yep. One is has known receptors, plural, like the GLPs. Yep. The other would category would be does not have known receptors, might have receptors, but can definitely impact biology in interesting ways, or so say the animal data. Yep. Okay. A lot of animal data. All right. I know a lot of people are interested in GLP s and I want to go there, but because I know most people are probably listening to this foremost because they want to hear about the other stuff. Let's start with BPC 157. What is it? What do we know about it? We'll explore safety. And what is your stance on it from the perspective of a consumer and a clinician? So first of all, what is BPC 157? Aaron Powell The best way to look at it is, you know, as humans, we'd be looking for medicines in plants for thousands of years. And in the last, let's say, 150 years, we've been looking for medicines in cells. So animal-derived versus plant plant-derived medicines is the way you think about it. You think about aspirin, you think about met formin, the statins, there's all discovered in you know plant tissues. Um statins more so fungi, but you get the point. Now we've been looking into animal tissues to find cures, medicines, treatments. So a group in Croatia in the 90s looks out for this peptide called BPC that they they and uh eventually named BPC. It's a 40,000 Dalton giant peptide called BPC. BPC157 is 15 amino acids from that giant peptide. We don't naturally make BPC157. That's what you'll commonly hear online. We make BPC the big uh protein. Did this group go looking for body prote ction compound. For those that aren't familiar in in the laboratory, you can take a tissue, grind it up, you can do what's called fractionation, you can start separating basically cells and tissues and liquids according to the size of different proteins, like different filters will bring let just like certain filters will let sand through or pebbles through or boulders through. That's kind of what you do. And then you figure out what the sequences are and then you throw them on cells or put them into animals and you try and figure out what they do. Why were they motivated to look for what eventually became BPC. So Pavlov, the famous uh scientist that would do the experiments on the dogs with the bell and making the dogs salivate. The other work he did was on gastric juices of dogs. What he'd do is he'd put a hole in the dogss' estomac , he would uh feed them food and then get the gas accuses and sell that as a medicine. That's how he made his money? Yeah, that was part of his business. So he got a Nobel Prize, he was also kind of like what did he have a like a um uh call code? It was like like uh enter Pavlov for d for discount at checkout. Yeah. Amazing. So this is BPC before BPC one five seven exists. There's probably other peptides and compounds in there, but they they found that gastric juices had positive effects on healing on people that had you know GERD and these kind of things. Wait, so people were taking BPC in the time of Pavlov. They didn't For what? GI distress, GI discomfort. Um some people will try it for wound healing. There was a big push in this era for like finding animal tissues and putting them into humans. That science fizzled out. At the same time, there's a scientist, Hans Seeley, that's coming up with uh the stress adaptation theory. And he notices that animals are stressed out th,ree things happen to them. Their adrenals get really big, so they make more cortisol. Their gastric lining gets destroyed. And then their thymus gland and their lymphatics shrink down. And he he has this pi published paper where you have clear adrenal from a stressed animal versus a non stressed animal So this group is looking and thinking like, hey, Pavlov had this gastrojuice. Hans Sealy said that there was damage when during stress. There must be some kind of cytoprotective or organ oprotective compound in the gut. The stomach is a very rich endocrine uh tissue. It makes ghrelin, all these other hormones. So they're like, there must be something else in the gut juice that protects the gut lining from further damage. Trevor Burrus Were people drinking the gastric juices of dogs? Drinking was mo mostly what they did. And it was supposed to be a medical elixir. Presumably it had many things in it. Yeah. Many peptides. Trevor Burrus Do the reports point to the fact that it might have worked? Independent of what was sold on uh Dr. Pavlov's non-existent website. Trevor Burrus This was in like the early 1900s. Yeah, exactly. And then uh Solia was what, nineteen thirties? I think Soya was about it. Someone will correct us if I'm wrong. And this other group in Croatia was ninety-one. Okay. Their first paper talks about this. Like, hey, there must be some kind of compound. They they identified the big 40-dalt on protein BPC. And then they they were like, well, what is what's causing the actual biological effects? They identified BPC157, the 15 amino acid peptide that's causing all these effects. There's actually more peptides in gastric juices that some other scientists may or may not have already identified. This field of peptides is going to be very interesting because almost every organ has a signature of peptides. Like if you think back Dr. Vladimir Yulovic in eighteen fifties, eighteen eighties, finds carnosine and carnitine in muscle of cattle. So you can think of that the first peptides that are found are carnosine and then carnitine is as the amino acid that's that have positive effects on strength training and performance and different effects there. But that was the whole idea. Is like, hey, there's muscle peptides that may have muscle effects. Right? So this Croatian group um isolates this 15 amino acid kind of mini segment of BPC. They and others start injecting into mice inducing injuries to nerve, to tendon. Maybe describe a few of those effects. I've I'm familiar with that literature, but I can tell that you are far more familiar with it. So what are some of the impressive effects that they observed that led to where we are today? Aaron Powell So they did all kinds of horrible things to these mice. They would, you know, sever tendons and then give them BPC through oral or injectable intraperitoneal uh administrations and they'd have faster healing times. They would sever ACLs of the mice. They would uh do burn wounds. So what when a patient has a burn wound in like the ICU, they end up having crazy gastric ulcers. But if they were able to put BPCL on topically for the mouse, they would have no gastric ulcers. They name it as this anti-stress compound is how they they they look at it. Now when they do that Achilles paper on the mice, that's what explodes the bodybuilder interest and leads us to today where we are like, oh tendons and and and muscle injuries. But the original idea of BPC was to use it as a gastric treatment, not to use it as a muscle skeletal. I'd like to take a quick break and acknowledge our sponsor, 8Sleep. 8Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity. One of the best ways to ensure you get a great night's sleep is to make sure that the temperature of your sleeping environment is correct. And that's because in order to fall asleep and stay deeply asleep, your body temperature actually has to drop by about one to three degrees. And in order to wake up feeling refreshed and energized, your body temperature actually has to increase by about 1 to three degrees. 8 Sleep automatically regulates the temperature of your bed throughout the night according to your unique needs. 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Terms and conditions apply. Again, that's HelloLingo.com /slash Huberman. Let me pause you here. People are probably saying, should I take it or should I just hang in there, folks? Because this is really, really important . What is so striking to me about BPC, and by the way, that's not an endorsement for BPC, it's just what's so striking to me, because my lab worked for a long time on optic nerve repair and neural regeneration. Nerves don't like to regenerate in the central nervous system. Peripheral nervous system, they do it, they do it slowly, but they do it. Yep. Not in the central nervous system. Ask anyone who's had a stroke or an optic nerve injury. It's a tough road at best. There are dat a that I've seen with my own eyes that show that you can accelerate healing of tendon, of ligament , of nerve pathways. In animals, yes. In animals, yes, thank you. And that it just generally promotes quote unquote repair. Yep. That's kind of weird. It is weird. Right? Because I could spend the next 10 hours or more telling you about all the ways that people have tried to get nerves to regenerate and couldn't. And as you point out, this thing doesn't really have one specific, at least known receptor. So the data on the gut make a lot of sense. This is, after all, a gut peptide. It makes sense that that gut peptide could get lots of places in the body. Right. But what is it doing mechanistically, if we know, to support regeneration or replenishment of all these different tissue types, because a neuron is a very different cell type than you know a fiberblast or one of the bits of collagen that make up different connective tissues. It's modulating a lot of these growth and healing pathways, like in the models of damaging the endothelial layer or the epithelial layer of different tissues, you'll get more VEG F signaling. So that's the vascular endothelial growth factor. So get more blood vessels, androgenesis being formed, which creates a lot of the controversy around BPC safety. You'll get cell migration, especially when coupled with TB500 and TB4. You'll get, you know, more access of the healing factors to the area through androgenic path ways. On top of that, you'll get an anti-stress effect. So the other big thing that they did was they'd give corticosteroids with BPC157 to these mice. And usually when you have a wound and you t you give corticosteroids, the corticosteroids will slow or even stop the wound healing from happening. When BPC was administered, the the the healing was either the same or even better. Is BPC considered anti-inflammatory? Because based on what you just said, it almost seems like it helps maintain some of the pro-inflammatory response. Some people might be thinking, why would you want inflammation? What Dr. Bakery just said is if you block inflammation with corticosteroids, you aren't going to call in the signals to repair tissues. Yes. So lowering inflammation is a dicey thing that maybe we set aside for later in the conversation if we have time. But is it thought that BPC is lowering inflammation or is just somehow hitting the gas pedal on all these regenerative, restorative biological processes. Trevor Burrus, it's more putting the gas pedal on these processes to bring in the immune system, the healing factors. For example, in one tendon model, they noticed that it increased the amount of growth hormone receptors on the tendon. So theoretically , this would allow more growth hormone to dock in and cause the outgrowth of the tendon and their and the regrowth of it. So there's that theory there. Downstream will modulate uh nitric oxide synthesis. So that's a big thing when it comes to wound healing, because you need to dilate the blood vessels, you need to call in different cells. So it's really changing the way cells behave at that level. But that's only for the like the tendon side of it. They also did weird things on the neurological side. Like they would make these mice drunk.. Okay And they would then give them BPC and they'd get less drunk and when they go through mazes. Oh boy. Okay. We did not just recommend you take BPC with alcohol. But people are gonna, you know will do their own interpretation. So I'm being semi-facetious, but very interesting. And then also they would give them get the mice drunk and then have them withdraw from alcohol. And that withdrawal is deadly. If we have a a patient in the hospital that withdraws, they could die during that withdrawal if they're not given benzodiazepines. They got BPC and they didn't withdrawal symptoms. I'm like, what's going on here? This is a very interesting compound. I think it gets it gets all the hype for the MSK stuff, but I think the neurological, neuropsychiatric, let's say, and then gastric effects are way more interesting when it comes to that, because it's modulating the gut brain access in an interesting way. We'll have people come to us and they're like, My Adderall's not working since I've been taking oral BPC. Are they happy with that effect? No, they're not happy. They're very mad because like it seems like it's blunting their Adderall. So it's doing something from dopinergic signaling both on both sides, both withdrawal, uh, when it comes to like the gapinergic side, but also the peak of signaling. So if you like peruse Reddit, which you should never do, um, you'll find all these anhedonia um discussions about BPC. People feel like depressed and low energy. Incredible. So it seems to be held in the U.S. In terms of effects in animals and anecdotal reports in humans. Because I think both your and my excitement about this might be occupying a substantial amount of the force field here, let's do something that normally I would do in a few minutes. I'm gonna ask you some very direct questions about this and you and I don't hold you responsible as being like BPC uh you know spokesperson, but here you are. Um that's Pavlov's job. Um and he's dead. Are there any known adverse events uh from people taking BPC, known and documented, okay. Adverse events where it's unrelated to contamination or something of that sort. Trevor Burrus In the literature, when it comes to um the animal data, they've injected animals with you know a thousand times the dose of BPC with no real adverse effects. So there isn't we don't even know the LD50 of BPC, which makes it hard for it to become an FDA approved. Maybe define L D50. L D50 is is the dose of which would kill fifty percent Aaron Powell And that's actually an important number as as you know, barbaric as it sounds, to determine for any drug. What's the LD50 for caffeine? What's the LD50 for aspirin? What's the LD5? This is every drug you take, folks, on or off the counter, you know, a prescription or non-prescription, has gone through LD50 testing in animals. To be a clinician to prescribe this, we need to know what that is. Which which limits us. Now there was two very small phase one and phase two trials on rectal BPC enemas in the early 2000s from that same Croatian group. So that's the big concern to BPC. All the data comes from one group. So people can be skeptical. There's a couple of Chinese groups that have also replicated some of their work. But uh those groups wanted to try to treat ulcerative colitis. It's a very, you know, miserable condition of where the immune system attacks the lining of the gut in multiple spots. Uh and they use NMUs of BPC up to like eighty milligrams, which is much more than than people would take. Trevor Burrus Most people are injecting micrograms. Yes. Maybe more. But you're talking about eighty milligrams. Yeah, rectal NMLs. They did a phase one and phase two trial. They're doing this daily or they do it once? They did it for a few weeks. Okay. And then they re-measured. They had it was placebo-controlled. The data is not available. The abstracts are only available. So that's what also gives us some pause when we're gonna push that forward, especially when the legal discussions are happening here in the next few months uh on BPC. Um the first the phase one trial showed no adverse effects. Um they and they didn't even have BPC in the systemic system, too. That's that's a key point to know that orally administered or rectally administered BPC doesn't seem to go systemic. Maybe define it that a little bit more specifically. If you take aspirin and then you measure blood aspirin levels, you'll notice the levels go up. When they measured BPC levels, BPC157 levels in these uh individuals, they didn't find it in the blood. So either it was broken down very quicklyy or it staed locally to the lining of the gastric tissues. That raises a question for me. Let's say somebody doesn't quote unquote take any BPC one five seven by NMR or otherwise. If I were to just draw your blood right now, uh there's BPC one five seven in there in the bigger protein. The bigger the bigger BPC protein. I don't think it's it circulating or is it re or is it contain or is it restricted to the gut? That's incredible, right? Because we're talking about these effects all over the body. We don't even know if it leaves the gut. No. But in well, the injectable is going to go systemic. And most people are going to take if they're decide to do this, they're going to take an oral or an injectable. They're either going to inject local to the injury, if they can. Or intraperitoneal. they found fragments of the fifteen. Like there's there's a paper in twenty twenty four that looked at this and they could figure out if somebody had BPC administered for doping reasons, because it's on the waddle list now. So they could figure out if someone had taken BPC. Got it. But there we don't know . Like we don't we need to know the dynamics. We don't know where it goes, how it goes. And we don't know the results in terms of what those N 80 milligram enemas of BPC did for the colitis. Aaron Powell In the phase one trial, it was just the safety. Uh it there was no adverse effects. In the phase two trials very small, like forty patients, there was at least a positive signal on on the ulcer to colitis. And this was done in the United States or this was in Croatia? Okay, so to be quite direct, on the one hand, you have groups who I think are mostly well-intentioned saying, hey, 80 milligrams of BPC by way of enema did not cause any adverse events. And that's the phase one that you described. Trevor Burrus If we believe they're data. Trevor Burrus. Trevor Burrus On the opposite side, many people, especially in the United States and you know and Northern Europe, where the regulations tend to be similar-ish, right, as compared to elsewhere in the world, would say , well, yeah, but that study was in Croatia. Now, I have many Croatian friends. That's not a knock on Croatia. Why would it be that the clinical trials in Croatia would hold less weight . This is this is a dicey area, but I think it's important because you'll hear this. Oh, those are Chinese peptides, those are Russian studies. Like Yeah, and you know, I mean to me, you know, the question is, was it good science? Was it done carefully? Would it pass muster for a phase one in the United States? Aaron Powell That's a good question. The groups seem to be very robust and they do really good randomized controlled, double blind placebo controlled trials. I think we're very uh United States centric. We we view ourselves as as the premier science and we are the premier science. So people kind of trust that more. And there may be no perverse incentives when it comes to different government bodies in like you know, Soviet area research that might be you know f pro fabrication when it comes to certain compounds that makes people hesitant. Because there's a lot of like these Soviet era compounds that are not peptides or some of them are peptides that are fan fantastic. They sound they sound amazing, but when they get tested maybe they're not as potent as the Soviet data would suggest. Trevor Burrus I always thought that the Russian stuff was like the really potent stuff that they didn't want anyone else to know about. It could go both ways. I mean but they were they were more interested in performance. They wanted better astronauts, better Olympians, better soldiers. We care more about, you know, a profit drug model that gets people on a subscription for the with the monthly drug, unfortunately. Sometimes it heals people, but so nowadays, is BPC 157 legal in the United States? Like if if I wanted to go online and buy BPC one five seven, I can do it, right? Legal legally. For research purposes only. I thought now under the new regulations uh recently passed that you can get it from a compounding pharmacy or technically not just yet.. Okay And it depends on medical boards. To break it down, BPC 157 never got FDA approved, right? So it gets into these compounding pharmacy lists. There's a category one, two, and three. Category one means the FDA thinks like, hey, this is not an approved drug, but we're okay with you compounding this and uh you're okay to push that forward. Category two, it's like do not compound. In late 2024, BPC 157 and um and like 20 other peptides got moved to this category two list. Since about 2017 to 2024, people have been prescribing BPC in these alternative medicine anti-aging practices. It gets removed from that list. Of course, you know, compounded pharmacies re-label it as PDA, uh pedadeca peptide arginate. But it's the same thing. It's the same exactly. Really? Yes. One of them will be an acetate, one of them will be an arginate, but the PDA is is BPC157. Aaron Powell Because there are many, many people selling compounded pentadecapeptide. Pentadecapeptide. PDA? Did I mispronounce it? Yeah. Pentadecapeptide arginate. That's the Arginate. Okay. I think the acetate one is the one that's on the phase the category two list. Now just in April of this year, it got removed from the category two list, and it's not yet on the category one list, which would allow physicians to prescribe it through compounding pharmacies. Now but they can prescribe the PDA version. People are prescribing PDA. Yes. Now state medical boards view that very differently. Like I got a letter from one of the um licensed in many states. One of these states reached out to me and is like, you cannot prescribe, not me directly, like to the general public of people in that state said you cannot prescribe non-FDA approved peptides, no matter what. So there's controversy there. Even if the FDA says, okay, we're okay with you prescribing it, is your medical board in that state gonna be okay with it? So it's state by state. State by state laws. What about with telehealth? So somebody's on the East Coast in a state that um allows them to write a script for let's just call it BPC because it's effectively what it is, or this other thing where they kind of wriggle through the regulation. Can they send that to California or to uh Wisconsin or or someplace else if the patient is there? The telehealth laws go into effect where the patient is . So if let's say in California it's not allowed to have BPC according to the state board of uh pharmacy or whoever uh bans that, even if you're a New York doctor that's licensed in California, that would be against the California Medical Board and they would ask you if they found out to stand in front of them. Now, are boards cracking down on this? Not really. There's a couple of states that are cra cracking down on people, and people know to avoid those states. But it's going to be very dicey over the next few years. Okay. Couple of questions. Anic data. We don't want to place too much on it, but the big kind of rumor out there that pricked up my ears a few years ago was when I heard that some athlete before the summer Olympics, this was two Smerum Olympics ago, from Eastern Europe, had a complete Achilles transection, not just a terror or a pull, but when we think about nerves and tendons, we think about like complete cut the whole way through. And the rumor was they took BPC -157, locally injected, for a few months and they podiumed in the Olympics. Yep. They still got a medal. Familiar with that story? That was the that was the story that kind of got out there that I feel kind of catalyzed this movement of BPC out of these niche communities and in started it toward the public awareness that leads to you sitting here today. Among other things. But we're restricting to BPC now. So do we have verification of that story? No. No. I don't think they only did BPC-157. They'd be stupid if they did. They should have, you know, all the best and latest, greatest treatments, whether exosomes, stem cells, other peptides, compounds. And by the way, I should say BPC 157 was not on the banned substances list at that time. It was so unknown. Just like there are compounds right now that athletes are using and not just in the enhanced games in preparation for the Olympics. I'm not saying they're all doping, but they're it's it's a common practice that athletes will forage into things that can help them that are not yet on the band substances list. And I mean good luck proving that BPC was injected, you know, a week ago. Because by the time the peptides are already gone out of your system. So or at least we think based on the pharmacodynamics that we understand now. That story was run with from the research community. They used it as a marketing tool to sell more BPC one five seven. 