Unlocking Secrets of the Body: Peptides, AI Injury Diagnosis, and Magnetic Pigeons

Wake up a little later and do something else with your time. >> I mean, yeah, I'm able to, you know, uh, leave leave. I still wake up at the same time, but there's always that extra 15 minutes of cushion in the summer now that I drop off. >> Uh, so I can sleep a little bit more and then, uh, I get to work a little earlier as well. Uh, you know, but it's kind of miss him too when I don't drop him off in the morning, you know, that conversation time in the morning. >> Yeah, you miss it for sure.

>> Yeah. It's cuz you know as a as a as as how busy as we are uh that morning time is one time that is just uh me and him just kind of hanging out talking you know and then and then when I come home it's kind of like just go go go feeding each each of the kids you know uh them playing running around getting them ready for bed. So that evening time is a little hectic. Oh >> yeah, it's it's more stressful at this age than dinner time than than it is fun and chill. >> Yeah. Yeah.

Dinner takes a while, you know. So, I mean, honestly, I mean, I don't know how it is for you, but I mean, my schedule is like 7 to 7:30 until they go to sleep. I mean, it's non-stop. There's barely any time for um you know, myself. Uh which is it's fun. I mean, with the kids, it's fun, but it is exhausting as well, >> you know. Um and even >> how taxing work is. Uh and you know you a lot of people say that they had a busy day because they had they had four meetings or five meetings.

You know I I on a daily basis sometimes have 25 to 27 meetings. And in those 27 meetings I'm in charge of documenting and uh taking notes and creating the agenda and the plan for each person that I'm having a meeting with. So those patient patient encounters are meetings, right? I mean >> Yeah. Every clinic patient is a meeting.

Yeah, most people have three to four meetings a day, you know, uh they talk about and there's multiple people and they in a lot of people's meetings, they can just kind of put themselves on mute and kind of check out a little bit and kind of do some work in the background where it's tough to do that in our in our profession. >> Yeah. Yeah. It's it's hard to just move the mouse when you're in the room with the patient looking at you. >> Yeah. Yeah. So, >> I hear you, man.

It's tough to like carve out time for yourself, you know? Oh, I mean the work obligations, the professional obligations are just ended work. They they come home with you in some fashion. And then your family stuff, like it's hard during the work week. Um whether you're on call or not, >> I think it's hard. It's really hard for me to find time, you know, just like to go to the gym or hang out with a friend or something or my brother who's in town.

It's almost like you've got to plan ahead for everything, which makes it a little annoying. I mean, it takes the spontaneity out of life because there's just so much stuff to do every day. Yeah, you know, it's uh even even um when I was on vacation last week and you know, we were traveling. That's why we haven't done a podcast in in a while. Both of us have been kind of out of town.

Uh and uh even while I was traveling in a way, you know, I had messages in the clinic and the staff had questions about patients and um you know, I I had to like refill medications. I I'm a solo cardiologist with private practice. There's no real coverage. I mean, no one knows my patients really well. No one really has access to my EMR to be able to send those medications. I can always have someone cover for emergencies uh in the hospital, but in my clinic patients, I need refills.

I mean, they need refills because they're patients within my EMR and that I'm the only one who can send in. And most people wait till that one week that I'm on vacation to call for. >> It's like, how do so many people need their statins refilled? this week. >> Yeah. Yeah. Exactly. That's the one time I'm like, you know, you you don't need a statin this week. >> Yeah. Exactly. It can wait. >> Yeah. But it does take a toll.

I mean, where do you find, you know, I had this theory with, you know, we used to joke about that you there's only, you know, there's four major things in life and you can't do all four. Like, you know, be have a social life, be a dad, exercise, and um be >> and be good at your job. >> Be good at your job. You have to let go one at least, if not two. >> Yeah, no kidding.

>> And a lot of time for most physician dads or most busy guys who have like pretty demanding jobs, the social life tends to be the one they cut out the most, right? >> Yeah, dude. I think people unfortunately they cut out social life and they also cut out self-care. you know that includes exercise, you know, going to your doctor regularly, eating healthy, eating on time, you know, not just regularly skipping meals and that becomes a routine, skipping sleep, being sleepd deprived.

I I like I put all of that in the same basket of self-care, including exercise. And I think that lags behind. I mean, I don't lag behind on exercise because it's just like it's very important for me, but I I mean, for sure, I'm like probably chronically sleep deprived. I sleep poorly and I don't sleep that often. um I wake up really early and go to bed late and that's not a good thing and it's not a sense of pride. It's like it's stupid.

