Peptides, Profits, and the Future of Medicine—What’s Really Happening

Episode 15 | Fertility and Other F Words

In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Brigham Buhler to unpack one of the most talked-about (and controversial) topics in modern medicine: peptides, and the healthcare system surrounding them.

Brigham is a healthcare entrepreneur on a mission to challenge and rebuild what he sees as a fundamentally broken medical system. He is the founder and CEO of Ways2Well, a functional and regenerative medicine clinic, and the owner of ReviveRx Pharmacy, where he is working to create more transparent, patient-centered models of care.

With firsthand experience navigating pharmacy benefit managers (PBMs), insurance companies, and regulatory frameworks, Brigham offers an insider perspective on how the system often works against patients and what it would take to fix it. He has become a vocal advocate for exposing the realities of corporate-driven healthcare and pushing for solutions rooted in prevention, innovation, and patient empowerment.

You may also recognize him from The Joe Rogan Experience, where he shared his perspective on the future of medicine and the urgent need for change.

In this episode, we cover:

• Why peptides are gaining traction outside of traditional medicine
• Barriers to adoption within the current healthcare system
• The role of PBMs, insurance, and pharmacy infrastructure in drug pricing
• Common misconceptions around compounded vs FDA-approved therapies
• How to evaluate peptide sourcing, quality, and safety
• What a responsible, medically guided peptide program should look like
• The risks of the growing DIY peptide trend

Key takeaways:

• The current healthcare system often prioritizes treatment over prevention, creating misaligned incentives
• Drug pricing is heavily influenced by intermediaries, making costs less transparent to patients
• Compounding pharmacies can improve access and affordability, but require proper oversight
• Peptides represent a growing area of interest, but education and quality control are critical
• Patients need guidance to safely navigate an increasingly complex and decentralized landscape

This episode is a candid, behind-the-scenes look at healthcare, innovation, and the future of patient-driven medicine.

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_02 0:00

In 1980, I started seeing patients as part of a large class action lawsuit exposed to dibromo chloropropane, which was a soil fumigant for primarily banana and and pineapple crops.

SPEAKER_03 0:16

But it's alarming at how much our environment is incredibly toxic.

SPEAKER_00 0:20

We've known each other 20-something years, yeah.

SPEAKER_03 0:22

Okay, tell me the origin story.

SPEAKER_00 0:24

I mean this genuinely. Like, thank you. Like, you changed my life. You really changed my life, Larry, and you were the first person that listened to me. You were the first clinician that I felt like gave a shit. I started out right out of college, bright eye and bushytail. I got an opportunity of a lifetime to be a drug rep for Eli Lilly. And so I got to launch Cialis in North America. And I would walk in and there'd be a beautiful toe fungus girl sitting there waiting to talk to the doctor, and I'd just walk back. Oh, come on back, the Cialis rep's here. Once I got moved to the antidepressants and the antipsychotics, I really began to see the dark side of Big Pharma. When I was a med device rep, um, I ironically had a surgeon approach me about uh trying to build a pharmacy that took patients away from opioids, and I loved the idea. And as I'm in the middle of exploring all that and looking at partnering with this orthopedic surgeon to build this, my brother died of opioids. And it was like a it was just a shock. It was like, it was literally a shock. And he had gotten addicted to opioids after getting an ACL done in high school. And none of us knew he was addicted. The regulatory landscape shifted, and you couldn't get opioids anymore. And it was much harder to get opioids, and a lot of those patients turned to the black market and the gray market, or the black market, I should say the illegal market, um, which is a lot of what I see with the regulatory pathways today with peptides. And that's one of the things that uh Politico just quoted me on today in an article. That I am I and it's truthful. I am fearful that we are repeating the histories of the past, and that those histories cause cataclysmic damage for patients and families. And now four out of five peptides being filled are being filled through gray and black market. It's getting dicey, it's dangerous, and it's scary.

SPEAKER_03 2:14

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 Prolman, board certified urologist with expertise in sexual, hormonal, and genito-urinary health, and co-founder of Prime Institute in Miami, Florida.

SPEAKER_02 2:33

And I'm Dr. Larry Lipschultz. I'm professor of urology at Baylor College of Medicine. I am a board-certified urologist and I'm head of the division of male reproductive medicine and surgery.

SPEAKER_03 2:44

All right, Larry, take me into your clinic.

SPEAKER_02 2:46

As we enter the clinic, you will smell. We're going to talk about a case. Uh, interesting case. This is a 19-year-old who came to see me uh after he uh was diagnosed with very low testosterone. Uh he was born in 2006, age four or five. He had to be placed on testosterone prior to his circumcision, which I don't quite understand, but you know, obviously they were trying to get the penis larger. Uh and then they started him on testosterone once a month in Jordan at uh 60 milligrams. Yeah.

SPEAKER_03 3:24

And that's at the current time that he's kind of presenting to you?

SPEAKER_02 3:27

Uh at this time, no, then he was treated transiently uh in Iraq in 21, but then he came to see me. He is not on anything at the current time.

SPEAKER_03 3:37

But you what do you think about that once a month dosing of testosterone?

SPEAKER_02 3:41

It doesn't last. Yeah. We're lucky if it lasts two weeks. Yeah. And at 60 milligrams, it was kind of like non-existence. It's like a sprinkle. Yeah. On physical examination, he did not appear overly under-masculinized, but the testes were eight CC's bilaterally.

SPEAKER_03 3:56

So small testicles.

SPEAKER_02 3:57

Very small. The hormones were extremely interesting. His testosterone was 36, with normal being 200 to 1,000. And then this gentleman at his age, 19, should have been 600, 700. Uh very low. His FSH and LH were each 1.6. So they were not responding to the normal cues from the testicle. Make more LH, make more FSH.

SPEAKER_03 4:22

Now his testosterone level is extremely low. Yes. How often do you see levels that low?

SPEAKER_02 4:29

Not very often. But you see, these are but we get a lot of tertiary referrals that nobody else wants to treat. So we would see it more than someone in regular urologic practice. But the key here is that his LH was not kicking in to raise the testosterone. So this is hypogonadotrophic hypogonadism. If he had lack of smell, it would be called uh Coleman syndrome. Um so as part of his evaluation, he had to have MRI. He had had one before. We repeated it just to be sure, and it was okay.

SPEAKER_03 5:00

Yeah, and you mentioned the MRI because when you say hypogonada hypogonadotropic hypogonadism, you're talking about the brain is not sending the signal it needs to to the testicles. Exactly.

SPEAKER_02 5:10

So you want to make sure he doesn't have an empty cellar syndrome.

SPEAKER_03 5:13

Yeah.

SPEAKER_02 5:13

Which means there's nothing in the pituitary space. But he, you know, it was there. It did not look bad. Um and as you do know, we do these whole genome sequencing on our patients, which we did on him. And he ends up having a mutation of uh the gene CHD7. Now, CHD7 is a very, very important gene for uh migration of the uh neurons uh for the olfactory for smell, but they also go beneath the pituitary, and that's why men who have abnormalities with these neurons have have pituitary problems, but they can also have anosmia. But they can't smell. He did not have inosmia. But this gene uh uh variation can have variable significance in terms of the amount of hormone that's not being produced produced, the protein that this gene produces can be a little bit bad or like non-existence, right? So this man only had infertility. Had he had really extensive impact of the gene, he would have what's called charge syndrome, which is terrible. It's got you know hearing loss, problems with speech, serious cardiac problems, pulmonary problems, but he just has the infertility aspect. So we're gonna the the option is this do you treat this man with FSH and HCG in an effort to establish uh sperm production, or do you treat him with testosterone, make him feel better, and then worry about the other uh hormones later? So my uh my current approach is to treat them with testosterone, and then when he's ready to have a child, we will introduce the FSH HCG and get some because the testicles are not the problem, it's the hormones. So his testicles should respond, albeit he's not gonna have enough to probably have a spontaneous pregnancy, but he'll have enough production for IVF.

SPEAKER_03 7:12

Yeah. How crappy does he feel with a testosterone level of 36?

SPEAKER_02 7:16

I mean, not as crappy as he would as he voices. And I think part of it could be language, cultural, and he just doesn't complain that much, but obviously he has no hormones.

SPEAKER_03 7:30

Yeah.

SPEAKER_02 7:30

So he should feel terrible. Yeah.

SPEAKER_03 7:31

Because when you see other guys with low levels like that, I mean they feel but he doesn't know what feeling good is. Uh right?

SPEAKER_02 7:37

He's never really been there. So I'm anxious to see him back.

SPEAKER_03 7:40

Yeah.

SPEAKER_02 7:40

Because I I I it should be a dramatic change.

SPEAKER_03 7:43

Yeah. That's great.

SPEAKER_02 7:44

Yeah.

SPEAKER_03 7:44

Because your other patients, when we see guys who have low levels like that, they don't feel well.