'Cause what what happened in the in the field is the GLP ones come online, you know, late twenty twenty one, twenty twenty two. With with Ozembek and Wego V they get the F D approval for weight loss. There's not enough of a supply from the traditional pharmaceutical versions of the GLP ones. So people start looking elsewhere to get their weight loss drugs. I know people that would drive down to Mexico and pick up pens. Because a pharmacy in the United States would cost $1500 for an osembla pen. Pharmacy in Mexico. Same drug. Same exact drug. How much relative cost? 150 versus 1500. So 10x. And this is the thing that Trump has been very vocal about, like that we that we're getting overcharged for drugs here. We definitely are. And the the Trump RX has lowered a lot of these prices, by the way, for for a lot of these drugs. Now, that time there was a shortage of semiglutide and then eventually trzezepitide. So the compound pharmacy game shifted into making these drugs. Compounded versions. So they're not the FDA approved versions. But when there's a shortage of a medication, the compounders are allowed to make these drugs to meet the shortage. And in fact, the FDA was reaching out to these people telling them to do it. Like Brigham stocking him last week at the ends games. He was like, yeah, the FDA told us to make this stuff and then they're getting us in trouble. This is Brigham Bueller, who runs Ways too well in a pharmacy for a long time. Compounding pharmacy. Yeah. We've never actually met in person. One of the best ones, yeah. It's not an ad for pharmacies. We have no I have no business relationship to bring him. So if there's a shortage, compounding pharmacies can jump in the game. Yes. And they did. And they jumped in very hard. On the GLPs. Yes. And they made a lot of money off the GLP ones. Were they selling them for less than standard pharma was selling. They were less than the Ozambic pens. Unfortunately, what would happen is the provider had the the discretion on the price. So all these providers also were making a lot of money. Who takes the difference? The clinician. Which is I don't think is legal in in most states. So let's say I wanted to take a Wagovie and there's a shortage. I can't get it from who's the the big manufacturer that's Novanoris. Novinorist doesn't have enough.. Yep My doctor says, listen, you need this. Yes. And I say, How much is it? And they say, well fifteen hundred um fifteen hundred dollars. But it turns out the compounding pharmacy through a different doctor, a more benevolent doctor, could have prescribed it to me for I could get for maybe three hundred dollars. In the case where I'm paying fifteen hundred, it's going to my physician, unbeknownst to me. I don't it's I'm cloaked from the process. If you're getting the the Novo Nordisk pen, the physician is not involved. Sure. No, I'm talking about if I'm if I'm drifted towards a compound inversion. So uh the the most of the times when it comes to compound pharmacies, which I don't think is is a is a good practice, the clinician gets a price from the pharmacy. So the pharmacy will tell you, hey, a vial of semiglutide costs 150 bucks. This clinician can now sell that vial to the patient, sell. It's really up, they're charging an administrative fee. All right. It's not a sale, because technically you get cell medications like that. They will sell it to you for $200 or $800. Okay. If I want to ask my physician, how much are you getting the drug for from because I know which pharmacy it's going to come from, because it's going to come in a violence as like upstate or tailor made or what's Brigham's pharmacy. Revive. Revive. It's coming from Revive. What are you paying for this from Revive? Yep. And then what are you gonna charge me? Yes. And I can assume the difference is going to my clinician. It's going to the clinician. All right. Sorry, clinicians. The game is up. Patients are now gonna ask, and you have every right to ask as far as I'm concerned. Yeah, because of what's gonna happen with the BPC and all these other peptides moving is there's gonna be telehealth platforms on every web on every corner now, they' greonna be like, hey, B PC 199, BPC 299, and they're gonna like check out and there's gonna be a doctor somewhere in a room that's gonna stamp the prescription. But it's just a you know e-commerce. It's supplements with the stamp of a doctor, which is not good medical care at all. Okay. To balance this a bit, the route that many people have gone for about a decade now, but primarily in the last three to five years, was to go to these for research purposes only, what we would call gray market. Let's just name names because they out're of business now anyway. They shuttered themselves. Peptide sciences, till a few years ago, you could go on there, you could buy pretty much any peptide. It would say for research purposes only, not for animal or human use. Yes. And you then sign that many times. And when you paid them, you would have to Venmo them, or you could do it through Zell. Yes. But they would ask that you not send it to a peptide sciences account. It was like some random name and the names kept changing. So everyone knew they were in on something like this. By the way, I I I want to be very clear. I ended up getting these things, right? I was too frightened to take them. Later, I have taken BPC. I've tried it. I don't take it currently, but I've I've tried it through a compounding pharmacy. So I just want to be very clear what that experience was about. So eventually they actually got payment processors. Like the this market evolved with the desire. There's maybe I'd say five to ten billion dollars on gray market peptides being spent in the United States in 2025, and that's going to grow this year. Aaron Powell So here's my question. Standard pharma we know goes through of all the things we're talking about, the most stringent process. You may hate pharma folks or whatever, that that's you're right, but the the the stuff that you get that's non-generic from Novonorisk, from Eli Lilly, you can be certain based on the product packaging that it's as clean as it gets. Yep. As pure as it gets. That's right. Compounding pharmacies are a mix. It depends on the compounding pharmacy. Yep. Do we know that gray market peptides had problems? Because there are people out there right now who are certainly not physicians, people like Robert Breedlove, who's best known for like his work in crypto, who's also now like very open about the fact that he's taken all these peptides and anabolics and things. And I heard him online the other day saying literally that he's tested the gray market for research purposes only peptides and compared them to the compounding pharmacy versions and they're identical. Now, he's not a physician and I don't think he's lying, but many people are taking that sort of evidence and saying, oh, I'll just get from gray market sources. As a physician, what is your stance on this? Aaron Powell So the API for all these active pharmaceutical ingredients comes from China. There are no such thing as American-made peptides. It gets finished here. So the API They're all from China. Everything's from China. The raw materials. The raw materials, like the semiglutide you're getting from a compounding pharmacy or a research pep peptide website, raditrucide included, comes from China and then gets either the raw material gets you know packaged here raw materials or ice or synthesized compound because there's a big difference between getting like the raw materials for something and getting the thing. The synthesized semiglutide gets made in China. It'd be very expensive to make it here. There are people starting to look at that, because that's that's the next thing in the in the arms race, to make American peptides. So they're all Chinese peptides. Everything's Chinese peptides. There's no uh Guatemalan peptides. There's no China's is the best at it at doing it. Now, the compounding pharmacies vary in grading. Some of them are really good. They do all the testing, sterility, they have very good quality control. So you get a good product. But they usually have to compound it with something else to get by the regulations, like the add on a B12 or a B 6, to say, like the patient had nausea from the traditional semi-glutide. We can compound them with B12 or B6 to get around the nausea. And that's that's meets the patient rule. Because there's two ways to get compounded medications.' Thsere a shortage or there's a unique need that the patient has. Aaron Powell Do we know that compounding with something else actually deals with the nausea or is that just a slight event? It might help some people. Got it. Anecdotally, people will say that they respond better to the pens, like the actual pharma pens than to the comp compared to the compounded stuff. The research stuff is all over the place. Like some of it could be better than compounded stuff. It could be the wrong substance. Like there's a there's a guy went viral on Twitter a few weeks ago. He got retitutide. He's like, I don't think I'm injecting retitutitis. Yes. He was injecting melanotane too. Folks, I realize that we're we're going places that not even I predicted we would go, but this is super informative. So all of the raw materials are coming from the same source. Yes. Then they're getting filtered into these different, let's just call them stringency bins. Yes. Standard pharma, quote unquote big pharma, being the most stringent. Yeah. Some of the raw materials are overseas, like I think Lily's opening some China factories. Some of it's here. Okay. Some are going into compounding pharmacies. Uh and compounding pharmacies, I think it's fair to say, have varying levels of stringency. That's right some are gonna be excellent, some are good, some are gonna be lousy. That's right. Fair? Okay. The quote unquote gray market peptides, the ones where it's quote unquote for research purposes only, but I made the joke on X a few weeks ago, like how many of you are running experiments in your home, not on animals? Well, you're doing cell culture at home? Like, come on. Uh like I know it's involved in doing cell culture. You're not no one's doing this at home. So those presumably also come in anywhere from excellent to dreadful. Yes. But we don't know which are which. Nope. We don't know that and batch to patch. That's the big problem. Gotcha. Okay. So it is risky to get research for research purposes on the right. That's the majority of the way people are consuming peptides, unfortunately. We should just because of the the the move in 2024 to get these from the category one to the category two list and make them banned, quote unquote, that opened up this gray market zone. Like the gray market existed for the last 15, 20 years. Bodybuilders would, you know have anecdotes about BPC 157, they'd inject it post you know, post-squats for different injuries. Nobody really cared about it. It was with the GLP1s and then the banning of the peptides, plus this you know, anti- medicine kick that's been happening over the last five years. Since the pandemic that people are like, you know what, I want to inject this because it gives them a sense of autonomy or they feel like their bro recommended it. Like I said the best job in 2025 was to be a peptide affiliate. Like people made my yearly salary in in a month selling peptides uh illegally on TikTok. And I will say because for people that think it's just bro science, it's also gal science, I will tell you I don't even know that is a term. Someone needs to come up with a better term. Um my understanding, and not from Reddit, is that more than half of the peptide market is female. That's right. You know, there's this perception that it's like, you know, only guys who like to lift weights and want to be jacked and you know, jacked and tan or whatever they say, you know. No. No. Especially when we start getting into things like GHKU copper, and we start talking about things for collagen and skin rejuvenation, there's a big peptide market in towards women. I actually think in the long run it's going to exceed, at least financially, the peptide market in men. I think it already has. Because like soccer moms are become like affiliate like you know, Amway and Herbalife was the big thing twenty years ago. Now soccer moms just do peptide affiliate. Where are they getting their peptides? Gray market. Yeah, all gray markets. Okay. We already know that they're not uh recommended. No. But what what about black market? What what what would be considered black market? Black market is like if you bought it directly from China. Like it like it's very cheap. Like a a vile BPC costs five bucks to make. Like now someone will sell it to you for one ninety-nine plus, depending on where. But it black market is either like, you know, your friend in China on WhatsApp sent you a vial BPC, do not do this, or someone synthesized claims they synthesize it in their bathtub, like just like the underground la uh gear. Like all those steroids that were in the 90s and the 2000s. It's like who knows what that is. What's so interesting to me is with steroids, it went from bodybuilding community to eventually hormone replacement. It was like TRT or what I call TRT plus, because a lot of guys are taking a lot more than that. Some are taking less, some are most are taking more, some are taking what they're prescribed. And then HRT bec has become very popular in women. So now HRT is kind of like a thing that it's not like oh my goodness, like so-and-so is taking estrogen replacement or testosterone. It's not not a big deal. Peptides is different because it it came, you know, the big explosion in this came through the GLPs. And I would argue, I'd love your opinion on this, why so many people are now peptide curious is because people, because of the GLPs, are now also very comfortable injecting themselves. Trevor Burrus Absolutely correctly. Like like five years ago, if you're like you're gonna inject yourself, people are like, oh my god, then they realize it's like this little tiny pin, it hurts less than a you know Texan mosquito bite. People are doing it on their skin and like you know, and somebody's you know, your girlfriend or wife is doing it as if it's nothing and you know like heroin addicts or diabetics.vor Burrus, you're not going intravenius. So that changed everything. Yes. That destigmatized it. Now, to be fair, I want to touch on the question about adverse events again. Yep. We're going to spend a couple minutes talking about some incredible things that we've seen and heard about BPC-157 in terms of its positive effects. Yep. The concern I've always had was the angiogenesis, the growth of vasculature. If somebody happens to have a little tumor or s what will eventually become a tumor sitting on their liver or in their gut or in their pancreas. In theory, it could vascularize that tumor and cause it to grow more quickly. Is there any evidence that that's actually happened? I want to be very clear. I'm not loading this question because it sounds like I'm kind of like leading the witness when I say that. I want to know. Yep. I'm not currently taking BPC 157. I'm fortunately I don't have an injury at the moment, so that would be the only condition which I'd take it unless you tell me there are other reasons. But I don't want to give myself that risk. So what is the realistic risk based on observations in humans or animals? Have we ever seen tumors grow more quickly? No. Like for example, most compounds, if they're you know carcinogenic, we will see that signature in the animals, like you know, with carterine, GW. Uh was a drug that was very po was very promising because it had you know diabetic implications for metabolism. Uh now it's a bodybuilder drug that they use for more cardio. What is this? Okay. But people use it for the I stay out of Reddit. Yeah, good. It increases your cardio um capacity. So it's banned on the water list, of course. But it was it had promise for uh treating diabetics because it changed metabolism in the liver. It had a signal of cancer in animal data. So that whole thing was scrapped. There's no signal from the animal literature on BPC157 for for you know cancers. Now that all that literature comes from one group. So we have to be very careful. It's that one creation group that tells you that it's it's the safest thing in the world. All the animal data come from one group. Almost all of it. Interesting. Almost all of it. Very few, like a couple of Chinese studies on BPC 157. Now they're starting to become more interest here. Like I think it's a phase two trial on hamstrings happening here in the United States. Really? Yeah. Humans. Yes. Phase two. Yes. We talked to a group, an orthopedic group somewhere on the East Coast. They wanted to do a BPC trial, so that we consulted with them to kind of happen, especially if it moves to this uh category one list and people can be prescribed it. At least we can get like a phase four trial where it's being prescribed and we can see what's happening to the people as they're getting it. And we can you know aggregate all this anecdot into one place uh ideally and report on it. So that's something we're working on in the in the background. Is that something you personally are yes? We're working on aggregating all this all this data together into a any1ne one dot study to put it all together. Because there's all the anecdotas exists but, like put it together somewhere. At least we can see what the signals are. For example, on Reddit, you'll find signals of hematomas getting worse, which makes sense with the with the VEGF pathway. I've heard this. So a friend and physician who is, I would say peptide curious slash positive, told me that when he takes BPC 157 for, you know, uh shoulder or knee or whatever, that angiomas on his face, um the sort of spider web angiomas, not the formal term, forgive me Yes. That's his his personal observation. I think a lot of people would don't want that. It makes sense though if it's promoting angiogenesis. Based on the the mechanism, it does make sense. Now BPC one five seven is not a uniform angiosis um upregulator. In some models, it decreases VEGF in a melanoma model, a cell cell line. Trevor Burrus So it might be potentially anti-cancer, but we need to test it. We don't know. And that which is what's really unfortunate about this compound. It's very promising. It has all this cool literature in animals, and we just don't know what it comes to. Yeah, yeah, exactly. Yeah, exactly. And and we'd love to know, because like if it does work, like I could see a million use cases in the ICU that we could use, you know, BBC one five seven to really help people out, especially during the critical illness, because like in ICU people get gastric ulcers. Like if if we knew that it would work, I would love to give them an infusion of BPC one five seven and that's the future I could see happening, but we need data. As many of you know, I've been taking AG1 for nearly 15 years now. I discovered it way back in 2012, long before I had a podcast, and I've been taking it every day since. AG1 is, to my knowledge, the highest quality and most comprehensive of the foundational nutritional supplements on the market. 