It's just like you you got to get stuff done and there's only so much time in the day to do it. So >> you're working on stuff and you go to sleep late and >> you got to wake up early and keep doing it. Um there just isn't extra time to focus on it. >> There's a there's this whole idea of revenge sleep too, right?

where you've been so busy all day that at night time that's the only few quiet hours in the day that you find that a lot of people tend to stay up late and do some work or do some reading or whatever they weren't able to do during the day. That's that's the that's you know uh that's the whole idea eventually that that's why a lot of times people end up getting bad sleep because they just stay up late because that's the only quiet time they get. >> Yeah.

And it's like, you know, you finally get like a little bit of moment to focus and do things that you like really want to do, really looking forward to. Like you get a new book, >> and you really just want to sit and read it. >> Yeah. >> And the rest of the whole day, you've just been doing stuff you need to do, you have to do.

You got to do your job, you know, you got to come home, help take care of the kids, and interact with them, you know, like play with them, take them to their jiu-jitsu class, go swimming, whatever. And finally the kids go to sleep. You know, you and your spouse talk for a bit and she goes to sleep and I'm like, "Okay, I can just sit for like 10 minutes and like read this book. Maybe you get through three pages and I'm nodding off.

I'm like, "God damn it, I guess I >> That's why it takes you forever to read through books cuz anytime I start reading it so late and I'm I'm tired, exhausted." Um, >> you know, in terms of exercise, I've kind of made I've kind of had this strategy where I've now put exercise on my calendar, like on my work calendar. I have that hour exercise built out. So, uh, no matter what I mean, everyone knows no meeting scheduled at the time, no no other events at that time is for exercise.

And sometimes you have to do that. And I tell my patients that that you have to find that time where you have to treat exercise like it's something mandatory. It's part of a meeting you have to attend. It's for yourself. It's a meeting with yourself. Um, and there's no there's no compromise around it because uh it's okay sometimes, you know, we think that it's okay to kind of ignore our health uh in our 30s and 40s cuz life is busy.

But then it catches up with you and I see so many people with severe metabolic and coronary disease. Uh it's it's scary, man. It's getting people getting disease earlier and earlier um >> right >> and exercise. >> I mean, let me let me ask you this. Like do you see your primary care doctor at least once a year? Uh I I unfortunately I am my primary care doctor. >> So that reads no. >> Yeah. Uh you know I I I I did this thing where I got you know uh it's not the right thing to do.

And I think there's been uh self treatment has shown to uh not be ideal. But what I've kind of done is uh I get I got function help which is this one time once a year you can pay for the service uh onetime fee and then you can get as many lab tests a year up to four or five times a year you can check your labs. So I at least twice a year I get my labs done, check my insulin levels and A1C levels, lipids and blood count and kind of keep track of it.

>> Uh and just uh then now I've started doing this thing where a lot of I tell my patients not to do but I doing it because I'm a slightly more educated in that in that area but I've started uh running ideas about my labs with uh with uh some of the AI agents as well. and kind of make sure that you know what I'm thinking is the right thing to do. Uh I don't think I advise that yet for everyone. I think that's the future where it will happen.

But I think given my background uh and I'm a trained physician and and a cardiologist uh I feel a little bit more comfortable doing that even though there are biases, right? I >> Well, I I'm hearing a lot of justification for not seeing your actual PCP. >> I don't have a PCP. I haven't seen a PCP in years and it's it's not good. And that's kind of what we're talking about where we ignore our health.

But >> sometimes, you know, one I I went to a PCP uh primary care doctor and and the stuff that I wanted to check and wanted to do that person was not even aware of uh of those labs that needed to be done or uh the medications that need to be started early on.

So at that point I was like you know is this I don't see don't see the point at that time unfortunately for myself >> you know and I mean that's >> yeah I mean you know think of it think of it in this way like let's say you know let's say you have a 1990 Chevy pickup truck and that's your daily driver. You could probably take it anywhere to get the oil changed you know to get it tuned up and it'll be fine.

But let's say now you have a sick sports car you have I don't know you got a Ferrari or something. You're not going to take it to Jify Lube. Probably you're probably going to take it to somewhere, I don't know, nicer, more expensive, a little more thorough, somewhere where you have a direct input and conversation with, you know, the mechanic, the staff, everyone that services your car, you know, you kind of think of your body in that same way.