SPEAKER_02 7:48

No, but we don't usually see them with low levels like that. But we know from androgen deprivation therapy that when you lower it, makes men feel horrible.

SPEAKER_03 7:58

Yeah, yeah. For prostate cancer treatment. Yes. Yeah. So I want to tell you about an interesting patient that I saw in clinic. When I initially saw him, he was 39 years old, and he was coming to me with some sexual dysfunction issues and this very long history of chronic pelvic pain. He had a bunch of urinary symptoms that he was diagnosed with interstitial cystitis. And these symptoms essentially started when he was a teenager. So he's been suffering now too.

SPEAKER_02 8:20

How did they make the diagnosis of interstitial cystitis?

SPEAKER_03 8:22

They did the full workup. They looked in his bladder. It was, you know, biopsy and stuff. Um, I don't know if they ended up doing a biopsy, but oftentimes when it comes to interstitial cystitis, it's people will pee very frequently to get rid of the pain, right? And he was on narcotic pain medication. He was on muscle relaxer medications. So I initially saw him, and I forget what we actually what we started off doing. I probably put him on, you know, Cialis. His testosterone level at the time was in the 400s. He had previously, before he saw me, he was trialed on testosterone therapy. His levels went up to the 600s. He it worsened his anxiety and his insomnia. So he actually got off testosterone therapy. So fast forward, I didn't see him for like two years. He came back to my clinic two years later and he said, Look, I was looking online and I read that HCG might help with my bladder and chronic pain symptoms. Would you be willing to prescribe it? He couldn't find someone to prescribe it. And I said, Absolutely. And I'll tell you, I said absolutely, not because I thought it was going to be efficacious for him, because, but because I knew I couldn't hurt him with HCG, right? And so I started him on HCG and I started him initially at twice a week. And he noticed his symptoms almost immediately improve, which I was absolutely shocked by. And what he noticed is that his bladder symptoms would improve like right after he did the HCG injections, but then kind of come back before he was going to get his second dose that week. So he asked me if he could microdose the HCG. And so now he's on a hundred units every day daily. And he says this has been game-changing. He's never felt better. Now it's hard to say if it's been the HCG alone, because he is on other therapies, right? He's he is on NAD. Now his another provider actually put him on like scrotal application of testosterone. So his libido is better, his energy is better, he's gone down in his narcotic pain, you know, uh uh needs, he's gone down in his muscle relaxance. I was surprised by this because I see HCG as more so as an adjunct, right? I would put someone on it who, let's say, is on testosterone therapy who doesn't want their testicles to shrink. I would put someone on it who, let's say, is not interested in current uh fertility, but is interested in future fertility. But in someone, when I put him on essentially HCG only therapy and he had this dramatic improvement in his bladder symptoms and his libido.

SPEAKER_02 10:31

But he's also on testosterone.

SPEAKER_03 10:32

And now, but the testosterone was added later and he had additional benefit. Have you seen anything like that before?

SPEAKER_02 10:36

Never.

SPEAKER_03 10:37

Never.

SPEAKER_02 10:37

First of all, HCG has works for 48 hours.

SPEAKER_03 10:41

Yeah.

SPEAKER_02 10:41

Twice a week, I don't understand how it would sustain him. Although, you know, you give one shot a week and it does help with testicular size.

SPEAKER_03 10:49

Yeah, because for guys that you put on HCG with testosterone therapy to maintain volume, I mean, you do once a week dosing, right? I know. Yeah.

SPEAKER_02 10:55

But uh, it's just peculiar. I'll I will say that I use HCG for guys who have low libido. Uh-huh. And it's not the testosterone because they're already on testosterone. There's something about the HCG molecule that I think is unique therapeutically and it may be doing something to this person.

SPEAKER_03 11:11

Do you think it's the estrogen since HCG can increase aromatization into estrodiet?

SPEAKER_02 11:15

I have I don't know. Did you measure his estrogen? Um Because on those low doses, I don't know whether it did.

SPEAKER_03 11:20

And it actually his estrogen increased a little bit above his baseline, and he kind of felt that. And he didn't like so he's actually that's why he wanted to micro dose on the HCG to reduce the aromatization.

SPEAKER_02 11:30

Yeah.

SPEAKER_03 11:30

So he's kind of experimenting on his on himself a little bit here. I'm fine with that because HCG, as we discussed, is a very safe medication. But I was kind of curious too if you have anyone microdose HCG, because now microdosing is everyone's asking about it, right?

SPEAKER_02 11:44

It's very big in the testosterone space because you don't get as high uh uh production of uh erythropoitin, so your hematocrit doesn't go up as much. But uh I just don't know about microdosing HCG. I mean I don't know. It's a very unusual story to say the least.

SPEAKER_03 12:00

Yeah.

SPEAKER_02 12:00

But and also a man that age with interstitial cystitis, I mean, how often do you see that?

SPEAKER_03 12:06

Well, that's yeah. And then he was, you know, diagnosed. I mean, with he's had these symptoms for like 20 years. So yeah, some things that we've discussed in our prior episodes go unexplained, but I'm just happy when we have a success story.

SPEAKER_02 12:16

I know you don't argue with success, but but then you think about well, is that did I really do anything or is it just psychological? Yeah. So but you don't care because he's better.

SPEAKER_03 12:26

Yeah.

SPEAKER_02 12:26

Right?

SPEAKER_03 12:27

One more follow-up question here. In terms of HCG, like there are Ural uh many urologists that don't prescribe HCG. Do you think that's one of like the secret sauces in our toolbox that we can provide for patients?

SPEAKER_02 12:37

I do. Yeah. But I think it's an we and you know then what's nice about it, it's not a lot of downside, right? Yeah. Maybe a little extra estrogen. Um part of the problem is the cost. Yeah. It is expensive. Uh, it's rarely going to be covered by insurance. So you have to find a good compound pharmacy that will sell it. And there's not that many. So I think that that is one of the biggest issues right now.

SPEAKER_03 13:00

Yeah. And maybe that argues for this kind of lower dosing and microdosing. He's only doing 100 units a day. So that medication is going to last him a while.

SPEAKER_02 13:08

Yeah, but is it doing anything? Yeah. So I think you have to, you would have to get more people on microdosing to see if it has an effect.

SPEAKER_03 13:15

Yeah. Are there any other indications for HCG that we haven't discussed where you think it might play a role?

SPEAKER_02 13:19

Well, no, I do it for people who have delayed orgasm or an ejaculation, just because it ramps it increases sexuality, uh, you know, libido.

SPEAKER_03 13:29

Uh you think it's helpful?

SPEAKER_02 13:31

Yes. In many patients, I think, especially for libido.

SPEAKER_03 13:35

Yeah.

SPEAKER_02 13:35

But it's not the testosterone because they're already on testosterone.

SPEAKER_03 13:38

Yeah. Okay, well, that's interesting. I'll have to add that to my toolbox for that patient population. Okay, fabulous. So, what do you have in terms of breaking bedside news? I know you've been busy scouring the internet, Larry.

SPEAKER_02 13:47

No, I mean, it really does take work to get ready for these things. I mean, I'm willing to do it. But anyway, so what I found was this really nice review article. If anybody is interested in a good review article on environmental determinants of male fertility, and it's a really good overview with good tables. And what they do is they look at all, you know, and they come start up by saying, yes, fertility is decreasing. Why? Let's look at the environment. There's so many potential hazardous substances out there, and they go through air pollution.

SPEAKER_03 14:18

Wait, really quick, before you go into that, this blew my mind in the introductory part of it.

SPEAKER_02 14:23

What they state.

SPEAKER_03 14:36

They're saying 77% of cases of male infertility are due to a toxic environment.

SPEAKER_02 14:42

Wrong.

SPEAKER_03 14:43

You think that's wrong?

SPEAKER_02 14:44

I think it's wrong. I think you have to look at the number of people that you see that have infertility that you can't come up with a like idiopathic infertility. It's not 77%. When you factor in hormone problems and varicocils and you know, trauma and tumors and whatever, it's not going to be. This is really high.

SPEAKER_04 15:05

Okay.

SPEAKER_02 15:05

So they look at such things as air pollution, uh, heavy metals, uh, environmental endocrine disruptors, and and then m microplastics, which are your favorite conversation. Well, yours is you like microplastics. But anyway, when you look at environmental uh endocrine disruptors, the interesting thing is, and I didn't I don't know why I I forgot. In 1980, I started seeing patients as part of a large class action lawsuit exposed to dibromochloropropane. Did you know that?

SPEAKER_03 15:38

You had mentioned this to me before.