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And I know from my own experience and from everyone I've heard that I recommended it to that they simply feel much better in a number of different ways when they take it regularly. If you'd like to try AG1, you can go to drinkag1.com/slash Huberman to get a special offer. For a limited time, AG1 is giving away a week's supply of AGZ, which is their sleep supplement, and a free bottle of vitamin D three K2 with your subscription. AGZ is something that I help design, it tastes great, and it's the only sleep supplement I take. It has a collection of different things in it that has dramatically improved my sleep, both my slow wave deep sleep and my rapid eye movement sleep, and I absolutely love it. Again, that's drinkag 1.com/slash huberman to get a week's supply of AGZ and a bottle of D three K two with your subscription. When is there going to be a formal randomized control trial on BPC and who holds the patent? There's multiple patents on BPC 157, depending on which salt they're in. The patent has been passed around a couple of times to through different places. Unfortunately, the company that had the patent under the PLIVA got acquired by Teva. Teva is this this generic pharmaceutical company and they don't they make you know Adderall. So that they have they're making tons of money making Adderall. They don't really care about PPC157. So they have one of the patents. The other patent expires in like 10 years. I think Sikrick still has it. Dr. Sikrick is the guy behind BPC 157. He's in Croatia. He's in Croatia, yeah. Would Teva um sell the patent? I'm sure they would if someone made an offer. The the problem is I don't I don't see the purpose of even having the patent because you can add on one chain to the amino acid. This is the problem with with peptides. This is what Eli uh Lulai uh Eli Lili is coming into when it comes to making Retta, is that patent laws for peptide is gonna suck because you can add on one amino acid, you can modify one thing on it, and suddenly it's a different compound. This is true for other pharmaceuticals. Like I'm familiar with some of the ketamine and ibogaine trials. And there's a company that took ibogaine and basically added a magnesium component to it. Exactly. I'm not saying that doesn't work. I think they have a good rationale for doing that. But so this game of sort of protecting patents . And plus millions of people have already used BPC one five seven through research use only So I I think it's millions is fair. But now how do you reveal that back? Like it's already the cat's out of the bag. So like it there's no financial incentive to run the giant study. Unless like we we crowdfund it as as you know peptide curious people. Aaron Powell Within the category of um interesting uh anecdotal data. Yep. And in your role as a physician, I realize you're not suggesting these things, but you you have a different picture of this stuff at the level of a mechanism and you're a clinician that works with, you know, uh truly FDA approved drugs and you're you're once you just share with folks, I said it in the introduction, but internal medicine means that you spend your days what? I'm on the on the wards of the hospital, admitting patients from the ER to the floor to the ICU, managing very complex disease ranging from, you know, a simple pneumonia to a coronary artery bypass patient. So that whole spectrum. Okay. So that lens applied to this as much as one can, would you say that like of the reports that you heard directly from people you trust and for people that who are not incentivized to say these things, like, oh, you know, it made me happier, you know, their skin look better, all the things that we one can find in it with an affiliate code attached to it. Of those, what do you think are the most interesting, potentially valid claims? And I ask thated because if we were going to fund a clinical trial, we'd need to pick an endpoint or a couple of endpoints. Is it going to be recovery from injury? If so, what kinds of injuries? Is it going to be the gastric stuff? Is it mood, interaction with dopamine receptors? I mean, I've heard so many different things. If we had a chunk of money and we're gonna we're gonna design a study and have someone else do it, so it's truly independent. Like what are the top three to five outcomes that you've heard that you have a good feeling there's quote unquote something there? Yep. And then we'd narrow it down to maybe one or two for sake of the study. What what are those five? I would say to complete the phase one, phase two on the ultra of colitis, do that phase three trial on proven that it has benefits for ultra of colitis. And I don't think we'd need to use an enema, we could probably have an encapsul ated version that releases deeper into the intestines. So fix the gut. Fix the ulcered gut. Yes. In conjunction with that, you could do a trial on like, you know, GERD. That's a simple condition. A lot of people have it. Randomized to BPC 157 oral capsules versus pentoprazol. Okay. And you're basing this on the fact that you've seen and heard that people who have GERD get better, feel better when they take it. Okay. And it could be place . Yes. I mean anecdotally, when when I travel, I I have a bottle of BPC orally. Why is that? I don't get, you know, traveler's diarrhea or or you know when I you know eat exotic foods on in random places, my friends all get sick and I I happen not to. Anecdote, right? But that's interesting. There seems to be some kind of gut prote ctive effect. And that's what they noticed in the the mice literature. They would have an offending agent into the gut and they'd notice that there would be protection deeper down in the in the gastric tract from that offending agent. Because if you think about it, the gut is the most vulnerable part of the body. Like you it's open to the outside world. It's a tube that runs through you. You can eat something and it can completely destroy you. So you have to have some kind of mechanisms, the prostagland ins, uh the you know, all these different hormones that are made, potentially BPC-157, is part of this robust armory that the gut What are some things outside the gut or indirect from the gut that are also compelling? So I I would love to see some neuropsychiatric um BPC studies when it comes to um And the hey, I don't need to crave insert drug here. Not recommending anyone tries that out, but for alcohol or whatever it may be. Aaron Powell Do you think that is likely due to the we're speculating, but likely due to a um interference with the reinforcing properties. Just like earlier you said people are getting less drunk. So people are getting less high, becomes less reinforcing. Or is it somehow touching the craving mechanisms themselves. It's probably touching the craving mechanism through the gut brain access because I don't think it's going systemic either. I think it's it's locally in the gut, shutting down the neurons from from from if you think about it, if BBC is what they claim it is, right, and that's a big if , that if you have a noxious agent going into your gut, your body has to have a mechanism to lock down protect your or your vital organs, right? So is BPC part of this giant transduction pathway to protect your vital organs, your brain, your heart, your kidneys from further damage. We had uh Dr. Diego Borges, I can never pronounce his last name, forgive me Diego, who's out at Duke, who's really the world expert on these neuropod cells in the gut that signal through the nodose ganglion up the vagus nodos ganglion to either promote or suppress release of dopamine to make you either approach or avoid certain foods. Yes. Very, very interesting. Wow. I would be more than happy to encourage his lab, even if get funds for his lab, to do something on this. What are some other categories of interesting effects that deserve careful study? Yep. So we need to see what BPC does on the muscle skeletal system. Like that's what the hype is, that's where everybody's is the is going. So as I look through like what model I would look for, you'd want something that's not very vascularized, but could be improved if the blood flow was good, like a tendon injury. So perhaps you know a bicep-tricep tendon type of uh post-surgical outcome. So like you get your bice pt tendon um torn, you get a repair, you get BPC either interoperatively or post-operatively, and you see if if that person heals faster. Because the idea is not to use BPC, it's not going to magically reattach an ACL that's torn, right? But But can it further accelerate the healing from an ACL surgery so you come back in six months rather than twelve months? That's the big question. And that's what like a lot of athletes are are using BPC 157 for that use. Has ever anyone ever done the one limb versus opposite limb control experiment? I mean I know that people take it orally or inject it systemically like under the scan or into the muscle. It goes systemically in the bloodstream if you apply it that way. Um if you can get to the injury site, sometimes people will inject locally. But it seems that the challenge is that let's say you have, you know, uh, you know, a tendinitis in one elbow and tendonitis in the other elbow, you could inject into your left elbow and not and not your right, but there's going to be systemic transfer. So it's hard to do that internal control experiment. Yeah, I know I I've had I've used BPC for one injury and I've had results on a different injury. Positive results. Positive results. I'm like, oh interesting. That like that my shoulder feels better even though I was doing it for my elbow or whatever it may be. Trevor Burrus This would be a good time for us to, you know, bracket what we're about to say by saying this is purely anecdotal, but filtered through I consider myself a skeptic on many, many things, especially things I would put into my body. I'll tell a a story. What's your favorite personal BPC story involving you and your body? Yeah. I tore my tricep a few months ago. Tore. Yeah. Tore tricept, lifting with people I should have been lifting with. They're much stronger than I was. Purple from here to here. Like i the pictures I posted them on on X, it's it's brutal. I'm like, oh I'm gonna have to have surgery. This sucks. I I don't have time to have surgery because you're in a you're in a brace for like three months. And I put BPC in locally, you know, don't try this at home, not medical advice, but locally in the tissue spot with a couple of other peptides. And within three weeks, my my PT is like, what the hell are you doing? Like this is healing so fast. Would I have healed that fast anyways? I don't know. But that's typically a grade two tricep tear with with purple arm from from top to bottom. It wasn't grade three, uh 'cause I could still extend my my elbow. That's usually a three month recovery and to be back in three to four weeks was was fantastic for me. Which is why I'm so excited. What dosage were you injected? Uh a larger dose than people would uh uh not micrograms no no you were up in the grams yeah yeah yeah a lot higher i i think uh personally and in some of our our our people we've used bigger dosages i think that's the problem the low dosages uh even though that translates well from the mice data for humans I think the dose is way higher but people just go based on the dosages that would fit in the pile through a you know peptide sciences website rather than what actually we don't have know what what the human dose is for BBC 157. So there's a lot of work to do to just to figure that out. Like when we spoke to the to the orthopedic group, they're like, yeah, we're going to start with you know 250 micrograms. I'm like, I don't know if you're going to see an effect at that low of a dose. You might need to to raise it up. Like that 's what people do online. I'm like, well yeah, but that's just because someone's peptide website sa says to do that. There's no data there. But you know, tricep was back to normal. Amazing. That was a an interesting BPC case. I've I've seen other injuries where BPC didn't really help. Much. Well I can't match your story. That's a that's a bigger result. I I can just say that I had a bad trap neck pull where I couldn't turn my head and I was like, oh one of those. And you know I had some BPC, so it was only I think only two hundred micrograms and just pinned it right into the that's street talk for injected um right into the kind of like upper trap ish area two days later completely gone course. I don't know what would have happened had I just waited. But it seemed um eerily fast. Yes. And then I stopped taking it. Yep. So there's a guy that, you know, and and by the way, that was um not gray market. It was obtained through a doctor's prescription from a compounding pharmacy. Yep. Labeled BPC157, not PDA. Okay, those are anecdotes. I've also read, just to be fair, we should balance this out. Certainly on X, you know, people can say anything they want. People saying, oh, you know, I didn't feel well, I stopped taking it. Okay, could be due to what it was dissolved in, could be due to their own unique of you know response, could be due to bad s sourcing, you know, contamination. So we don't know. But not everyone has a great result. And some people have no result. Right. But many, many people report what can only be described as pretty astonishing positive results that cannot be directly ascribed to the BPC because of the placebo effect, et cetera. And I'm not saying that to protect myself, I say that so that people can couch this in the like Yep. Is because of stories like this. There's two possibilities. Either BPC is as amazing as we think it is, and it's unfortunate that millions of people don't have access to it, or BPC is actually either ineffective or harmful to people and millions of people are injecting it right now by buying it through online sources. Both cases are very bad endpoints. One is worse than the other. You can argue which one. But that's why we need this data and we need people to push this forward to figure this out because we don't want these endpoints. Because if if in 20 years we find out BPC is as good as you know Secret Slabs says it is, then man, people are pissed off all the you know joint replacements and injuries that didn't heal and all the athletes that maybe could have had a longer career, that would be very unfortunate. But if it's the opposite, and like you know, every 18-year-old kid in the in the gym will come up to me and say, I'm gonna inject BPC, like, where do you get it from? Before I'm like, dude, you you're 18, you have you got all the peptides you need uh in you, like the parabiosis studies, the use of young animals. L youike actually take your blood and into the Trevor Burrus, Tony Weiss Corey on the podcast. It was you know, young blood is rich with these things. And no, we're not talking about harvesting blood from babies. Check out the Tony Weiss Corey episode. We'll we'll provide a link. I mean, what you just said about young guys coming up to you in the gym and saying, Should I be taking or I'm already taking BPC is you know, we could have a whole other conversation maybe another time we will talk about testosterone and synthetics and things like that. I I see a lot of young guys taking everyone. I don't know. I don't know if it's a good idea Many, many people are taking testosterone exogenously who uh truly don't need it and potentially permanently shutting down their fertility or causing other issues. With the looks maxing trend, too. With the looks maxing trend, you know, they're walking around with hammers, sludging themselves in the face, this kind of thing. I'm sure when I was in my twenties, you know, people in their 50s were probably like, what are these kids doing? You know, and it wasn't in anything like this , but who knows? It was like baggy pants and like, you know, and and like what there was weird stuff going on, like hacky sacks and stuff. So not me. Not me, but I'm confident that thanks to you we've framed the history of this, which by the way is fascinating and kind of where we are now. Very, very well. So thank you. Thank you. Thank you. Thank you. I have two questions. Um well one comment and one question. The comment is I think there's a s third category of problematic outcome. One you said is this thing works spectacularly well for a number of important problems, to solve important problems, and we don't find out about it because it wasn't looked at carefully. The other is it's detrimental. There's the other one, which is we start hearing about adverse events and it goes kind of the way of the dodo or it kind of drifts back into who you know and is it the good stuff or not the good stuff, because we don't actually know whether or not the the adverse outcome was due to BPC itself, to misuse of BPC, or to like, you know, like the factors that it's it it's dissolved in or something like that. And I think that's the most likely outcome, unless we get our arms around this. And that's where you could say like the hormone replacement therapy field has actually enjoyed the fact that if a woman decides she's going to take progesterone or estrogen replacement therapy, perimenopausal, or menopausal or something for PCUS or whatever, that wouldn't be what to take for PC OS, but you get the idea where a guy decides in his you know 40s or 50s or whatever it is, okay, he's gonna go on TRT. He can do it carefully, she can do it carefully and kind of knows what adverse outcomes to look for. No one's thinking, oh my God, the sesame oil that it's dissolved in is possibly causing these problems. Trevor Burrus Well some people will will be very particular on which oil their testosterone comes out. That's in the gym community. Yeah yeah totally with you and where to inject and so forth. But that aside, my concern is that it is kind of Wild West-ish. Yes. And I'm not so concerned, I'll get in trouble for this, but whatever. I'm not so concerned that these actual compounds are necessarily harming people. I worry that the way they're arriving to people is harming them, and we're gonna miss out on that first possibility that these are very useful. And of course, I don't want anyone getting hurt. So here comes the question. As a physician, I realize that you are more than peptide curious, you're very peptide-friendly in your own life, you know. If you have a patient who has, you know, just their gut is a mess or they're dealing with you know post-surgical issues, and you know that BPC from the right source is either going to be benign or could potentially help them, what kind of position does that put you in? Yep. As an American board certified physician? Very uncomfortable position because if I'm s you know rounding on a patient in the wards of a hospital and like, hey, you should take BPC instead of your pantoprazolt, I'll probably get my license provoked. So not a good idea. Don't do that. What about in addition to? In addition to. So like if they come see me in clinic, that might be a place where we can have that discussion. We're gonna see very shortly here what the FDA is gonna tell us about BPC and all these other peptides, uh, the legality of them. If they get moved to the category one list and then the states say, like, hey, the FDA said so. We're not gonna look, we're not gonna care about this. You can do what you want to do as a physician. And you counsel the patient, like you have an honest discussion with the patient. I think that's what it should be. It should be between the physician and the patient. Like, hey, there's this promising compound, it's not FDA approved. We have minimal to no human data, but we have an ac data. Are you willing to try this on yourself? And we'll monitor you, we'll have clear endpoints for that. That should be what this looks like. Okay. Frame discussion between a physician and a patient. Now if that patient has an adverse effect, they can go to a medical board and say like, hey, Dr. So-and-so gave me BPC157 and I had a bad effect. And I would be like , hey, you give them a non-FDA approved compound, A, for injectable. B, the problem is there's orals that are being sold as supplements now. Like BPC 157 as an oral available supplement, because it's not a medication. It's never been uh approved as a medication in the United States. So what is the BPC's legal status? Is it dietary available? Therefore, because if you cut up an animal and ate its stomach, you'd probably get some BPC in the middle Well, I can buy desiccated liver tabs. You can go buy liver at the the like you won Michelin Star resta urant not down this road but a different road. Yeah. Yeah. I mean like Dr. Cavinson identified many peptides and livers, like livogen and ovogen that you'd find in your desiccated liver supplement that you're eating it's like the the biggest distributors of peptides have been these organ meat companies because each organ has a signature peptide that comes out of it. Do they get absorbed? Yes. Are they bio available active? Dr. Kavanson's work s uh suggests that it is. Dr. Vladimir Kavanson is this Russian Soviet scientist that gives us epitallon and thymolin and pinelion and all these Russian peptides. Dye and tri peptides can be orally available if they're the right shape and size. They're not very well uh available, but they can be available. So you won't necessarily get it from the organ uh I mean there's cardiogen, which is one of the c heart peptides that that was scantly studied uh in the late 2000s. That may be orally bioavailable. The problem is no one's doing the work to figure that out. You painted this picture where not you, perhaps, but let's just say um another physician has the awareness that BPC-1 57 might be useful to a patient of theirs that's dealing with a you know they had like an ACL tear. Sure. They're not recovering very quickly. Doctor says, listen, you're doing everything correctly. There's this new category of stuff. We don't have a lot of data on it. I'm not aware that there are any severe risks, but they they could be there. So if you're willing to embrace those unknowns, you could take X number of micrograms or milligrams per day for two weeks and see how you feel. Patient says, okay, I'm willing to do that. The physician says, okay, you want to make sure that it's real and you want to make sure that it's clean. Yep. There's not no contaminants. If that physician says, you know, I can write you a script for it and this compounding pharmacy will send it to you. And they're making money on it. A lot of people, well, the moment they hear that, they think, oh, well, they're totally incentivized to do this because they're gonna get a cut. But if we go back to the original pharma model , it is a little bit of a different situation, right? Because let's say Lily charges $1,500 for a pen of some sort of GLP. The physician who prescribes that? they Are getting a cut of that fifteen hundred? But there are kickbacks and you know pharmaceutical incentives and pharma dealing. Those are real. It's flights to Hawaii for a conference. Really? So there are real incentives, even though they're not getting paid directly. Yeah, there's always there's always incentives in in any kind of business. Especially a business as big as pharmaceuticals. Well physicians are already getting paid, so I'm not saying that I mean these are a these are peripheral incentives. Well the far the farmers also lobby a lot of the medical schools and they you know gotcha. So there's a relationship there, but it's not cold hard cash. Right. But in a compounding pharmacy, now this physician, hypothetical physician, could say, hey, you know what? You can get it from this compounding pharmacy and it's gonna be five hundred bucks. The patient we've now established, because they've heard this podcast, has a right to say, what do you paying