I mean, if you take care of yourself and you want to take care of yourself and you want to be high performing, you know, like the Ferrari in this example, instead of going to a run like, you know, not in a dismissive way, but a run-of-the-mill dock in the box PCP like what you're talking about, seek out a a PCP or an internist or someone who has a great reputation, is known for taking the next step like a direct care model, concurge model, you know what I mean?

like it may not be for everybody because entry price point or the amount of stuff you want to do, how specific you're going to be because of the knowledge you already have just being a doctor and being in cardiology and doing preventative health and preventative cardiology. But you know, you know what I mean? Like I don't think the exact same type of primary care doc, the exact same type of routine checklist primary care visit is for everybody. >> Yeah. Uh yeah.

As physicians, I think we do truly need a different type of uh care because the kind of questions that we have and kind of things that we look into and I think that kind of access is opening up to everyone because everyone knowledge is becoming a commodity right I mean anyone can look up and what are some ideal labs to order for myself and people now people are coming into my clinic uh with pretty complex questions I mean they they come in and they have a list of labs they ask me why they should Should they be ordering those labs or should they not be?

And I and you know and they have certain list of medications that they should be on when I when I recommend medications they always say okay let's discuss this after I've done some research and and knowledge has become like a thing where it's available on a few fingertips and people look them up read about and then we come and have a good discussion.

One thing I'm noticing is a lot of people are coming in with um you know they talk to Claude or Chad GBT and Claude and Chad GBT are are pulling information from all kinds of websites and uh online data available right so there's a lot of extreme uh lab test and unnecessary uh recommendations that are coming in and people are bringing those in uh with not that much evidence behind them um uh and that's when my role comes in where I kind of counsel them hey you know This is a good, you know, with clots suggested in this case, this is a good uh lab and I think we should do this, but this one right there, uh, you know, your omega-3 index may not be the right lab right now because there's not much we can do about it at this moment versus your lipoprotein A or your APOB levels.

Yes, you're right. We need to check those or HSRP or whatever. >> That that kind of counseling is happening. And I feel like I'm I'm doing the same thing but from a different angle. And I and you're right. I think uh me uh seeking out maybe a concierge level primary care that I can just kind of run ideas by uh or have you know um these open discussions with might be the better option for me, you know. >> Yeah. It may just be what you need, right?

Like to make yourself kind of what you're saying, feel comfortable and feel heard and you know have your needs met. That's just what it is. I mean people have different requirements and what they want. Um, you know, one thing you mentioned that I think is really funny, like you know, patients almost like fact-checking you or double-checking you against like a large language model like a claude or perplexity or whatever.

It's one of my friends, he's a rheatologist and he was texting me the other day about his like neighbor or someone that lives down the street that fell and they had an injury in the shoulder and he was like, "Hey, this is like a picture of the X-ray he sent me and I only have the MRI report. like what do you think? And so I was telling him I was like, "Look, it looks like he's torn his rotator cuff.

He may have a biceps injury, whatever it is." And I was like, "I think this, this, and this is what he needs, you know, probably doesn't need surgery for this and whatever." And I'm happy to see him if he wants or, you know, he can see whatever. This is just, you know, I was just texting him back and forth and he's like, "Oh, wow. You basically said the exact same thing that Chad GBT said." And so I texted him back.

I was like, "So if I said something different, you wouldn't trust me or you wouldn't trust Chad GPT? Like where do you actually put your more of your stock in? Like whose word do you believe more? Someone who's a dual fellowship trained orthopedic surgeon that does this every single day or some random large language model that combs the internet and collects all of the good and bad and gives you a response in an articulate way.

It's just so funny that he has another physician and someone like I know like mentioned that. I was like okay like what is >> this is happening every day. I can't even tell you how much is happening every day where patients are coming in with a list of questions, >> right? >> They already have put in their labs into uh you know clot or or or perplexity. >> Yeah. >> They come in with their labs, they have re recommendations. They're not telling me what they recommended.

They're waiting for my answer. >> My recommendation. They're like, "Oh, wait. I I guess you're right. Yeah. You you >> when you're in like fourth grade doing math problems and you know you turn to the back of the book to get the answer, it's almost like they feel like they have the back of the book answers. Like dude, a lot of this stuff is not cut and dry. I mean there's there's a spectrum of injury.

There's a spectrum of treatment options depending on you as the patient, your age, your activity level, the extent. I mean, there's so much stuff. It's I just think it's hilarious that it's like as if, okay, well Claude said it. It's got to be the right choice. >> Must be true. Yeah, it must be true. I mean, you know, I've I've done kind of like exactly what some of these patients are doing. Um, and and I can kind of parse through the BS, right?