SPEAKER_02 15:39

Which was a soil fumigant for primarily banana and and pineapple crops. It's still going on. I am still seeing groups of patients now from Ecuador. So it started in the United States when men were found to be sterile, no sperm, working on the assembly line in California making this chemical, this pesticide. So then, of course, they stopped it. You know, they found out this is what was doing it. And uh and these men all sued huge lawsuits, and then plaintiff attorneys started getting groups of people who put it in the soil, uh banana workers and pineapple workers, and those people were band together and started class action suits. So, you know, we've been through Nicar huge Nicaragua, Costa Rica. Uh now we're seeing people right now from Ecuador who were who have not been exposed since, I don't know, 1990? And they're suing now. So it's an a huge number of people.

SPEAKER_03 16:38

So what do you do in those scenarios? Like they're coming to you to kind of prove the point as part of the case, or they're they want to have children and they're having issues.

SPEAKER_02 16:46

No, they're old. These are guys are 60, 70. No, they're claiming that they didn't have children or as many as they wanted due to exposure.

SPEAKER_03 16:54

So what do you do as a clinician?

SPEAKER_02 16:55

So I'm looking at their semen analysis history, their physical, other reasons for their infertility. And what we do know is applicators, these men are all, if anything, applicators, because they're not making it. Yeah, yeah. Applicators in the environment, putting the spneaticide into the soil with these kind of drills, are not being overly exposed because they're outside. I mean, it's going up, it's going into the soil, it's not being breathed or it's not being applied to their skin to where they can get it. So there have been, while there have been some class action groups that have settled, for the most part, we find that this is not the cause of their infertility. I mean, just because someone is doing something doesn't mean there's a cause and effect. Right. And what we're finding with many of these banana workers, it's not a cause and effect. It's just true, true, unrelated. Yes, they were there, uh, but it's not the cause of their fertility. So but I thought it was interesting because it is mentioned in here. And what's what's also interesting is that so many of these toxins, whether they're air pollutions um or whatever, look, coal is a big one uh that gets into the atmosphere and causes problems in people who live in mining mining uh uh towns, uh, that um they can have problems through uh the production of reactive oxygen species. And they've been measuring it. And we used to measure it in our infertility patients. I don't know why we don't measure it in the semen anymore, because it could give you an idea that maybe there is a pollutant.

SPEAKER_03 18:27

Oh, so let me ask you this when it comes to testing, are you testing the blood or are you testing the semen or blood?

SPEAKER_02 18:33

Semen. When we did it, we were not testing anymore.

SPEAKER_03 18:35

Right. What about heavy metals?

SPEAKER_02 18:36

They're testing semen. I don't know if they're testing semen or blood.

SPEAKER_03 18:39

Because they mentioned heavy metal toxicity.

SPEAKER_02 18:41

They do.

SPEAKER_03 18:42

And and I have a lot of patients because I'm in the Miami area, a lot of people, you know, have uh increased mercury.

SPEAKER_02 18:48

And cocaine. Isn't that really big in Miami?

SPEAKER_03 18:56

But um, and that's kind of part of a lot of like the concierge medicine labs where they test for the heavy metals. So are you testing your patients for heavy metal expenses?

SPEAKER_02 19:03

We're not. Uh-huh. We're not. Should we be? Well, I mean for those of us in Houston, yeah, we have so many chemical plants and refineries we probably should be testing. Yeah. But we but we don't. Yeah. We don't routinely test. But I think it would be worthwhile, I think it'd be worthwhile. Yeah.

SPEAKER_03 19:20

Well, and you were previously on the Dr. Gabrielle Lyon podcast, and she's big into testing for environmental exposures. So I'm just I'm kind of curious, like in a typical infertility clinic, and we know environment is playing a role, what tests should we be using and what should we be testing for?

SPEAKER_02 19:34

Well, you should be testing for these substances. The question is you can't go to LabCorps or you know, the labs that we have easy access to and check check off a box and get them all done because they're individual tests and they're unique to laboratories that specialize in looking for toxic substances.

SPEAKER_03 19:52

Well, let me ask you this. So when you're doing an intake and you have a new patient coming in who's coming in with male infertility, how much do you get into the weeds in terms of their potential for environmental exposures?

SPEAKER_02 20:01

We ask, but we're not testing per se.

SPEAKER_03 20:03

Yeah. Does it change your management?

SPEAKER_02 20:06

I mean, uh not if we could find something else, but if it falls into the idiopathic group, it would be nice to find out if it were something that they were exposed to. Yeah. Because then theoretically, if you remove them from that environment, they should get better unless they've been there forever.

SPEAKER_03 20:19

Yeah. Okay, one last question. So for these workers you were talking about working like on the banana farms, right? So if they were exposed, like, and we know that sperm takes like three months. If you're gonna make any change, then make the change for at least three months before you recheck their semen analysis. Right.

SPEAKER_02 20:35

So what we did is we went into two factories in mobile. Mobile, mobile.

SPEAKER_04 20:40

Yeah.

SPEAKER_02 20:41

And we um examined people who were I think they must have been workers in these factories, right? And we got all their semen analysis. We identified maybe 20 or 30, I don't remember exactly, and they were all low.

SPEAKER_01 20:54

Mm-hmm.

SPEAKER_02 20:54

Low. We waited a year, brought them up to Houston, and did a uh we at the time we had a CRC at Clinical Research Center, retested them all, and the majority had gotten much better.

SPEAKER_03 21:06

So you took them out of the environment. Yes. Ah, interesting.

SPEAKER_02 21:09

They stopped. Well, they were no, yeah. We brought them up here because we were doing things in the clinical research center.

SPEAKER_03 21:13

Right, right, right.

SPEAKER_02 21:14

Oh, because they also but we also biopsied them.

SPEAKER_03 21:16

Yeah, yeah.

SPEAKER_02 21:16

But the plants stopped.

SPEAKER_03 21:19

Gotcha.

SPEAKER_02 21:20

You know, when we went in, they had just stopped.

SPEAKER_03 21:22

Yeah.

SPEAKER_02 21:22

When they found out this was a problem.

SPEAKER_03 21:24

Oh, gotcha. Okay. Well, so that's really interesting.

SPEAKER_02 21:26

So in other words, with with the DBCP, if it doesn't sterilize you, a very good chance that you'll get better.

SPEAKER_03 21:33

Okay. I think that's a very important message. So I think that argues like this point that we should be highlighting and maybe testing for some of these environmental toxins because there could be recovery.

SPEAKER_02 21:41

Yeah, I mean I and I, you know, this kind of re rekindled my interest in seeing what we have available now to check, especially for things that might be coming out of these chemical plants or refineries.

SPEAKER_03 21:51

Yeah. Um, I would say this article was alarming for me.

SPEAKER_02 21:54

And that, but it was so well done, right?

SPEAKER_03 21:55

Yeah, no, it was so well done. But it's alarming at how much our environment is increasing.

SPEAKER_02 22:00

Right. And the microplastics they're finding in the semen.

SPEAKER_03 22:03

Yeah. Yeah. Fascinating. All right. Well, why don't we get into today's episode, shall we?

SPEAKER_02 22:09

Yes.

SPEAKER_03 22:10

Welcome to today's episode. I am thrilled to introduce our remarkable guest today, Brigham Bueller.

SPEAKER_02 22:16

So Brigham Bueller is a healthcare entrepreneur on a mission to disrupt and rebuild America's broken medical system. He's founder and CEO of Ways to Well, a functional and regenerative medicine clinic, and the owner of Revive RX Pharmacy, where he's helping create more transparent, patient-centered models of care. With first-hand experience navigating pharmacy benefit managers, insurance companies, and the FDA, Brigham brings an insider's perspective on how the system often works against patients.

SPEAKER_03 22:51

He's become a bold advocate for exposing the realities of corporate-driven health care and pushing for solutions rooted in prevention, innovation, and true patient empowerment. You may also recognize him from his appearance on the Joe Rogan experience, where he shared his vision for a better, more accountable future in medicine.

SPEAKER_02 23:10

So, Brigham, thank you so much for coming today and talking to us. It's really I know it's hard to get you here from Austin, and we appreciate that. So Brigham and I go way back. Yeah.

SPEAKER_00 23:26

When do you think the early God, we've known each other 20-something years. Yeah. I know Brigham when he was 20 years.

SPEAKER_02 23:33

I knew him when he was big and fat.

SPEAKER_00 23:34

Yeah. If you could believe it, okay. Tell me the origin story. Let's hear the story. And I I literally, I mean this genuinely. Like, thank you. Like, you changed my life. You really changed my life, Larry. And you were the first person that listened to me. You were the first clinician that I felt like gave a shit. It was hard, man. I was overweight. I couldn't lose the weight. I felt like I was working out every day. I couldn't get traction. And finally, a nutritionist, Michael Florida, who's a mutual friend of ours, said, something's not right. And again, this was at this point, I don't even know how many years ago, because I was already your rep. I was your striker rep at the time. That's true. That's true. Um, and you got me into the clinic and you ran my test, and we uncovered, you know, some hormonal deficiencies and some challenges. And when we tweaked that, it was like a whole new lease on life. It's the new Gregum. Everything for me. So for anyone out there who hates me or what I'm doing, you can blame Larry. It's his fault.