for it versus what you're charging me. Yes. They might lie, they might tell you the truth. Or the physician could say, you know what, I'm not making a dime on this. It's just I think it might be useful to you. That physician is protected or not protected if something negative happens to the patient. don't think that's a Something happens to they is somebody suing a compounding pharmacy or they're suing their physician. That's pretty scary. No malpractice provider is gonna give you coverage for peptides, especially non-FDA-approved peptides, unless there's high-risk malpractice providers that will cover you for that. Trevor Burrus Let's say somebody gets hurt taking one of the prescribed pharma GLPs and they're pissed and they and they sue. They sue their doctor or they sue the pharma company depending on who who had the liability. So if the the doctor didn't warn you that you know injecting 10 times a dose might cause pancreatitis and you had pancreatitis, they can claim the doctor is at fault. If someone has deep pockets, they can go at Lily and say like, hey, Lily, you didn't disclose this risk. I think now people, thanks to you, are armed with enough information to be able to make really good decisions about whether or not to say, eh, waiting for those clinical trial results, or I'll stick my toe in the pond, or I'm going to continue to learn more, but I'm going to now learn more thanks to you, genuinely, with a lot more understanding about how this stuff flows from website or from doctor to patient. Let's talk about pineal . Yeah. Pineelon is one that most people probably haven't heard of. I'll just go on record saying I've tried it a few times or more. I don't take it regularly, but I tried it before sleep. Yep. If I take it at the beginning of the night, it reduces my deep slow wave sleep and gives me far more REM across the night. Not a great situation. Great situation is if I go to sleep, get my usual ration of deep sleep. If I happen to wake up in the the middle of the night to use the restroom once or so, not uncommon, if I do a very small injection of pinelon at that point, the one and a half hours of REM that I would get in the final hours of my sleep, now I'm getting three hours in the same amount of sleep. It's just a higher fraction of REM. Yep. Sometimes wake up feeling a little groggy, but it is a whole other life to get that much REM. I don't do it regularly. It's not, you know, I would say maybe three times a month. But here's the interesting thing. It improves my percentage of REM on all the other nights in between those three injections. So I'm coming clean here. Very cool. You're interested in pinealone for a whole other set of reasons. But first of all, what is pinealone and where does it act? Does it have a known receptor? No known receptor. So pinealon is a tripeptide uh EDR discovered by the mentioned of Dr. Vladimir Kavanson. He's a Soviet researcher that comes out of this Soviet-era research to make soldiers, astronauts, and pilots uh better. There's concern that the US might be using lasers to shoot at soldiers. So the Soviet Union um tasks him with identifying peptides to defend soldiers, their eyes, and then their aging. Because what would happen is they'd be in a submarine for a few months, there'd be a nuclear sub, and they'd they'd come back to shore and they'd be like, you know, these submariners, let's call them, would look 10 , 20 years older. Also happens to astronauts. Yes. So then the same thing as the astronauts are coming back, they're they're aged. So Vladimir Kavinson's looking at this and he's like, hey, there's there's got to be a solution for this. There's been literature about using extracts of other tiss ues, notably the pineal gland and the thymus, from you know late 1800s till this 1970s uh point that we're there were you know starting our story. And he starts grounding up these um extracts and injecting it into these people and then undoing a lot of this aging effects through pineal extracts and thymus extracts. Because these the what do these soldiers have? They had very bad circadian rhythmicity. So they they can't look couldn't sleep properly. They had terrible immunity. They'd get sick often. They'd be uh have autoimmune problems, all these conditions that come with it. And then they were able to undo this using these organ extracts. So Vladimir Kavinson takes it a step further. He looks like, hey, what's causing this effect in these in these tissues? Like people have been injecting pineal glands in different research models or taking out pineal glands from rats from the 1800s onwards. He finds peptides in these extracts. He's like, huh, I wonder if these effects are from the peptides, not from the gland itself. So then he sequences from the pineal gland, uh, epithalon, and from the thymus gland a couple different uh peptides, vilon, thymogen, crystogen, that you'll be hearing about in the next few years that on their own do a lot of the effects that the whole extract would would do. Now you're talking about epithalon, but pineal on and epithelon. It's pineal gland. Even though everyone No, I think it's called that because there' theres's as far as I understand, please correct me if I'm wrong, there are uh animal data suggesting that pineal can help either regenerate or enhance the general functioning of pineelocytes. So it's having an effect on the pineal when culture well, like you take cultured pineal glands, like little p-side gland and you put it in a dish and you dissociate the cells or keep it you know as a little p-sized thing and then you give it pineal on and seems to improve the timing and perhaps even the amount of melatonin output from the pineal, these kinds of things. Epithalon does that. So that's a big confusion. I don't know why he named them the way he named them. If anyone knows, please let us know. But epithalon is from the pineal gland. Pineal comes from a ground-up brain extract called cortexin. And brain has a pineal in it. Aaron Powell Yeah, but it was the cortex specifically, not the subcortical regions. So he specifically not the subcortical regions. That's reassuring. So Blader Cavinson identifies, he makes it a drug in Russia. It's cithalamine, which is the penile vine extract, and had great effect on circadian rhythmicity and especially giving people melatonin. But also you upright the enzyme that creates melatonin from serotonin to Nacetyl serotonin to melat So like um when he gave it to young monkeys, the monkeys had no effect. But he gave it to aged monkeys that have decreased melatonin, and you know, from puberty onwards your melatonin levels dramatically decrease. He was able to restore melatonin production in these aged animals and eventually re-replicated it on humans. Aaron Powell I want to talk about thymus because it's fascinating and you're truly uh versed in this. But before we do that, pinealin comes from the cortex, not the pineal. Yes. That's annoying. Yes, very annoying. Maybe we just rename it today. I'll let you do the renaming. We'll call it EDR. EDR. That's a three amino acid sequence. Great. We'll call it EDR so people don't get confused. What are some of the known effects? Or am I just imagining this REM increase because I can't change what's happening to me during sleep. Yep. That would be an amazing placebo effect. And the reason I say amazing is there are many things that one can do to improve the amount of slow wave deep sleep, not eating too close to bedtime, doing some exercise early in the day, et cetera, et cetera. Very hard to increase RAM except by heating your sleep environment in the last third of your night. And maybe some alpha GPC in the late day can bump it up a bit. Or you can REM deprive yourself. Or you can smoke cannabis for 10 years, then quit, and then you'll get a lot of REM because you got no REM for 10 years. Do not recommend that protocol. But for me, it was just striking. So why would EDR tripeptide with no receptor? Right. Previously called pinealone, but from here uh here forward, EDR. Why would that have this effect on on REM sleep? Yep. And and I actually searched through all of the literature from Caventon. He never mentions REM sleep once in his studies. He studied Pinulon quite extensively on different neuronal tissue extracts, animal studies, even in athletes, and never mentions the REM sleep. They weren't having they didn't have whoops in the 1970s in the Soviet Union. What? They didn't have H sleep? You're kidding me. No, no no., So they they didn't have sleep trackers in the 1970s. Right. Uh when it came to to these. So th there was no reports on on that. But what seems to be happening, let's let's see what what is this canele on this EDR? It's a tripeptide that meets the groove of the DNA of different key regions and helps the promoter region be exposed, so then that DNA transduction can happen, trans uh translation transcription. So you get turning on genetic programs. Yes. Actually, a little bit like a transcription factor. Yeah, yeah. Almost like that. Or maybe assisting transcription factors in accessing the DNA in the right places. So pinelon in in one sentence, it's leading to better brain metabolism through moduling all of these different pathways. For example, GDF-11, SOD one, SOD two, uh, irisin, PPR alpha, PPR gamma. So what seems to be happening? So he made Pinulon as an anti-stress um cognitive performance compound. And it was available orally in like Kazakhstan to sleep, I should be taking it in the morning. Yes. So I if you take a high enough dose, there is sedation from it. But if you take it in the morning or pre-hit workout, you get quite an interesting effect. So he studied this um compound on athletes and he would uh do have them do their training session, go to exhaustion, and then do a test afterwards. And there's two groups, Pinelon and the place bo. The Pinalon group could keep the performance up despite I feel like such a dummy. Here I am having like these elaborate dreams I don't really remember or care about and when I could be actually thinking better during the daytime. So a lot of people will report less brain fog, you know, better thinking . Uh a friend that has a a you know nine figure company has all of his employees on pineal on. They're taking it in the morning. In the morning. Uh or at night, depending on the. Do you know the dosages? Uh. Not that we're recommending it. Orally people will take anywhere between, you know, half a milligram up to three milligrams is what poor people um settle in. Um the Caventin ones that that that come from Russia are like two hundred micrograms. Some people are injecting it. Some people are injecting it. Egosystemic. Egosystemic. It's orally available through these uh Latin PEP transporters. Crosses the blood brain barrier? Most likely, yes. Okay, because it's coming from cortex, but otherwise we're the way you're describing it, we're putting no one's infusing into the brain. So we're assuming it's small enough, it's a tripeptide to cross the blood brain barrier. Have you tried it? I mean I took some last night, but Okay. At night. Yeah so I I will take larger dosages uh if I want to get good sleep. I I'll describe as 8KRM. Some people it will cause them to have a little bit of awakening . Um at first, that may be why your deep sleep is going away. I'll say this: if I take half of what was recommended, I'm great. Yes, yes, but I'm very sensitive to everything. Sure. Just sensitive. If I take what was recommended, I fall very deeply asleep. I have elaborate dreams and I wake up. Yeah. And I couldn't tell if that was a disruption in sleep architecture. I just found and and granted I'm only doing this three times per month maximum. And I often forget and then I go months and months and I was like, oh maybe I'll take a little pineal and you know , whoa, this is wild. And then I'd stop taking it because I don't know enough about it. Now I know it's cleanly sourced because I trust the compounding pharmacy it's coming from, but I should ask, are there any known risks of EDR? Aaron Ross Powell So far, nothing in the Russian literature. So big caveats, Russian literature, it's not gold standard American research that we love here. So there's nothing that's come up as a you know clear sign. 'Cause what what it seems the big theory of Caventon is that as you're when you're younger, you make a lot of these peptides naturally, these tri dye, tri and uh tetrapeptides. And as you age, they go down in function and quantity. And by replenishing these peptides, you're restoring some aspect of youthfulness. Something similar happens in America with GHK copper, which is another tripeptide that's technically like the collagen regulator. So pinilon is the brain regulator. And GHK copper is the collagen regulator. But so far, the the side effects we've noticed, uh and uh we have the probably the biggest anecdotal uh compilation of n equals one. Every every day I wake up, someone texts me, like, hey, Pinelon did this to me. Some people have a little bit of drop in blood sugar because it activates PPR alpha, PPR gamma. So it'll it'll have positive metabolic effects. So that's something to keep on an eye out. And so in case uh some people even had their A1Cs drop. So not that. And then very vivid dreams. So for some people that could be disheartening if they if they have like you know nightmares or something like that. But very, very vivid dreams uh as a result of a pineal, and especially like the cut the color and the the quality of the dre ams is very different than you'd nor normally expect. What seems to be happening is like just like you know, psychedelics changed the redox state of the brain. Pinelon's doing something similar where you're getting more alertness during the day. Like you don't wake up with as much brain fog, uh, at least anecdotally. Um, you get better performance during like high-intensity interval training, and then you get more REM sleep at night because the the neurons are in a better oxidative state thanks to the PPR alpha, PPR gamma, iris and all these different pathways that it's modulating. With no clear one receptor that it's doing it through. Function provides over 160 advanced lab tests to give you a clear snapshot of your bodily health. This snapshot gives you insights into your heart health, your hormone health, autoimmune function, nutrient levels, and much more. 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The reason I thought it was nonsense is I used to co-teach neuroanatomy when I was at UCSD, uh, before moving my lab to Stanford, with a guy named Harvey Carton. You guys can look him up. Unfortunately, he passed away. He was in his late 80s, and he had this incredible career as a I think one of the greatest neuroanatomists of the last hundred years. And it's a that's a good category to be in, because we have like Cajal who's like discovered everything basically, and then the rest of neuroscientists are just kind of tinkering around with what he predicted. And then a few other neuroanatomists like Ted Jones, et cetera, but he's like the neuroanatomist of my generation. And I asked him about this calcification thing, because he had looked at the brains of so many different species, including humans. He was also an MD, by the way. And he goes, yeah, I don't know whether or not this calcification thing is real. And he kind of brushed it aside. And I thought, well, Harvey doesn't take it seriously, so I'm not going to take it seriously. But even though he was absolutely right about many, many things, I think he might have missed that one. Because when I go to the literature now, it's a little bit tough because the cadavers that you looked at in medical school, not all of them are processed on the same timeline, right? It's not thankfully, it's not a controlled science, right? These are people that j generously donate their bodies to science, right? Does our pineal calcify and even if it does, does that somehow inhibit its ability to communicate with our other tissues Aaron P?owell It's a big kind of debatable thing in in the pineal research. If you look at the pineal gland Wikipedia, it's very under developed, let's say. Because it's kind of woo-woo. Like when you think of pineal gland, you think of someone who's going to sell them. Who neuroscientist chooses to work on the pineal gland. They should, but it's not a very sexy thing. It's not very sexy. Yeah. But I think it's it's a key aspect of aging and longevity. So that that 's what gives us our interest in it. The pineal gland um it seems from Cavins' work that the decrease in pineal gland function with aging is more of a physiologic than a anatomic problem. I will see some calcification on MRIs when we have a patient come in for like a stroke or you know TBI, we'll look at their MRI and like, hey, there's that looks like a little bit of calcification there. Uh maybe my neurology uh colleagues will disagree, but that seems to happen. But the question is what is actually leading to the deterioration of melatonin synthesis? Because it decreases quite dramatically. And some people even think that might start puberty. Like if you have a penile penile cyst, you can have precocious puberty like an eight or nine years old. The rhythmicity in melatonin. Because a a young baby, very young baby, uh their melatonin secretion is not very rhythmic, but they're in REM like a lot. Yeah, a lot of their sleep is REM. It's a beautiful thing, right? With time, it becomes more rhythmic. Yep. And of course, in today's day and age, with all the artificial lighting and the lack of sunlight exposure, things that you and I care a lot about. Um people are making themselves somewhat arrhythmic or face shifted. But epithalin is somehow restoring pineelocytes, it's somehow enhancing function of the pineal and other tissues. Yep. So uh in in Cavens's work, he's found that it will increase the expression of the different clock genes. So in in like you know, lymphocytes that he'll measure in peripheral tissues, he'll notice that the clock genes actually change. So in in a more rhythmic pattern. He'll notice that morning cortisol is higher. Great. Which by the way, folks, I've said this in the cortis cortisol episode, you want your morning cortisol super, super high. You want your evening and nighttime cortisol low. If you're a resident in medical school, just listen to what your superiors say. You gotta do the hard work and then uh later you get to later you get to go to bed. It's a little weird that the medical profession, tortures their own by disrupting one of the one of the primary anchors of health. Yep. And cognitive flux. Yep, right, right. I mean I've had 28 hour shifts and that's what got me interested in security But yeah, the idea was it was restoring a more um circadian appropriate hormonal profile through you know HTH, cortisol. Taken when. Anytime. Because the idea with these bioregulators, unlike you know a GLP1 drug that you take today and have the effect for the next week. The idea from the Cavinson model is that you take these and then you accrue benefits when you're off of them. Like you notice with Penilleon, you took Penillion for a a day or two or three days a month and you had effects until you took the next dose. So the idea is can you accrue benefits from these compounds as they upregulate or downregulate certain genetic pathways in a more favorable state and then keep those effects later on. So in the Kavinton's seminal work was his 15 year um longevity study. He got people in nursing homes, two groups. One them got uh epithalon in the form of uh epithalamine, which is the whole pineal gland extract, and then a thymus peptide called thymulin, not thym ulin. There's a two different peptides. A lot of people can confuse them. Every peptide website confuses them. But I injected them for fifteen years, like a 10 or 20 day course per year. Just just uh beginning of the year, middle of the year, and that's it. And they had a significant lower mortality when it came to cardiovascular disease, uh infectious risk, and for um cancers. So Russian study, caveat. But that would be the most interesting longevity study I've seen done, if accurate, if true, uh, because he was able to take nursing home patients, give them peptides for, you know, very small amount of the year, and yet they accrue benefits the rest of the year. Impressive. Uh one of the things that really got me excited about epithalin is it Aaron Powell The Russians say epithelon, is the the way they say it, but it's spelled with a TH in the whoever wants. I'll say epital in because it's uh easiest for me and forgive me if anyone takes offense. I took interest because uh in my former life running a lab focused on of among other things, uh visual pathway repair to reverse blindness or impending blindness. There's some interesting papers. And there I can really gauge the data. Even though they're in mice, I can say this is a real effect or like a meh effect or like a whoa effect. Using epitholin to combat some of the neurodegeneration in things like uh retinitis pigmentosa, downstream neurodegeneration in RP, uh which is a very common, unfortunately, blinding disease. Or even in glaucoma.. Yep I should mention that BPC 157, to my knowledge, hasn't been looked at extensively in terms of optic nerve repair, but it absolutely should be. If if someone knows those papers, please put them in the comments. So I was intrigued. Yep. Like there's this molecule that' someshow involved in DNA repair, and it's uh either maintaining or restoring some of the machinery that would otherwise definitely be lost in one of these optic nerve damage conditions that models things like glaucoma, retinious pigmentosa, stroke, uh traumatic head injury. It's a big deal. Yep. Vision and movement are kind of the biggies. So I mean there are other things too, but look, you know, you don't want to lose those. And if you do, you can get by, but it it you need additional support, obviously. So the reason it's so interesting to me is that it's getting to DNA repair as opposed to these downstream um you know working on any number of vague receptor-ish, maybe no receptor things like and this is what gene therapy is about. Trevor Burrus So do you think of epital in as kind of a gene therapy of sorts? Or do you think about it more as support for genetic machinery that has lots of downstream targets? Aaron Powell Yes. I think it it supports this genetic machinery. When it comes to the eyes, it seems to be repairing some of the photoreceptors that might get damaged in a redinized pigmentosa. Melanopsin wasn't when Cavinson was kicking it around. But I would my my theory is that epiphalon is working on melanopsin. Interesting. And