The and the recommendations that come in and do this and do that. But you can tell that it's it's getting it's it's ideas from all kinds of sources. And some of it is not legitimate. Some of this is not actionable. Some of it is not even a test that is available, right? But we know that.

But when someone comes in with those exact lab tests and they ask you about it, you're like, "Well, I mean that this doesn't even exist." How do you explain that to a person that is thought is not right and it's over over analyzing and you know it's but >> yeah all that stuff like those things those programs are missing context. >> You know they're not sitting in front of a patient and assessing them.

like one person who's 65, super active, healthy, fit, goes to the gym, doesn't take a single pill, is very different than your 65year-old that rolls into your clinic in a wheelchair. But, you know, if the patient is not divulging all of the details of their life, they don't know that. But you can see that in a human being when they're sitting across from you and you're talking to them. You know, I I I think the context is so important to put in perspective.

It's not just a lab value in isolation, an MRI finding and isolation. It the whole picture really matters so much. >> Yeah.

But some of it will change and these models are getting so good and with the advent of wearables uh our our lab data being readily available being able to put that in all these lab apps and your health medical records being connected now you know cloud perplexity all of those can connect to your EMRs and extract all your personal uh health information along with your wearable data your your vitals your your weight all that stuff and along with that labs I think I think it's not far off where uh patients will be coming with legitimate information and they they will be coming to us maybe for the action not for the advice which which I I I can see it happening eventually like okay I need you know this is what I need and this is what I want to get done uh what do you think are you going to do it or should I go to someone else and I do think we are getting to a point because I'm seeing a this trend of these 40 to 50 year old uh men mostly men women too But men that are super hyper obsessed with optimizing optimizing their health, you know, they want they want that optimal last 5% of health.

They're they're doing wearables. They're collecting hyper data. They're plugging it all in into Excel and into these into these LLM models.

um they're keeping track of their labs almost every other month and they're creating these graphs and and being hyperfocused about their sleep and it's a new trend and that kind of goes along with people then supp using supplements or injectables GLPs and and peptides now uh which are becoming much more mainstream and using those to uh kind of gain that optimization you know um I I am listening all these mainstream podcasts now like you know the diary of a CEO is Steven Bartlett or Joe Rogan, they constantly have physicians come in and talk about peptides and um and the whole mahog.

>> Yeah, it's it's everywhere. I mean, like everything online that you read about wellness, health, longevity, it's all peptides, peptides, peptides. >> And we've talked about peptides a bunch on on this on this show. And the short and dirty of it is the vast majority of these peptides for so-called optimization, muscular skeletal health, tendon healing, rejuvenation, they have no real clinical data. It's all extrapolated.

There's very strong and consistent and reliable animal studies that have been done in multiple animal models in with multiple different peptides, multiple different areas of those animal bodies for tenant healing, fracture healing, cartilage restoration, uh preservation of the joint. I mean, it's so much stuff. There's a lot of real data, but again, there's no real clinical data. And so what you're talking about, Homayo, I agree. There's a lot of hype about it.

And it's almost like it's being rushed forward. Whether you think peptides are promising or not, they're being used in a way that other medications in the past have not been. They they have not been through rigorous testing. They haven't been through a series of clinical trials. They're kind of just being pushed using this gray zone of a research chemical so that anyone can source them and inject them however they want.

And now you have the anecdote and like you I got so many patients in clinic that use them that ask about them. I mean I just repaired this guy's this guy's like on real steroids like highdose testosterone replacement therapy. He's he's an older guy but I mean he's just jacked and he tore his distal biceps. I just fixed it. And he was like arguing with me in clinic about like can I inject like day one, day two after surgery, his incision isn't even healed.

Can I start injecting BBC 157 into my incision to make it heal faster? I was like dude, you're going to get an infection. Like just don't do that. And he's like, but I've read about it. And I was like, that's great. You've read nothing meaningful to me. And so as your surgeon, I'm recommending strongly that you don't inject some random thing you bought from a pharmacy that is labeled BPC 157, but you don't really know what it is. like you don't e inject it. >> Yeah.

I mean, you know, so far these these all these drugs have been category 2 uh drugs and they're not even allowed to be compounded at legitimate uh these this 503A and 503barmacies, right?