SPEAKER_02 24:26

I think people only appreciate what you're doing. I don't think any of them.

SPEAKER_00 24:29

I'm the guy who changed my life, and all I've tried to do is take a little sliver of what I've learned and implement that into like what we're building out to try and uh do the same for people. Yeah, you are. You are.

SPEAKER_03 24:40

So it's very personal to you.

SPEAKER_00 24:42

Oh, it it it it really is. Like, and I say this my dad's obese, my brothers were obese, my sister's obese. When I met Larry on the clinician side as my clinician, I was in what I tell people is the pit of despair, which is what I have met so many obese people when I meet them, they're in when they come to our clinic. And they all think this is one of the challenges of this new GLP one world. Everyone immediately thinks I need a GLP one. And so many men come into the practice and they've never had their hormones done. Yeah.

SPEAKER_02 25:09

Same thing with women. Because you became lean and mean before there was GLP.

SPEAKER_00 25:13

Yes. Yes. And you that that's there's so many men that think that they need a GLP one, and what they really need is to have their hormones addressed. Exactly.

SPEAKER_03 25:21

Or potentially both.

SPEAKER_00 25:22

Or both. Yeah. There is a definitely value in the synergistic effect of utilizing the compounds, and some people need, you know, multiple modalities.

SPEAKER_03 25:30

Yeah. So you're right now on the forefront when it comes to very polarizing topics in healthcare. But where did your career in healthcare begin?

SPEAKER_00 25:39

Yeah, go over your journey to where you are. I try and tell everyone. All I'm just all I've ever tried to do is fix the problems. And so like I started out right out of college, bright eye and bushytail. I got an opportunity of a lifetime to be a drug rep for Eli Lilly. And so I got to launch Cialis in North America.

SPEAKER_03 25:55

What a dream.

SPEAKER_00 25:56

I know. It was fun. It was it was like the heyday of big pharma. It was when the rules weren't as strict. And when we could go out for dinner with you guys.

SPEAKER_03 26:04

Well, you were in the heyday, like as a physician, and you were in the heyday as a rep launching Seattle.

SPEAKER_00 26:09

And it was fun. Things were good here in Houston, I can tell you. It was a fun time. And I really believed in that molecule. That molecule was awesome. It still is. Cialis is a phenomenal phenomenon.

SPEAKER_02 26:19

It was easy to sell. Yes.

SPEAKER_00 26:20

It sold itself. And I joke all the time. I'm like, it was still a time where there were so many drug reps that like people would be stuck in the lobby for an hour waiting to talk to the doctor. Right. And I would walk in and there'd be a beautiful toe fungus girl sitting there waiting to talk to the doctor. And I just walked back. They'd be like, oh, come on back. The Cialis reps here. So it was a different world. Um that world's changed in a bulb. But I I got once I got moved to the antidepressants and this antipsychotics, I really began to see the dark side of big pharma. And I didn't stay.

SPEAKER_03 26:48

I talk more about that.

SPEAKER_00 26:50

I um I was moved to drugs like Zyprexa and Prozac. And I remember even going to the trainings on moving from urology to mental health and looking that's a huge switch. Huge. And I looked at it and I was, I just remember asking the doctor, Prozac barely differentiated from placebo in the clinical trials. And so I'm asking, wait, placebo had a I think it was a 45 or 47% of people experienced improvement. And it was only a moderate difference for the control group. And uh, and they were it was just odd to me at the time. And then as I began to get more and more into that, you're being asked to hey, don't ever promote off-label, don't do this, don't do that. And you sign all these contracts saying you're not going to do that, but then they bring in these speakers that teach you how to promote off-label. I mean, this really happened all the time, where there's now this thought leader who comes in and says, Well, here's where I'm using it in my practice. And then you're at dinner with a doctor as a 20-year-old kid with pressure to hit a quota, and you think, Well, do I tell the doctor about what this guy told me where he's using it off label? I know I signed that waiver, I'm not supposed to. I know in one breath they're telling me not to, but it kind of seems like they want me to. Like, and it started to not feel like where I wanted to be. So once I moved away from urology, it just wasn't my passion and it didn't seem, it just seemed different. And so I wanted out of that as fast as I could. So I was only a drug rep for three years and literally the mental health drugs for maybe a year. It took me about a year to get out of that. And that's when I had the opportunity to go work at Stryker, um, Med Device, where I worked with some of the best and brightest surgeons through different, all different walks of life, from orthopedic surgeons, sports medicine to urology. Um, and that was a lot of fun because you're just working hand in hand with clinicians that are passionate, that are doing surgery. And these that's an area of medicine that I don't criticize often because I think we do a really, really good job at triaging and treating, you know, surgically issues. Where we do a piss poor job as a nation is primary care, proactive, predictive medicine, preventing chronic disease, because this entire business unit and infrastructure from the regulatory pathways to the hospital systems to the sales side is all built around monetizing chronic disease. Like whether we want to acknowledge that or not, it's just kind of the system we've all inherited.

SPEAKER_03 29:09

When did you have that epiphany? Or has this just been over the last, you know, 10, 20 years or years?

SPEAKER_00 29:15

Was when I was a med device rep. Um, I ironically had a surgeon approach me about uh trying to build a pharmacy that took patients away from opioids. And I loved the idea. And as I'm in the middle of exploring all that and looking at partnering with this orthopedic surgeon to build this, my brother died of opioids. And it was like a it was just a shock. It was like, it was literally a shock. And he had gotten addicted to opioids after getting an ACL done in high school. And now that none of us knew he was addicted. Oh, really? He it was and and then the regular the regulatory landscape shifted and you couldn't get opioids anymore. And it was much harder to get opioids, and a lot of those patients turned to the black market and the gray market or the black market, I should say the illegal market, um, which is a lot of what I see with the regulatory pathways today with peptides. And that's one of the things that uh Politico just quoted me on today in an article that I am I and it's truthful. I am fearful that we are repeating the histories of the past and that those histories cause cataclysmic damage for patients and families. Patients got used to affordable, accessible, compounded medications, and now the regulatory oversight has changed so much in a vacuum with no no no like heads up or acknowledgement of the sector and the patients that are utilizing these medications overnight. And now four out of five peptides being filled are being filled through gray and black market, which is very dangerous because you lose all clinical oversight. There's not a there's not a urologist, there's not a no primary care, nobody's involved in the chain of custody. No patients are buying peptides online and they can't even ask Chat GPT anymore how to mix them. And none of these things come with reconstitution instructions, sterility instructions. They don't send them with alcohol swabs, they don't send them with biostatic water. Yeah. I mean, it's it's getting dicey, it's dangerous, and it's scary.

SPEAKER_02 31:07

But you know, I saw a guy the other day, and it really annoyed me. A patient comes in and he and I started talking to him about peptides. And I would say 90% of the ones I mentioned, he already had. He was buying them online. And I'm saying, you know, number one, how did you know what to get? And number two, how do you know what's in it? Well, I send it off to XYZ and they test it and tell me it's good. I mean, where is he sending it?

SPEAKER_00 31:30

So we've done those tests, and most of them are not good. Uh one of the ones that I can honestly say had some good products was peptide sciences, but they shut down. Yes, I'm not.

SPEAKER_02 31:39

But I know that, but I mean when the people get these peptides and they say, I've sent them off for testing, where do they send them?

SPEAKER_00 31:44

I don't know where the general public would be sending them. Um there's some, it's online. Yeah, there may be there may be facilities that they the general public could send them to, but we validation test as compounders all of our products. So we did for the YouTube channel uh that my buddy Ryan Hummeston does, he did some research and he ordered from all the different various, and there were not only instances of contamination, but also instances with GLP ones of massively higher dosages in those vials than they were supposed to be, which is a huge problem with what could happen with misdosing a GLP for patients. Um I just think it's a ticking time bomb. Um, and I know that's a little bit of a diatribe, probably moving forward to where we're headed, but uh I think seeing that with my brother, and it's important so the patient so that patients and listeners can understand. I did open a retail pharmacy and I build insurances and I worked within the insurance ecosystem. And what I saw was even as terrifying as what I've seen with the big pharmaceutical cartels. We would literally get phone books of all the drugs that the insurance companies was no longer going to cover. And it had nothing to do with efficacy and quality, it had to do with what rebates they were getting from the pharmaceutical companies that quarter. And they will negotiate and adjust tier pricing on patient medication based off kickbacks paid to the PBM. And so where that gets. Explain PBM. Yeah. Yeah. Because people don't know what it is. So as running a re before running a retail pharmacy, I didn't know what a PBM was. Um, in the 80s, the government established they we attempted to regulate and bring down the cost of prescription drug care to make it affordable for the average American. So they established what's called a pharmacy benefit manager. The goal of the PBM was to drive down the cost of care and make drugs affordable for all of us. So grandma and grandpa can afford their meds. That got corporately captured about as fast as it was formed. And the big five insurance companies, United, Cygna, Aetna, Blue Cross, Blue Shield, these companies that control all these patient lives went out and bought those PBMs. So now they not only control the patient life, what doctor they're allowed to see, what medical practice they're allowed to go to, they also control the insurance formulary that decides what drug gets covered, what your copay is, what your deductible is, what tier pricing that drug is on the tier plan, and all the reimbursements and how all the money flows. And a real world example is if an elderly woman were to come in and give me a blue cross-blue shield insurance card in Texas. When I ran this farm, when we owned this pharmacy, we had a gag clause. I was not allowed to tell that patient that I could sell her Metformin cheaper for cash than her copay or deductible. So that patient would pay a $10 copay on a $3 drug. The pharmacy doesn't get to keep that. That gap pricing gets clawed back and goes to who? The PBM. And so the PBM is literally making money on every generic, on every copay, on every deductible.