that it may be upregulating melanopsin levels and then making that morning sunlight that everyone likes to be more effective. Because the big problem is a lot of people will tell me, okay, uh doc I did morning sunlight, I didn't I didn't feel like have you had enough darkness to regenerate melanopsin levels? Because we know that uh in animal studies, five days of pure darkness dramatically increases the amount of melanopsin in the retinas. This is interesting. And I certainly have a lot of close, close friends that are in a position to do these studies. Um the podcast is uh obviously available free to everyone, but we have a premium channel that funds research. We don't talk a lot about it, but we we've given a lot of money away to excellent laboratories where they're free to explore these things. I'd love to see some of the studies that we're talking about today supported. And by the way, that's done in collaboration with donors that do a match. So we could get the right people to do the right studies with no bias toward what the preferred outcome is. In fact, the scientists that we both know, the right ones, would try and disprove the hypothesis that any of this stuff was real. Right. And if something makes it through that filter, then they would conclude it's real. Otherwise, they're trying to essentially knock down the quote unquote positive outcome. Yep. And I think as a clinician, one of the key things to people for people to remember is that we've screwed up a lot of times as clinicians with through different gro tesques abuses of our you know trust. We've done you know interventions or drugs that weren't the most efficacious. For example, like in the 1910s to 1940s, we irradiated the thymuses of young kids to prevent SIDS. This was considered gold standard medicine. Like this have anything to do with SIDs? No, they thought that the sudden infant death. They thought that the thymus was too big and was sitting on the heart and that might be the cause. So tons of these kids, and I think at least 10,000 died from cancers. No, I think the only person that's talked about it is Sapolsky. He has a video talking about this. So we've had a lot of issues as a as a as a field. We have to be very cognizant of that and know the history of where we've been. Like like Verkow of the famous Verkow's triad , he was like pro this therapy. And we all know learn about it in medical school, but no one talks about this aspect. So there's a lot of grotesque abuses of medical power, let's say. If you have to be very careful on which interventions we give people, and the first thing is like do no harm. So while we are, you know, excited about these therapies, we have to be kind of careful and where we're taking people. Appreciate it. I wasn't aware of that study. Perfect um tee up for uh no pun. Yeah. Uh for the thymus. Tell me about th theymus. Super interesting organ. Yep. We gland. Yep. We all have one when we're born. Yep. By time we're what age is it mostly gone? So the thymus is grown under the influence of a lot of these youthful hormones, melatonin, growth hormone, um DHEA, um, and then it's shrunk at the moment you hit puberty. So until it from your the day of birth until puberty, you grow this massive thymus. Where is it set it's right above your heart. Right behind this is the collarbone. How big is it? It's a in in a baby. It could be quite large on the on the chest. Big as a baseball? Like maybe uh the size of half the heart, let's say. Maybe bigger, depends on on on on the size . Right now, uh in our bodies, it's gonna be a bunch of fat with a couple of different globules of thymic residue. Tiny, tiny. Very tiny. In fact, most surgeons will just remove it um when they do surgery nowadays for like open heart. Uh but there's you know good data from the New England Journal of Medicine that removing the thymus tissue, residue tissue, leads to uh a mortality signal within the first five years after those surgeries. So people have died because of thymus removed. They'll have like either higher rates of cancers or you know higher rates of uh autoimmune diseases if they have their their thymuses removed. Now there are thymomas where people have to have their thymuses removed, but we're talking about people that you know the surgeons going in to do a coronary artery bypass surgery. Aaron Powell Is the thymus neurally innervated? Yes. So it's getting signals from brain? Vegas nerve, yep. So it's getting uh sorry to get technical here, but I since I did the episode in the Vegas, some people might remember there's a lot of ascending of sensory information from the vagus going up to the brain. There's also motor control from the brain going down through the vagus, so it's two-way street, mostly up, some down. Is the thymus can controlled by the descending? In other words a question. Is something going on in our brain like stress level or sleep controlling our thymus output? There's sympathetic and parasympathetic innervation for thymus. Uh-huh. Um, that dictates its hormonal output. Because the thymus , yeah, what's it secret? It's it's a gland that both secretes hormones and develops the T cells. So your your lymphatic cells are found in your bone marrow, that's where they're made. The T cells will travel up to the thymus and get trained so they don't kill you and they don't attack your own tissue, but attack a foreign invader or a cancer or whatever it may be. That process is very good in youth and as you age, you get more autoimmunity, more cancers, etc. etc. Because the immune system is not as robust. Both because the thymus makes less of the hormones that train the immune cells and makes less of these immune cells themselves. So when you're 15, you're making 10 to the eighth magnitude of these cells every single day. They're called naive T cells. They will eventually become your CD4 and CD8 T cells. As you age, this number dramatically decreases. And those cells will live somewhere between 10 and 15 years. And that can kind of gauge when the mortality window kicks in for a lot of these different disorders, when your thymus which is a you know minimum level of output, you get a lot of these disorders like cancers, uh heart disease, uh autoimmunity. If you put almost any disease and look at the thymus um risk associated with it, it increases as the thymus um function uh decreases. There's a nature paper uh 2026 l just came out that looked at cardiovascular disease and cancer mortality and all these different metrics that they did MRIs of of people and the people that had the higher thymic scores had less mortality across every single one of these conditions. But you said not challenging this, but what's surprising about that very interesting result Aaron Powell The rate of decrease varies dramatically from person to person. So we call this thymic involution. So from the moment puberty starts till um you die, your thymus is slowly shrinking. That really happens in your 20s and 30s, the majority of that. Under the pressure of androgens, estrogens, progestins, and corticosteroids. Those are driving a lot of the shrinkage. Aaron Powell So the hormones that everyone seems to want to increase the rest of their life and that uh become you know, active a lot during puberty actually cause thymic involution. Yes. So like uh castration will undo some of the thymic involution. Um pregnancy is a great time to involute your thymus, which makes sense because you don't want to be uh having an autoimmune attack against the baby or an immune attack against the baby. Do women's thymus disappear after pregnancy? They they involute and then will regrow during the breastfeeding period under the influences of growth hormone and prolactin. So hibernating animals will have a dramatic shrinkage of the thymus during hibernation and then a regrowth during the feeding window. Aaron Powell Is there any benefit to doing or taking something to either maintain or regenerate thymic size. As an as uh let's just say somebody twenty-five or older. Yeah, there's a um interesting study, trim trial from uh Dr. Greg Fahi. He's doing a study where he's giving a cocktail of growth hormone, metformin, and DHE A. Uh gave that for 12 months and had the thymic size increase on imaging. The amount of CD4 or CD8 T cells increased and the ratio of which improved. Uh and then some of the markers that would show like immune cell exhaustion, like PD1 and So they're they're trying to use growth hormone to regrow the thymus. Getting us directly to peptides, many people who are peptide curious, start asking about thymusin alpha. Is thymusin alpha a peptide that comes from the thymus? Yes. Thankfully they named it appropriately this time gr uh great uh for that. What does thymusin alpha do endogenously when you're not injecting it or taking it, what's its normal function? So uh thymus alpha 1 is part of this thymic family of hormones that gets secreted, it's like these 21 amino acids. It uh increases T cell development in the thymus, increases T cell perforation outside the thymus and makes the T cells more likely to properly attack a pathogen. Um it's like a you know jet fuel for the for the T cells. So it's like pro-immune. Yes. I've heard of people taking it when they feel run down, if they're traveling, they're sleeping less than usual, they're a new parent. So obviously that's kind of uh you know uh peptide wild west kind of indications. It was FD approved as Zidaxin um for kids that were born without a thymus or a a malfunction thymus, like D. George syndrome, these different kind of um genetic abnormalities, um, to be used for these kids to help develop the T cells that they had that weren't um in the thymus. Because they'd have like bone marrow T cells that weren't properly developed. So there was good support from thymosinophyl for these kids. I don't think that FDA approval still exists. So the people are trying to, you know, grandfather thymosenophyll 1 into this this peptide conversation. Um in other countries it's approved for a adjuvant therapy for like hepatitis B, hepatitis C, and then different cancers. So far, the sepsis literature and the infectious literature is not that promising. It might be like if you take antibiotics with thymus alpha-1, you might have a quicker bounce around. Well, what I would be interested to see is like if you went to nursing homes, inject everybody with thymusinopha 1 in November, in December, would you have less flu in January and February? That'd be the interesting thought experiment. Both thymusinopha 1 and thymus and beta 4 come out of the Goldstein lab. That's the very famous lab that studied the thymus in the 70s, 80s, and 90s. Uh but thymic research kind of fell out of favor the last few decades. But now is as sexy as the Penny Lionel. I say that sort of tongue-in-cheek because I mean I think these are f ascinating glands. And um the reason I ask if they're neurally innervated is that you know nowadays there's a there are a lot of reasons why people choose to study one thing or the other. But these um understudied glands, if neurally innervated, then open up a lot of interesting questions about brain control, behavioral stress control. And the experiments kind of write themselves. Doing them still takes a lot of work, interpreting them as no easy task either. But I think there should certainly be more work on um on the pineal and on on the thymus. So I want to make that clear. That ha have you taken thymus and alpha? Oh yeah. I I've I've used uh thymus alpha one when uh when I travel. To to avoid the uh cesspool of planes and hotels and all all these places, which uh like I would say traveling and then this year on the wards, the first time I don't get flu, cold, whatever kind of infection, I dosing Fam SNAF one throughout and I didn't sick a single time. What time of day or night are you injecting? Uh twice a week, uh time agnostic. Uh we're talking about you know two point five milligrams uh as a prophylactic. That's not FDA approved or that is just you doing your thing. I'm curious and see if it would it would work. And you're trying to stay healthy so you can uh take care of patients. Exactly. So you're willing to be your own experiment. When we hear about thymus and alpha, we usually hear about T B five hundred also. What's T B five hundred and how are the are the two related, if at all? So while Kavanson's finding thymolin and he's injecting that into people, the Goldstein lab finds thymstin fraction five, which is this giant uh protein that has many different peptides in it, thymusin alpha 1 being one of them, and then thymusin beta 4 being the other one. Thymus alp ha 1, thymus and beta4 were discovered in the thymus, but they're not exclusive to the thymus line. They're also made in other tissues. Uh thymusin beta 4 seems to be uh this 43 amino acid um peptide that helps in the actin cytoskeleton of cells. So if you think about it, immune cells have to move a lot. So they have to re-reorganize their actin cytoskeleton quite quickly. So it seems to upregulate that movement. Which, you know, the horse community for doping and other athletes have found a niche for thy thymus and beta 4 to use it as a dope. Yeah, horse races, thymes and beta four is a very common doping agent. For the riders or for the horses. For the horses. Yes. Do they test the horses? Yeah, no, there's like a big doping scandal when it comes to to horses and uh thumbs. I don't know they test them or they like it. You know what's funny? Uh this is a r very relevant tangent. Occasionally someone will say, hey does all this morning sunlight stuff, does that work on like dogs? And I go, listen, I hate to tell you this, but like a lot of the literature came from animals, not necessarily dogs. And they have melanopsin ganglion cells, they have superchismatic new like yes, yes, and yes. And then recently, won't say who, wasn't me. Um truly I have a friend whose uh dog was injured, and the question becomes like, would BPC work? And you can actually say, well, there's a lot more animal data than uh human data. Talk to a couple vets, and vets will they're a lot more adventurous than we might think. And I thought, well, listen, you know, now of course these are pets. They're I love my dog, you know, isn't not the same as a human. I am a bit of a species, but love them tremendously. Um and I think the pet peptide industry is going to be enormous. So here's the question. And then we'll go right back to what we were saying before. There's been so much interest in NAD, NMN and NR to upright N A D. What N A D is a pro-longevity, N A D for you know one of these things that drops over uh over the lifespan. Although the paper last week says that it doesn't drop in blood. The landmark paper. I will say the which the basic stories on that claim that I called it a longevity drug. I've always said that NAD , I I do augment NAD using NMN. It gives me more uh morning energy. I will say it does make my nails really thick, my hair grow fast, two effects I was not looking for. But I like the energy effect. I've never said it increases lifespan., ever So um this was mentioned in the New York Times and elsewhere, and it's absolutely false that my name's included in that statement. So their fact checkers need fact checking. NAD has been kind of the thing for a lot of people who want to go beyond supplements, right? They come beyond creatine, beyond magnesium, beyond what they can get, you know, just on Amazon or whatever, but they don't want to go all the way to, you know, like blood cleansing and all this other stuff, which I I certainly don't do myself, and I think that's uh uh too extreme, at least for me, to each their own. When I hear about Thymus and Alpha, TB five hundred, BPC, it occupies this kind of middle ground, right? Yep. And so I think this is why a lot of people are saying, hey, I listen, I love my dog. I love my cat. I don't know if NED is going to do anything for their longevity. It doesn't look like it may or may not. I don't know. But I think a lot of people are starting to think, oh, you know, like and here we go, Pavlov and his dogs. So I do think this is another category of interest. And of course, we're the curators. They don't get a vote. They can't consent. Right. Right. So we have to be very thoughtful there too. Yep. If I ask you, let's say I had an aged dog and I come to you and I go, listen, I know you're a human physician, but he's getting sick a lot. I don't know. Maybe getting some thymus and alpha, he's kind of creaky joints, get some BPC, he's probably got a couple years to go and that's it. Would you say, like , well I know you're not a vet. The veterinary board is gonna sue me now, but actually the uh I have relatives who are vets. They are very open. Very open. The veterinary community has been very open. I che injected my previous dog with testosterone later in life, and I expected the vets to come after me with pitchforks and I got calls that said we would love to prescribe this. In fact, we wish we could just do vasectomies on male dogs, let them keep their testosterone, and then you don't worry about this breeding problem. And you let people train them not to hump. Yep. No, my my my sister was at a competing pharmacy here locally that would give dogs their testosterone and so much healthier and happier. I have zero regrets. I'm pro-peptides for pets, let's say that's it. I think there would be uh beneficial effects. We know dogs when they vomit, they s they end up licking Maybe from a Pavlovian. So I'm like, but I mean int intuitively, instinctively, there might be something there, like there m they might be trying to get BPC out of that, who knows? But um I think there would be less hesitation for people to use these on animals. They come from animal literature, like you said. We don't want to be harming these pets, right? But a lot of I think a lot of the the positive signals are gonna come out of people giving them to their pets. Unfortunately, there's so many brands now that are popping up every day given uh their pets peptides. Um 'cause BPC is it gonna be treated as a supplement when it comes to oral capsules or is it gonna be treated as med? Like we haven't got that answer from the FDA. RFK himself has kind of said like uh these are supplements, they're not they're not medications. So FDA said that he said that we we're not gonna regulate them as as meds because they're not meds. Which I don't know if the agency themselves is going to be too happy with that. I don't ever know how to pronounce his last name, um recently left. So that there was a from what I understand, a kind of a split. I don't think he left because of peptide anything. I think it was really to other things that I'm not aware of. But I do think the question that you're uh raising is one of the most important questions. Is BPC gonna be taken seriously as a drug? Yep. Or is it more creatine-ish? Yep. I mean for example, I could give you a B12 supplement. You could buy that on Amazon or I could prescribe that to you. But if I was to give you an injectable B12 shot, you would need a prescription for that. So is that distinction gonna apply to peptides also is the big question that no one's answered. And is a you know Pinulon is a supplement you can find in Kazakhstan and Russia and Ukraine, wherever all these different countries, over the counter in different pharmacies. Is Pinulon available as a capsule? It's available as a capsule. Does it work as well as a capsule? In a capsule, higher dose is needed, but it still works. What are the doses dosages, excuse me, that people are injecting versus taking orally? So when it comes to the bioregulators, the epitolon, pinillion, the cabineton literature looks at like microgram dosages from 10 to 100 micrograms of um of the actual raw peptides. Of the peptide mixes, we're talking about 10 milligrams. So 10 milligrams of you know desiccated cowbarine that might give Oh man, desiccated cowberry makes me think of uh Crutzfield Yakub with AK mad cow prion. Please, please. Like these these uh these pre on things are really serious. Yeah. Yeah. Scary. It's really scary. It's really, really scary. And not just from wild game, but it's it's really scary. By the way, I think this setback all that research in the when the when the you know the prion stuff happened in the early two thousands, that set back a lot of these animal derived peptide research dramatically because people were like, Oh, we don't want to touch these extracts anymore. Makes sense. 10 different groups in Eastern Europe that came up with their own thymus peptide drug, which was a polypeptide fragment with you know, thymus F1, thymus beta four, violin, thymogen, crystal, like all these different peptides that you'd get together. The the Eastern Europeans went down like this mix of just mixing up young thymuses. Because you don't want an old thymus from a cow. You want a six-month-old cow that has the giant juicy big thymus with all the healthy hormones in there. Uh they'd grind that up and inject that into into humans with positive effects. Like you know, hundreds of papers on that. The American side, the Goldstein um group came up with thymusin fraction five, which has thymus half one and thymic beta four in it, also thymus and beta ten, thymus and beta nine, a bunch of different different thymicins, but studied these two dramatically, thymysin alpha and 1 thymysin beta 4. The French came up with the actual main thymus hormone, which is thymulin, not thymulin. Thymulin is the Russian polypeptide mix. Thymulin is a 9-amino acid uh peptide that is the uh marker of thymus function . It also has very interesting neurological effects, which I think you'll you'll find interesting because it modulates the what we're calling the thymus pituitary adrenal axis, thymus pituitary gonadal axis, thymulin is this peptide that's secreted by the thymus dramatically decreases with age, um, as zinc dependent. So it biology likes to use metals with different amino acid structures, hemoglobin with iron, GHK copper with copper, uh thymulin is zinc dependent, so it's nine amino acid peptide with zinc inside inside of it to do its effects. That will develop NK cells and T cells, um stimulate the immune response. But also in the animal models, not replicated in humans yet, when they take out the pituitary and then inject, you know, ATTH or ACG, the amount of thymulin sensitizes the end organ to production of the targeted hormone, for example. If you were to give ACG alone, to the animal HCG. Yeah, ACG. Synthetic glutenizing alone. Yes, yes, yes. It's called ACG LH receptor. So they would get more testosterone produced when they got ACG with thymul in versus ACG alone. So what you're saying is that thymusin alpha potentially, or TB500, or other thymic hormones. Okay. Thymulin specifically. Okay. Other ones do different effects on the on the potatory axis. So thymulin specifically can augment the effects of endogenous and perhaps also exogenous hormones. Yep. Interesting. And it makes sense because if if you're not robust when it comes to immune status, because you you can think of your thymulin as high in youth, low in in aged. You have no business investing in reproduction. You have no business in creating a lot of corticosteroids, because that gives you that you know youth ful energy in the morning. But if you're making a lot of corticosteroids, you're shrinking your thymus. So it creates kind of a feedback loop, negative feedback loop to prevent you from overrunning your system. A lot of young guys will be like, oh my immune system sucks and my testosterone is low. Like, is there there a thymus link is the question. Interesting. And I I'm sure that you're the first person in the last twenty years to be talking about this publicly. don't know a lot about the biology, but you've really um opened people's eyes to and uh um what it is that it goes away over time. People taking thymusin alpha, T B five hundred and um thymulin. Yep. Is this something that people would cocktail or is taking thymulin something that generally could be a good idea under certain circumstances? Thymulin itself has a very short half-life. The goal would be to increase endogenous production of the thymulin itself. How would you do that? So sufficient zinc status is necessary to make thymulin. The first sign of zinc depletion before RBC zinc or serum zinc decrease is your thymulin levels tank. I'd like to take a quick break and acknowledge one of our sponsors, Element. Element is an electrolyte drink that has everything you need and nothing you don't. 