So 503A 503barmacies is you know these are 503A pharmacy you know so kind of going back back in the day before mass production you know people would have uh some disease and they would be referred by their doctor through apothecary like a local pharmacist that would mix up >> dude apothecary makes me think of like Harry Potter you know like middle ages Europe some dude with that like you know that beak looking mask like the plague masks >> yeah I mean you know People used to, you know, these these pharmacies used to mix up different medications and kind of customize the medication for for the people and and then mass production came and large scale large largesiz pharmaceuticals came and they started mass-producing medications and and then medications were not so personalized but there's a whole belief in people that you know not everyone responds to medications certain way that one one a dose of 20 milligrams or superatin might be good for one person but might not be uh good for another person with a different body size.

So yeah, they believe that medication should be compounded to a personal uh p to a to a specific person. Uh and that's where 503AIES come in where they these are smalleries regulated by the pharmacy board and they're focused on providing u compounded medications directly to patients. Whereas 503barmacies are uh kind of like they they're regulated by the FDA and their their mass scale production.

and they supply compounded medications to hospitals and clinics directly rather than directly to uh patients. So that's the main difference. So so far these there's these two types of compoundingies that have different regulatory bodies and u these peptides are not even allowed to be compounded.

So there they are currently so far up until this recent change had been category 2 uh chemicals and they were only >> which means but just for everyone listening you know I mean not many people I mean I wasn't until we researched this what categories mean when the FDA is classifying drugs these are different than like a schedule one schedule two schedule three drugs which we prescribe um the categories of these drugs category 2 is a restricted drug um which is like can't use it, can't make it, can't compound it, which is which is a stark thing.

But I think what you were talking about is a lot of these drugs very recently have been taken off. These peptides have been taken off from category 2, meaning they're no longer explicitly restricted. >> That doesn't mean they're approved, but they're not explicitly restricted anymore. >> Yeah. I mean, so far people were able to sell these medications because they were marketing them as for research use only. >> Yeah. Research chemical. >> Research chemical.

So they were able to sell those because these were research for research purposes. So someone could buy it theoretically to test it on their rat or on their animal, right? It was for that purpose, but most people were using it on themselves. Uh but now they've been removed from that category too where there's going to be a vote on uh July 23rd uh by the the pharmacy comp is the pharmacy compound advisory committee. And you know this was greenlighted by the by RFK Jr.

where this uh these compounds were moved away from category 2 and there'll be a vote by this committee to see if these compounds can be moved to um category 1 where they'll be allowed to be compounded by thesearmacies and I >> should be really I'm really interested to see what happens because you know that PCAC that PCAC group they've basically voted against peptides in every single one of these things since 2024 but you know now that RFK Junior is involved involved and he's, you know, a very vocal, outspoken person regarding anything and everything that is not traditional medicine.

Not in not in only a bad way, but he's just very much into the wellness longevity thing. Um, but to the point in some areas of being like an antivaxer, making false claims. So, a little bit of farce and a little bit of danger in a lot of the stuff he says. But the the whole podcast sphere and especially podcasters like you mentioned Joe Rogan earlier. Some of these podcasters have such a huge following and reach and also a lot of political impact.

I mean he was crucial in getting Trump via text message to start reooking at certain medications. Um you know like people like people like Rogan could and others like him could really push for this and with their influence over the political side. I mean they could bypass a lot of the traditional mechanisms where medications become legal and become utilized by patients. >> Yeah.

I mean, yeah, it's it's and it's being rushed through because, you know, RFK, I'm sure he believes that he only has two or three more years to kind of push his agenda of getting this non- mainstream um kind of anti not anti- medicine, but you know, kind of off the rail route, anti- big pharma kind of compounds out to the public.

uh and they're they're pushing it through without much evidence where the biggest trial uh with BPC57 which is one of the most popular peptides is two patients you know two patients two patients got the drug and they started >> yeah the whole study was basically they took one man one woman and they gave him an IV dose of 20 milligrams of it and they're like okay well they didn't die >> yeah it's like >> you know there is there is there is the whole u if you look at on the other side I mean there there is potential in the future because you know I'm I'm pretty involved in the clinical research world and and even in the clinical research world the idea of real world evidence trials is becoming big.

I know orthopedics has always been kind of like that where they do a lot more real world evidence trials. They don't have to go through those phase 1, phase 2, phase three, phase four trials. Um they they do a lot of the devices get real world data and they uh extrapolate the safety and efficacy of the device based on those.

So that's kind of happening as well in the pharmaceutical world where a lot of big pharmaceutical companies are focusing on real world evidence trial with especially with the advent of AI and able to uh process large scale data quickly.

