Inside the Peptide Industry: The Truth About Safety, Sourcing, and Results

Episode 13 | Fertility and Other F Words

In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Rick Manuel to pull back the curtain on peptides and regenerative medicine.

Rick is one of the owners of Optimal Balance Pharmacy and the owner of Houston Regen Consultants. He works with physicians around the world, helping them implement evidence-based protocols and navigate the rapidly evolving peptide space.

In this episode, we cover:

• Rick’s journey from the supplement industry to personal training to the stem cells and compounding pharmacy world
• Concerns and real-world issues with SARMs (Selective Androgen Receptor Modulators)
• The logistical challenges of conducting clinical research in this space
• Side effects seen in clinical practice with certain peptides
• Behind-the-scenes look at peptide sourcing, including:
  • FDA-registered facilities in other countries
  • The “Green List”
  • What proper due diligence actually looks like
  • Method suitability testing and sterility testing
  • Potency and quality control testing

Key Takeaways:

• There is very limited high-quality research on the safety and effectiveness of many peptides
• That said, real-world clinical experience treating hundreds of patients suggests there may be a role for peptides in select individuals with specific goals
• When sourced from reputable compounding pharmacies and used with appropriate oversight, peptides appear to be generally well tolerated

To learn more about Optimal Balance Pharmacy, check out https://obprx.com/

Notice: 

The Fertility and Other F Words webcast and YouTube channel are intended for general informational purposes only. They do not constitute the practice of medicine nor do they provide medical advice or create a doctor–patient relationship. Use of the information provided through this webcast, YouTube channel, or any linked materials is at the listener’s/viewer’s own risk. The content is not a substitute for professional medical advice, diagnosis, or treatment. 

Listeners/viewers should never disregard or delay seeking medical advice for any health condition and are strongly encouraged to consult their own qualified health care professional with any questions or concerns.

All content from the Fertility and Other F Words webcast is the property of PODCAST WITH DRS. AMY AND LARRY LLC.

Listeners and viewers may not use, distribute, re-distribute, reproduce, alter, or edit any portion of this content without the express written permission of the webcast owners.

The views and opinions expressed in this webcast are those of Drs. Amy Pearlman and Larry Lipshultz and do not reflect the official positions or responsibilities of Prime Institute, Baylor College of Medicine, or any affiliated institutions.

Transcript

SPEAKER_00 0:00

Actually, we wrote a paper I just realized. It's called Death and Bodybuilders. I was in college and I was doing health and human performance with my my my bachelor's and um the teacher was talking about protein intake and I raised my hand and I was like that's incorrect. That's not near enough protein. And we got into an argument in the class. So I didn't go back to her class. Uh some other um students in the class came to me like a week later, they found me somewhere on campus, like, hey man, you gotta come back to class. She wants to apologize to me. Did you go back? I did.

SPEAKER_01 0:34

Did you apologize? She did.

SPEAKER_02 0:36

Larry, let me ask you, in your clinical experience, because you how long have you been prescribing these peptides for?

SPEAKER_01 0:41

I don't know, three to five years. Okay.

SPEAKER_02 0:43

Would you say you have hundreds of patients on these peptides? Have you seen a side effect from these peptides that concerns you?

SPEAKER_01 0:49

The only side effect I've ever seen is uh something at the injection site from an allergy. Yeah. I have never had a systemic problem.

SPEAKER_02 0:59

That was a profound comment that you said. Think about the medications that we use that are FDA approved. Would you say that side effects or more severe side effects with some of those medications are more concerning than with peptides? Yes. I think that's profound. Because from a healthcare provider's perspective, I'm interested in offering these peptides to my patients for the reasons that we've discussed. But how do I know if they're being sourced correctly? How do I know that they're not going to be contaminated?

SPEAKER_00 1:24

We actually hired an in-house compliance officer who was an ex-state board inspector. So she looks at everything. Everything that we do, we we hire people that are smarter than us in certain fields that protect us and protect our patients.

SPEAKER_02 1:37

Welcome to Fertility and Other F-Words, the webcast that tackles fertility, sexual health, and everything in between. No topic too taboo and no question off-limits. I'm Dr. Amy Pearlman, board-certified urologist with expertise in sexual, hormonal, and genito-urinary health, and co-founder of Prime Institute in Miami, Florida.

SPEAKER_01 1:55

I'm Dr. Larry Lipschultz, a professor of urology, Baylor College of Medicine. I am a board-certified urologist and director of Baylor's Division of Male Reproductive Medicine and Surgery.

SPEAKER_02 2:07

All right, Larry, I know you've been busy as always. So what's something that's happened that's interesting recently in clinic?

SPEAKER_01 2:12

Yeah, so I thought I'd share this specific case, but I wanted to recap the fact that we do talk about cases related to either erectile dysfunction, low testosterone, or male fertility. So this, we're talking about an infertile couple. Okay. They came to me, uh, they were both 41 years of age. Uh, they had been trying to initiate a pregnancy for about eight years. Uh, they did undergo IUI for three or four cycles in 2021. They did get a conception, but they had a miscarriage or an abortion at 14 weeks. Uh since then, they've tried IVF multiple times. And what seems to be the problem going to two different centers is she does produce anywhere from three eggs to 10 eggs. They have a poor fertilization rate rate, and what does fertilize doesn't make it to blastocysts, it arrests. So, what's going on here? Well, we looked at his hormones relatively normal. We look at his sperm density, it goes anywhere from 4 million to 26 million. This was in 2021. Now it's trending down. He's averaging now about four to five million with 60 to 70 percent motility.

SPEAKER_02 3:30

So let me ask you this do you ever take one semen analysis result and say this is what's going on?

SPEAKER_01 3:36

Never.

SPEAKER_02 3:37

Tell me why.

SPEAKER_01 3:38

Because men differ, they vary.

SPEAKER_02 3:40

You and you just mentioned from four million to twenty-eight million, that's a huge variability.

SPEAKER_01 3:44

But it was over the course of four years. So there could have been intervening illnesses or something, but we don't know about. But um sometimes when these cycles fail for no apparent reason, we say, well, maybe something's happening after the sperm leave the testicle, and we do an office testicular sperm extraction, which we did in this man, they went through IVF again, and no good outcomes. So we're dealing with a couple in whom the man has a lowish count, they don't have high fertilization rates, and they do not make good blastocyst. So, what's going on here? What do you think is going on here?

SPEAKER_02 4:22

Have you done whole genome sequencing in him?

SPEAKER_01 4:24

It was normal. So I'll tell you where the issue is. Yeah. They're both 41.

SPEAKER_03 4:28

Yeah.

SPEAKER_01 4:28

And we know we deal with advanced maternal age, but now we're talking about advanced paternal age as being an issue. And uh Mike Eisenberg out of Stanford has made this kind of his new uh focus of research.

SPEAKER_02 4:40

And you trained Mike Eisenberg.

SPEAKER_01 4:42

I did, and he published a paper that has yet to come out, I don't think, in mass publication, but it did come out uh in the Stanford publication that that was where he works. And it was a very large group of patients. It was 40 million.

SPEAKER_02 4:56

Yeah. They looked at over 40 million US. 40 million.

SPEAKER_01 4:59

And but but what concerns me though is he states in the beginning that he's defining it as over 35.

SPEAKER_02 5:07

For advanced paternal age, which was younger than I would have thought.

SPEAKER_01 5:10

Yes, because when he said when he cites studies looking at abnormal outcomes, 45 and 50 years old. So to me, I use it as over 50.

SPEAKER_02 5:20

That's kind of my personal So you would say you would define advanced paternal age as over 50.

SPEAKER_01 5:24

Yes, and I've always done that. And I don't know, I don't know. I when I see him, I'm gonna find out why they picked 35 to look at. So I I did something kind of, I don't know. I guess it's okay. I went to uh open evidence. Do you use that? I do. And it's you know, it's a good review AI because they only use the JAMA and New England Journal. And I got two different answers. So the first answer Oh, what did you ask it? I said something about in a couple where both the male and female are 41 with poor fertility and uh poor blastocyst production, uh, in a man with an average sperm density of four to five million, what do you think are the possible reasons? And the first time they said the most likely reason is the combination of low sperm concentration, parentheses, severe oligosospermia, and advanced paternal age. Nothing about women. I thought that was kind of strange. She's 41. And I asked it again, and this time it said advanced maternal age at 41 years profoundly impairs oocyte quality, fertilization rates, and blastocyst development.

SPEAKER_02 6:39

Yeah. So I mean So one focused on it being a male problem, and the other focused it on being a female problem. Right.

SPEAKER_01 6:46

There is one where they said, huh, they also say the synergistic effect of both partners being 41 years creates a particularly challenging scenario. But they don't go into detail this time. They did the last time. But I think this is a problem we're going to see more often because we're starting to see more of these patients coming in, certainly with the woman old being older, because they're postponing having children. And now we're seeing the men coming in uh being older. And the question is we know that women are now pushing towards freezing their eggs earlier on. It's becoming more and more popular, especially professional women, women who have a full-time job and don't want to have a child right then and there. But should men be freezing sperm prophylactically? What do you think?

SPEAKER_02 7:32

Oh, I think it's a great question. I offer my patients who are, let's say they have some hormone issues, um, I offer them all sperm cryopreservation. Because they could say no. Right. You know, now it usually if they're very young, like in their mid-20s, and having a child is nowhere on their radar, they'll decline that offer. But I think a lot of people think that freezing sperm is way more expensive than it actually is. I mean, I send patients to the University of Miami and it ends up being a couple hundred dollars to do like the sperm cryopreservation, and then it's a couple hundred dollars every year for storage.

SPEAKER_01 8:00

Yeah, and that's the same thing as Baylor. Except at Baylor, they always forget to send out the yearly bill. So it's really a good deal. You get away with something.

SPEAKER_02 8:09

I think it's something we should offer people.

SPEAKER_01 8:11

Yeah, I do too. Uh I don't.

SPEAKER_02 8:13

Yeah.

SPEAKER_01 8:13

But you know, I am gonna start. I've you know read this a little bit more about paternal age. Uh Mike's coming to town uh to be our visiting professor, and uh, this is a topic he's going to address. So I'm gonna be interesting to see actually how he actually presents the data.

SPEAKER_02 8:29

Yeah. And what's interesting too, and I don't know if you have the same sort of demographic or situation that I do in Miami, but like this past week I saw a guy, he's 61. His wife is in her early 40s, and he was coming in for maybe ED. Uh, and I just asked as part of that conversation, like, do you have any kids? And he said, No, but we really want to have a kid. Right. And at 61, he's definitely advanced paternal age. And so you would actually send me this article like right as like the day before I was gonna see this guy. So I actually pulled over the article and I said, You are advanced paternal age, and I just want to talk to you about what some of the risks are. She's early 40s.

SPEAKER_01 9:01

Yeah, so that combination is not good.

SPEAKER_02 9:03

Right. So I Especially for autism, yeah, preterm, yeah, low birth weight.

SPEAKER_01 9:08

Yes, but I mean the autism thing scares me.

SPEAKER_02 9:11

Yeah, yeah. So I think that's also it's something we need to educate more guys about. But I'm seeing a lot of guys who are older that get together with younger women, especially in Miami. Do you see that a lot in Houston? Yes. Yeah.

SPEAKER_01 9:20

And I think the other thing is if you're gonna offer them sperm banking, do you have to at the same time say, but if you're gonna use it effectively in the future, most likely you should be considering IVF because they're gonna have a finite quality quantity of sperm. So one thing I have them do is I do have them divide up the sample into multiple straws, they're frozen in straws, so that they don't have to thaw the whole thing just to do it one cycle.

SPEAKER_02 9:47

Yeah.

SPEAKER_01 9:47

So that's maybe you want to speak to your Yeah.

SPEAKER_02 9:49

Well, they they they put it in multiple vials. Yeah, yeah. That's a great point.

SPEAKER_01 9:53

And they put the vials in different tanks. Yeah. So if there's a burnout in one of the tanks or a meltdown, yeah, you still have your sperm.

SPEAKER_02 9:59

Yeah. Yeah. So I want to tell you about a patient that I recently saw. He's in his mid-40s and he came to see me, actually, and my sister, because he wants to get healthier prior to him seeing.

SPEAKER_01 10:07

What does your sister do?

SPEAKER_02 10:08

So she's a gastroenterologist and does medical weight management, but also counsels people on nutrition and exercise. And he's already lost significant weight. He had lost about 70 pounds even prior to seeing us. As part of his full evaluation, I checked his hormone panel and I was expecting his testosterone actually to be on the lower side. And his testosterone level was well in the normal range. His total T level was in the 800s.

SPEAKER_03 10:25

Oh, that's great.

SPEAKER_02 10:26

That's great, right? And I checked his IGF one level, and I actually started checking IGF one levels after you and I have had some conversations, right? And he has a normal IGF one level that stands for uh insulin growth factor, which is a surrogate marker for growth hormone. Okay, yes. So I'm glad you made that important point. Um, so he saw my sister about a month prior, and just with nutrition and exercise changes alone, so he hired a trainer who's really focusing on his protein. He lost four pounds and gained a pound of muscle, which is amazing. Yeah. And that was just in about four weeks. And even during that time, it was the holidays. So usually people put on weight during the holidays. And what he said was, I appreciate your clinic and your advice because you're not throwing a bunch of medications at me, right? But that begs the question for this guy who's like feeling pretty well, where lifestyle modification is making great changes for him thus far. Is there a role for peptides?

SPEAKER_01 11:14

For what? So I mean, if you're going to offer a medication, you have to address the problem you're solving. So what problem would you be treating?