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I also drink element dissolved in water during any kind of physical exercise that I'm doing, especially on hot days when I'm sweating a lot and losing water and electrolytes. Element has a bunch of great tasting flavors. In fact I love them all. I love the watermelon, the raspberry, the citrus, and I really love the lemonade flavor. So if you'd like to try element , you can go to drinkelement.com slash huberman to claim a free element sample pack with any purchase. Again, that's drinkelement.com slash huberman to claim a free sample pack. G-H-K-U Copper. Yeah. Most of the questions I get about it are from women. Yep. I sent out a little informal poll to the uh be careful how I say this, the women in my life, um, including siblings and things like that. And and almost all the women said, What about GHQ copper? I hear it can be good for my skin. Should I use it topically, take it orally or inject it? If I inject it, should I inject it locally? I'm like, please don't inject it in your face, because I don't as much as I'm comfortable with people giving themselves like a little, you know, sterile injection and you know the belly or something like I get worried about non-experts injecting themselves in the face and other other tissues. So a lot of interest in this. What is it? Why is it made it into this kind of um aesthetic category? Because I'm guessing it has a lot of other effects too. But it's kind of funny how things kind of land in one region. Like creatine was like the muscle thing for a long time. Then it got some kind of like maybe it's good for cognition, maybe for people with Alzheimer's, maybe women should take it too for all those reasons and more. And it kind of reverted back to like the muscle thing. Aaron Powell GHKCU is a tripeptide with a copper uh ion in the in the middle. It's gly glycine, histidine, and lysine. Um it's actually found in type 1 collagen fibers. So maybe where type 1 collagen fibers are all over your skin, your hair, and to connect the tissue. So uh just like vladimir Kavson discovers these 40 different peptides, liver peptides, brain peptides, penile peptides, whatever it may be, there's a American researcher, Lauren Pickhart, Dr. Lauren Picard, uh , he discovers GHKCU uh in the collagen tissue. And it's like, hey, this might be the factor that controls collagen synthesis and also collagen breakdown. So he does a bunch of studies. His work is all about this. So almost all the the literature comes from this one lab, a common theme in peptides, unfortunately. Um he discovers it in maybe the mid-70s. It's um found to be very high in youth in in serum levels. So you'll you'll find this in the blood of anyone that we test, um up to like 200, I think, nanograms, whatever the the unit was , and then gets down to like in the levels of the sixties by the age of sixty-five. So it dramatically decreases with age. It's thought to be maybe what leads to the youthful appearance of young skin. And with age you lose that effect. So he did a bunch of trials both topically for skin, for hair. Um, there's now injectable work being done. So similar to the BPC, they would you know cut rats open, inject GHK copper uh in a different site, and they'd get faster wound repair uh of the the skin tissue from injecting this. So that's you know, it's uh become synonymous with BPC one five seven, T V five hundred, wolverine stack, which is someone online just made up. It's those two. Yes. TB500 and Alpha. No, the T B 500 and BC157. The B B C 157. Okay. Now people will add on G HK Copper and call it the Glow Stack. The Glow Stack. Yeah. Oh, interesting. Yeah. Okay. Some someone has made it up in a research chemical glow, wolvery. Yeah. Yeah. There's there's a big debate about whether or not mixing those together causes you know denaturing of different peptides. That's uh beyond this discussion. Point is GHK copper, it both upregulates the synthesis side of collagen and the breakdown side of collagen. So because when you're you're remodeling tissue, if you're just rebuilding it, you're you're gonna get like very pathogenic uh structures. And if you're just breaking down, you're getting bad structures. So you're doing both. So the idea is, does it number one have a skin effect, which it seems to be the Picard's, you know, compared it to retinol and vitamin C creams and all these things with positive uh effects and people will anecdotally talk about like, no, the crow's feet going away and topically it does good for them. There was a study on hair that didn't seem too promising. So it's not gonna uh the peptide sites try to tell you like this is better than monoxidal. Not really. Maybe it could be an adjunct in a lot of patients will have that success uh using that with some other other topical um hair hair loss agents. And now there's a Chinese group studying it for um lung regeneration, because there's a lot of tissue in the lungs uh between the different uh alveoli, and there's some you know hype there of using um GH copper as a regenerative from that side. How many people are trying to regenerate their lungs? COPD and and smokers, it's it's a big, big injury. Maybe lung COVID from what I hear is a real thing, lung damage from COVID. Yep. I know some people will debate it, but it seems like there are enough people walking around who were vaccinated and non-vaccinated who claim that they have symptoms post-COVID that have lasted a long time, aka long COVID. So that might be an interesting place for them to remain peptide curious. Yeah. Post-COVID. Yeah, because uh any infection actually leads to we talk about the thymic involution that happens with age. There's thymic atrophy that happens after every infection , the thymus kind of shrinks down. And then the idea is that you, you know, recover, you convalesce. We just have convalescent homes for sick patients, and then you regenerate your thymus in the state of health. I think the problem in modern day people are stressed out, they're at work, they get sick and they get keep getting sick. So they never get this this chance for that thymus rejuvenation. So then they're c constantly getting hit down and they're ending up with these diseases of aging that could have maybe been augmented, ameliorated, maybe pushed down had their thymus function been better How long were people recommended to take some time off after a cold or a flu or some other question just like with um sort of uh how long um maternity leave type things. Like, you know, the idea now is people are being forced to go back too quickly in countries like in Scandinavia, perhaps where they get more time, they're positive outcomes for baby and mom. Like I think it's an interesting and important question because our biology hasn't changed that much in the last you know couple thousand years at least. Like after one has a cold, typically people go back as soon as they deem themselves non-infectious, which really worries me. But do you think people are getting back to work too quickly? Yes. I mean I understand the reas ons why, but do you think that adding a stage of of really getting back to full functioning without getting into the you know, back to the gym, back to work, back to everything is could be beneficial for these longevity effects. Right, right. Well, I mean, if you think about it, nothing that they do once they come back is is, you know, additive to healing. Their circadian rhythms are thrown off, they're under malilluminative lights all day. They're not getting sunlight. They're not their vitamin D levels are atrocious. Their blue light exposure at night is is high. Their stress levels are very high. Their guts are inflamed from from eating processed hyperprocessed hyperpalatable foods. They have obesity or they're pre-diabetic. So all these things now lead to this inflammatory state, and they just got sick and their thymus didn't bounce back. So then they get sick the next time in two or three weeks. Like a post-pandemic, uh a lot of my colleagues were like, dude, I get sick three, four times a winter now, before I'd get sick, you know, once a winter. So this is where the interest in thymic peptides is very elusive. We have to figure out if the STPs or the PTEs are the more interesting ones. There's synthetic thymic peptides, thympha1, thymetafor, thymulin, and there's purified thymic extracts. There's the the two different research committees that exist when it comes to the thymus. Which one will be more advantageous? Vladimir Kavansen came up with the thymulin injection injectable and oral versions of that, and he had positive uh immune markers and he showed like C D4 cells come up and CD8 cells improve and all all his um immune markers become a more youthful state, let's say. But unfortunately what's happening here is we don't have thymologists. Like we don't have a branch of medicine that's dedicated to this aspect of immunity. Like there's you know allergies, uh uh allergy and immunolog immunologists, but they focus more on you know allergies to different uh agents or very severe immune diseases, they're not really addressing the the immunity of the general public and how you can boost that. And I think post pandemic a lot of people start to ask like, hey, how can I have better immunity for myself. And now finally people are starting to talk about the thymus. Unfortunately, it's been a little too little too late. That would have been great during the pandemic. Because we could have used these thymic, you know, focused interventions, whether it be zinc or you know, uh thymic peptides or your purified thymic extracts to augment immunity of the population as a whole. Especially because Dr. Evanson was doing this in the 70s in Russia. Even in Russia, they don't really look kindly to this research. Um the Soviet era research has been kind of pushed it aside and it's like more big farmer style because it's more profitable. Because how many thymuses are you gonna inject into people and how many thymuses exist on the planet to make these different peptides from? But you could inject a lot of synthetic thymus and alpha T B five hundred um and maybe BPC. So wolverine stack plus, you know, so it'd be very interesting if if we can get that 'cause now that everyone's getting like these Panubo scans and different full bell MRIs, we can see the thymus size. I've done whole body imaging. It is somewhat costly and that's a that's a pr barrier for for people. But if people can afford it, I actually think it can be useful. I have a number of friends, including a neurosurgeon friend, who said that he's um uh some people are still alive now because they got that scan. A lot of people get scared about what they see. Wouldn't you rather be scared about what you see and be told that it's okay than not know it's there and then have a catastrophic event? Car accident, young 45-year-old car accident comes in, has a pancreatic mass. They they would have never known about had they not had that accident. They get a CT scan just to check for any kind of internal bleeding. They find the pancreatic mass that gets removed. It ends up being a malignant mass that had they waited six months, they would have, you know, had stage four pancreatic cancer and passed away. So that that''ss the theory. There is the concern about false positives and false negatives when it comes to these screening modalities. Like any screening modality is not perfect. So there's a big debate on whether or not to do do these that will leave to people in their physicians. But i I've I've been trying to lobby them to give the a thymic score to everybody who gets one of these scans. 'Cause it could see like, hey, can you can you see where the thymus is at? 'Cause you know, someone might come in, you know, for five different scans over five years, they did a TRT protocol or a G H protocol or whatever it may be, and we could see did that improve uh thymic status or or make it worse, or different infections, different interventions. That'd be very interesting to to to kind of tease out. On blood tests, we we've been trying to work with a couple different labs to figure out a thymic score. The most commercially available is gonna be a lymphocyte count, which looks at C D4 to CD8. There's an ideal C D4 to CD8 ratio that's more youthful. You don't wanna have more CD8 cells than C D4 cells. You don't wanna have too few of either of them. That goes more into like the HIV literature. But the the most simple thing that almost every single person has gotten done, but no one's looked at, is their lymphocyte to monocyte ratio on their CBC. So almost everybody's gone to C BB CC with diff. It's a $3 lab test . If you type in any disorder, cardiovascular disease, cancer, uh diabetes, and put lymphocyte to monocyte ratio, there's a study that will talk about how low lymphocyte to monocyte ratio is associated with poor outcomes when it comes to that disease state. So it gives you kind of a general gestalt of what's going on with the immunity because you want a high absolute lymphocyte count, not too high because it's associated with like lymphomas, but somewhere the hazard when, you look at the charts, around 1,000 total lymphocytes is um where the hazard of different cancer sites starts to increase. A young healthy person will be between 1500 and 30, 3,000 total lymphocytes. And you want the ratio to the monocytes. Monocytes are different types of uh immune cells that are more inflammatory. So if you have a robust amount of lymphocytes with low amount of monocytes, that suggests you have a more, let's say, ready and robust immune state. So three dollar lab test that everybody gets, almost every lab testing company now checks it and no one maybe reports on it. But you can kind of uh stratify people into disease risk based on that score. Out of a hundred randomly polled um physicians who were received their license in the United States. How many of them probably know what you just described? Zero. Why not? It's like rabbit holes that you kind of go down and find out. Like I've been lobbying everyone in the hospital to look at this. But it's easy right? The data are there. No, I looked at the data. You got to bill insurance. No, no, it's there. Like I I I started to care about the thymus uh post-pandemic because I noticed people's lymphocyte counts were lower. And I'd I could notice that you know anecdotally, or looking at you know small data sets, like, hey, the people that had lower lymphocyte counts had worse disease or like earlier, like people that had cancers in their third, late 30s, early 40s, and like, huh? They all had like lower lymphocyte counts. So I started to like dig into the literature. And I'm lobbying a lot of the hematologists and infectious disease doctors in my hospital to start to look at this. Unfortunately, they they kind of are textbook. It's not part of the guidelines. It's it's in a space that's not pathology. So it's not clear like, hey, if I check your lymphyte to monocyte count right now, is it gonna change my management of you in the hospital today? Not really. It's more of a long-term look. So that's where all these direct-to-health, uh, direct-to-consumer um companies have an opportunity to kind of modulate the way medicine is practiced in the United States. But if we if we have this metric that we can study, why not use it and then like try different interventions and see what actually helps people? Like we've gotten sometimes peptides and we've had people go from like a four to one lymphocyte to monocyte ratio to an eight to one ratio. Now, is that significant? That seems to be significant. Um, but no one's really kind of discussing it unfortunately. I know who I'm putting my vote in for surgeon general and uh if ever there's a turnover But I think uh your voice should be heard uh uh far and wide on these things. I mean, like more data is good. The scientist in me just says you got the data. Data could be informative. Take a look. There's a category of peptides such as growth hormone secretogoths, tesomerolin, ipomerolin, MK677, that we could we could do the deep dive on all those, but I'll just batch those and maybe we parse them a little bit. And things like melanotans. Sure. Um, these are, to my understanding, FDA approved for certain indications. So they've gone through the randomized control trials for like uh growth hormone secretogogs for uh small stature in kids, they might use it for that, or for um post-surgical uh burn uh recovery, I think that is. That's all I'm saying. So the idea here, the sort of framework that I'm I'm teeing up, is that the these molecules are have been explored for their known biological function in animals. It's established. These molecules lead to an increase in growth hormone above what would normally be secreted. They do it indirectly by, so they're sort of the gas pedal on that system, growth hormone secrete a gog, cause more growth hormone to be secreted, not actual growth hormone. They vary in terms of how much they stimulate hunger or don't stimulate hunger. Yep. And on on you should take them if you're gonna take them before sleep, uh but uh not having eaten in the last two or three hours, all all that stuff. We can save ourselves some time here. Yep. Most people who are taking these things, whether they get it from pharma or compounding pharmacy or gray market, research purposes only , um, or black market, God forbid, they're doing this because they want to lose fat, gain muscle, recover from exercise more quickly, and look more youthful. Yep. Can we assume that those effects are real g,iven that they were FDA approved for other things. Aaron Powell Yeah. So when it comes to let's parse out the effects and the different types of compounds that exist in this category. So there's the ghrelin side, the ghrelin agonist, like FK677, not FDA-approved, orally available pill that makes you bleed out growth hormone. Like you make so much growth hormone in response to that. And in non-pulsatile fashion, growth hormone is a very circadian hormone that gets released in the first 90 minutes of a slow wave sleep. And if you miss that big pulse, you're gonna get small pulses throughout the day. The question is, is that big pulse better than small little no um mini pulses throughout the day? These secret agogs will uh address the the broader category of something called somatopause. So you've heard of menopause, you've heard of maybe andropause. Somatopause is this event that happens somewhere in the 30s where growth hormone production dramatically decreases. So if we kind of paint a picture, your pineal glands aging before puberty, your thymus right after puberty, you know, in your 20s. And in your 30s, you're having somatopause. That's where your growth hormone production is decreasing. You're having uh they call it adrenopause, where your adrenals stop making as much DHEA and the different ratio of cortisol. And then you're having menopause, andropause, and all the other chronic conditions. So that's like your first 50 years of your life, that's what you have to expect. The question has been, and it's a big debate in the medical community, is replacing growth hormone and addressing somatopause useful. Because you can measure if we had your IGF 1 when you're 18 and your IGF 1 when you're 30 and 50, that's going to be a dramatic decrease in that. Should we now replenish this IGF-1? The proponents will say IGF 1 is important for skin and good quality sleep and for muscle recovery and joints and all these things. And those are true. We know growth hormone has all these beneficial effects on that. We also know growth hormone is thymoregenerative because it stimulates the regrowth of an aged involuted thymus gland based on Dr. Fah 's work. The question is, is there an oncogenic signal when it comes to growth hormone? Does it cause cancer? Yes. Can it sorry. Can it promote more rapid growth of other of existing cancer. Yes, because I don't think anyone thinks it causes cancer. It's mutagenic. BPC causes cancer. There's no mutagenic effect from BP like is B PC like smok smoking a cigarette, smoking a cigarette. You get carcinogenic damage to the lung tissue that causes a cancer later on. There's no direct mechanism that would link any of these peptides to a carcinogen, a carcinogen ic effect. But is it you know a growth factor that could grow cancer potentially? There isn't good data showing that. The the debate may be like, hey, by boosting thymic function from growth hormone, are you increasing immunity and then immune surveillance of different tumors? Right. And therefore decreasing and then causing the scale. There's a big debate of whether growth hormone is even beneficial when it comes to aging, because growth hormone does grow certain tissues. There's models where people are growth hormone deficient and live a lot longer. And