Um what now they're able to look at is you know getting getting data from wearables from EMRs uh patients reactions their vitals uh from uh services like remote physiological monitoring where patients check their blood pressures and weight every day uh and extrapolate that to kind of prove efficacy of certain medications for certain uh indications. So that's happening.

I can see that happening with peptides where uh you know a lot of real world evidence trials can be done very cheaply gather data from doctor's offices and their EMRs of patients who are taking these peptides and then then extrapolate that data data and and see okay there is efficacy but right now we don't have legitimate phase 1 to phase three phase four trials for these >> yeah and you know that's that's where I think like in my opinion it's harder to define efficacy in something that is not a medication treating a condition you know like these peptides there are different type of drug that I I don't really think has existed before that they're not really purpose-built to treat blank like they're not a statin to lower cholesterol.

They're not a metopol to treat you know as a beta blocker your heart and your blood pressure and stuff. They're not an anti-inflammatory you know acting in an NSAID pathway. These medications have a vast array of effects. And a lot of the effects at least that are being touted anecdotally and in animal studies are in general benefiting and maintaining the health and integrity of like tendon and soft tissue structures, ligament structures, things like that.

Accelerating healing, which those are harder things to track, you know, like are you getting rotator cuff tendinosis or not? That's not something that can really be tracked by lab data, by wearables, by an EHR, unless you're doing serial advanced imaging like serial MRIs, which no one is doing because no one is paying for that. No one can afford that.

Um, so a lot of this stuff regarding, you know, the most common peptides used by your typical weekend warrior athlete type guy, you know, between 40 to 60 years of age that goes to the gym, has a little bit of ligament issues, has tendonitis here and there, and they want to inject it so that they avoid surgery, but they don't want to just use steroids. They want to use something that they believe is actually regenerative.

That's hard to track and I don't know how that's actually going to be tracked. It's easy to track safety profiles using wearables data for sure and adverse effects, but real efficacy, a lot of it is based on how the patient feels and kind of parsing how much is placebo versus actual objective improvement. And again, without real imaging data, I I think that's going to be very challenging to do.

Yeah, I mean you know there there are a lot of similar kind of trials going on in uh the GLP world where patients with no disease healthy patients are being given GLP1 medication and now we're doing uh you know even doing trials in patients who are not obese or morbidly obese they're just overweight or just you know BMIs of over 25 and we're doing these obesity prevention trials where they they are testing uh these GLP ones for prevention of obesity in young patients uh patients who are heading that route, patients who are developing uh poor metabolic health uh and exposing them early to GLP1 medications along with exercise.

Does that does that help or not? So there there are medication and I think GLP1's kind of opened uh the the the route for these these peptides as well because GLP1 itself is a peptide. It was found as we've talked about in Gaia Monster uh uh Gila Monster uh um saliva as well.

uh and eventually it got uh you know patented by uh large pharmaceuticals and they were able to do clinical trials after stabilizing the molecule and kind of doing large scale studies and now it's a highly highly highly profitable drug which is running economies of a lot of countries like you know uh like Nova Nordisk is one of the largest uh companies in um like wait is it Sweden Denmark I forgot I'm blanking out Yeah, one of the Scandinavian countries, sorry.

Uh, so it's kind of pretty much running the economy. So, uh, GLP and I wonder why there there's this whole argument that, oh, these compounds, uh, these sorry, these peptides occur naturally, so they cannot be patented. uh how are we able to do those uh trials and develop medications along with around GLP-1 medication and why can't uh BPC57 or other molecules like that be down the line studied and patented and um there could be a push from the pharmaceutical side behind that.

>> Well, same with insulin, right? >> Same with insulin. I mean, our bodies produce insulin. Our bodies produce GLP1, but we were able to kind of find derivatives that we they could be patented. they're more stable and could be mass-produced. So I I mean there's a lot of money to be made and I I doubt big pharmaceutical companies will kind of stay back and not want to uh kind of capitalize on this possible profit because there's such a demand for it too.

And I think with the change with a with a change in this from this category two to maybe possibly going to category one, it might open up to them wanting to do more real world evidence trials and then maybe even package it and market it and sell it uh to mass markets. Um you know so let's see how things go. But you know one thing yeah I mean I I I I hear your point.

I just don't see how we do get large scale data and large scale trials uh without the backing of uh these pharmaceutical money companies that have all the money to do those trials right um I I don't see that happening without them and and without those large scale trials yeah we we would know that there's benefit through anecdotes but we will not know if we give this drug to 20,000 people will 20 of them develop cancer because of this drug and just for that reason I'll always be hesitant unless we have large scale data about these medications and I'll I'll be thinking twice or three times before giving it to myself because I just don't know what I'm giving to myself uh because I don't know how it acts longterm in human bodies.