SPEAKER_02 11:21

Well, I think that's a great question, right? So I think if this guy were to see people in five different clinics, he would be offered five different options of therapies, right? Why?

SPEAKER_01 11:30

But why are we treating?

SPEAKER_02 11:32

Well, I think he's coming in and he wants to feel the best that he can.

SPEAKER_01 11:34

Right.

SPEAKER_02 11:35

Right. So from my perspective, I'm like, you're doing amazing. Your testosterone level is normal. Keep doing what you're doing and let's reassess.

SPEAKER_01 11:42

Exactly.

SPEAKER_02 11:43

And so he's happy with that, right?

SPEAKER_01 11:44

With every medication you give, is the caveat that it may not work and it might make you worse. Right. So I'm not that's not true for all medicines.

SPEAKER_02 11:52

Yeah.

SPEAKER_01 11:53

But some of them can just make you worse.

SPEAKER_02 11:55

Yeah. But let's say this guy says, okay, yes, I gained a pound of muscle. I hired a trainer, but I would like to be, I would like to recover better because I'm going to the gym and I'm feeling quite sore after I'm working out.

SPEAKER_01 12:05

Well, that's different. Then you're treating his post-workout soreness and aiming for a faster recovery. And we do know that BPC TB500, a combination of two medications that are peptides that are quite synergistic, that would be an option for him.

SPEAKER_02 12:20

Yeah.

SPEAKER_01 12:21

You have to be careful with the IGF one, though, because you're only going to treat if it's really, really low. And what are you going to give him?

SPEAKER_02 12:28

Like if his IGF one were really, really low.

SPEAKER_01 12:30

Yeah, which is a surrogate marker for growth hormone.

SPEAKER_02 12:32

So what we're saying is I'm not going to treat him with growth hormone.

SPEAKER_01 12:34

Your growth hormone's low. Right. So we'll try to give him something that'll stimulate his own growth hormone release. So that's that would be reasonable. But I don't know. I I I just think who someone just doesn't feel wants to feel his best, you know, you got to be careful, you know, uh the enemy of good is better. So he's good. Yeah. So I mean, I don't know. I probably wouldn't do anything.

SPEAKER_02 12:54

Yeah. Well, I like that approach. And I think we have a very similar approach there. But again, if you ask five different people, five different clinics.

SPEAKER_01 12:59

People feel like they have to give him something. Right, right, right. Especially if they're selling it from the office. Right, right. So Yeah.

SPEAKER_02 13:05

So let me ask you this though, because you mentioned that you do check IGF 1 levels in a lot of patients, especially if they're considering peptide therapy.

SPEAKER_01 13:11

Right.

SPEAKER_02 13:11

So have you found that people who even have a normal IGF 1 level benefit from something like a growth hormone secretagog?

SPEAKER_01 13:17

Well, so once again, we're dealing with normal ranges. Yeah. And it's if you think it's bad for testosterone, it's worse for growth hormone. So, you know, what's good? I mean, I don't know. We like it to be, I guess, above 300. Most people come in in the 200s, 250. So I would expect it to go above 300 if I give them something. Yeah.

SPEAKER_02 13:35

So you're not strict about it.

SPEAKER_01 13:36

No.

SPEAKER_02 13:36

Okay. But then are you checking IGF 1 levels on follow-up? And what does that tell you?

SPEAKER_01 13:40

Whether or not what he got is real.

SPEAKER_02 13:42

Uh-huh.

SPEAKER_01 13:43

But I don't have a target. I just want it to be higher.

SPEAKER_02 13:46

Okay. All right, excellent.

SPEAKER_01 13:47

Okay, so let me know how your man does.

SPEAKER_02 13:49

Okay, sounds good. All right, let's get into today's episode. So I am thrilled to introduce our remarkable guest today, Rick Manuel.

SPEAKER_01 13:58

Rick is one of the owners of Optimal Balance Pharmacy and the sole owner of Houston Regenerative Consultants. He works with physicians around the world, educating them on evidence-based protocols and peptides and regenerative medicine. Rick partners closely with clinics to help match the right therapies to the right patients, with a strong emphasis on safety, appropriate dosing, and clinical outcomes, particularly in musculoskeletal and aesthetic applications. So, Rick, thank you very much for coming. Yes, sir. And we appreciate you taking the time out. I know you're busy to come here and talk to us today. And uh for our relationship, uh, you know, we go back to 2011. You were then uh managing the gym that I was going to. And since then, you've your career has skyrocketed. You're now also president. Are you president of the company with the uh stem cells? Yeah, I'm a vice president of sales nationwide and some international for three different collaborations of stem cell companies. Right. And the reason we're particularly excited about having you today is because you also are co-owner of a very productive pharmacy, compounding pharmacy, from which we get a lot of our peptides. And you know, we we're gonna get into that today as the uh as our discussion progresses. But again, thank you very much for uh for coming. Yeah, thank you for inviting me. Did you want to start out? I know you're gonna be.

SPEAKER_02 15:17

I know you have a question. So when you guys were working out at the same gym together, you um were a few. Oh, wait, a gym question? Yeah, yeah, yeah. Was he crushing it?

SPEAKER_00 15:26

He was he was there all the time.

SPEAKER_02 15:28

He was there, he was present.

SPEAKER_01 15:30

And listen, showing up, showing up was half the thing. Okay, you're right.

SPEAKER_00 15:33

He had his personal trainer, so he was doing what he needed to be doing. Yeah, right. Yeah. We didn't train together, so I don't know exactly what he was doing, but he was there and that's all that mattered.

SPEAKER_01 15:40

I always showed up. Yeah, and I always did what he told me.

SPEAKER_02 15:43

I love that.

SPEAKER_01 15:43

There you go. Yeah. And I still do.

SPEAKER_02 15:46

Yeah.

SPEAKER_01 15:46

Oh.

SPEAKER_02 15:46

Yeah, I mean you work out with a trainer a couple times a week, right? Yes. Yeah, I love that. Yeah.

SPEAKER_01 15:50

Used to working out with Danny, right? Yes. You got great memory, yes. And he's doing very well. That's my trainer.

SPEAKER_02 15:55

Yeah.

SPEAKER_01 15:56

Yeah, he's a he's a nice guy. I like him a lot. So uh I I think it's important to like, first of all, many people watching may not know what a peptide is. So how do you differentiate a peptide from a biologic?

SPEAKER_00 16:09

It's it's the strand of it so a peptide is is in a a certain sequence of amino acids, right? Laid out linearly. If in the certain amount of amino acids you would get too many of them, they're considered a biologic, right?

SPEAKER_01 16:21

Right. Um But who set who set the number at 40? I mean, you know what? That that's the limit now. Above 40, they call it a I guess the FDA.

SPEAKER_00 16:28

It used to, yeah, the FDA said it. It used to be much higher. Yeah. It used to be about 150 link peptides or amino acids to be considered biologic. Um what I what used to really they didn't even term it that way. A biologic used to be something that came from natural matter. And now it's, you know, they kind of try to curtail that definition to be able to, you know, look at things and regulate things differently. Yeah. So it's all about their regulations.

SPEAKER_01 16:53

Yeah. Which is a big which is a blessing and a curse. Right. And we want the FDA to regulate, yeah, but we don't want them to over-regulate because then it gets into the uh arena where we can't write what we want to write.

SPEAKER_02 17:05

So let me ask you, how did you get into this space? Because you were managing a gym. Now you're managing a stem cell, you know, consulting company and peptides at a pharmacy. What's your background?

SPEAKER_00 17:14

Uh my background honestly started out as a personal trainer for years.

SPEAKER_02 17:18

And so you're like on the ground seeing what people need.

SPEAKER_00 17:21

Right, exactly. And I I started working in supplement shops like in college, like GNC and things like that. So I would sit back there and be kind of bored and I would just study. And I was interested in like what makes the body work better, how can I perform the best? Um, I was not the best salesperson because people would come into the store to buy certain things and I wouldn't sell it to them because I would tell them, this is not really, it's it's all hype. Yeah. You know, they used to have a uh a product that was a myostat inhibitor, it had this big bull on the front. I forget the the breed of bull. They were saying if you take this, you're gonna have unlimited muscle production. Well, I knew it was I looked at the ingredients, I could tell that none of that was gonna do that. And so I wouldn't sell it to anybody. So I got in got in trouble by the same thing.

SPEAKER_01 17:58

So you were there you were there in the era of SARMs, yeah. Which are terrible. Uh so a SARM is a selective androgen receptor modulator as opposed to estrogen modulators, which we still use. But the SARMs would turn off the HPG axis. And the guys are coming in still, and they have like irreversible changes, which I don't understand exactly. But SARM garbage as well. But this is what they were selling out of these uh stores, storefronts, and promising, especially college guys, yeah, high school kids, that they were going to get big by taking SARMs because it stimulated androgen receptors. But it was so non-selective that it was dangerous. Yeah.

SPEAKER_02 18:37

Do you still see people that are on SARM?

SPEAKER_01 18:39

No. I don't see them on it, but I see them with the problems secondary to taking them.

SPEAKER_02 18:43

Yeah, even after being off of them. Yeah, for many years, several years. Yeah.

SPEAKER_00 18:47

I think those came about because there was so much negative connotations towards testosterone back then, right? And so people were like, well, let's figure out a way to to boost people's testosterone without giving them testosterone and around tests.

SPEAKER_02 18:58

Yeah.

SPEAKER_00 18:59

It didn't, and it also caused a lot of damage, like you mentioned. Yeah.

SPEAKER_02 19:02

What else did you learn from being in the supplement industry? Uh we won't tell anyone.

SPEAKER_00 19:08

No names. No, I mean, just more or less where they're sourcing their ingredients from. Like you look at certain things. Um a lot of supplements out there are just they have good marketing, but when you really look at what the base of them is in there, it it's the things in there, all these herbs, herbs don't turn on hormones the way they should, right? They're they're not they're not designed that way. It I always explain to people if it's if it's not from a human or a mammal source, those proteins, they're not gonna signal the same way. Like you have people that use um plant-based stem cells. Well, I always my my joke is if you have if you have a heart replacement, you don't use an artichoke heart, right? Because it's not the same thing. I like that analogy. You know, they didn't work the same, so you're not gonna get the same signaling. You have to have complete proteins. The body, everything in your body requires proteins to function. You need a certain amount of protein to initiate a response. And a lot of these supplements are underdosed or they don't have enough of the complete array of proteins. Like the biggest thing that people sell is branch chain amino acids. Those are three amino acids. You actually need all nine essential amino acids to stimulate um mTOR properly and to leave it turned on. High leucine will turn it on, but it fades. You have to have all nine essential amino acids to be able to sustain that that pathway. And that's how you get, you know, protein synthesis. You grow, you recover.

SPEAKER_01 20:28

So do most of the protein products that we buy uh you know, in the big great big jars, uh, do they have the amino acids in them? Do they claim to have them in there?

SPEAKER_00 20:39

They do. Um they have the essential amino acids and and many more, but you have to look at what type of protein it is.

SPEAKER_01 20:45

What's your favorite type of protein?

SPEAKER_00 20:47

I like to use like an isolate protein, a whey isolate.

SPEAKER_02 20:50

Because whey is high in leucine.

SPEAKER_00 20:52

Yeah. But you you but you have different forms of whey. Uh-huh. You have whey concentrate, you have um caseinate, which is a very slow responding uh protein. You have different forms of protein. And back in the day, people just put blends of different proteins in there. The whey isolate has the highest bioavailability, so you're it's going to absorb much better, be more productive. It doesn't taste as good. But it works better.

SPEAKER_02 21:12

Okay, so you were in the supplement business, and then what happened?

SPEAKER_00 21:15

I just decided I wanted to be a trainer. Like my my first thought, my first goal when I was younger, I was I was very strong in high school. Um, not big, just strong. So I wanted to be a strength coach. And then I got into personal training, and that led me to moving to Houston in 2006 because where I came from in Lake Charles, Louisiana, people didn't value it as much. So they didn't value it as much. Yeah. And so eat terribly.

SPEAKER_03 21:37

Yeah. Okay.

SPEAKER_00 21:38

Right. Yeah, of course. It's great food. Yeah. But it's not good for you. Yeah, and it's it's it was more of the mindset of just lift and eat, lift and eat, lift and eat, even they weren't focused on what they were eating necessarily, right? Just get the calories in. And I was part of that when I moved to Houston and started just redoing more research and and learning that you have to have quality things coming in your body at all times to to be able to be successful.

SPEAKER_01 22:00

You've got to watch the episode with her sister Michelle because she goes into all this. Yeah. You know, down to like almost the molecule.

SPEAKER_02 22:07

But it's really important, right? Everyone needs to know how to discuss nutrition, you know, because when you were a personal trainer, you were interfacing with the patient or the person way more often than we ever would as their healthcare provider. So everyone has to give like a consistent message, otherwise, they get different messages, people get confused and they ignore all of them.

SPEAKER_00 22:24

Yeah. I think the biggest thing when is in my my field as a was I was a trainer is I would tell people list everything that you like to eat, right? And then I'm gonna take that list and I'm gonna find the things that you can't eat in this diet instead of just telling them what to eat, because they'll never do it. Right. If they don't like chicken, don't put chicken in their diet. You find something else, right? And so I would just eliminate things rather than tell them what to do.

SPEAKER_02 22:47

I love that approach.

SPEAKER_00 22:48

And it just it helped them to kind of be able to do the diet that way for sure.

SPEAKER_01 22:52

And they like you better because you weren't taking away their foods, so to speak.

SPEAKER_02 22:56

What were some of the other challenges that you faced when you were a personal trainer? Like, was there an extent to which you could help your clients?