SPEAKER_02 34:30

But why did there have at that point in time, since the majors owned the PBMs, why didn't they do away with the PBM? I mean, why literally it wasn't going to the PBM, it was going to the insurance company. Correct.

SPEAKER_00 34:41

So you've got to follow the money. I always said, show me the incentives and I'll show you the outcomes. It was a strategic move because now you're controlling the pharmaceutical cartels and their ability to provide accessibility of care of a drug for patients. So you have a bartering chip because you bought the middleman. And so you can say insulin's a prime example. From when PBMs took off in the heyday to now, insulin has 7X in cost. But the price to produce insulin has dropped astronomically. Why is it costing seven times the amount to get a patient insulin? It's because the pharmacy benefit manager, the PBM, which is the parent company, is artificially inflating the cost so they get rebates. Why that is important is that price point establishes the average wholesale price point for all of America. So if I'm united and I am negotiating to uh manage Medicare, Medicaid, or Tri-Care, because people don't understand that too. A lot of the governmental payer programs are outsourced to the PBMs, which are the big insurance companies. Now I've set a false flag for what is the average wholesale price of insulin. Hey, Obama, insulin is costing $700 a month, but we're going to sell it to the federal government for $300. But it wasn't. It was costing you $150 and you got the rebate. You're cooking the books in a way that allows you to continue to hit quarterly earnings and quarterly profits. And I'm not saying this. A Senate hearing committee identified that roughly 30% of the revenue coming into the insurance companies is coming in through monetizing prescription drug care via the PBM. So then you go, well, wait a second. If the insurance company's paying that, aren't they paying that dollar amount? Why would they want to inflate the price? Because if they inflate it by $150, aren't they the ones really paying that? No. Because 90% of Americans are insured through their employer. So, like me now, across both companies, I employ 600 people. If they're inflating every single employee's price of drugs and every American right now, the average American's on four or more prescription drugs. Four or more prescription drugs right now. The average American. Now every one of those drugs is being artificially inflated. And at the end of the year, those insurance carriers come back to the employer and say, I'm sorry, Larry, you got 600 employees. Those employees cost us X amount on your insurance plan. We've got to raise your copays, your deductibles, and your employment cost. And that cost gets passed down to the employer. And that is how every year the big five insurance companies are able to make more and more profit by covering less and less. Like you can't make record-breaking profits and record-breaking quarterly earnings by providing record-breaking care. You do it through cutting care, passing the buck, passing down the cost, blocking and obstructing, or as that kid Luigi would say, delay, deny, depose. Like it's catastrophic. And that built an entire ecosystem that has led partially to this chronic disease crisis. Because so many clinicians, and I don't know if y'all are seeing this in urology, but I can tell you in like other sectors of healthcare, it's hard to get a surgery done. It's hard to get a damn insurance company to cover the procedure. You gotta battle these guys, but they will instantly cover a drug. And people go, well, they're really good about covering my meds. No, your employer is ending up covering your meds. The insurance company is monetizing your chronic disease. Well, I'll tell you something crazy about insurance.

SPEAKER_02 38:06

In Texas, Blue Cross Blue Shield has an exclusion in 90% of their policies for penile prostheses, even in men who've had prostate cancer, bladder cancer, end stage diabetes, they will nothing else works. They will not cover it. Wow.

SPEAKER_00 38:26

There's no option.

SPEAKER_02 38:27

None because the employer had it excluded. Now who they probably didn't realize when they were signing that contract.

SPEAKER_03 38:34

They just probably wanted a policy that was lower in costs.

SPEAKER_02 38:36

Exactly, but they don't tell the employer what he's excluding. And then when you go to the employer, they say we didn't know anything about that, but that's what's in the policy. They can't change the policy.

SPEAKER_00 38:46

I can tell you, and there's a lot of horse trading that happens too. Uh I don't want to say names because I don't want to get sued, but a huge hospital system here in Houston, Texas, back when I was uh on the entrepreneurial side calling on clinics and practices. We we had we ended up launching the pharmacy and we were trying to work within the insurance framework. But while I was doing that, we also launched lab testing. And so I would go out to primary cares uh and OBs and all different clinicians and educate them on the importance of comprehensive lab work. And I would talk about the importance of doing a genetic test, especially at a pain practice. Or, you know, in women's health, um, you know, the the the gold standard at the time was any woman over the age of 30 who was expecting or trying to have a child or pregnant should have this genetic test because it tells us if your child is going to have a genetic defect prior to the child being born. And that was the standard of care. That was the gold standard that everyone agreed upon. And I know for a fact that one of the big insurance companies negotiated with one of the hospitals to delay that and change the policy to the age of 35. And they attempted to horse trade through the reimbursements of what that hospital system would get on deliveries and other things that that hospital was doing. And it it happened. And so all these women overnight that were part of this insurance plan lost their ability to have this genetic test done. Um, and that happens, those things happen every day in industry. And that is one of the reasons that I did start like my my business was I was just trying to solve problems. So we build the compounding pharmacy and we try to make meds affordable.

SPEAKER_03 40:22

And I literally would just And that came after owning this retail pharmacy. Yeah.

SPEAKER_00 40:26

And I built that compounding pharmacy because we would take the phone book. I I found a pharmacist, my business partner, Aaron Schneider, who is to this day still runs the pharmacy. I would take the phone book of all the drugs they were telling us they weren't going to cover anymore. And I bring it to a guy way smarter than me and Aaron and go, hey, can we make these? Because this is all the stuff they're screwing people on. Let's just and I called it um healthcare of the gaps. And so literally how we started was trying to fill the gaps of where this giant medical conglomerate was screwing the average patient. And immediately a lot of that became urology because men couldn't get their testosterone covered. Insurance didn't want to cover their blood work, insurance didn't want to cover peptides, insurance. So literally all the things they wouldn't cover, we would compound. And then getting to that was it when I started working with you as a compounder, and Larry would give me the list of things that he needed in his practice and what would be valuable, and Dr. Lipp Schultz would help guide us on where he was seeing success in his practice, and you were ahead of the curve. Yeah. I mean, you were you were way ahead of the curve. Like honestly, I look back and I'm like, God, that is. We were ordering them a long time ago. It's also mind-blowing to me. I really mean this genuinely, like, how the hell did you do all that and be part of academia?

SPEAKER_03 41:39

Because it's Yeah, that's a good question. Well, because you're so well respected in the field of urology, and yet you've been probably 10, 20, 30 years ahead of people your entire career. Being on the cutting edge is a scary place to be. There's a lot of potential criticism there.

SPEAKER_02 41:54

How did you it never happen? I mean, it was it was n we were never criticized for probably because you were doing the research.

SPEAKER_03 42:00

Yeah. I mean, you've been in a you know being a very good thing.

SPEAKER_02 42:02

Well, I think it really helps being in an academic setting. You are somewhat protected because, you know, people know that you do the right thing in general. So I mean there was and plus the fact we were 99 times out of a hundred salaried. So there was very little profit incentive to do it. So, you know, you were protected. I think it was in a protected environment that enabled you to go out a little bit on the limb, whereas the guy in private practice wanted to wait and see what happened with you before he did it. Which is crazy.

SPEAKER_00 42:29

Yeah, you're saying it's so nuanced though. It is it is the it I at the time I didn't realize how much of a pioneer and like how far out you were. You were definitely on the bleeding edge. Yeah. Because we're doing the things you were doing 15 years ago, 10 years ago, you know. And people think we're on the bleeding edge, but we're really doing things you were already doing in academia.

SPEAKER_01 42:49

Yeah.

SPEAKER_00 42:50

But now it's been labeled, you know, especially in the last 18 months, as like voodoo pseudoscience. Like peptides, you mean? Yeah, and and I know it's a it's a culminated like an effort funded by the big pharmaceutical.

SPEAKER_02 43:02

But you know, when when we were using peptides, it was not scary. It was not considered there was nothing like uh investigational where we were worried that somebody was gonna come breathe down our necks.