Um we we have now enough data on insulin now we have enough data on GLP1s. We have enough data on statins to comfortably say and suggest it to our patients. But on these on these peptides we don't have data. We know that it works. We know it possible. We just don't know what harms it causes. Yeah.

I mean there there's a lot of safeguards around it and a lot ofarmacies double check and doctors double check and there's screening methods to check for those things like pancreatitis and meularary thyroid cancer and men men one men two syndrome.

So um yeah you hope that people are doing it the right way and and and selling these drugs and making the prescribing these drugs in a safe manner but there's a lot of profitering going on as well where people are ignoring these safeguards and bypassing them just because they can sell these drugs pretty easily. Yeah. Yeah. Exactly.

When when the pharmaceuticals are are designing these clinical trials, a lot of times it's not to look at the efficacy of the drug itself, it's or or or to find the dangers of the drug. It's their hope is that they find the benefits that then eventually they can sell or find certain data points that they can market and that's always the whole point of the clinical trial. So, it's it's tough and we'll see.

But one thing you know people uh cannot do trials on and we uh cannot people ignore because everyone's ready to take these compounds but exercise right exercise is a big thing which people for some reason most people don't have the time to do but they'd rather inject GLP-1s and these peptides right u that's the hard part and and every day in my clinic I'm having these conversations about exercise and I do have a lot of patients on GLP1 medications.

But unfortunately, every time I talk to them about exercise, they're like, "Yeah, I know I need to exercise. I need to do strength training, but I'm not and I don't have time and I'd rather just lose the weight this way, which is which is hard." And you know, they understand that they need to do it, but people are not. But we know that exercise does not mean spending 50 50 minutes every day in the gym just pushing yourself and really just tiring out your muscles.

mild to moderate amounts of exercise can be useful. And for a lot of my sedentary patients, patients who are not doing anything, I just tell them, hey, just every day after dinner, just go for a 20-minute walk. That's the least you can start off with for now. Uh and just some kind of movement every day, right? So for sedentary people, just any any little movement uh uh is important, but most people are not doing it.

Yeah, I think five minutes of exercise for someone who's not doing any exercise, it's still beneficial. Yeah, >> five is better than nothing. And I think that study was done in patients who were mostly sedentary and it showed that people who at least did even five minutes of exercise had a had a much significant benefit compared to those who were not doing exercise. And we know that the exercise curve is is not linear.

It's more of a um it kind of in initially it it rises up pretty fast and then it plateaus over time.

But you know it's we know that there's there is an optimal amount of exercise where you get to a certain point after which there's a higher risk of injury right uh so uh for patients who are just starting out and uh are very late in their in their in their journey to exercise you know um my recommendation mostly is start slow start small uh don't just tire yourself out with the first session don't go on and lift uh 150 pounds on the bench press and then start doing bicep curls with like 35 lbs on each side.

Start slow. Start with just the bar. Start practice the movements. Get the motion right. Uh even if you're not super sore and your muscles are not aching at the end of the day, that's okay. It's about the habit getting there, getting some movement every day, you know, three times or sorry, three times a week. Uh and getting used to being at the gym and doing the exercise. That's more important than actually doing a full heavy load workout where you're maximizing your weight count. Yeah. Um, yeah.

My my my my whole idea is that not everyone and majority of the people are just not used to exercise. And what we don't want is them to get overwhelmed right off the bat. That thinking that they have to do this amount of exercise every day. I I think the main message to get to people um is movement is good, exercise is good, some kind of resistance training is good. Uh so first get started. Yeah, I agree.

they eventually you need to get to that level where you're doing it appropriately and you're mastering it and and and pushing yourself as you go but um majority of the population I'd say 70 to 80% of population gets very overwhelmed with exercise uh and they get to the gym and most of the people don't they walk around and they try the the familiar exercises they know and then they stop so um I think it's it's important I think it's important idea to at least get in encourage people to go ahead and do movement daily because the initial effect of you going from sedentary to doing some kind of movement is is pretty significant and I think that's what this article is trying to get to rather than you know this is all you need.

>> Yeah. Yeah. But you know the the one important thing is our body is an amazing uh set of organs and uh there's a lot of different uh functions of the body that sometimes we're not even aware of. And this this recent study that we both read kind of like just boggled my mind. It was kind of uh amazing what they found in pigeons, right? These um homing pigeons, the pigeons that fly long distance and you know can kind of navigate through directions.