SPEAKER_00 23:03

Yeah, I mean, a lot of the clients would do what you asked them to do inside and outside the gym. They would all do what you wanted to inside the gym, right? Because they're in front of you. But you would realize I realized after a while, these people aren't listening. They're not they're not going home, they're not eating the way I want them to. And I started to become frustrated, honestly. And so I started looking for something else to do to be able to help people. And um and that's when I kind of got in the medical field after a while and started working with a lot of doctors, including Dr. Lip Schultz for hormones and different things like that. And I I always ask questions everywhere I go, because I'm always trying to learn. I'm definitely not the expert on anything. I have knowledge on a lot of things, but not the expert by any means on anything. But I just want to understand how things work. You tell me this does this, well, explain to me why it does this. Because the reason why it does something could be negative long term. You know, we we see this with some of the some of these um hormones that you it shuts off pathways that can be dangerous down the road, depending on what you're doing, how much you're doing of them, you know. Because I did competitive bodybuilding for a while after that. And so when you're doing that, you you're putting things in your body that other people aren't, right? Lots of high dose hormones. And back then we didn't have the uh nice pharmacies that we work with now. So you were getting the stuff from wherever you could, right? You never know what you're putting in your body, you're just hoping that it's right, you know. And that was uh a big problem.

SPEAKER_01 24:30

I've been so I've been impressed by the fact that guys who are competitor competitors uh in the bodybuilding space will almost take anything. I mean, I think their filter is like, yeah, there is not there. Uh right? I mean, yeah, there's some I there are things that people take that I have never heard of. I don't know. So where do they get it from? They get it on the street. Yeah.

SPEAKER_02 24:53

Well, let me ask you this. When a bodybuilder, you know, tragically passes away, does that affect anyone? Like are people like, oh my gosh, you know, I know he this guy was taking this, this, and that, and I should probably stop taking it? Or is it like, oh, that was sad, but I'm still gonna take the risk of taking these therapies?

SPEAKER_00 25:09

Yeah, unfortunately, the latter is true, right? They're like, that's terrible that happened to him, but I'm gonna keep doing that. And you know, there's this attitude that it's not gonna happen to me. Yeah. And what you see a lot of times is a lot of these bodybuilders that have passed away, it's actually not from like cardiovascular events. It's more the diuretics that they're taking will affect their kidneys to the point where you know it limits their health and they get they get sick. Like Flex Wheeler was one of the top bodybuilders in the world, and he had such bad kidney damage from all these diuretics that he now has amputary legs. Oh my goodness. It's terrible.

SPEAKER_02 25:40

Well, it's interesting you bring that up because on a prior episode, when we were interviewing my sister, she competes in fitness competitions. And when she was initially training, she was like, I did it in such an unhealthy way. She was like, I think I gave myself like a compartment syndrome. I was probably in kidney failure for a couple weeks because I was taking so many diuretics.

SPEAKER_00 25:56

Yeah. And the diuretics are not needed a lot of times. If you diet right and you do your cardio, you get the body fat down, you shouldn't have to manipulate things that much. Um, the the problem is they get the day before the show, they look at their body and they're holding a lot of water because their cortisol is elevated, because they're they're stressed, they're they're have anxiety, and so they take something and knock it down. But when you pull all the minerals out of your body as well, what these diuretics do, they don't just pull water. You the muscles need those minerals, right? The muscles go flat, so to speak. I know that's a weird term for people that aren't in the in the bodybuilding community, but you you've heard of the word getting a pump in the muscle, right? The blood flow and all that. Amy pumps regularly.

SPEAKER_01 26:34

Seriously, she goes to the gym almost every day.

SPEAKER_02 26:37

I take my daily C L S, if you're wondering.

SPEAKER_01 26:40

I don't think that ever crosses mind.

SPEAKER_00 26:43

But if you don't have the proper mineral balance, you won't get that same pump. You need your magnesium, you need your sodium, you need your potassium, you need those three specifically to be able to get the proper pump to pull the nutrients into the muscle.

SPEAKER_01 26:55

It's interesting you mentioned about the kidney problem. So we actually we wrote a paper I just realized. Yeah.

SPEAKER_02 27:00

And it was called You've heard so many interesting papers. I love it.

SPEAKER_01 27:03

This one we have to talk about. I have to pull it. It's called Death in Bodybuilders. Uh and we looked at, we got as many as we can from some registry that that uh we had access to through a former bodybuilder who was interested in looking at this. He wrote it with us. And I don't remember how many guys we found. And the and kidney failure was quite up there on the cause of death. And I was taking care of. Do you remember somebody named Nasser Elsombody? Yeah, so he was my patient. He was gigantic. I mean 6'6, like 350 or he wasn't that tall.

SPEAKER_00 27:33

No, he was he was probably 6'1, maybe, maybe. Maybe I was shorter. But he looked but he was 340 pounds.

SPEAKER_01 27:41

Yeah, he looked huge to me. Yeah. And he ended up dying of kidney failure in Europe. He he stopped and went to stopped competing, you know, went to Europe. He died in his 40s.

SPEAKER_02 27:50

Oh, wow.

SPEAKER_01 27:51

Yeah. Yeah, he was a monster. But what's happening then, what happened then, and it's not happening now, that I see as a plus is people are not people used to bulk up like 40, 50 pounds and then lose 40, 50 pounds to step on stage. And this yo-yo with their weight, I think was very bad for cardiovascular health. Absolutely.

SPEAKER_00 28:10

But that was one of those people.

SPEAKER_01 28:11

But I don't see that much anymore. I think the guys stay leaner. They stay fit most of the time.

SPEAKER_00 28:16

Because when you do that, you get you gain all that body fat and extra water and everything. To get your to get it back down, you have to do so much cardio that you end up wasting muscle. Yes.

SPEAKER_01 28:26

I don't think we had the techniques then, like the in-body in your office that you have to actually look at muscle mass. Yeah. So people thought, well, I'm getting bigger, and but they didn't didn't really have sophisticated ways of looking at what was going on inside.

SPEAKER_02 28:38

Yeah. So, Rick, let me ask you this because you alluded to the fact that you're a very curious person. Um, and I think curiosity is one of the most amazing traits that someone could have. And you've been in a lot of different industries surrounding healthcare. So, my question for you is um, how do you determine, like, how do you find the evidence? Where are you learning from, right? And where does like, you know, published research play a role? But also you as a patient, you working in the fitness industry, you in the supplement business, how do you kind of reconcile all of that information together?

SPEAKER_00 29:13

You you have to pull it from many, many sources, right? A lot of the sources are trying to sell you something, right? So you have to be able to identify that right away. Like if you go and Google um what what does this supplement do? The first hundred things that drop down are gonna be somebody trying to sell you that supplement. Uh a lot of a lot of things, if you want to really dig into like studies, they are hard to read sometimes, is to go to Google Scholar, right? And you'll that's just nothing but studies there. They're not gonna be specific to what you're looking for a lot of times, um, because these studies are very, very specific is what they're looking for. But you can kind of you know extrapolate that that that data and kind of figure out that it would do what you want it to do. Um so it and and I've just met really smart people over the years. Yeah. One of the PhDs I work with out of California is Dr. Rafael Gonzalez. Um he's been in stem cell research for like 27 years, and he's he's one of the best in the industry, and he understands how the body works, how these different mechanisms of actions occur from here to here to here. So honestly, I just bounce things off him a lot. Yeah, he's been a mentor to you in this space. Yeah, yeah, definitely. Um he's helped me to understand on the cellular level with stem cells and exosomes and NK cells and all these things that he really focuses on. By understanding that how it works, it helped me to understand how peptides actually function in the body.

SPEAKER_01 30:30

And that's important. Yeah.

SPEAKER_00 30:31

To know the whys.

SPEAKER_02 30:32

Right. And that there are so many like data-free zones in this space that oftentimes I think what um dictates what we might or uh offer or not offer a patient is like, what did my friend tell me? What's been my own experience? I think that is the clinical and expert experience is almost just as valuable as a study. Because even looking at a study, okay, that's in one population of people, which are like, it's like they're trying, they're you're cherry-picking the easiest patients that you think you can see some sort of benefit in, which is not the real world experience. And I think we have to put more value in what happens in a typical dude walking down the street, what's his experience?

SPEAKER_01 31:07

Yeah, exactly. Part of the problem with research in this area is the fact that most research is funded uh by big pharma. Yeah. I mean, even your NIH money is coming indirectly, many of the times from big pharma. And they're not interested right now in the areas that that Rick's in. Yeah. They don't want to put the money up because they've got other things. The things you see on TV that we were talking about that they're advertising all over the place now, that's where they're making their money. And so for them to do a study on a particular peptide, you know, is is very, very costly. And then you then you have to then they have to come up with, well, how much are we going to be able to sell this peptide for to recoup our investment? And it's it's just not worth their money most of the time.

SPEAKER_04 31:49

Yeah.

SPEAKER_00 31:50

And the problem with that, with studies is if you have a product that's not patentable and you go through spend it to go through a proper FDA-approved clinical trial takes anywhere from three to ten years, three hundred to five hundred million dollars, right? So you have capital investors coming in. If this product is not patented and you get it approved, then everybody else can make it. Right. Right. So you can't make your money back. And that's a lot of times why a lot of these peptides have been pulled out of studies, is because they weren't patentable, right? Um, as the the original ones that got approved by the FDA, they had the ability to patent them. You know, they developed them, they patent them, they were smart about it. A lot of the other ones they just created and didn't patent them. And so now there's no there's nothing.

SPEAKER_01 32:26

And many of them are naturally occurring in the body anyway, and they're being Is that why they're not patentable?

SPEAKER_00 32:32

Well, no, you you just they they create them. Yeah. And like there was there's one main p uh peptide. I'm not gonna say the name of it because I don't want to uh hurt this lady's reputation, but she created it and didn't put a patent on it, and Big Pharma took it and patented it, and we have a very popular drug today. She went back and recreated it through different amino acid chains that were very similar, and that's released now as well. Um so she learned her lesson, right? You have to people with more money than you and more greed than you are gonna take from you if you don't know what you're doing, yeah.

SPEAKER_04 33:05

Basically.

SPEAKER_00 33:05

And that's how this industry has gotten so I for lack of a better word, corrupt.

SPEAKER_02 33:09

Yeah.

SPEAKER_00 33:10

You know, they're not really trying to cure people as much as they are trying to make money.

SPEAKER_02 33:13

Yeah. Larry, let me ask you this question, because so much in from like a healthcare provider standpoint when it comes to peptides is well, there's a lack of research. You are one of the most well-published healthcare providers in the entire world. What are some of the limits? I know. What are some of the limitations of research?

SPEAKER_01 33:30

Money. Money and money.

SPEAKER_02 33:33

Yeah.

SPEAKER_01 33:33

Because, you know, if you don't have the money, you can't hire people. The research infrastructure. Yeah. Uh, you know, and you know, I'm at an academic institution, you have to pay the IRB, you have to go through an AR IRB. Everything is so examined under a microscope that, you know, research is difficult, not just the doing the research. Getting it published.

SPEAKER_02 33:53

Getting it published is very challenging these days. And it's thousands of dollars to get something published.

SPEAKER_03 33:57

Right.

SPEAKER_02 33:58

And, you know, I think, like from my perspective, um, you know, at the end of like every study, a retrospective study, it'll say, we need randomized placebo, you know, controlled trials.

SPEAKER_00 34:08

And the reality is for this conclusion.

SPEAKER_02 34:10

I've been involved in randomized trials before, and they are so challenging to implement. Because when you're in a busy clinic, you know, clinic, you can't do that. You can't be in a room with someone for two to three hours to sit down with them to make sure you're checking all the boxes on the questionnaire. And as much as we want to set up these great protocols, patients are not compliant. They don't show up for their follow-up visits, you don't get all the information you need. They are so challenging.

SPEAKER_01 34:32

It's very, very challenging. And I think that's why uh people don't do it. And if they do it, they're going in a direction clinically that's going to be profitable for your funding organization. You know, people think that the NIH money is given because you've got a great grant or a great study. No, a lot of times it's because pharma is going through the NIH to fund your study so they can get the drug.

SPEAKER_00 34:55

Yeah, exactly. Or the technique. Yeah, there's there's so there's so many things we could get into there that we, you know, shouldn't, I guess, you know, but there's there's so many yeah, there's so there's so many negative things on the back end of that that we see. I mean, we were talking about earlier, like the drugs you see on TV, they're marketed. Uh one I brought up, it was it the list of side effects included this basically will give you cancer and eventually kill you, right? And it was treating bipolarism.

SPEAKER_02 35:21

Yeah, but it was probably two people walking on a beach looking very happy, holding hands.

SPEAKER_00 35:26

You you didn't know what the drug was for until the last two seconds of the commercial. This treats bipolarism, and it shuts off. And you're like, wow, those people look happy for now.

SPEAKER_01 35:34

Yeah, they're not. And that's so interesting that he brings up these ads on television. Think back five years ago, there weren't ads. Now, no matter what channel you turn on, if you're looking at TV, you're gonna get advertisements.

SPEAKER_02 35:47

Have you seen like the flash mob for like, you know, the GLP ones? The one just like a bunch of people dancing.

SPEAKER_01 35:52

Oh, yeah, yeah.

unknown 35:53

Like, really?

SPEAKER_01 35:54

So that's what are they all fat? Not anymore. Until they can dance. No, I've been watching. They actually they had really pretty good commercials for the GLPs. You know, they it's a good jingle. They had a series, yes, it was, and they had a series as they went to a new commercial, you know, they mod they kept changing. Yeah, they were always heavy women.