growth hormone is not positive when it comes to a cardiometabolic perspective. Trevor Burrus And in species like dogs where there's tremendous variation in the amount of IGF-1 that's made between, say, a Chihuahua and a Great Dane, the breed that makes more IGF-1, downstream growth hormone, of course, lives a lot shorter lives than smaller versions of the same species So you want a dog around for a long time, get a chihuahua. You want a real dog, get a great excuse me. You want a dog that lives a long time, get a great day or a bulldog. There's a whole that whole discussion of what's better. And then you get into antagonistic pleotropy. Is this something that's good in youth but detrimental for longevity, or is it pro-longevity? And that's big the big debate in the longevity field, whatever that you know field is, of whether or not to use growth hormone. So now growth hormones become very difficult to acquire through clinical prescriptions after the whole anabolic steroids act and very bonds and all that stuff. So people have now shifted to using the secretagogs in lieu of growth hormone. Also, growth hormone is very expensive. Very expensive. Yeah, like Pfizer's pens are in the thousands of dollars. So like if you want if you're rich, you can afford a you know have a growth hormone have it. But otherwise a circuit og costs less than 100 bucks. I'm told that growth hormone uh doesn't shut down one's own production. Aaron Powell It's not it's not a a uh strong shutdown like the testicular axis. I'm also told that when people take it, they feel awesome. Which is scary to say on a podcast because you're like, oh no, I don't want everyone running out in it. Young people are already making tons of it. But I mean that combination of looking younger, feeling great, cognitively feeling great. I mean, I have some friends who've taken like an IU a night, or even two IUs a night, you know, five nights a week for years, and you go, hey, like are you worried about some of the tumor effects? And like you just function at a whole other level. And then you go, oh God, that's really enticing. But you know, even with great imaging, you don't know if you've got tumors that you're accelerating Yeah, and and we don't have data set that would show that. Like where's the body count from growth hormone? Uh like the bodybuilder body counts are from other compounds, and that's the same. Yeah, exactly. I mean when you go into a gym, you can tell who's who's doing growth hormone versus not based on their skin shining. Like, you see a forty-five-year-old dude that's through somatopods but has perfect young skin and you know there's Botox and all the other things involved. But you can tell there's like that growth hormone look, the hair looks a little bit healthier. Because growth hormone f favors the the conversion of T4 to T3, so it changes the thyroid dynamics. Uh it can have protesticular effects as well uh from the IGF one perspective. So there's a lot of you know, useful effects to it. The question is, is that then a good idea to replace it. Traditionally, like the medical field's kind of anti um using these cra gs to augment somatopause. But I think there's gonna be a role for it, perhaps cyclically. Because I don't think anything in nature is is rear round. So what what if you did a cyclical cycle of, and this is not medical advice, but theoretical, cyclical cycle of tesamor in for uh a certain amount of time, got your IGF one to a certain level under clinician guidance, measured your your thymus on an MRI before and after, and then you saw that the thymus grew and you had you know higher C D four C D eight count, that would be pretty interesting. A few years back, and I've told this story publicly before, I tried um Surmerolin, which is different than obviously than tesmerolin, but similar in the sense The endpoint is you're seeking is more uh growth hormone IGF1. And it dramatically increased my deep sleep and like nuked my REM sleep. It's like the opposite of pineal ones. Yep. Yeah. So well, didn't try that. The other thing that it did, and the reason I halted it almost right away, because I was really just running it as an experiment on myself, was that it spiked my PSA, my prostate specific antigen. It had always been in range and and relatively low. Boom, spiked it. And I was like, whoa, that's wild. And I don't want that. Came off it. Yeah. It reverted to a low level. So that was pretty striking. So obviously, you know, hyperiverespons prostate to summerolin, maybe it wouldn't have been to testomerolin, et cetera. But those are the kinds of things that might be. That's a good point. As you age, your prostate gets bigger, the bane of every man is going to be BPH. Like that's gonna be the reason that you hate your life when you're in your sixties and seventies 'cause you're gonna wake up wake up at night to to to pee. And then you when you're at a you know an amusement park, you're gonna have to find the neuros bathroom very frequently 'cause your bladder sizes don't work it out. There's there's prostate peptides we're looking at. So Thanks. There's like young guy, old guy, like taunting, like you know, you got ten more years before you're miserable. Thanks. You'll save me. No, there's there's people uh,, this guy named Brendan Henry who's translat ed like thousands of these papers from Russian to English. So shout shout out to him, no affiliation, but he's translated a lot of this Russian literature and helped us from that. So that's great. But the prostate is growing with age under the control of DHT and estrogen, and then probably growth hormone. So the question is: do you want to be messing with that and increase in the size of that? There's concerns about cardiac growth, liver growth. So there's all these things. But also growth hormone and the secretive logs have a negative effect on on insulin sensitivity. Right. So people's A1Cs will usually jump. Like the the joke in the bottom of the community is you have to get lean enough and healthy enough to be able to take growth hormone. Oh it's happening. Growth hormone or the secretagogs. The growth hormone or so the secret. It can make you insulin insensitive. Yes, uh especially with more like tesamorlin, especially when combined with epimorlin. Tesamorin is kind of a weaker um GHRH. Tesamorlin, especially when combined with epimorin, uh tesamorlin is FDA approved, epomorin is not. The GHRH versus G But those two together can c create a giant growth hormone response where your IGF one is in the three eighties, three nineties. Um so that's that's that's quite high, like puberty levels of IGF. 1 And you're hungry all the time. Yeah, yeah. With MK for sure. With with testamorlin. So testamorlin has more fidelity and less ghrelin effects, especially um because you can have gorelin effects, prolactin effects, and cortisol effects from whenever you're mucking around with the pituitary, because they're all in that in that same area. I think MK bleeds out the worst when it comes to having the other effects. MK is not a peptide, it's a non-peptide GHRP. What's happened now is people are now stacking their GLP1 as their insulin sensitivity tool, their growth hormone or their GHRH , and their androgen m modulation therapies as this Trinity stack. Trinity stack. To get very fit, very healthy, quickly. So a lot of these transformations you see in CEOs and celebrities and stuff is using a combination of those three things, you know, your TRT plus maybe anivar with terzeptide or retitrutide, whatever it may be, and then using a growth hormone modulation, whether if you can afford growth hormone or testomorin, apomoralin, and you're seeing people lose a lot of fat, gain a lot of muscle in short amounts of time. Is that healthy? We'll find out. But that is like the celebrity protocol. Very interesting. And I'm guessing that for women, the it's the combination of growth hormone secretagog plus um something like and we'll talk about these now, uh Reditrue Tide or um one of the other GLPs. I'm going to acknowledge 'cause people are going to start like dart throwing darts at me about this. Yes, Reddit is hitting things other than the GLP pathway. It's also GIP and glucagon pathway. But most people put it under the category of GLP. So you are an encyclopedic, my friend. I really, really appreciate the clarity and the thoughtfulness of your answers on these. And as people are probably becoming aware, we could spend fifty hours talking about Celank, about cerebral lys, and I think we we will have to have you back to explore those other ones. There are a few other things I'd like to talk about if you're willing to give us a time. We should uh close the hatch on GHKCU. I misspoke. Yeah, yeah, yeah. I saw it in your eyes. You're like, he said it wrong. Do I correct him? Yes, correct me. Everyone else does. Um G H K C U for the collagen effects. It's available in a lot of creams. Assuming it's real, assuming people are doing this medically supervised. Um is there any benefit to putting it directly on Crow's feet or other wrinkles or face versus injecting it for it to go systemically? Yeah. I think if you have a a well formulated topical that's actually not broken down, because a lot of these, you know, from these research chem sites, they' sellre topicals now, because everyone's in skincare. Uh they're you know poor quality, they're not even blue. Like the GHK should be blue but that that is blue from the copper, yeah. Well okay, that makes sense. My copper pills are blue. Yeah, that makes sense. Yeah, okay. But that doesn't mean that it that it's real. copper Could be just fallen out of the G the complex of the G HK. So yeah, you want a well formulated, like a good skincare brand that knows how to formulate these uh and deliver them into the skin, 'cause that's that's another thing. So like, you know, every skincare brand has their now GHK formulation 'cause people are demanding it, but it's been around for 30, 40 years on topical. The injectable is not FDA approved, of course. I think it's gonna be on the second round of discussions when it comes to the peptides coming back to category one. The first round is going to have these seven peptides, BPC, TB, et cetera. I think the second round is going to look at GHK. I don't imagine that that makes it there's no good human data on that. But topically there's great human data on like different aesthetic outcomes, especially when coupled with red light therapy, because it seems that the the blue pigment and and the red light seem to be synergistic in that effect. There's also some some uh literature when it comes to G H K C U um for post um UV damage. So people that are you know sun friendly um can use GHKCU topically to alleviate some of the the photo damage. Of course dermatologists are gonna get mad at us and say like you just use sunscreen and don't get the damage in the first place. But for people that you know aren't as responsible, you can use GHKC Listen to the derms who are slightly more sun positive. Especially low v low UV index sun when the sun is low in the sky. Yep. Dr. Abu Dakri is is perhaps the only other person on the planet besides um my friend Samura Hattar, who has been on this podcast, who's uh as excited about circadian biology as an organizing feature uh as I am. There are a couple others out there, but in terms of people who are like really grounded in what's real, that he's um he's I put him in that category whether he likes it or not. So people are taking GHKCU cream, putting it on and then doing red light therapy. And there are human data that that perhaps can augment some of the collagen reparative effects. Some of the the photoaging effects, some of the the effects of aging when compared to like different retinols and and stuff like that. I think the the consensus in the field now is to use it with the rest of your skincare routine, not in place of it. Um but a lot of people especially bros that have never been into skincare are now into skincare because of the case. Oh my goodness. Okay . So there's that. But it it's promising. Yeah. What do you call that? The manosphere? It's like the skinosphere. Well, with looks maxing, that's it's it's the looks maxing peptide now, GHK, because all these guys that are into LuxMaxing will use GHK. They're dipping their hammer in GHK and and tapping themselves and go. By the way, if you want great long wavelength red near infrared and infrared light to augment your GHK C U uh peptide, by the way, I'm not suggesting that there's this thing called sunlight that provides that. You just have to be careful not to get too much UV in the process. So before before the uh people start thinking they absolutely need a red light device. Full spectrum too, free. Full spectrum, balanced, great article in nature we can link to recently that describes the different uh spectrums coming out of different devices and that thing that we call the sun, which is the best source of all of that. And better blue light, too. Trevor Burrus , Jr. Because we're we're deprived of 480 nanometers in this setup. I don't get paid to say what I'm about to say, but I 'm really excited about something. For a long time I've used Bond Charges bulbs because they have these bulbs that switch from full spectrum in the day. Then you you know flip the same switch and it goes to yellow and then slip the flip the switch again and it goes to red. I find the red to be kind of difficult to navigate at night. Raw optics. Yep. Reight light full spectrum with a with some a lot of blue in there on purpose to wake you, you know, part of the way. And the right blue the four eighty cyan glitch blue blue. Switch the same switch, don't have to change the bulb. It goes to kind of a late morning mode to afternoon mode and then goes to candlelight mode in the evening. And here's the cool thing. Not only did it get the spectrum in the balance right , but it doesn't flicker. They got rid of the flicker that you get from LEDs and yet it's an LED, so it's energy efficient. Yep. It's a lot of infrared and I have no affiliation to them whatsoever. I pay full price for these things. And I have to say I really, really like them. Even my bulldog puppy has a little one. I have this little monkey holding a lamp and I say when the monkey goes to candlelight, you're going to sleep. And he knows he's learning when it goes to candlelight. Now he's sorry, he's dichromat, not a trichromat, but that's a different podcast. All right. GLPs. Yep. Now we can comfortably exhale into your colleagues can you can feel completely comfortable about anything that uh that they might think or say because the GLPs are the reason why people are comfortable injecting themselves. It's why this whole thing of peptides has really taken off. BPC kind of rode in on the GLPs, in my opinion, even though it's been around for a long time. And so have all the other peptides we've been talking about. So what are your thoughts? I've never taken one of these. First things first, we're hearing that some people, I think Sam Altman actually talked about this publicly. Um , with with Kara Swisher about uh what he thought yeah, where he overdosed. Actually a compound pharmacy issue he thought was what did it. I trust him to do the right calculation. So it does sound like that was a compounding pharmacy issue. Could afford it. Does the buy the farmer a great option? I think back then people were just getting them where they could. But nonetheless, get the dosage right. Make sure you're getting the right stuff clean. But he talked about the kind of lack of uh motivation. Yeah. Which many people have described anecdotally um like okay, lowered their food drive, but lowered their drive period. Yep. Makes sense. You know, depending on which pathways are being affected. But do you think that's a real effect? Is that something that people need to be concerned about? Do you think people can microdose this stuff? Because a lot of people are microdosing it, regardless of what their source is, they're taking a lot less than the kind of standard clinical trials will be. And we're leaving out Red or True Tide for now.. Yep Because it's so new. We're gonna talk about it, but I'm talking about the standard if you're semiglutide and trosepatide, yeah. Yeah. So you have your you know, semiglutide, which is ozembic and wegovie. Uh the wegovy is the FDA approved version for the weight loss. For triseptide you have ZEP bound and Mongero, Zbound being the FDA approved version for weight loss that allows them to keep their patents for for longer. Um these medications are good trying a transforming medicine, especially if where where I practice, right? If you if we kinda zoom out , our medical system, if we didn't have these interventions, was going to collapse on itself thanks to the obesity, prediabetes, diabetes epidemics. Because we don't have enough clinicians or finances to get everybody who was pre-diabetic in the in the last you know twenty years had they all transitioned to diabetes and ended up with you know diabetic medications and dialysis and eventually cardiovascular disease and all these things, we don't have the resources to take care of all these people. Like our medical system was gonna collapse. And there wasn't enough finances to take care of it. Now these GLP1s are coming in and kind of transforming that phase of medicine because now we have a chance to dramatically change the rate of obesity, uh diabetbeteses, predia, and all these cardiomyabolic disorders. So where do we stand? We needed something to happen. I mean ideally everybody, you know, would get morning sunlight and eat only healthy foods, unprocessed foods and have low stress and sleep great at night. And maybe no one would develop to become obese. But the reality is people become overweight, obese. They get stuck in that hole. And if you just try to step out of the hole the way you came in, sometimes that doesn't work. You need a different path out of that problem. And that that's been, you know, the diet and exercise literature for the last 40 years. Millions of books have been sold on how to get people leaner. We now have interventions medically that can dramatically change people's weights for the first time. We've had drugs in the past that you know five-10 percent of body weight. Now with the GLP1s, we're getting 10, 20, even 30 percent of body weight being shaved off of people, especially with the new red true tide data. Is there a free lunch? That's the the big question. Like like we kind of talked about earlier, there's always been these medical mishaps that have happened. So far, the data is very promising when it comes to GLP1s in that we are now reversing this rate of chronic disease. Is it going to stay that way? That's a good question. Um I'm cautiously uh optimistic when it comes to these medic ations. I've been prescribing them since I was a resident uh in my VA clinic. I was putting all these vets that are, you know, 300 pounds on GLB1s, they were losing 50, 100 pounds. Before we was in FDA approved for weight loss, we knew that that if you put diabetics on this drug, they would lose weight, thanks to a lot of the bodybuilders. Um that kind of pioneered that. When did the bodybuilders first start using GLPs? Uh late 2010s. Wow. Early and then the signal. I don't I don't think Norvo or Lilly wanted to make these for obesity. They were focused on making diabetes drugs. Because like if we zoom out even further, this is another animal derived compound, right? It's found in the saliva of the Gila monsters. GLP1 was discovered. It's too sh um short-acting to have worked on its own. Then pharmaceutical companies, this is where you gotta give farmer their credit, they develop these druedgs into more functioning versions that had, you know, longer half-lives and could stick around in the serum for longer to have the clinical effect. So then we started noticing that diabetics, like my my grandma got uh Bieta, which was one of these first uh GLP1 drugs, like 25 years ago. It was the one out of all the drugs she was on, the reason I went into medicine, that was the drug that changed her her whole trajectory because she had less insulin needs and she was losing weight and more energetic. So we had seen the effects on diabetics and then you get uh luroglutide, dull glutide, and then eventually semaglutide was the is the blockbuster. But you get all these positive effects coming from these drugs on diabetics. It gets translated into obese people and overweight patients. The question is, what is the long-term effect of this? Do you have to stay on this drug forever? Um, can you titre it off? The pharmaceutical companies have not given us good guidelines on that. They've shown us what happens if you stop the drug. You max out on maximum dose forze peptide, pull the brakes on. People tend to sometimes gain the weight, some people don't, but some people will regain back to baseline. Because if you think about it, the better way to think about weight loss, it's a calculation your brain does every single day with all the different hormones and and r peptides that are made from the gut, the GIP, GLP, glucagon, insulin, testosterone, estrogen, all these things kinda modulate and there's this thing called a set point theory or settling points. And they integrate, should I eat or not eat, right? So the GOP1 is a giant signal to the brain of don't eat. So we're we're modulating this pathway. What happens to all these young kids that are 18, 19 years old on five milligrams of retidrutide uh that have lost 30 40, pounds, are they going to have to be on that for life now to maintain that weight? Aaron Powell Can I ask you about that? Because when people say perhaps you have to be on a drug for the rest of your life, I think, okay, what's the availability? What's the cost? Yes. What's the real world cost of taking six months off because you can't access it? Yep. There's a shortage and maybe better drugs will come along. Like I don't necessarily have a problem with it, although if you talk to type 1 diabetics in the old days, they they weren't crazy about the idea that they had to constantly inject themselves with insulin. Now they're better better delivery devices. I kind of feel like eventually there'll be some slow release polymer that will just kind of give you a microdose of it. You could dial it up if you want to. But there's all pills now? Personally, I don't worry so much about like for the rest of your life. I worry more about the sh much shorter life if people are obese. But what about these brain effects? I do worry about a brain that's developing in the context of a you know thousandfold or more increase in these GLPs. Because when we had um Zach