SPEAKER_04 43:14

Yeah.

SPEAKER_02 43:15

We were just using them because they worked. Yeah. Remember, we were doing GHRP2 and 6. Yeah, and they were fantastic. People loved them. But I didn't know that somebody was going to take them away. I mean that never, we never discussed it.

SPEAKER_00 43:27

Well, and that's what gets so challenging because the idealist in me would like to believe that these regulatory bodies have the American people's best interest at heart. And but when you get behind the curtain, and again, this is not a knock on this administration, because I know they inherited a lot of these problems. And my true insight has been in the last six months with Secretary Kennedy and Marty McCary and some of the folks that are now in power, but prior to these individuals, the real world example, and I said this in other interviews if peptides were dangerous, when the prior administration removed Them from accessibility for the public. We submitted 17 FOIA requests. And what is a FOIA request? It's a request to the government that they are legally obligated to respond to, asking for additional information and clarity on their stance. And they are legally supposed to be a good question.

SPEAKER_02 44:15

But who would it go to FDA?

SPEAKER_00 44:16

They went to the FDA. We submitted 17 FOIA requests to the FDA. They have not responded to one. Requesting for safety and additional clarity. And why did we come to this decision? And is there something we can do? Is there room for discussion? We were stonewalled. Now that changed when M Marty, McCarrie, and Secretary Kennedy took over HHS. Now we have at least a voice. At least I'm not saying we have a vote. We got a voice. And we gotta we gotta have a chance to meet and to discuss and to explore. And that's I think that's what we have to hope for.

SPEAKER_02 44:48

So tell me, thinking back, what was the impetus to reclassify the peptides?

SPEAKER_00 44:54

I think a large part of that was my belief is the pharmaceutical lobby was attempting to destroy compounders because of what is going on with the GLP one boom. But it was before that. It happened during GLP1s were ramping up. Um and I think part of this all got the baby got thrown out with the bathwater. Um, why the we still to because they haven't responded to the FOIA request, we still don't know. Like, you know, the the the throwaway talk track it from you know legacy employees that are there is well, we made these decisions because peptides refringe and these things don't have uh safety data, and there's no uh randomized control trials around these compounds. And so from my meetings with the FDA, and again, this new administration, I said, look, I want to take a step back. Like, let me just give you a real-world lens. These compounds were being used safely and efficaciously in the proper patient populations under the guidance of a trained clinician made through compounded pharmacies that were FDA inspected with FDA-approved green list product, API, ingredients, pharmaceutical ingredients. There were not a bunch of adverse events. We're asking you to show us if there were, but we weren't seeing it. Yeah, we saw none.

SPEAKER_03 46:08

Yeah. Well, I asked you recently, I said, Larry, you've been prescribing peptides for years. What's the worst thing that you've seen?

SPEAKER_02 46:14

I didn't have anything.

SPEAKER_03 46:15

He said like some injection site reaction, which blew my mind because I think about all the medications that are FDA approved that we use on label for indications that have way larger implications in terms of side effect profile.

SPEAKER_00 46:26

Yes. And so uh to Marty McCary's credit, he's a very open-minded individual. Uh he's he comes from academia, he's a surgeon, so he wasn't using these things. Um, but he gave me a chance to sit down and I just said, Marty, I just let me plead my case.

SPEAKER_03 46:42

Like Is this like how the conversation goes?

SPEAKER_00 46:45

He and I, so Marty and I met each other testifying before he was the commissioner of the FDA. And one of the things that resonated with me about him is he's truly a patient advocate. In his book, uh Blind Spot, he talks about that dogma isn't consensus. And what's become medical dogma is getting labeled as medical consensus. And one of the prime examples is the war on testosterone. And look, Marty and uh Admiral uh Christine are now over the FDA, and they reversed the dogma that has been a hundred-year dogma against testosterone, which is insanity. Right. And they're doing the same thing with the women's hormones and the women's health initiative.

SPEAKER_02 47:25

Yeah, but they what they made actual changes for the women. We didn't get huge changes yet. Maybe they're coming.

SPEAKER_00 47:32

I know that uh Admiral Christine is is passionate about removing the black box warning around testosterone and making testosterone uh less stigmatized because he, as a urologist, yeah, he knows is aware of the this is all medical misnomer.

SPEAKER_02 47:47

Yeah, let me ask you something, because I don't understand. So there's there's places in, and correct me if I'm wrong, there's places in China and India that are FDA approved sites for APIs.

SPEAKER_00 47:58

Yes, sir.

SPEAKER_02 47:59

Right? Correct.

SPEAKER_03 48:00

And you mentioned the term green. Is that what you were talking about?

SPEAKER_00 48:02

The green list is FDA approved ingredients. So you if you buy ingredients from the green list, in theory, the FDA has vetted and approved these ingredients. Here's where this gets a little shady.

SPEAKER_03 48:13

We love the shady.

SPEAKER_00 48:14

Laura Loomer, who's a political whatever you want to say she is, she's politically motivated. But where does she what is she and where is she? Uh she's a she's a big voice in a political movement. She tweeted just yesterday that compounders are sourcing their ingredients from communist China. But where who where does she work? Oh, I don't I don't know enough about her. I just know that she's got a big platform and a lot of political people listen to her, and she's like a political talking head.

SPEAKER_02 48:39

I mean, so is Amy.

SPEAKER_00 48:40

I mean, you know, no one's not a clinician and she's not in the healthcare space at all. But what is she? She's within the city. She's gonna be tweeting that, and I guarantee you if you follow the money, you'll see that there's funding, funding, or pressure from Lily. Like there is with everyone. But she doesn't work for Lily. No, she doesn't officially work for Lily, but I guarantee you that in some capacity there was a donation. I'm I'm I would bet my life on it because I've seen I've uncovered it enough times. Yeah. You don't why is this political activist analyst like tweeting about compounding something?

SPEAKER_02 49:10

Political analyst has to eat, they have to pay rent, they have to have a source of income. And it's not because she's tweeting.

SPEAKER_01 49:17

Yeah.

SPEAKER_02 49:17

You know, unless she has sponsors, yeah, which would explain that, but her sponsors need to be identified.

SPEAKER_00 49:23

So in one breath, while Eli Lilly, and I know this, I know their lobbying is saying compounders are dangerous. They're sourcing this API and these ingredients from China. 100% of Eli Lilly's delivery mechanism of the pen comes from China. Eli Lilly just went out and acquired, guess what? A spent $7 billion to acquire what? A peptide facility. Where? In China. Seriously? Eli Lilly just spent $7 billion and acquired a peptide facility in China three weeks ago. Now I think now is that in one breath, it's dangerous. Don't do it. But in the next breath, we're acquiring facilities in China. And then when they burn everyone to the ground, they'll lobby to be able to bring stuff in from the channel.

SPEAKER_02 50:04

But are they blocking, are these is this a facility big enough where a lot of the peptide producers in the United States have been getting their API? And well, could they shut them down by just Well, they're working an array of angles to shut them down. But that would be one because they didn't have the source.

SPEAKER_00 50:23

And I think compounders, look, I am willing to bring a I'm willing to build my own API facility. I'm willing to bring everything stateside. I'm willing to vertically integrate. I can't do that when every week the regulatory landscape shifts. And every week I don't know if I'm going to lose 70% of my revenue.

SPEAKER_02 50:41

Right.

SPEAKER_00 50:41

Right? It's very hard to run a business and help people and make things affordable when every time you turn around, the regulatory oversight is colluding with industry to make crazy catastrophic decisions for the end users like you guys and compounders. And so I go back to like in my meeting with Marty, I can understand where the law, not even with Marty, with anybody in the administration that I've met with, they've told me, well, you know, the big pharmaceutical companies are saying this and this and that. And the gist is the same. You're sourcing API from China. Um, they're costing us $7 billion a year in revenue. Who is when you say they? Uh Lily and Novo, they're direct like lobbyists, and their teams are telling almost anybody that'll listen. Senators, like I met with Senator Tubberville. I've met with uh, I mean, you name it, senators at the federal level, the state level. Um, I have a lot of inside baseball on what they're being told.

SPEAKER_02 51:34

And the gist of it is when you say losing seven billion because of the compound pharmacies or what?

SPEAKER_03 51:39

Yeah, they're losing what, seven billion dollars of business.