SPEAKER_04 36:13

Yeah.

SPEAKER_01 36:14

Did you notice they weren't? Where were the heavy guys? They were like, I I guess guys won't pay for it. They weren't advertising to the men.

SPEAKER_02 36:21

Well, you know, women make up to 80% of the healthcare decisions for themselves and their loved ones. So I think a lot of that marketing is probably directed towards women who are material.

SPEAKER_01 36:29

But do you think a woman ever turned turns to her husband and says, Honey, you're fat. Yeah.

SPEAKER_02 36:34

And the husband's like, Cool, thanks.

SPEAKER_00 36:36

I'm still gonna eat pizza.

SPEAKER_02 36:38

It's like PHAT.

SPEAKER_00 36:39

Men don't really want to take care of themselves. Well, it's it's getting it's changing now. The environment's changing. But I remember growing up, like, men didn't go to the body. But you grew up in Louisiana. I did, right?

SPEAKER_01 36:49

I grew up in the country, but um But look what's happening with the growth of gyms. Yeah I mean, all over the place. Yeah, expensive ones, not expensive ones. It's amazing in the number of new gyms that are popping up.

SPEAKER_00 37:01

Yeah. And that's the number one way to make your body better, right? Yeah, yeah. Is exercise. And eating right. Yeah, of course. Yeah, the food is is number one. But without the resistance training, you know, especially as we age, honestly, the more the older you get, the more you need to train with resistance training. You keep that muscle on. I mean, all the studies are showing now that the more muscle you have, is the older you get, the healthier you are. Yeah, we talked about that yesterday.

SPEAKER_01 37:23

And to prevent osteoporosis, if you can. Yeah, definitely.

SPEAKER_02 37:27

So let me ask you this. You had mentioned the word corruption. Are there any other sort of like points within that topic that you kind of want to bring up when it comes to medications?

SPEAKER_00 37:36

Um, no, it just well, one thing that I I've seen is we've talked about the studies and how expensive they are. Well, there's drugs that are approved in Europe. They've gone through their clinical trials, they're approved, they have good safety data. If you bring those into the United States, they still have to go through the full trial. They start from scratch. Um this this is obviously just for money. There's no other reason the studies are done, the safety's proven, the results are proven, and they're probably better studies than we do here, honestly. And then they still have to pay hundreds of millions of dollars to get them through. And they don't know. Right? Is because it gets approved, you get a drug approved so that you can get it billed through insurance. That's the main goal. Insurance company pays for it. It's easy to get your money back because they set these at super high prices. I don't know if you've seen recently there's been a lot of people get arrested for Medicare fraud for skin grafts. You know, they use them for wounds.

SPEAKER_02 38:29

Miami's like the Medicare fraud capital of the world.

SPEAKER_00 38:32

And and and I used to work with companies, we'd we would use those those graphs, and then I would see they they did work, but there was much better ways to treat those wounds. Like we could take something as basic as amniotic fluid, right, and inject around the peripheral edge of that wound, because wounds heal this way. They don't will heal this way. And we could pick a half a milliliter, go around that wound, and within two weeks it was closed. They're billing hundreds of thousands of dollars for a single wound, and it might be closed. And if it's not, they have to wait a certain amount of time and then start over again. They don't let them keep going. If it's closing, closing, closing, you still have to wait a certain period before you can start it again. Medicare is killing themselves. If they would just let them heal the wound, it would be over with. It saves so much money.

SPEAKER_02 39:14

I had someone reach out to me, like asking if I wanted to open up a wound care clinic. Yeah, and I was like, oh, that's gonna be a hard no. That's bottom of my list. Yeah, I was like, absolutely not. But for but they he was really promoting the financial implications, and I was like, that's a hard stuff.

SPEAKER_01 39:28

I mean, I I that's not a big thing here, I don't think. I don't know. I don't is it in Houston? It's huge. It's really I just don't come in contact with that.

SPEAKER_00 39:36

We we could have made millions of dollars using those, those, those, uh selling those things. And after a while of doing it, I realized it just felt dirty. Right. It's like let's let's do something else. I didn't like playing with Medicare dollars. That's I I didn't feel right about it. Um so that's why we moved to everything I do now is all cash pay.

SPEAKER_04 39:55

Yeah.

SPEAKER_00 39:56

If the patient wants to pay cash for it, they can get it.

SPEAKER_04 39:58

Yeah.

SPEAKER_00 39:58

It's not up to the insurance willing to pay for it or not. You know, uh, we're not we're not cheating the system, we're not doing anything. If you want to buy this, here it is. Yeah you know.

SPEAKER_01 40:07

You know, but it's uh speaking of which, you know, it is it is a kind of a thorn on my side that we will start a patient on some, let's say testosterone syppionate. And going along fine, no problems, very affordable. All of a sudden we get my office gets an email or a message on my chart that says, Would you please send my prescriptions to Walgreens? My insurance will pay for it. Well, we then have to go through a prior authorization to get that patient covered. The cost to me is much greater than the cost that patient's gonna save because it's not that much of a savings for him. He still has a copay, yeah. And we can get him this testosterone, it's so inexpensive, relatively speaking. Yeah. And it yet, I mean, every day I get these text messages.

SPEAKER_02 40:52

I just tell patients I don't do prior offs for testosterone injections. Yeah, you know, because it could be$113 for three to six months' supply depending on the dose.

SPEAKER_01 40:59

Yeah, I'm I'm gonna have to start doing that and telling them that.

SPEAKER_00 41:03

Not to change the subject too much, but that brings up a uh we're going back to my my background, the protein intake for muscle and everything. Yeah, I was in college and I was doing health and human performance with my my my bachelor's, and um the teacher was talking about protein intake. And I raised my hand and I was like, that's incorrect. That's not near enough protein. And we got into an argument in the class, so I didn't go back to her class. And then two weeks later You showed her. Well, no, no, here's the thing. She's like bipolation. Some other um students in the class came to me like a week later. They found me somewhere on campus, and they're like, Hey man, you gotta come back to class. She wants to apologize to me. Oh no. I'm sorry. Did you go back? I did. Did you apologize? She did. Publicly in front of the class. Wow. She said, Look, here's the here's the bottom line. This is what's in the textbook. This is what you're going to be tested on. But what he said is true. And my point was everybody that takes those classes are athletes.

SPEAKER_01 41:55

Yeah.

SPEAKER_00 41:56

Like we require more protein than this is telling you that you need. And that was my only point. And um, and we became good friends after that. Yeah, she she would actually ask me questions about different things, you know. But it's just knowing that what's written in the books is not always accurate. You need to dive into it. Especially if it's an old textbook.

SPEAKER_02 42:12

Yeah. You know, well it takes years to even get a textbook published, so by the time it's published, it's like I'll dude it.

SPEAKER_01 42:18

Look how fast things change. Yeah. You know.

SPEAKER_02 42:20

Which is the nice thing about like podcasts is you can update the information in real time. Yeah. Yeah.

SPEAKER_00 42:24

But you had brought up earlier how like just evidence of using certain things over the years has proved to you that that they work. And that's that's really the best evidence. Yeah. You if you if you eat more protein, your muscles recover faster, you get more, more muscle size. Well, you f actually you feel better.

SPEAKER_01 42:39

Yeah. I don't think carbs make you feel good. They do at the moment you eat them, but then it's kind of well, and you see, like you're you have a very busy clinic, right?

SPEAKER_02 42:47

So if you compile like the experience that you've learned from your patients over the decades worth of your career, that's way more patience than any research study.

SPEAKER_01 42:56

Yeah.

SPEAKER_02 42:56

You know, there's so much value in that.

SPEAKER_01 42:59

So it still helps to go back, and we do a lot of retrospective. Yeah. Because we've got such a huge database. Right.

SPEAKER_02 43:04

And we need the research, right? So we need, it's like the art of medicine is combining what does the research tell us? What are the guidelines tell us? What do our colleagues tell us? What do our patients tell us? And what does our personal experience tell us? And then when we combine all of those factors and not just look at one research study, that's what makes us incredible providers and educators. Yeah.

SPEAKER_00 43:21

Yeah. Yeah. You have to be able to prove all these things, right? And so the studies are important, even if it's retrospective, like you go back and look, okay, we did this, here's the outcome. You can prove that outcome, and now you can talk about it plainly in front of people. Yeah. Otherwise, you're just giving them, hey, I think this is gonna do this. Yeah. Right. And that's usually effective, but not always. Yeah. Depends on what's going on with the body.

SPEAKER_02 43:41

Um, okay, so let's dive into peptides because you had mentioned that you painted this picture of this commercial.

SPEAKER_01 43:45

Wait, can we go back just one step backwards and say so how did the thing start? How did you get into pharmaceutical, actually running a pharmacy, owning a pharmacy? How did that evolve?

SPEAKER_00 43:57

So I I actually had a booth set up at a bodybuilding show. For my stem cell company. And a gentleman came up to me and he started talking to me and he told me, you know, I'd gotten stem cells by this doctor in Houston area. And I don't want to use the word stem cells, regenerative medicine basically. And I told him, well, I supplied that for that doctor. So we got to talking and he told me he had a pharmacy and it was very small. And so he asked me to come in and kind of see if we wanted to partner up and build a bigger one. And so I started doing my research on that, brought another partner of mine that that owned a retail pharmacy. So I knew he was familiar with the environment. And we just decided let's let's go into this. And when we started it, we weren't I know the GLP one craze is obviously huge. Well that wasn't our intention going into this. Like we named the the pharmacy optimal balance because my goal was to be able to optimize and balance your hormones. That was my thought process. Like that's what we wanted to focus on. Of course, by the time we were halfway through construction, we saw that the GLP1 craze was crazy. So I started then I started really diving off into learning about peptides because semaglutide, tryzeptide, there are peptides. Right. You know, and that's what got me into that and just started branching off into everything else.

SPEAKER_01 45:08

Yeah, it's interesting that the entree into peptides was the drug that everyone else taking. Right?

SPEAKER_00 45:13

Yeah. And pep, I mean, peptides have been around for years and years. I mean, semaglutide's been an approved drug for over 10 years. But it wasn't popular until people realized they could lose weight on it. Yeah, you know.

SPEAKER_02 45:23

On the Kardashian thing.

SPEAKER_01 45:25

Oh, I didn't know what's what's the Kardashian? I didn't know anything about this.

SPEAKER_02 45:28

Well, uh, Kim Kardashian had some, you know, like stuff on or online or whatever in the public saying, you know, talking about Ozempic. And then uh people heard about it. Interesting.

SPEAKER_01 45:37

I did not know that.

SPEAKER_00 45:37

Yeah, I didn't either actually.

unknown 45:39

Yeah.

SPEAKER_00 45:39

I don't pay attention to that. Maybe you should be a spokesperson for the pharmacy. Maybe so. Yeah.

SPEAKER_02 45:44

So you had mentioned you were painting this picture of this commercial on this drug to treat, you know, bipolar disorder. And, you know, you said like the basically listing all the side effects was basically the took up the entire time of the commercial. Yeah. Right. So there are medications that we have that are FDA approved for patients that have a long list of side effects where they could really hurt someone. A lot of people get concerned about peptides because they're concerned about safety. That's my biggest concern is safety. What do people need to know about the safety of peptides?

SPEAKER_00 46:13

Well, peptides are they're very basic amino acid chains. Like we discussed earlier, everything in your body functions off of protein signaling. Your cells receive protein signaling. They create what we call an endosome inside the cell that creates all the mRNA, microRNA, messenger RNA, and it expresses it out into the environment that goes to another cell, communicates. That is how the cells work. So when that's happening, it's sending out peptides. Peptides as well, not just an exosome, so to speak. There's other extracellular matrix that has these peptides in it. Um that we find a lot in just natural production of cells is LL37, which is antimicrobial, right? It kills viruses, bacteria, and fungus. So everything in your body functions off of peptide signaling at the very basic point of it. Um and so as we age, we have less of these signals. We as we age, we have less stem cells in our body. This is why we see as we age, we get collagen reduction in our face, we get wrinkles. It's because we have less cells that are able to produce those, those, those um hormones and functions. And so all we're doing with peptides is we're now basically not, I don't want to use the word anti-aging or reversing age, but you're basically giving your body the signal that it used to get when it was younger. Like a big one, it's not a peptide, but people kind of categorize it that way as NAD. As we age, we have less NAD, less energy, less focus, less brain cognition. You supplement someone that's older with NAD, immediately they have better energy, better focus. It's because they're lacking those nutrients, they're lacking those signal pathways. So we're not giving them a drug that has all these other mechanisms and actions. They have a very specific thing that they can do, and that's all they can do. They're not going to signal all this other stuff. You know, it's very, very basic signaling in the body. And that's why it's safe. It's all it's doing is doing a natural what your body naturally does every day. We're just turning it on, maybe amplifying it a little bit.

SPEAKER_01 48:09

Are all are all peptides naturally occurring or are some synthesized de novo?

SPEAKER_00 48:15

There's a lot of that are synthesized.

SPEAKER_01 48:17

Like which I mean, because I I looked up some of them and it was amazing. Like, you know, some come from the placenta. They're extracted and purified from the placenta. Uh, others are from the uh the gastric secretion, BPC, which which is very widely used right now as an anti-inflammatory, and it the people love I mean, my patients love it. Yeah, and I think its origin is a gastric secretion. It is. So I just wondered how what percentage are naturally occurring.

SPEAKER_00 48:44

I think the original um layout of these amino acids into these peptides is all naturally occurring. Um they know because what they need to do is they need to figure out what a range of peptides do I need or amino acids do I need to have to commutate this signal.

SPEAKER_01 48:58

Right.