Knight on the podcast, he's not a clinician, he's a scientist up at UCSF, Howard Hughes investigator, which means he's like a superstar and deserves to be in that category, he described that the diabetic drugs would increase GLP by like double, quadruple, but the weight loss effects weren't really there. But the drugs that you rattled off a few minutes ago, Monjaro, Zempic, et cetera, and and certainly Reddit True Tide. We're talking about thousandfold increases in GLPs. We don't know what the long-term effects of those are on like neural plasticity and learning. Could be great. Yes. Could be positive. We shouldn't always assume those effects are bad. Yeah, like the effects for like, let's say, a 60-year-old prediabetic diabetic on Alzheimer's disease seems to be potentially positive. I think the the study last year will didn't show a good signal on our Alzheimer's prevention, but we know diabetes and cardiometabolic disease speeds up that transition. So controlling insulin dynamics might be beneficial there and the obesity is not great for Alzheimer's risk. The question is, what about for like these cognitive effects? Is the effect happening from the drug itself? Is it from misuse of the drug, too, too high of a dose, you're not getting enough electrolytes, you're not getting enough uh micronutrients, macronutrients, you know, your blood sugar sugar is low. Because a lot of these patients, the way we we approach it is training wheel effect when it comes to GLP1s. Okay, you come to us, you're a patient, you want to use GLP1s, we'll give you a lowest dose as possible that has an effect for you, GLP1, in conjunction with lifestyle modification, dietary advice, exercise programs, et cetera, et cetera, et cetera. And then hopefully peel away those those training wheels or keep them on if you need them until we get to the endpoint that we want. Now, when people do it that way, I don't hear a lot of these effects anecdotally from from Brooklyn patients that we hear about online where people are like, oh, I'm depressed. I hate my life from from these drugs. And the question is, is are they just, you know, l a lot of people have low blood pressure from from these drugs because they're not, you know, consuming enough electrolytes or enough food, period. Because like some people will take a mega dose of these drugs and end up not eating bl like a day goes by, they've eaten one meal. That's not conducive to to good feeling good. Everyone you know the reason people are beast in the first place is because eating is is such a pleasurable experience for humans and a social experience, et cetera, et cetera. Other thing is if you're not eating with people on the same table, are you having less of that socialization aspect? A lot of times you meet up to eat or drink or whatever it may be. So I I'm very curious when it comes to the cognitive effects, is it from the drug directly interacting with receptors in the brain when we we've seen that the right amount of dose decreases inflammation in the brain? Or is it because of the social aspects of the drug changing the way you behave and therefore leading to negative output? How dare you think of confounding variables now? It's like, no, it's so cool, because you're willing to go outside the box and say, hey, listen, this might be due to some of the um downstream consequences of of reduced appetite. And we know the literature shows that people now are having less alcohol cravings from from this. It might be ch changing the way the dopamergic signaling is happening in the brain, which is concerning, right? Because a lot of people will be stacking this with, you know, ADHD medications. Uh they might be using some of these peptide stimulants, um, smaxylank, whatever it may be. So the question, because what happens is people go to these websites, they buy one peptide and they've got a great result. And they'll be like, you know, let me add three more peptides on the side. It's an increasing AOV problem. So the average sale value goes up from these features sites. We'll see where GLP1s go. But the the the reality is it's here. There is no pre-GLP1 world for us as clinicians, as health enthusiasts. We're in a post-GLP one world and everything kind of dictates downstream from that. Aaron Powell The people I know have taken um these, and I don't know exactly which are taking much lower dosages than were prescribed to them. And they are indeed sharing them with getting the prescription, then people are sharing them, people are cost sharing. Now people are trying to get them from other sources. Several of those people say they they feel like they can think better, but I told them, Well, yeah, if your insulin sensitivity has improved, if you're carrying less body fat, body fat's an endocrine organ, it's you know, you need some body fat, but there could be a number of reasons for that. I don't know if these are direct effects on the brain. Yeah, well, I mean the left sensitivity increases as you decrease the body fat mass. There's there's GLP1 receptors on the POMC neurons in the brain. So and no one's kind of examined what that means downstream for the leptin melanocort uh leptin melanocortin pathway and what that means for energy status, you know, thyroid hormone production, reproductive status. We know a lot of people are ozembic babies in that a lady will will be subfertile or infertile, start a weight loss drug, and then find out by accident she's pregnant. Was she obese before? Yeah. That are having uh their fertility improve as a result of losing the weight because we know uh your leptin status is a key driver of fertility, because if you if you're having low leptin levels, you're starving, you shouldn't fertile. If you have too much leptin and you're at leptin resistant, you shouldn't be having kids either. So both of those those things kind of get modulated by these drugs as well. Aaron Ross Powell There was a science paper some years ago that leptin hitting a certain threshold is actually what signals the onset of puberty in females. Is that still considered true? I think that's that's that's part of it. Makes sense, like enough body fat to signal that there are enough resources and then um animals or that was an animal study or the idea was that people perhaps also become females become reproductively competent at the point where there's enough energetic resources that interesting. Have you ever taken one of these? Oh wow. Yes. I uh I uh had a family member with a GLP1 pen uh from four years ago that uh said it wasn't. So I'm like, okay, let's see what's going on here. I got a pen. Don't do not do this at home. And I was like, yeah, it's not working. Like it's bunked. They got them from overseas. It was a brand name, Ozambek pen, but gotten from overseas. Got the pen. I was like, you know what? If it's bunked, let's see what it is. Don't do this at home. Biohackers in me came out and tried it. I injected a I think it was a milligram of Ozempic. What's a standard dose? You start at 0.25 and escalate to point five or you went straight to a milligram? Yeah, because I was like, ah they they're like, it doesn't work. I'm I'm eating so much. I'm okay, whatever. You got bunk, bunk pen from overseas. I go to do a shift. I was on a night shift that day, and I've never had Charizard-like projectile vomiting. Oof. And low blood sugar, presumably. The blood sugar effects for for non-diabetics did don't get that low, but it was just miserable. Like I would go admit a patient, go upstairs, vomit in the in the call room. You just gave a really good reason why people shouldn't just do what you just said. No, they shouldn't do that. Uh then go back to back to the the ER, admit a patient, and then it was it was the most miserable night of my life. Uh so be very careful how you use these drugs. And that's why I titrate very slowly. Um luckily with the newer ones, the effects are much less. Like people who report trzaptide and retitrutide even have less of these gastrointestinal effects. But um that's a peptide gone wrong story. Peptide gone wrong. Um ret itrue tide. Yep. I put out a post on X, I thought, and I do still think that it that red true tide is going to be a trillion dollar industry, not because so many people are necessarily going to use it for weight loss , but because many people will use it for weight loss, many people will use it for other things because you can be sure, absolutely sure, that Lily is going to find other ways to market it. And you can protect a patent by finding additional uses for things. I mean a lot of the the blockbuster drugs for eye diseases, um the patents to prevent generic forms were continued by here's the deal, folks. Companies are really incentivized to take the hundreds of millions of dollars that they spent on clinical trials and research and development and not have to do it again. So if you can find another valid use for a drug, you don't have to run all the safety stuff. You don't have to do a lot of stuff. You just have to show efficacy and a few other things. But that's the way that drug companies continue to play the game to protect their their investment, right? I mean it's you can understand why they do it. That's your business. But um so I'm guessing that Reddit True Tide is going we're going to discover that it's um useful for a number of things and from the clinical trials. There's a reason to believe that's going to be the case. And the big thing they're trying to do now is classify as a biologic. So retitruside has 39 amino acids. Uh to be a biologic, you have to be above 40 amino acids. And once you get to above forty amino acids, if you are a biologic, then the patent lasts are way longer. I don't know the exact number. Yeah. So we're talking like hundreds of hundreds of millions of dollars, maybe billions of dollars if it's a if you and you can tinker with this. You can put amino acids. And more importantly, no one can compound it if it's a biologic. Or if it's very difficult to compound, like I guess that was the right certificate. Something similar happened with ACG where it was taken out of the compounders um recently. Really? Yeah. So ACG, um, human corneotic another . This is commonly prescribed for trying to restore fertility to uh to men , but it's main mostly being given in IVF cycles to women. Yep. There's a big controversy about HCG compounders and who can compound it and who can't. That's that's beyond this. But uh this is a very important thing. Cause if Lily gets Retta Redatrutide as a biologic, then the compounders are out of luck. Because the compounders all have the formula for Retta. They're ready to make it. Like they can get the API from China and and start um compounding it as soon as it's available. It'll be it will make them all billions of dollars. But if Lily's able to do this, they'll be able to protect themselves from what's gonna happen. So the Trump administration now is trying to get with Trump RX, Lilly, and Novanoris to drop their prices to make him more available, which has happened. Like it now I think you can get a you know $300 d monthly dose of trisepatite available through these websites. Yeah, fifteen hundred w without insurance. Some insurance will cover it, some some wouldn't you'd have to get a you know savvy clinician that will advocate on your s on your behalf to get these covered. But cash pay for between, you know, even some of the pills, I think you can pay 150 bucks a month for the orforgarplon, which is not a peptide, but still a GLPL 1 agonist. Which kind of gets into the point. Like it doesn't matter if it's a peptide or not. What matters is where it where it touches, what receptor it touches. Because orphoroglupon is more similar to semiglutide. Both of them are GLP1 drugs. One's a peptide, one's not, then BBC is the semiglutide. So like everyone online talks about peptides are good or peptides are bad. There's no actual scientific category of peptides that gives you a functional definition that's discussable between two people. Because what do you mean by peptide? Do you mean carnesine or do you mean ratitude side? Excellent point. Uh speaks to a lot of the confusion. Um you are a beam of clarifying inform ation uh on this. I actually am gonna put in a vote um publicly right here and now, but also uh I'm gonna do what I can to contact folks that are relevant. I think you should no joke. Uh I think you should be in charge of a nomenclature committee. I think for in in the world of genetics, for a long time there people would just name genes. Sonic hedgehog or Sink One or the people name it after their cousin or what and it was a mess. And so what ends up happening is you find similarity between genes across different laboratories. And eventually eventually you have a meeting and you come up with a you have a nomenclature committee, and then you say, this is you know Ephrine 1, 2, 3, 4, 5, 60, these are these are the sequences. The general public doesn't think about molecules in that way. No. But the general public are diving right into this. They are the experiment. And so what I think would be very, very useful would be a um clear and accessible nomenclature to divide up what we've talked about today. You know, BPC-157, um you know The regenerative peptides, as you've called them, things like thymus and alpha TB500, which are immunogenic peptides. I think the word peptides is just too general. I'm putting my vote in for you. Not that you don't al haveready enough to do to um come up with some nomenclature that maybe I can help propagate in some of the other people in the podcast community. We'll even contact our our our close, close friends in in um legacy media and explain to them how this works and maybe they can help propagate just for sake of clarity. Yep. Right? We're not taking the stance these are good or bad, but just for sake of clarity as uh given that there's so many people that are peptide curious. Okay, so before we wrap, I solicited X and Instagram for questions about peptides. I did not reveal exactly who you are, but I gave some of your credenti als and got back many, many excellent questions, most of which, thanks to you, were answered during the course of our conversation up until now. But there are a couple of them that many people asked. We didn't touch on, at least not directly. One thing that's come up several times is the question about for women who have endometriosis or fibroids or other things related to reproductive health and potential, can things like BPC-157 help and or hurt those circumstances given their potential role in angiogenesis and the other things you described. Trevor Burrus No literature exists on either animal or human data that that relates to those peptides. I'd say those are more hormonal slash metabolic issues that a good Obi-Guine should take care of. They're very difficult to treat conditions and very miserable to have for people and have fertility implications, but those are more on the hormonal side. I think the hormonal lever is way stronger than a peptide lever like BPC or any of those. And as far as I'm concerned, there's no case reports or studies that would suggest positive or negative Aaron Powell CNS effects, central nervous system, excuse me, of BPC157 or other peptides that we've talked about that are don't fall under the you know typical um umbrella that people go to when they think about BPC-157. Now you talked about some of the uh stuff related to alcohol and perhaps other things like Adderall, but anything known about, you know, people feeling better or worse on different peptides, just psychological TBI, I'll throw TBI in there for myself. I don't have TBI fortunately, but I know many people that do. They reach out to me. Could it be beneficial in those cases? Yeah. TBIs when it comes to cortexin and cerebralysin, which would probably never be available in the United States. So we'll we'll skip those. There's no good data on BPC and TBIs. They theoretically could be useful from an anti-stress perspective. That would be interesting to explore that. BPC's neurological effects are very homeostatic in nature. They don't let you get too high in the in the mice data at least. The mice can't get too drunk and they can't withdraw from alcohol. They can't get too high on on the mice methamphetamines. And they can't get too high on the methamphetamines and they don't withdraw either. So there's a homeostatic mechanism that might explain some of these anhedonia uh side effects that people are reporting, where BPC modulates the gut brain access in a way, which we do not understand, it's kind of woo-woo, that makes it so that your brain can't go too far in one direction. Maybe in putting if we think of a just so just so story, it's putting you into a rest and digest state to heal whatever problem you have. If that's why BPC exists as a big parent compound, that might be part of the fact that if you screen BPC, your body goes into like a convalescent mode. Because it will it will take away stimulants, it will take away sedatives. Um, don't try this, of course, but there seems to be a homeostatic mechanism in BPC that needs to be explored f further with good data. Very interesting. Thank you. The major question was: what should people do if they are actually interested in obtaining peptides? Let's just set the GLPs aside, because it's kind of a separate category. And they want to explore their use and they want to be as safe as possible. Where shouldn't they look? Yeah. Is how I'll phrase the question. Um where should they look? Who should they talk to? At what point do they they can be confident that what they're taking is what you know the bottle claims and and that it's you know free of contaminants and so on. I many, many questions. But I think this is what kind of the question.ep, y Yep.'s It it's the most difficult question to answer because uh the majority of people are getting their peptides from research only websites. Uh unfortunately those are not reliable. We don't know what's in them. They they could be good, could be bad, could be as good as a compound pharmacy, could be much worse, could be the wrong peptide in in the vial. So we don't know what's in there. What should happen over the next six, twelve, twenty-four months is there will be a lot of physician-led options for patients to get peptides. Number one, you should encourage your physician, if you don't have one, uh, get one and get a good relationship with one, because having a good relationship with your physician is a key aspect of driving good health. But having a physician that's educated on peptides, uh, to my doctor friends, all of you guys who now live in a peptide era, you have no choice but to get educated. So get educated, we should create resources for that. There will be a lot of telemed options opening up soon uh through various companies that will offer these peptides. And it will be good for the consumer because it will be a race down in price. And then we'll know which which compounding pharmacies are better, which ones are worse, so you can get better source peptides, but you should get them from clinicians. The question that's going to happen is there's going to be a lot of these orally available peptides and they're going to be all over supplement websites. Like you'll you'll find them with your magnesium, your creatine, and then your pineleon or your BPC-157. The question is, what is that gonna look like like? So we'd, you know, our FDA overlords to give give us some guidance there on what can and cannot be sold and bought. But it should be physician led. You should be doing this under the guidance of a physician that's monitoring you. You shouldn't take tesamorin without checking IGF one levels. Uh a GLP one even should be monitored with the physicians that can counsel you on on too much weight loss. Like some of these some of these celebrities should have had better clinicians uh monitoring their GLP one journeys because they lost way too much weight. That doesn't look healthy at all. Unless someone's first of all, some ifone 's not having the basics in in place, there's no point in putting all these peptides in like morning sunlight, sleep, darkness at night, yes, good diet, minimally processed food. Yes. The next phase of peptide curious and peptide-driven discussions is gonna be like how do you incorporate it into a giant health system? Like you do morning sunlight, blockers, and epitalon, you do you know BPC and you work out in the gym or whatever it may be. There's gonna be protocols that that develop. But I think within six months there'll be very good physician options for everybody. Aaron Powell Aboud . Amazing. Thank you so much for coming here today and again shedding so much light on what all of these things are. You have an a clearly a virtuoso level understanding and ability to communicate about the history of these things, what they are, what they aren't, what we know, what we still don't know, um, the potential upsides, the potential hazards, the uh the regulation and on and on. Um there are 50 other topics that you and I must talk about at some point. Your knowledge of hormones in men and women, pregnancy and women's hormones affecting the fetus, how progesterone impacts DHT in male offspring. Incredible. Absolutely want to have you back to have that discussion, but we'll let people digest this in the meantime. We'll put links to where people can find you. And I just want to say thank you for doing what you do. And if you don't mind me sharing, you're you're thirty three years old. That's right. I love that you're a clinician and you're practicing medicine, but please, please, please keep wherever you can keep up your efforts as a public educator. Come back and talk to us again. Uh you're a gift to us all and um thank you so much.. Thank you It's a pleasure to be here and thank you for the kind words. Thank you for joining me for today's discussion with Dr. Aboud Bakri. To learn more about his work and to find links to the various things we discussed, please see the show note captions. I should also mention the Dr. Bakri has just released a new app, which is focused on circadian biology, which we didn't talk about today, but he's a true expert there as well. You can also find a link to that app in the show note caption. If you're learning from andor/ enjoying this podcast, please subs cribe to our YouTube channel. That's a terrific zero-cost way to support us. In addition, please follow the podcast by clicking the follow button on both Spotify and Apple. And on both Spotify and Apple, you can leave us up to a five-star review. And you can now leave us comments at both Spotify and Apple. 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