SPEAKER_00 51:41

Yes, and then here's where this is a lie, and this is what I've had to break down. And I and I said this on Rogan's podcast earlier this week. I can put myself in the shoes of a legislator or a politician who knows nothing about healthcare. And God, if like a big American company's coming to me who's supported my campaign and they're saying, gosh, I brigham like these guys are costing me $7 billion. We we spent $3 billion to bring this drug to market. Uh, we're hemorrhaging cash because they're violating our patents, and I need you to do something about it. Well, that's a very compelling story. And if you don't have the other side of the story, you're gonna jump too. But when I pragmatically break that down for politicians and explain to them the real truth, the real truth is they didn't spend $3 billion to bring that drug to market. We did. The consta the taxpayers did. Most of these molecules come from the NIH. The NIH is funded by me and you and our taxpayer dollars. In fact, out of 200 and something blockbuster drugs, I think it's 209 blockbuster drugs, uh 190 something of them or whatever came from the NIH. Like, it's they buy them after they're through phase one trials. Right. And then the $3 billion number was created by industry for industry to benefit industry. It doesn't cost $3 billion to bring a drug to market. It is a way to block and obstruct small mom and pop in uh ingenuity and the creative mind of scientists. And in my testimony at the Senate level that started all of this, I literally quoted Eisenhower and I said, I President Eisenhower warned the American people. He warned us about the military-industrial complex. Everyone talks about that part. Nobody talks about the second half of his speech. The second half of Eisenhower's speech, he heeded caution and he said if we allow industry to capture our institutions, our academia, our scientific processes and protocols, it will be catastrophic for the American people. It will kill the garage tinkerer, the inventor, the creator, and it will stifle innovation. We have seen that. We are living that. Rather than treating and curing chronic disease, we're monetizing, masking the symptoms of chronic disease. They're blocking peptides, they're obstructing testosterone therapy. They've literally built protocols that deliver people straight to the sick care door, where they then monetize and profiteer off of chronic disease. And so as we systematic walk through, so that's one aspect, the $7 billion number, the entire compounding sector did $7 billion. That's infusion care, that's critical care, that's hospital, that's fertility, that's testosterone. In the heyday, when the FDA threw up the bat signal and asked compounders to fill the necessary lifeline gap of medications for the American people, we did it. We responded and we did a whopping $2.8 billion, which is a big number. I don't want to trivialize it. But it's national. Nationally. And half of that was Novo Nordisk. Half of that was Eli Lilly. So $1.5 billion in the heyday. We now you've removed that loophole. You've shut down 503Bs. It's only 503A's, which are patient specific, can make a GLP one right now. Yeah. Uh technically, in the law of the land. So where is the $7 billion number coming from? It's an inflated, made-up number. That's not true. And for Lily to say they're infringing upon a patent, that's not true. If we were, you would have beat me in the court of law. You didn't. I beat you in the state of Texas. In fact, we beat you so many times that Texas has now thrown the case out and said they're not allowed to be patent. They're not even suing people for patent infringement because they'll lose because we are following the laws of the land. But but you said they did sue you and what they're telling the government is we're infringing patents. What they're suing people on is marketing and advertising. And most of us aren't marketing and advertising, so they weren't able weren't able to prove that. And that that that case got thrown out with prejudice in Texas, meaning Lily can't refile. So what Lily and these companies are doing is they're using the regulators as an attack dog to try and diminish, demolish, and demean compounders and obstruct patient accessibility. And the problem is when they give their set of data with no context, it is compelling. And so I was trying to explain to these regulators, it's not 7 billion, it was 1.5 billion in damages to Lily. It's not damages to Lily because they were patients that were never going to go to Lily in the first place. If you look at the market they didn't have the product at that point. They didn't. And if you look at the market today, it would be less than that. And if you say these companies spent $3 billion on bringing the drug to market, they didn't because of what we just covered with the NIH. And now let's go to the last thing. We have to protect American companies because God forbid they spend all this money on innovation, Brigham. And what if they don't ever get to reap the benefits? Eli Lilly has 7x their market cap. They were a trillion-dollar company. They're today valued even in a down stock market at $800 billion. That is sevenfold what they were worth prior to GLP ones hitting the market in America. I think it's safe to say they've got their return on investment. And I my argument is the system worked. It worked. The way it is today, my my message to the regulators is please just follow the laws of the land. They're working. Patients were able to ring the bell, they were able to get accessibility to care. All that is left on the vine today for clinicians to reach out and grab is patient specific. And now you're going to argue the nuances of patient specific and argue with clinicians and their ability to make that decision on their own. Because you don't want compounders because Lily's telling you we're bad. Because that's the truth of what's happening, and a lot of people are scared to say it. These guys have a lot of money and they donate a lot of money to the campaigns, and they are putting immense pressure through misuse of facts and oftentimes outright lies to try and manipulate politicians into making catastrophic decisions.

SPEAKER_03 57:33

So let me ask you this. You said your message to regulators. What's your message to the young person, let's say 40 years old, who's watching this podcast, who's maybe thinking about peptides or some of these medications? Why should he care?

SPEAKER_00 57:46

Uh, because I think if you're young, the whole point that I'm trying to paint is for me as a 45-year-old guy, if you wouldn't have intervened with pharmaceutical interventions like HCG or testosterone to fix my hormones, I was headed down the path of chronic disease. I was headed to being the average American. I would have been on four or more prescription drugs. I would have been diabetic. I was pre-diabetic. I was headed over a cliff. And so many Americans are headed over a cliff. And part of getting proactive, predictive, and preventative is to do the work, to come in and have the work up. And I encourage everybody, find a practice in your area and find a clinician you trust and do the comprehensive blood work because it will give you much deeper insight into what you need. I'm a huge proponent and believer in peptides and hormone optimization, and I think there's a way to do it safely, and that is through the supervision of a clinician. And that is all I'm uh I'm I'm advocating for.

SPEAKER_02 58:41

And that's And that's such a basic truth now. I mean, it's not up for a discussion. Yes.

SPEAKER_00 58:46

I mean, that's true. Yeah. And in the and that's where I do think uh that Marty and Secretary Kennedy and this administration really do understand like people are still doing peptides, they're just doing them illegally and black and dangerously and dangerously. We have an opportunity to to right or wrong of the Biden administration in that era and to put the horse back in the bar and to provide affordable, accessible care for American patients. We are talking about the two things that regulators try to stand on are safety. And I think we've provided an array of safety data. Over 800 clinical trials have been submitted to the FDA on peptides on the list of the 17 peptides. Um, we also have pragmatic real-world data of these compounds were being used for four or five years prior to the FDA intervening without any major adverse events. And then the third thing I'd say with safety is if there's a bunch of adverse safety data, then respond to the 17 Fourier requests. Simple ask. Shelf safety. We know they're safe. We're fully aware these are amino acids found in nature. Over 200 peptides are found in the human body today. We're taking what nature or God or whatever you want to call it gave us, and we're utilizing those to optimize your chances at staying healthy and at healing and recovering. The second part would be efficacy. And here's my argument on efficacy that I have presented to the organization, to the FDA. If I'm asking you for an indication, I'm asking you to take taxpayer dollars and give me Medicare, Medicaid, Tri-Care, and force insurers to cover the cost of care. I'm not asking for that. Compounders are not asking for that. Urologists and clinicians are not asking for that. What we're asking for is for the federal government to get out of the way of a patient in a clinician relationship and to allow compounders to make safe and accessible medications. We have the checks and balances in a cash-pay compounded market. If a medicine doesn't work, a patient doesn't keep paying for it. Like we're talking about evidence. This isn't a set it and forget it. Like in traditional medicine, a patient goes in and gets a lipator prescription that gets covered by their insurance. And if the patient feels like it doesn't work, a lot of times they just quit taking it and their insurance keeps getting billed and the script prescription keeps getting filled. And we, the taxpayers and the other business owners are the ones funding that. This is a cash pay market where a patient is making an educated choice alongside an educated healthcare provider to decide what is best for their children. But if it's not working, they're not going to buy it again.

SPEAKER_03 1:01:12

So, Larry, going back to like your clinic, I mean, you follow your patients very closely. They come in at what every few months. So you probably have more experience in this peptide space with short, intermediate, and long-term follow-up than most healthcare providers. Would you agree?

SPEAKER_02 1:01:27

Yes.

SPEAKER_03 1:01:28

What have you heard from patients?

SPEAKER_02 1:01:30

Nothing. I've had no side effects, ill effects from peptides. Nothing.

SPEAKER_03 1:01:35

How do you find that they're helpful?

SPEAKER_02 1:01:37

Well, it depends which peptide I'm using. I mean, they are very, very diverse.

SPEAKER_03 1:01:41

What are some of your favorites?

SPEAKER_02 1:01:42

I mean, right now, BPC, TB500, you can't keep because everybody wants it.

SPEAKER_03 1:01:47

I mean And who's a typical patient that you would see that you feel like would benefit from the Peter?

SPEAKER_02 1:01:51

Well, it's it's just a good anti-inflammatory uh for joints, tendons, recovery after workouts. The patients just do better.

SPEAKER_03 1:01:59

Um because we tell them, what do we tell them as healthcare providers? I need you to lift weights and do cardio and eat healthy. But a lot of these guys are like, I'm trying to, but my freaking shoulder hurts.