SPEAKER_00 48:59

So they've found that signal within the body somewhere. Like insulin's a peptide, right? These are all all these things are peptides that people don't really realize they are.

SPEAKER_01 49:06

Yeah, so a pet a protein uh peptide is actually a protein hormone as opposed to the testosterone derivatives, which are steroid hormones. Right. And the peptide hormones, if I'm if I'm correct, stimulate receptors on the cell wall, whereas the uh steroid hormones are fat-soluble but go into the cell and actually work more in the nucleus. And that's a big difference between these.

SPEAKER_00 49:30

Well, you do have some peptides like um MOT C SS31 that affect the mitochondria of the cell. Right. You know, they make the cell produce more ATP, which gives you more energy and ability to function through physical activity.

SPEAKER_01 49:42

What I like about their pharmacy, optimum balance, is my new order sheet, they've actually named some of the peptides as to what it does, which makes it, you know, makes it much easier to explain to patients. Yeah. And also make it reminds the doctor, oh, I need something for this function. Well, look, this is what the recovery blend. Yeah. They have a recovery blend which has BPC and several other things, but it's all in one check box for me. So I don't have to like go and pick it up throughout the whole menu of things they produce. Yeah.

SPEAKER_02 50:12

So Larry.

SPEAKER_01 50:13

Which I like.

SPEAKER_02 50:14

Larry, let me ask you, in your clinical experience, because you how long have you been prescribing these peptides for?

SPEAKER_01 50:19

I don't know, three to five years, maybe. So and you so you would you say that you have to let me go back to, you know, yeah, I guess three to five years.

SPEAKER_02 50:25

Okay. So do you think you have, would you say you have hundreds of patients on these peptides? Have you seen a side effect from these peptides that concerns you?

SPEAKER_01 50:31

The only side effect I've ever seen is uh something at the injection site from an allergy. Yeah. I have never had a systemic problem. I don't are there what are the systemic problems that are.

SPEAKER_02 50:43

Like what's the worst that could happen? Yeah. What's the worst case in the world?

SPEAKER_00 50:49

Sight injection reaction. Um, but there's one specific one we see with some of the growth hormone-inducing peptides where a patient will be taking it with no issues, and then all of a sudden they'll inject themselves one sub Q area, it gets really swollen, and then all the other spots they've ever injected themselves react. So we know it's an immune response. It's not necessarily an allergy in the same yeah, there's maybe some histamine reactions there, but it's not, it's because the immune system is just freaking out. So it's not going to cause anaphylaxis. Absolutely not.

SPEAKER_01 51:17

But uh are there any peptides with specific blood pressure issues or you know. I know that the uh um one of the causes of water, the uh abutamorin, which is not a peptide. Right. But it's on, you know, it's in it's in the category, right? So you have to be careful when you talk about these products and use the umbrella peptides, they're not all peptides. Right.

SPEAKER_00 51:41

They're small molecules, but they're not all peptides. And the reason that one gives you so much water gain is because it affects your hormones, it affects your growth hormone.

SPEAKER_04 51:48

Yeah.

SPEAKER_00 51:48

That one I I did a lot of research on. They use that one a lot with with children with growth hormone deficiencies and had some of the best growth hormone data that I saw out of any of the products. And it's an oral version, but it it also affects your ghrhrolin, which makes you very hungry. Yeah.

SPEAKER_01 52:02

So that's why I use it. I use it a lot of time for people who are trying to get bigger.

SPEAKER_02 52:06

Yeah.

SPEAKER_01 52:06

Um, because it it makes the meat.

SPEAKER_02 52:08

Yeah, which is interesting because I think so many people are focused on you know, people who are carrying excess weight and trying to lose weight. Yeah. But for people that want to gain weight, it's a full-time job.

SPEAKER_01 52:16

It's hard. Yeah. Yeah. It's hard all because you get satiated.

SPEAKER_02 52:19

Yeah.

SPEAKER_01 52:19

And you still need more calories because you're trying to grow. Yeah. And that's why I like the Ibutamorin. Yeah. I use a lot of that, I think.

SPEAKER_00 52:26

I wish it was around when I was competing in bodybuilder, honestly. But even when you're dieting uh for a show, you have limited calories, but you have to eat so much protein, it's just hard. You finish eating a meal and like it feels like you're about to start eating another one. Right. These kinds of supplements. Yeah. Yeah. Yeah, basically.

SPEAKER_02 52:41

But even for people who are just trying to gain some muscle mass who aren't, you know, an elite athlete, it's you know, the typical recommendation would be a gram of protein per ideal pound of body weight. So that means I need over a hundred grams of protein in a day. I mean, that's even hard to get that amount of protein.

SPEAKER_00 52:56

I suggest to people that if you're trying to gain muscle, like obviously eat as much protein as you can, but supplement with protein shakes. Yeah. You know, fit them in where you can in between your meals. Most people have regular jobs these days, right? So you you can't just go eat whenever you want to. But you have a protein shake, you can get it in. And that's the biggest thing with like the GLP ones, is you see so many of these ladies and men, they lose so much muscle. Well, people always think, well, these GLP ones are making my body lose muscle. There's actually things in there that protect your body from losing muscle, right? And we're not talking about the new one that's not approved yet. We're talking about semaglutide and entrazepatide. But the problem is when you reduce your calories that much, and also if the like semi glutide specifically makes you more nauseous, enterzepatide. When you're nauseous, you don't feel good. What do you think about eating? It's not a chicken breast or rice, it's something terrible, right? That's that's tastes good that you can that you can put down. And so people are eating bad foods. And so I just tell everybody look, if you're gonna do these, you need to get your protein up. Yeah, that's bottom line. I don't care what else you do, you have to eat enough protein.

SPEAKER_01 53:57

Well, Amy has you've shown that in your practice that you can help people not lose weight.

SPEAKER_02 54:01

When we optimize their hormones, they stimulate their muscle, and they eat enough protein, then they can have more muscle at, you know, when they're at their goal than when they started. But you have to have three of the three. You can't have two of the three. And the first thing that they eat off their plate has to be their protein. You can't start with the bread. You eat the protein first. If you're still hungry, then you can go to the vegetables and then you go, you know, to like the starchy item. So going back to your point about the side effects, that was a profound comment that you said.

SPEAKER_01 54:24

What was my comment?

SPEAKER_02 54:25

Is you've treated hundreds of patients with peptides, and the only thing that you've seen is an injection site reaction. Think about the medications that we use that are FDA approved. Would you say that side effects or more severe side effects with some of those medications are more concerning than with peptides? Yes. I think that's profound. And that goes on to what you were saying about these commercials, right? And so that safety thing is very important. Now, I've had some patients that they've been on BPC and other peptides and they say, Oh, my it's amazing. And other patients that say it did nothing for me. Okay, so efficacy, it's gonna work in some people, it's not gonna work in others.

SPEAKER_01 54:55

All the FDA approved. Exactly.

SPEAKER_02 54:57

But if it's safe, that is huge. But I want to dive deep into that a little bit more because from a healthcare provider's perspective, I'm interested in offering these peptides to my patients for the reasons that we've discussed. But how do I know if they're being sourced correctly? How do I know that they're not gonna be contaminated? Right.

SPEAKER_01 55:13

I want to talk about that, but I also want to talk about the whole legal aspect of us writing.

SPEAKER_02 55:17

Yeah, yeah, yeah.

SPEAKER_00 55:18

So go into contamination and stuff where so um when we opened this up, we were kind of naive to what it was, right? Like where to source them from. And we you reply you kind of look at these vendors that sell it here and and figure it out. Well, real quick, I thought, let me just look at a Google map search of their manufacturing facilities for one of the largest peptide offerings in the in the country. Um and so I looked it up, and all of their locations they had listed as their manufacturing facilities were not manufacturing facilities. So I called them and I said, What is this?

SPEAKER_02 55:48

Like what were they?

SPEAKER_00 55:49

They would just have like abandoned structures. Now it's Google Maps, they could have been older, images, whatever. But I I told him I was like, I'm not going to use your product until you can prove to me that these are actual facilities. And and they didn't. And so I didn't use them anymore, right? We they were not only pass-throughs, or were they were they non-existent companies? I I'm not sure what they were doing. I think they may have just had them listed wrong, right? Like old addresses. I don't know how long that company's been in business. Yeah, you know.

SPEAKER_02 56:15

But where do you think they were manufacturing their product? You don't know. That's what they're doing.

SPEAKER_00 56:18

Well, they're all people always this is the funniest part about it, is people go, I don't want anything from China.

SPEAKER_02 56:21

Yeah.

SPEAKER_00 56:22

Well, it's all from China. Right? China, India, and Europe. That's where they're all done. If you get peptides right now in the current market that are st that are manufactured in the United States, they're not the same quality. Honestly. They're they're considered research great.

SPEAKER_01 56:35

But I think you have to emphasize the fact that all the drugs we get, not all, huge number of drugs that we get are coming. The same places.

SPEAKER_00 56:42

It's not unique to peptides. It's because they can make them cheaper, right? Yeah. They have the manufacturing facilities, they have the cheap labor, that's why they make them there.

SPEAKER_01 56:50

So tell me something that that's important, and that is I've been told that the F that the places we get our raw materials from in the United States have to come from FDA approved source of facilities in China and India. These are not, is that correct? That is correct. These are not like random companies. These are companies that the FDA says they are approved. And if that's the case, what is inspect them for that?

SPEAKER_00 57:16

Yeah. They go to make sure they inspect them to make sure that their safety techniques, their, you know, all their SOPs are correct for the safety of the product and to make sure they're actually producing what they say they're producing. Um and so what we use for us currently, I can't speak to any other pharmacy, the vendors we work with, they're they have a team that actually goes into these facilities, goes into China, they go look at all these facilities, they inspect them personally, and they are FDA-approof facilities. There's a new term called the the green the green list, right? Um if you're gonna if you're gonna import trisepatite or semi-glutide, it has to be from one of those facilities or it can't get into the country anymore. Um I'm sure as things get by, right? Um there was a time probably two years ago where you couldn't get semaglutide. It was on back order, period, everywhere in the world. And people started using semaglutide salts. And I had providers call me and they're like, hey, why can't you make this? Other punk companies are doing it. And I said, I refuse to do it because it's not the same product, it's not FDA approved, like it's I just won't do it. Yeah. Well, they're doing it, I'm gonna go to them. I said, You will get in trouble for writing these prescriptions. And two weeks later, almost every single one of them call me back and they're like, You're right. You know, they didn't get in trouble, but they they realized they did their own research and realized that I wasn't trying to I wasn't trying to deter them from buying something from somewhere, I was trying to protect them.

SPEAKER_04 58:31

Uh-huh.

SPEAKER_00 58:32

So I don't care about anything else but protecting people. I'm gonna if you do the right thing, you're gonna make the money that you need to make. Uh-huh. Right. It's not about making the money, it's about protecting people, providing this for the patients, and all that other stuff will come.

SPEAKER_01 58:44

Yeah. It's hard for me to wrap my expression, wrap my head around. This FDA approved facilities in China and India. I mean, how in the world did that get started? I mean, what branch of the FDA doesn't we hear? Yeah. Do you ever hear anything about that?

SPEAKER_02 58:58

No, when we get RFK on our podcast, then we'll have to ask him.

SPEAKER_01 59:01

Yeah, he's coming. Not.

SPEAKER_02 59:04

Okay, so you do your due diligence when it comes to these manufacturing facilities.

SPEAKER_00 59:10

Yeah, and then we get and then we get the COAs from them to it shows if there's any contaminants in there, the purity of the product. Um all of these things have to be in place.

SPEAKER_04 59:20

Yeah.

SPEAKER_00 59:20

Uh we we actually hired a in-house compliance officer who was an ex-state board inspector. So she looks at everything. She knows what what is required by a pharmacy in Texas.

SPEAKER_04 59:31

Yeah.

SPEAKER_00 59:32

Uh in other states as well, but she was a Texas board uh certified inspector. So we we basically we did this early on. You know, we we've only been in existence for a little over two years, but I made sure that everything we did was compliant and safe. And so we paid the extra money for her to be in-house. Most people don't do that. Um, everything that we do, we we hire people that are smarter than us in in certain fields that protect us and protect our patients. Um, I know there's people out there, there's other pharmacies, compounding pharmacies that are producing products that they shouldn't be doing, right? Uh, and it it's not that they're not safe or anything like that. It's just they're they're still in clinical trials. And when a product's in clinical trials, you shouldn't touch it.

SPEAKER_02 1:00:11

Yeah, Redatru Tide, right?

SPEAKER_00 1:00:12

Yeah.

SPEAKER_02 1:00:13

We have we both have so many patients that are on that medication. Yeah.

SPEAKER_00 1:00:17

From the reason from the reason I would tell people not to take that is because they're actually the reason it's not out yet is because they've experiencing cardiovascular events.

SPEAKER_02 1:00:26

Yeah, you would mention that. Yeah. Yeah.

SPEAKER_00 1:00:28

Yeah. So it was supposed to be released last year.

SPEAKER_02 1:00:29

Yeah.

SPEAKER_00 1:00:29

And now it's pushed to either late 2026 or early 27 because they're having cardiovascular issues. And I talked to people that have taken it. Uh, I was just A4M in Vegas with the hugest longevity conference in the world. So I talked to a lot of providers and they're like, yeah, I take it. My heart was racing a lot. And I'm like, well, that's not good. Like, you shouldn't be a 120-pound female with a racing heart rate just because you want to lose some weight. It's ridiculous. You need to understand what it's going to do to you long term before you put it in your body. And we don't know that yet.