And they found that uh their ability to kind of navigate and find their destination and find their way back home was dependent on the amount of um iron stores they had, the iron macrofasages they had in their in their liver cells and in their liver. and the the the the there was some kind of interference with the magnetic fields and the iron uh available in livers that was that allowed them to navigate their way and use it as a compass to know direction. >> Yeah. >> Yeah.

I mean you know for many years there's been this talk of like you know a lot of people just say you know I have this gut feeling about the environment. people are in a certain environment where they start feeling some kind of sense of danger and um they start noticing that there's something wrong with that area.

That gut feeling you get is there something more to that feeling now you know is there some kind of a like you know something like an iron store that's that's detecting certain danger or magnetic fields around us that that's sense you know increasing our senses. You wonder that now because you know last time we talked about the dogs that were able to smell cancers and now yeah that's what it is.

I mean yeah and and as humans our our brains are so limited and you know we use it to such a low capacity that some of us uh and most of us are not even able to sense a lot of these things and people who are very in tune with their environment right some people can and and I wonder now some of those people that have can feel the aura or feel a certain the energy around them and can harness the energy and kind of um manifest energy to other people around them. Are these people up to something?

They're on to something. They must they might just be happy.

But but you wonder if some of those gut feelings that people get there there's a known phenomenon now you know in the gastronurology field where the gut brain access where a lot of the nerve cells in the gut a lot of the the the microbiome and biome and the in the gut affects how we think and our our brain fog right uh so there is a true um this idea of the gut brain access uh and I wonder if there's more more to that and I think as we find out and we do more of these trials, um, you know, we're going to discover so many different unique abilities of animals to harness the environment around them to kind of navigate this world that we cannot even imagine right now.

And who knows what kind of technologies we'll be able to uh develop because of that. You know, uh this that reminds me this this reminds me of this idea that you know, science it's it's never that hypers specialized field that u finds breakthroughs. It's not that one person that's super hyperfocused on one area and goes on and makes a major breakthrough.

A lot of the major breakthroughs happen when people uh from one another field combine ideas of another field together and they've come up with something unique that's was not known to the world. And I read this interesting book called uh range and it talks about how people who uh who develop uh you know many different skill sets they're not just hyper specialized into one field. They're not prodigies.

the these are people that uh that gain knowledge from different um principles, different ideas, different fields. They tend to do much better overall. They have a higher uh um uh higher amount of intelligence and higher ability to make breakthrough discoveries uh in life compared to those who hypers specialize and are focused. Savant. Yeah, I mean there's these ideas with Malcolm Gladwell and uh you know even in Robert Green's book about putting in 10,000 hours into one field to gain mastery.

uh uh but um a lot of a lot of evidence points against that too because uh a lot of discoveries and uh are made because you combined ideas from one field like you know uh animal biology or uh the the navigation patterns of pigeons and then and then combine it with biology of the liver and macrofasages and iron stores and combining those two kind of uh you know you make these breakthrough discoveries which kind of can be sometimes world altering, right? Um Yeah. Yeah.

And and you know, even for example, if you think of someone like Leonardo da Vinci, you know, he was a Renaissance man, right? kind of like literally uh he was an artist. Uh and because of his artist and his ability to visualize nature and humans and he eventually ended up uh drawing up human bodies and you know wrote books on anatomy. You know he developed you know he combined arts and science in a way that we were able to learn a lot more about the human anatomy because of him as well.

Same with many other people. I mean look at if you look at the people who made the biggest discoveries in the world they did not just hyperfocused and specialized in one field. They weren't just physicians or scientists or artists. They did multiple different things and they they learned about different. They learned about philosophy. They learned about science. They learned about mathematics and physics.

And because they learned about all these different principles, they were able to find patterns and and make new discoveries.

And and I find a lot of physicians uh getting so bugged down and all they do is just read medical articles and and studies and you know only um only reading they do is in their own field and and they truly don't learn or reach out and um kind of explore other areas of the world or other fields and you know it it they're very hyper specialized rather than kind of increasing their range which I wish more physicians did that because I think medicine would be in a different place.

Uh and physicians as leaders would be in a different place as well. >> Yeah. But yeah, I mean, you know, it was a nice uh uh break that we took from the podcast. Sometimes you got to get away to come back and uh appreciate what you're missing, you know. So, uh it's uh we we'll be back and it'll be producing more episode. But this is a good one. Some some interesting interesting studies.