SPEAKER_01 1:00:57

Wouldn't it be interesting to know how much reditrutide is being sold in the United States as we speak? Yeah. Because I mean, your sister was talking about a patient in flying.

SPEAKER_02 1:01:06

Who's doing great? But she's like, I want to be on the triple agonist. And she's like, what does that mean to you?

SPEAKER_00 1:01:12

There's a ton of people taking it, right? And it allows me to be a good thing.

SPEAKER_01 1:01:14

But we just know we're in just here. What is going on? Is this throughout the United States in terms of the phenomena? But what other drug can you remember that people were taking across the United States that hasn't even been released by the FBI? No. You can't think of anything.

SPEAKER_00 1:01:31

No, not a single thing. And then I guess the uh technology advancements make everything more available, right? Look, it it's it's the social media.

SPEAKER_01 1:01:40

Yeah, yeah. Because that's how people find out about all of this. You know, they're advertising. These companies are advertising. You can get the Red or True Tide, and they're buying it online.

SPEAKER_00 1:01:51

If it's real, how do they even know it's real? They don't. They don't. They don't, no. Um that's my biggest issue is with this environment now is social media, YouTube. There's so many people that go out there that are doctors or PhDs, um, a lot of chiropractors, that they start promoting a certain product for a certain thing, and they'll say all these just crazy stuff. If you do any bit of research, you can just prove everything they're saying. But people are doing it. Yes. And they're and but those people are not only doing it, they're telling their friends about it, right? And so these there's there's a lot of people out there that have become really, really famous online. What's the guy that made the uh Bullet Crew Coffee, Dave Asprey? If you talk to that guy now and see what he's talking about, it is insane. Like, and people are still following him. It's crazy. There's no evidence of what they're talking about.

SPEAKER_01 1:02:38

But then you look at the you look at this stuff being sold online, right? Yeah, and then you have hymns.

SPEAKER_03 1:02:43

Yeah.

SPEAKER_01 1:02:44

And nobody says anything bad about hymns. It's the same thing. They're selling it online without a real doctor. Well, they say, but I mean, you know, not a face-to-face doctor.

SPEAKER_02 1:02:53

So let me ask you this what's the difference? Because I have so many patients that tell me, okay, I want this peptide. I heard that I could get it from this pharmacy. Can you send the script to this pharmacy? Right. And it's like an online storefront. So what's the difference between like a pharmacy like yours, which is a compounding pharmacy, and some of these just companies that have websites online that are just selling these medications like candy?

SPEAKER_00 1:03:14

Well, they're not pharmacies.

SPEAKER_02 1:03:16

Yeah.

SPEAKER_00 1:03:16

Right. We don't even know if they're labs.

SPEAKER_02 1:03:18

Yeah.

SPEAKER_00 1:03:18

Right. We don't know anything about them. A lot of times though you'll see online, they'll put up we tested this product at this lab and they flash it up on the screen. Well, I froze it the other day, pulled the lab up. It doesn't exist. Oh god. Right? So they're testing. You can I can make a piece of paper and show you the testing is amazing. Yeah. Right. But I you need to have the testing done from like a third-party, legitimate testing lab. Right.

SPEAKER_01 1:03:41

So to give you an example of what they do, I I wanted to get I I read some uh reviews and some uh research on KIS peptin, uh-huh, which is used for libido, which we you and I have discussed. It's a big problem. We don't have a good treatment for men who have issues with an ejaculation, orgasm, things related to sexual arousal. Uh and the KIS peptin stuff looked good. And they had they had it. And I called and I said, Listen, I want to order some KISPP. Well, we're all out. I said, Can you get some more? They said, Yeah, we can get it. It's gonna so they get the KIS peptin raw material, and I spoke to I know I think I spoke to you, and you said it's still in testing. So they have to quarantine their stuff until a third party tests it before they can even make it.

SPEAKER_02 1:04:21

Yeah.

SPEAKER_01 1:04:21

I mean, and I think that due diligence is appreciated.

SPEAKER_02 1:04:24

That's huge. Third party testing is huge.

SPEAKER_00 1:04:25

So the testing that we do for our products is what they call a methaseability test first. That is to find the method in which to test it to prove that it's sterile. Because every drug is different. Some we can do a scan RDI, which just goes through a machine, 24 hours later it tells you it's sterile. Um, then sometimes you have to do a direct inoculation. You you actually put the pathogens in there and let it culture for seven days. Um, there's a filtration, there's a there's a medium test in there. There's all these different tests that you can use. So to identify which is the proper test to be able to test for sterility. That's that's the biggest thing because I could I asked them, I went to the lab and I asked them, we had this product that wouldn't pass because of these two pathogens. And I said, Explain it to me. And they said, we can't get these two pathogens to grow in your product. And I said, So it's sterile. And they laughed and they're like, Yeah, technically it is, but we can't put our name on it that it is sterile because it doesn't follow this pathway, whatever their protocols are, right? Um, which is frustrating. But at the same time, I I I appreciate it because I know that when I get my products out, they're gonna be sterile. But how about testing for purity? How is that done? Because I know you do that. Yeah, we we do we test for the the potency essentially. Purity is so if a product comes to us, it needs to be, you know, with between ninety five and ninety-nine percent potency. Nothing rarely is a hundred percent potency. Um, and then we make it, it needs to have that same number when it comes out. And so, you know, the regulations are it has to be to between a hundred ninety and a hundred and ten percent. That's our range.

SPEAKER_02 1:05:57

We have to get a hundred and ten percent.

SPEAKER_00 1:05:59

You put too much.

SPEAKER_02 1:06:00

Oh, okay.

SPEAKER_00 1:06:01

Yeah. Um so which is not really a big deal unless you're talking about something that you could overdose on, you know. Right. Like even vitamin D.

SPEAKER_04 1:06:09

Yeah.

SPEAKER_00 1:06:09

Right. We had a batch came back at 115%. And we we trashed it because I can't if I tell all the doctors out there this is 1415% potency, I can't change the label because that's not what it is, right? Um so I have to just I just get rid of it. It's not worth giving it to somebody that patients will always take more than they should. Not always, but there's a lot of people that will, yeah, right. If they can.

SPEAKER_02 1:06:34

Yeah, and vitamin D can be a problem.

SPEAKER_00 1:06:35

And if it's too high already, then what it is, they think they're taking more, but they're taking way more. It can hurt somebody, right? And so we have to make sure we fall in that in that range. Um and I'd like to keep it at at as as 100 as best we can, right? Um sometimes it comes back low, and we have to figure out why. And sometimes it's because that peptide is light sensitive. Like methylcobalamin, which is not a peptide, it's B12, right? It's extremely light sensitive. When I get it into the pharmacy, we wrap it in tenfoil to block it from the light. When they go to make it, and the and the thing we actually kill the lights, we take it out, they mix it, blend it, do all that, and then when they're filtering it out, we have it in a in a um what do you call it, a beaker that has tenfold over it with just enough of a hole to get a hose through there to pump it out. If you don't do that, your potency will be less. It's very, very sensitive. And so the you have to know all these things. You if you're not doing all the potency testing, you're not doing all the sterility, endotoxin testing, you really don't know what you're getting. And so we we all we have that that data and we provide it to our providers if they request it so they can see that we've actually gone through this and make sure it's there.

SPEAKER_02 1:07:42

Yeah. I love that. I love hearing all of the technicalities behind this. So I'm gonna ask you both a question here. I want to know what are the most popular peptides. I was just gonna keep it.

SPEAKER_01 1:07:51

Ah, I was gonna answer.

SPEAKER_02 1:07:52

And then I want to know what your prescription is.

SPEAKER_01 1:07:54

I don't know what my my list, but I was gonna ask you for the 10 most popular what's what is the most frequent prescription you're feeling right now? BPC, right?

SPEAKER_00 1:08:03

Of the peptides, yeah. Yeah, the BPC 157 is the most by far. But it's not just the BPC by itself. Like you mentioned earlier, the recovery blend. It has BPC 157, TB500, KPB, and GHKCU. They were all, in their own right, regenerative, we can say, right? Recovery type. Some are anti-inflammatory, some are immune modulating. You have all these different things, some are collagen-producing. And so you blend them all together and they're synergistic and they work really well.

SPEAKER_01 1:08:31

Now, is that the one that people call glow?

SPEAKER_00 1:08:33

Have you heard that? There's the glow. But what is glow? There's the glow and there's the glow, which is K L O W. Um is this the glow? It's it's similar, right? Um Do you make something called? You don't have a product called Glow. No. But what is it? That's just a kitschy name for it, right? For the same thing? Basically. Yeah. But what I see a lot of times, the ones that are marketing it that way are the research companies, right?

SPEAKER_04 1:08:56

Yeah.

SPEAKER_00 1:08:57

And the clow or the glow, I can't remember which one it is, the the copper peptide in there, the GHKCU, is 50 milligrams per milliliter. If you were to inject that daily, like you like we recommend, you would get copper toxicity.

SPEAKER_04 1:09:09

Yeah.

SPEAKER_00 1:09:09

Um, ours is not near that high, it's one-fifth that dose. And also, when you see if you get a copper peptide product and it's not blue, it's fake. Copper peptide is always blue. And I see these research companies, people bring them to me, what do you think about this? I'm like, it's clear, it's fake. You know, you're not getting what you think you are.

SPEAKER_04 1:09:25

Yeah.

SPEAKER_00 1:09:26

And um, and we use those kind of stuff in topical applications as well to produce collagen in the face. So this is a good thing. What is your topical? I don't know.

SPEAKER_01 1:09:32

I didn't know you had that. What's a topical collagen?

SPEAKER_00 1:09:35

Uh so the G HKCU actually works really well. I thought it was injectable, but you have it. It is injectable, right? But it it it produces it helps to produce collagen. So if you put it on the face. But you have a topical? We do. We just came out with the topic.

SPEAKER_01 1:09:45

Let me add that to the list. Let me tell you one of the problems with the company.

SPEAKER_03 1:09:48

Okay.

SPEAKER_01 1:09:48

Is that they don't have sales reps.

SPEAKER_03 1:09:50

Uh.

SPEAKER_00 1:09:51

We have a ton of sales reps.

SPEAKER_01 1:09:52

I don't have a sales rep. Who's my sales rep? It was uh Kyle. He's still your sales rep, technically. He I've seen him three times this year. Yeah. But that's how companies grow. Yeah, yeah. They grow by having sales reps, especially, you know. And I think that the philosophy is, well, you know, this guy writes so much. We don't have to send our sales rep there. But the problem is, as you get new products, if we don't know about them, we're not going to write for them. So I had to, we had to organize this podcast, webcast, for me to find out that you've got topical GHK.

SPEAKER_00 1:10:24

Well, we haven't released it.

SPEAKER_01 1:10:25

Oh, now he's backpedaled.

SPEAKER_00 1:10:26

No, no, no. We haven't released it yet. Like it it's um it's been formulated. We have our we have our wonderful girls in the back that do all of our non-sterile protocols. And they've just been doing making stuff, researching, making stuff, and um and I found an additional peptide to add to the cream that she'd already developed, which is Snap 8, is another peptide. It relaxes the muscles in the face, so it works similar to the droop? No, it works sort of Botox, right? And so, but it's not a neurotoxin, so you don't have that like long-term issues, but it also is collagen-producing.

SPEAKER_01 1:10:53

I just want to tell you that Amy tries a lot of the stuff that we do we talk about here.

SPEAKER_02 1:10:58

Of course. You can try it out. That'd be amazing. Thank you. I appreciate you in advance. Um, I do. Because if I'm not gonna try it, why would I expect my patients to?

SPEAKER_00 1:11:06

Yeah, I'm the same way.

SPEAKER_02 1:11:07

It's not like I'm like I'm gonna try a cancer drug just for shits and giggles, you know. But if there's a therapy that like I think could provide patients' benefit that I can get and try, that's just one other thing I can add to the conversation I have with my patients.

SPEAKER_01 1:11:18

Yeah, it's very admirable because you can tell you. Thank you.

SPEAKER_02 1:11:20

I'm taking one for the team.

SPEAKER_01 1:11:21

She is, and she can tell people this, you know, it really works.

SPEAKER_02 1:11:24

And I think some people think that's unprofessional. My patients love when I give them the personal experience. I like it. Yeah, I like it. I like it.

SPEAKER_00 1:11:30

You you almost have to, really, like to be able to explain to people what they're gonna feel, yeah, what the results they're gonna get. And I've I've I've tried everything that we make. And people always ask me what peptides are you on? Yeah. Well, I'm only at one at a time. Yeah. Because I'm seeing what it does. I have to give it time to do that. Um, there's been peptides that we've carried that I removed from our list because it didn't do anything to me.

SPEAKER_04 1:11:49

Yeah.

SPEAKER_01 1:11:49

Um, but that's I mean, is that a fair test in that not everybody is gonna respond the same to these peptides or even hormones?

SPEAKER_00 1:11:58

Yeah, no, you're exactly right. Everybody's biology is different. Right. You know, you can give somebody something, they're gonna see remarkable results, and like you mentioned earlier, some people get known. Yeah, right. But that's all about where their body is in their hormone levels, their health, cellular health. If everyone is in the same boat there as far as like being healthy, they're gonna see the same results. Yeah. Unfortunately, nobody is. Yeah. Right. Um, and and their rise genetics are different as well. Your ability to root to receptor sites and different things. You see, pro bodybuilders, how big they are. People think they're taking just stupid amounts of drugs, which they are taking a lot. But those guys have better receptor sites. They absorb better.

SPEAKER_01 1:12:36

They're careful about their diet. So careful. And they are so into working out. I mean, some of them don't do anything else but train. That's right. That's all they do. They train and then you know they sleep. So I know if if I don't know how many people would not respond that way, given all these uh criteria of eating and sleeping and lifting weights. I mean, unfortunately, most of us have to earn a living. Yeah. Right? Exactly.

SPEAKER_02 1:12:59

You mentioned another interesting concept, which is a peptide stack. And I think that's why maybe some people don't notice benefit, because maybe BPC 157 by itself is insufficient. And what I think what maybe you've told me your Alex Tatum is like they like the combination of TB500 with BPC 157.

SPEAKER_01 1:13:16

So sometimes that's the only way you can get it from them right now. It's pre-mixed.

SPEAKER_02 1:13:19

So sometimes just when you're doing like one agent at a time, sometimes it's good to know whether or not that one agent is helpful, but sometimes that one agent is not going to actually get you the results.

SPEAKER_00 1:13:27

Right. Yeah. Exactly. It it'll it'll it'll address one part of the problem, but there's other problems on this.

SPEAKER_01 1:13:33

That's where reps are so important. Yeah. Because they come with the knowledge that you don't have.

SPEAKER_02 1:13:38

Because it would take 10 years of clinical experience to get this information versus I want someone like you, like you, to say, hey, I've done this for the last year. This is what I've found. Okay, great.

SPEAKER_01 1:13:47

Now, if they had a great newsletter that went out to all the people who prescribe, you know, new drug, drug of the month, you know, new new insights, then everybody would be on the same page. And that would be much more cost effective than sending reps to everybody. I agree. But you've got to get the information out to the doctors, or the doctors can't write the prescriptions.

SPEAKER_00 1:14:07

Right. And we are coming up with a newsletter soon. It when we opened, our job was to make sure everything was done correctly and all that, and we grew at a rate that we couldn't imagine, right? And so we're constantly playing catch up, and we we do a good job of it. But as far as like you talk about the marketing to the physicians and all that, we're depending on the reps to go out there, but they don't have the same mindset that we do all the time, right? But some of them do. So we have some reps that we work with now that are that just created a newsletter and sent it to me. They're like, Do you approve this? I'm gonna send it to my doctors. And I was like, Yeah, this is amazing. It's not something I thought about, but that's not my mindset. My mindset is to make sure this is good and not put out marketing material, right? And it but it's important to be able to educate people. Um, because if you meet with a rep, honestly, like how much time do you have to spend with them? Not very much. Right, give me something.

SPEAKER_01 1:14:53

I like when they give me something, you know, like not a not a cookie, but material to read, right? But something to read. Yeah, yeah, yeah. Yeah. Because it's telling us that you are taking the time to educate the doctors who you work with. I really like that.

SPEAKER_02 1:15:08

Yeah. So what else is a popular peptide?

SPEAKER_01 1:15:11

Well, you write this down.

SPEAKER_00 1:15:12

You're writing.

SPEAKER_02 1:15:13

I'm taking a mental note.

SPEAKER_00 1:15:14

So we do one we call it the fat burner blend. So yeah, I think part of the the popularity is that you'd like the name, honestly. But it identifies what it does, right? And so it's it's AOD, 9062, 9624, um, MOTC, testmoralin, epimerelin. And so it's it's three different growth hormone-inducing peptides at moderate doses that work synergistically, but they also those specifically help with reduction of body fat in the abdominoid. One's visceral and one's subcube, right? And so you'll see a change there. The AOD, you need to be on it for quite some time to get the best results from it, where the testmerelin works pretty quickly. Um, and none of these are instant, right? These are peptides, they're signals telling your body what to do. You have to give them generally several months to see long-term good outcomes from them.

SPEAKER_01 1:15:58

And I've seen that with GLPs. I've seen that the people don't really realize the benefit until three months. And then they'll tell us, I'm starting to lose weight.

SPEAKER_02 1:16:05

And it's not even necessarily the number on the scale, but now there's like, you know, cardiovascular, you know, things and with sleep apnea, and so many other mechanisms that we haven't identified that even if the number on the scale is stable, there are probably like, you know, 50 other mechanisms by which we're not tracking.

SPEAKER_00 1:16:19

Aaron Powell And the the problem with that data is it's like they've got it approved now for cardiovascular issues, right? It's not that it's making all that happen necessarily, it can be. But the if you eat less food, you're taking less calories, your body functions better, you're you're going to give all that symptom relief. Inflammation in the body, if you're eating shitty foods all the time, you're gonna have inflammation in your body. You're not your body proper growth uh factors in the body cannot function in an inflamed environment. That's why you see type 2 diabetics not heal because they're so inflamed that the growth factors can't close that wound and things like that. Uh you have to be able to optimize the body, number one. That's just what you have to do. And uh now I kind of got off a tangent, forgot what we're the original question.

SPEAKER_02 1:17:03

Well, I have another question. Yeah, go ahead.

SPEAKER_00 1:17:04

No, you go ahead.

SPEAKER_02 1:17:04

Well, I was gonna say, like, a big concern with the GLP1 medications for some people is okay, if I'm on this medication, I'm gonna have to be on it for the rest of my life. Is that the case with peptides where like you only get the benefit when you're on it? But let's say the person is eating well and they're exercising and they want to trim some visceral fat, so they take, you know, the fat burner cocktail that you're talking about, and they're doing all the things, right? They take it for let's say six months and they stop. What happens?

SPEAKER_00 1:17:28

Well, if they continue eating in a poor habit.

SPEAKER_02 1:17:31

What if they're they continue eating in a great way?

SPEAKER_00 1:17:33

Then they'll they'll sustain that, right? What I'm what my goal is or my hope is for people that are doing peptide therapy is to learn a new lifestyle, right? If you're taking these things, you're trying to improve your body, quit doing what you were doing that made your body dysfunctional. And when they start feeling better, they're going to start going down that pathway. You start feeling better, you're like, well, this made me feel better. It rewarded me. I'm going to keep doing it. That was my my hope with the GLP1s is that people would learn new eating habits. The reality of it is, as soon as that say they they got that satiation signal gone, they start eating again.

SPEAKER_02 1:18:05

Yeah, well, and a lot of people are never taught the foundations of nutrition or how to eat on those medications. They don't.

SPEAKER_01 1:18:10

So we don't have a lot of people like your sister in Houston. I can tell you, we do not. Do you know who you can send somebody to who will talk about their nutrition and their gut health and their microbiome? Who do we have?

SPEAKER_02 1:18:22

And minimize GI side effects while they're on GLP ones.

SPEAKER_01 1:18:25

I know probably one person. Who? Oh, wait on, tell me later. We don't want to say name. But yeah, seriously.

SPEAKER_02 1:18:30

But are these peptides like GLP ones are safe for people to be on long term? Are these peptides safe for people to be on long term? Do we know that?

SPEAKER_00 1:18:37

They are, but we still we don't have super long-term, right? And so we always recommend if you're gonna do something, do it for a few months, take a break. Yeah, I don't understand that with peptides.

SPEAKER_01 1:18:47

They are telling people three months on, one month off. And I don't I don't know the why of that.

SPEAKER_00 1:18:53

I don't honestly either, except for the fact that Well is it like folklore or something? Yeah, let's make sure we're not you're gonna causing problems, I guess, is the idea of it. Yeah. Or just the receptors for those signals maybe get clogged up and they don't function as well.

SPEAKER_01 1:19:04

We can saturate receptors, but it's not gonna make them stop working. You know, we don't have to be able to do that.

SPEAKER_02 1:19:09

But it's interesting because we don't do that with anything other medications that we prescribe, right? We just put them on it and say and say, okay, you might be on this for the rest of your life.

SPEAKER_01 1:19:18

A case in point is alfusicin. In alfusicin, we give people to relax specifically the muscles in and around the prostate for men who have voiding dysfunction. If you miss one day of that drug, the symptoms come back.

SPEAKER_04 1:19:30

Yeah.

SPEAKER_01 1:19:30

Because it just works when you're taking it.

SPEAKER_00 1:19:32

Right. And that's how these are the peptides. I mean, they're they're they're amino acids, they're signaling mechanisms, they they get used like that. Once it turns that signal on, it's gone. Yeah, so if you stay in your body and cause it.

SPEAKER_01 1:19:44

Being the devil's advocate, then the month you're off your BPC, everything's gonna hurt. It could, right?

SPEAKER_00 1:19:50

Hopefully the the goal is with BPC and TB 500, things like that, is actually heal the injury. Yeah, right. If we heal the injury, you don't need it anymore.

SPEAKER_01 1:19:56

Yeah, so that'd be interesting to see. Maybe Well, that's what I've heard from patients, though.

SPEAKER_02 1:20:01

Like I've heard patients say, Oh, I entered my shoulder, I took BPC 157, TB500, I feel great, and they got off of it. So they just take it when they need it for recovery. Right. Which I think that's the ideal medicine. Right.

SPEAKER_01 1:20:11

And it's especially after surgery, like orthopedic surgery. I give a lot of BPC to my patients and they just have to take it until they get better. But for people who use it for aches and pains and recovery from working out, I mean, they're always going to have aches and pains when they work out if they're working out hard. So I don't know whether but I also I mean I do cycle some of them off. It's kind of like out there in hypers in uh hyperspace, the patients know that the the the word on the street is, you know, come off every once in a while.

SPEAKER_00 1:20:39

Yeah, like you said, folklore, I think is kind of what it is. There's not enough data to show that you should come off of them. But if if you have a good peptide that's doing the function it should, it should get your body where it needs to be. Now, the ones that are losing fat and things like that, like the Tess Morelin, that when you quit taking it, you're gonna reduce that signal. Unless you've changed your diet. Unless you change your diet, right? I mean, you can take all the peptides in the world, and if you're still eating terrible, you're not gonna see much results with them, period.

SPEAKER_02 1:21:05

I think that's part of the problem.

SPEAKER_01 1:21:06

Let me ask you something internally in the pharmacy, do you think about which ones are FDA approved and which ones aren't? Does that enter into anything? It doesn't to me. Because Tessamerelin was FDA approved for years. It was a pr it came around because HIV patients in the early days of HIV would put on centripetal fat. So this was developed to help them lose and FDA approved to lose centripetal fat. But then for some reason they withdrew it. I don't understand how that happens actually.

SPEAKER_00 1:21:35

Well, they pushed it into they say it's a biologic, right? And so then it's on a different category altogether. It's just ways of regulating things to make more money, essentially.

SPEAKER_02 1:21:45

So follow the money.

SPEAKER_00 1:21:46

Always follow the money.

SPEAKER_02 1:21:47

What company is selling what, you know, yeah.

SPEAKER_00 1:21:50

Yeah, exactly. Um yeah, we we have clinical trials going on with uh our pure stem cell source we use uh with Dr. Gonzalez, who I mentioned earlier, and the amount of money and the amount of stuff they have to do to get through these trials, I mean, they have to be so careful. They can't say anything that's off brand. Like basically we'll we'll go to conferences and people ask him questions and he'll go grab me and pull me over and you say it.

SPEAKER_02 1:22:15

Yeah.

SPEAKER_00 1:22:15

Right.

SPEAKER_02 1:22:15

Because that gets into the concept of like the legality. Yeah. Right? Where some patients will say like or like we'll say to patients, well, it's not legal, so I can't do it. I've said that like countless times, right? So, like, is what we're talking about illegal?

SPEAKER_00 1:22:26

No, that that's the biggest thing is people say illegal. That's a criminal defense. That's gellable or ticketable offense, is what illegal is. Um if someone's doing peptides and they explain to their patient that these are not FDA approved, they're technically considered research, right? If you explain that to the patient and but then show them the data, this is what it did in this subset of patients. So I think it might help you, right? You're just explaining to them that it's not FDA approved. It may or may not work. Give it a shot if you're willing to do it on your own. You make that decision. That's the compliant way to do any medicine, I think.

SPEAKER_01 1:23:02

And I think I told you what I do. I I have my patient sign an informed consent that talks about peptides and the FDA and that they understand they're not taking something that's FDA approved. Yeah. And they sign it and it gets scanned into their chart. So they know, they should know. Yeah. Are they understanding it? I who knows. But I think they are because it's pretty clear.

SPEAKER_02 1:23:21

Have you ever had a patient say, oh no, I'm not signing that consent?

SPEAKER_01 1:23:24

Never.

SPEAKER_02 1:23:25

Patients don't care.

SPEAKER_01 1:23:26

I know I don't think they care. No, they don't do the research themselves. I care. Yeah. That's why I'm not sure.

SPEAKER_00 1:23:32

I'm protecting my practice. Yeah, of course. We always advise people if they want to have uh informed consent to do so, right? It's your practice. You handle things. And there's no reason not to.

SPEAKER_02 1:23:42

Well, honestly, you're probably giving more education and informed consent when you actually talk about peptides than with any other medication we prescribe. It is so often as healthcare providers, we just say someone comes in with urinary dysfunction, we say, Oh, I'm gonna put you on FlowMex, here's a medicine. Tell them nothing. And we tell them, and we don't tell them about the side effects.

SPEAKER_01 1:23:57

They're gonna lose their visible ejaculate.

SPEAKER_02 1:23:58

Well, but I've had so many patients say, I had I was never told that information. I was never told I could have orthostatic hypotension. So I'm almost wondering in this scenario, it seems like we're educating patients on peptides because we're actually having informed consent.

SPEAKER_00 1:24:11

Yeah. Yeah. And also the the patients are really informing themselves.

SPEAKER_02 1:24:14

Yeah.

SPEAKER_00 1:24:15

We opened this pharmacy, we noticed we would see, and specifically your practice, we would see this. Um, because we had more visibility. We had less people coming in, we were tracking everything. And we would see a patient would get on a peptide. The next month they were on two peptides. The next month they were on three peptides. I guarantee you weren't in there marketing peptides. They you would get them on a peptide, they would get the good results from it, and then they would go do their own research. And they would go to you and say, I want this peptide.

SPEAKER_01 1:24:39

The other thing is I don't like starting patients on more than one new drug. Because if I start them on two, I don't know which one's working. Yeah. Especially if they're doing if they're in the same kind of arena.

SPEAKER_02 1:24:49

Unless it's part of like a stack, I guess, that he's talking about, right? Yeah.

SPEAKER_01 1:24:52

But they come pre-blended. Yeah. But I'm talking about like I wouldn't but just I don't like doing that with any not the peptides, anything. Yeah. Yeah. Well, what else do you think? Yeah, if I'm going to start them on alfusicin, I'm not going to start them on phenasteride at the exact same time. I want to let one work.

SPEAKER_03 1:25:06

Yeah.

SPEAKER_00 1:25:06

Yeah. People keep asking me to uh mix NAD with other compounds, and I refuse to do it because NAD can give you immediate negative side effects if it gets in your bloodstream too fast. And if if that works for somebody, if they take it properly, that's great. But if they're taking this combination and they get these side effects, they assume that everything in there is causing these side effects. But it's just the NAD. Um so I don't make it because I don't want side effects to happen from something that's not a good idea.

SPEAKER_01 1:25:31

Have you thought about infusion therapy in terms of something that you would make? Or does that require another type of pharmacy?

SPEAKER_00 1:25:38

Aaron Ross Powell No, we we're classified to be able to make all those things. We can make up to cancer drugs in our pharmacy. Um we have negative pressure, ventilated hoods, that vent the chemicals out of the building. Um we can make anything in there we want to, except for biologics.

SPEAKER_01 1:25:52

But infusions, you're not going there yet.

SPEAKER_00 1:25:54

Not yet. Um it's just you're talking like what you're talking about for like a Well you mentioned NAD.

SPEAKER_01 1:26:00

No, no, no, no. I'm talking about NAD, yeah. You know, vitamin C, high-dose vitamin C. Yeah.

SPEAKER_00 1:26:05

We make the solutions that you can put into an IV bag.

SPEAKER_01 1:26:07

Yeah.

SPEAKER_00 1:26:08

But we don't pre-make the bags. And part of that is most of these most of these combinations do put a vitamin C in there, which is orbic acid, and it will delineate the other vitamins if you combine them all into one bag. So regardless, we still have to ship the bag. It could have some solution mixed in there, like a Myers cocktail or something like that. But then we have to ship the vitamin C separately. They would put that into the bag prior to infusion. Right. It's it's hard because if you make these bags, you can't make them ahead of time. Because once they're in that saline solution, they're gonna lose potency over time. So we would have to make them to order, and it's just not feasible for us.

SPEAKER_01 1:26:40

Well, you can have an infusion uh uh something, an infusion, what do you call them? Center associated with your pharmacy, like some places do. Yeah, but big in Miami? We work with a ton of infusion, people going for infusions. That's really big here. These very wealthy people go and they have everything infused.

SPEAKER_00 1:26:58

Yeah. And you can use lower doses because it's going straight in the bloodstream. You know. Uh a lot of our stuff we market as you know intramuscular injections, but it's it's sterile safe to use on an IV as well.

SPEAKER_02 1:27:08

So what are your top peptides that you're prescribing?

SPEAKER_01 1:27:11

Certainly BPC, uh Ibutamorin, MK MK six seven seven, uh CJC atamorelin. Testamoralin. Uh yeah, CJC for cutting and leaning. Uh IGF 1R3. Yeah, for bulking, I do IGF LRC.

SPEAKER_02 1:27:30

So it's very nuanced. So we have to educate ourselves. Because even if someone asks for a certain one, they may not not understand exactly what that's for. And each like everything that you've discussed so far, it's kind of for sort of a similar patient that might be looking to enhance their performance, but they're g it's very nuanced.

SPEAKER_01 1:27:46

It is nuanced. Yeah. But I mean, you know, I think what they're doing is helping because they're giving me names associated with the compounds. So if someone asks me something, I don't have to, yeah, you know, I can even, you know, show it to them. I don't like giving out my prescription thing. So do you what do you think?

SPEAKER_00 1:28:02

We're actually making we do we it's made already. We have for every peptide that we carry, it's gonna have a lengthy thing describing what the possible benefits are. No, this will be for you to hand to your patients. Oh nice so they can take it home and read it, right?

SPEAKER_01 1:28:14

How will I get that if I don't have a rep?

SPEAKER_00 1:28:17

We'll email it to you. You print them off. No. No, we'll bring them to you. Um they when I need something, I call.

SPEAKER_02 1:28:22

Yeah. You just go right up to the top. I mean, I don't I don't know. I think the problem is you're bypassing it.

SPEAKER_01 1:28:27

I don't have anybody. No, there's nobody for me to call right now.

SPEAKER_00 1:28:30

Yeah. I mean, reps we struggle with that, right? But you've been there. You know the whole rep environment for years. Yeah. You have to go back and talk to their doctor because guess what? Tomorrow another pharmacy is gonna come talk to you. Yeah, as you know, right? As they have. For years, right? And if you're not in there, you know, building that relationship, that's what it's about. Building a relationship with the doctor, providing beneficial things like education. If you're not going doing that, if you're just bringing donuts or whatever, who cares?

SPEAKER_01 1:28:56

The donuts are good. Yeah, yeah, yeah. But you have to be able to give you a sabotage. Do you get that? Do you have reps bringing you like well you were sister don't need to do it?

SPEAKER_02 1:29:04

It's so funny, and I always feel bad, but some of our colleagues, right, uh, will send us gifts during the holiday time, and it's like this huge gift basket of processed foods. And I don't want to be rude and be like, Do you not know what we do? But we don't really allow those foods in our office. We have events at our office quite frequently. And I I asked my sister one time, like for our opening party, I was like, Michelle, do you think we should serve ice cream? And she was like, I cannot believe you asking that question. Because we want to show people that you can entertain and still do it in a healthy way. Yeah. You know?

SPEAKER_01 1:29:33

Um So what are you gonna have at your what did you have to eat at your Oh, we serve Mediterranean food.

unknown 1:29:38

Yeah.

SPEAKER_02 1:29:39

Yeah. I mean anti-inflammatory food. And there's really good food on there.

SPEAKER_01 1:29:42

You guys can eat so many beans though. I know it's good stuff.

SPEAKER_02 1:29:45

So, Larry, can you describe the typical patient that comes in to see you that you would consider putting on peptides? Because if someone comes in and they have low testosterone, are you addressing their testosterone first and then considering peptides?

SPEAKER_01 1:29:57

Yeah, always. Always. Right now, we don't have anything peptide-wise that does anything with androgen receptors. Do we? No. So, in order for me to give patients that type of a uh therapy, I have to go to steroids. And I would always use that therapy first. Again, I don't want to do two different things. We'll do that, see how they respond, and then if they still need other uh things to help maybe lean or to bulk, or you know, with aches and pains, uh, or with their libido, I will then go to the I'll add the peptides one by one. Uh and again, it's nuanced. I mean, you have to know what the peptides are expected to do so you can address their specific issues.

SPEAKER_02 1:30:40

Yeah. You're truly practicing personalized medicine, but you're so ahead of your time. And you've been so ahead of your time probably your entire career with the innovative therapies that you offer. And you've also sat as top dog of many very well-respected organizations. Do you get pushback from your colleagues about what you do?

SPEAKER_01 1:30:59

Not yet. No, I don't because Because you're you've built a great reputation.

SPEAKER_02 1:31:02

No, it's not just that.

SPEAKER_01 1:31:03

But if I'm gonna be in a situation where I'm speaking to an audience, another group, I'm not gonna go into areas that I think are fringy. I'm not gonna I'm gonna just try to stay mainstream unless I'm asked specifically. Uh, like for instance, at the Sexual Medicine Society, I was asked to speak about peptides. Yeah. Which I did. Yeah. But I made sure they understood these are the peptides that are FDA approved, these are the ones that are not FDA approved, this is what's being asked for, what's being manufactured out there. So it was education, but it wasn't, this is what I'm gonna do with Mr. X. I mean, that's my personal practice, which I don't like sharing. I mean, you know.

SPEAKER_00 1:31:41

Yeah, and uh to that point, I think the most important aspect of peptides and doctors prescribing them is that they should never say this peptide will do this, right? Like you can't give an indication it's gonna treat this specific issue. Um because now you're you're giving an indication that it was never proven to work for. Um as a provider, that's giving inaccurate information to your patient. Yes, but if I give them BPC, you explain.

SPEAKER_01 1:32:08

I'm giving it to them because they're having pr issues with tissues.

SPEAKER_00 1:32:12

With inflammation, yes. So inflammation is not a is not a diagnosis, right? But osteoarthritis is. So if you say it's gonna help your osteoarthritis, it might, but you can't say that. No, yeah. So I'm just it's it's just kind of my my uh that's very nuanced in terms of verbal. Uh that's not proven for. If it's FDA approved for something, have at it, right? But just to protect yourself, explain it to them what it does, how it can work, what we've seen happen, and that's and leave it there. Yeah, leave it to the patient to make that decision. Yeah.

SPEAKER_02 1:32:50

Would you say that's your big message to potentially prescribing providers?

SPEAKER_00 1:32:53

Yeah, absolutely. That's that's the main message.

SPEAKER_02 1:32:55

That's the main message.

SPEAKER_00 1:32:56

Yeah. Um we saw this years ago with stem cells, people were claiming all this stuff, and the FDA came down on a lot of people. Well, we realized the FDA wasn't coming down on the products, they were coming down on the verbiage. That's what they care about. You cannot market or promote this in a way that's inaccurate from the data. And so as long as you're promoting what we've seen, and you can you can talk about other studies, right? But it's not FDA approved for that that persist that specific indication, but we know the mechanism of action can help that specific indication. Right? It it's gonna help the causation of that indication. We're trying to we're trying to resolve symptoms. We're not trying to cure the endpoint, you know, which eventually will cure the endpoint.

SPEAKER_02 1:33:34

But it's all about the verbiage.

SPEAKER_00 1:33:36

The market some people are so uneducated that they say these things, but they actually don't know what they're saying. Right? It's important to be educated on it because when you talk about it, these guys will just hear from somebody, oh, this will help with this, and they put it on their website, but they don't know what they're talking about. They don't know if it'll actually do that. Yeah. Um, and it's dangerous, I think. So it's just important to be educated. And find someone, take courses that that'll educate you on the there's I mean, Dr. Seeds. Everybody in the industry that does peptides knows Dr. Seeds. He has a very good course of the I don't know Dr. Seeds. You never heard of Dr. Seeds? No, never. Dr. Seed is like the number one peptide guru in the country. Where is he? I'm not sure. He's he's actually an orthopedic surgeon. Yeah. See, there you go. Right.

SPEAKER_01 1:34:15

And um There's also an orthopedic surgeon out in someplace in the periphery doing vasectomy rehearsals. So the business must not be good.

SPEAKER_00 1:34:23

Yeah, yeah. It's uh but he's been doing it for a long time. He is he's he's on tons of podcasts, you can listen to him, but he has a course that you can take, and he'll educate you on this, and it's it's much more comprehensive than some others that I've seen out there. So I would I would definitely use that one. It's not cheap, but it's worth it's worth a money.

SPEAKER_02 1:34:40

Yeah. Rick, you're awesome.

SPEAKER_01 1:34:42

Yes, and thank you so much for coming today. I mean, we know you have a lot of other things you could be doing, but thank you for spending time with us. We we've we learned a lot. It's an honor. I appreciate it. No, well, thank you.

SPEAKER_02 1:34:54

I'm so glad that you brought Rick onto our webcast today.

SPEAKER_00 1:34:57

Yeah.

SPEAKER_02 1:34:57

Because I always find it fascinating to get a look behind the scenes. There are so many pharmacies out there, and the biggest thing that we can do, I think, as healthcare providers is to find the good, trustworthy pharmacies. So the information I learned today from Rick, I am going to bring back to my patients immediately.

SPEAKER_01 1:35:12

Yeah, I think that's one of the important things about the speakers that we get is we get take-home messages for ourselves. But I also think it was interesting to hear the fact that the materials that they use to make peptides comes from FDA approved facilities. These are actually inspected uh sources of the raw material. And once they get it, they retest it here in Houston for uh the purity, safety, lack of uh pathogens and have to maintain a certain level of purity uh above 90%, above 95%. So that's very reassuring.

SPEAKER_02 1:35:50

Yeah, he clarified a lot of the concerns that I had coming into today's webcast. So I'm excited because I'm gonna start delving into the peptide space because I think at least now I can offer my patients something that I know is gonna be safe.

SPEAKER_01 1:36:01

Yes.

SPEAKER_02 1:36:01

So I appreciate your feedback on your clinical expertise as well.

SPEAKER_01 1:36:04

Oh, of course. Anytime. Feel free to ask me anytime.

SPEAKER_02 1:36:07

Okay, sounds good. Larry, what's the final F-word for today's episode?

SPEAKER_01 1:36:11

Okay, well, today the F-word is pharmacy, but I know it doesn't begin with an F word. Okay, I'm glad you clarified. I just want to make sure people know that I understand this.

SPEAKER_02 1:36:21

Thank you for joining us today on fertility and other F words.

SPEAKER_01 1:36:25

And don't forget to like, subscribe, and leave a comment.

SPEAKER_02 1:36:28

Until next time.