SPEAKER_02 1:02:08

Right. Right. And so we do. We facilitate them being able to continue exercise. But I mean, you know, I'm not, I'm not dumb. I mean, if I have a patient with persistent shoulder pain, I'm gonna send them to the orthopod down the hall. I'm not gonna keep treating them with an anti-inflammatory. But for the man who does not have identifiable, correctable disease, you would give them an anti-inflammatory anyway. But this does not have side effects. They don't get GI upset. As a matter of fact, BPC in an oral form is used to treat GI problems, you know, anaeritis.

SPEAKER_00 1:02:37

So I mean that's where this is a I'm so excited. I'm literally I really am very excited. I don't get to talk uh like in a forum like this with academia. Yeah. And so in most of the time when I am talking to academia, it's them mad at me.

SPEAKER_02 1:02:49

So, like, but to be able to talk to you guys, it's I think it's I don't think academia would ever be mad at what you're doing. Yeah, I think it's non-academia. That it's it's business.

SPEAKER_03 1:03:00

Well, actually, talk a little bit about because I feel like in our space, some people will say, Well, don't prescribe a peptide because you're putting your medical license at risk. But you have patients signed consents that were approved by the university in which you work.

SPEAKER_02 1:03:12

First of all, one of the guys in my group is very no, no, no, you can't do peptides. So I called the a risk management lawyer at Baylor and I said, Listen, you know, can I do this? Do you think I should have him sign an informed consent? He said, Sure, have them sign an informed consent. I'll review it. I wrote it, sent it to him, got it back. So my patients sign an informed consent, saying, I realize this is not an FDA approved drug, and now, you know, everything you put in an informed consent. It's the same thing we do. Yeah. But I mean, you know, but you know.

SPEAKER_03 1:03:41

Which is way more informed consent than we do for medications that have real implications on side effects. Think what's the informed consent for Prozac?

SPEAKER_00 1:03:47

Yes, thank you. Thank you. All right, to the FDA. If we're being real, these are your numbers, not mine. 60 to 80 percent of the medications that make it through the FDA approval process will have a major recall or label change. Is it? 60 to 80 percent. These are your numbers. This is what made it through the process. And I'm not here disparaging like the FDA. I'm all I'm saying is these are the real numbers. And when we take science and controlled trials and we move that to the general populace, you have a much wider patient demographic with a much wider set of comorbidities, with a much wider set of prescription management. And those, like we said, they're on four or more prescription drugs. My dad's a prime example. He's on like nine drugs. His cardiologist is arguing with his urologist, his urologist is arguing with his kidney doctor, they're all blaming each other. His kidneys are overladed, he's taking too many meds, this drug's doing that, they're all contra-interacting. It's nuts. The system we the third leading cause of death in America right now is medical misdiagnosis and misuse. The third thing, so don't tell me not in my office. Yeah, but don't tell me this system is working, is my point. To everything is risk reward. Medical intervention is a risk reward assessment. But peptides are on the safest of like that side of the spectrum to me. Yeah. Again, naturally occurring. They appear to uh be very well tolerated from an immunomodulatory response, like an immunosum. GI.

SPEAKER_03 1:05:16

Well, let me ask you this, because I have patients all the time that are like, oh, if I start this medication, please look at my existing medication list. Will it interact with anything that I'm on? Are there any absolute contraindications to these medications that we're talking about that you're not that I know of.

SPEAKER_02 1:05:29

First of all, they're protein hormones. They interact with specific receptors on the cell membrane. They're nothing that goes throughout your whole body acting on everything. I mean, there's very I don't have I have not had any solutions.

SPEAKER_03 1:05:41

And I think now that so many people are on so many medications, that's one of the most important questions we have to ask ourselves. If I start this patient on this medication, how will it interact with their four plus other medications? Right.

SPEAKER_02 1:05:51

And the other thing I try to do, I try not to introduce more than one or two drugs at a time. Yeah. Because then you don't know what's causing one. Right. So, you know, I think. One of the problems is there's so many peptides to choose from. You know, you gotta introduce them slowly. You know, we'll get to what all all the ones that the patient needs, but not all at one time. Yeah, it's way too much.

SPEAKER_00 1:06:12

And you'll see too, uh this was a Stanford trained clinician who said this. So it's not my words, it's his, but I I I I really appreciated his like nuanced perspective. He said, What I like about peptides versus a drug is a drug gives a command. It gives a command. A peptide gives a suggestion. And I remember you telling me something similar to that about the GH uh GHRP uh two. Um it's going to upregulate your natural production, but your body is going to tell it where to stop. It can't upregulate past where your body's capable of upregulate. Whereas if I were to put a synthetic growth hormone, I could put you at a level that is so physiologically beyond a physiological normal level. And that's the same thing we see with testosterone. Like nobody's having adverse events when utilized appropriately under the guidance of a clinician. I agree. The guys having adverse events are the guys taking non-physiological, massive bodybuilder doses with no checks and balances and no clinical oversight. I don't know how many times in America we have to relive the same nightmare before the regulatory landscape goes, hey, wait a second. Maybe we should trust the doctors and let the doctors who are the users help guide us in what makes the most sense. I think that makes a lot of sense in itself, that statement.

SPEAKER_03 1:07:30

Well, I've had people say, um, hey, Amy, I'm gonna start this peptide. What should I dilute it with? And I'm like, I don't even know what you're taking. Like, what does the bottle say? It's so it is scary.

SPEAKER_02 1:07:39

But tell you that the instructions for diluting a crystallized, you know, something that comes in powder form is very clear. I mean, the stuff that comes out of your place and No, but I think the problem with the on the black market and great market is they don't give those instructions.

SPEAKER_00 1:07:54

The challenge is right now, like all of those companies, because they're trying to thread the needle and not get federally indicted, because what they're doing, and I and I, this is a crazy story, but it's honest to God the truth. I had an executive from Harvard who is now a CEO of one of those companies, and they put me on the phone with him to talk to him about why I think he needs to move to legitimate compounded versions of peptides. And this guy was so arrogant, and everything was, well, we know what we're doing, and I've got attorneys from this school and that school, and they know better than you what the law is, and da-da-da-da-da-da-da. And he's like, we say it's lab use only, we say it's this, we say it's that. And I go, okay. You also pay this influencer, and I know you pay this influencer, and if I know you pay this influencer, you better believe that the federal government could figure out you pay this influencer. And in one breath, you're saying, we have written legal opinions and we're not marketing it for human use, but you're paying an influencer to market it for human use. You don't think that's gonna get discovered in discovery? And you don't think the second that a patient mixes something inappropriately or gets an infection that they're not gonna sue you, or even worse, has a catastrophic event because you've misguided them and didn't give instructions or dosing regimen or any sort of clinical guidance, and you claimed it was being marketed for lab use only, but you weren't. You were paying hundreds of influencers to go on Instagram and sell it to the American public. If I can figure that out, a knuckle dragger from University of Houston, you don't think some Ivy League attorney is gonna figure that out? Or what do you say? He resigned a week later from the peptide company. 100% he resigned. And I'm like, because my message isn't that that's we just need checks and balances. That's it. And we had them.

SPEAKER_02 1:09:29

And the problem is, you know, if you don't legitimize it, if you don't let people do the doctors do what they want, you're gonna have patients like the one I saw who was self-prescribing his peptides. I mean, you know, he did, and his idea of what they were going to do came from social media.

SPEAKER_04 1:09:46

Yeah.

SPEAKER_02 1:09:47

I mean, and he was treating himself. And I really wanted to fire, I've never fired a patient, but I just didn't want to deal with the fact that I and why was I trying to convince him? I mean, he came to my office, and I think he came for something that he couldn't get. So he wanted me to, and then that's not my job. Yeah, you know, my job is not, I'm not a store. Yeah, yeah. You know, so but I've never fired anybody, but I really was tempted to say, look, you know, you know it all, you don't need me. Yeah and get up and walk out. But I didn't do it.

SPEAKER_00 1:10:15

Well, there's there's clinics like yours that do great jobs. Like, and and I I I covered this too. Like, what scares me too is the evolution of cash pay, even it's going down a darker path. Like it's split off from traditional insurance-based medicine, and now there's like these two pathways. There's the Peter Atias of the world that are charging people insane dollar amounts to do basic medical care that everyone should have been having access to in the first place. Now, I don't want to say it's great clinical care, but at what cost? Like 99.99% of Americans can't afford that. And then there's the hymns of the world that are going the path of almost becoming pill mills, where it's like, get a bit of a.

SPEAKER_03 1:10:58

Yeah, it's weight loss and men's health commerce.

SPEAKER_00 1:11:00

Yes. And the problem we were talking right before we came on, one of the questions asked by the other urologists out there was why did the FDA make such a harsh statement against compounders? It is because companies like Hymns were doing very aggressive and I would even argue illegal things. They were using the brand name, they were making claims, and they're identifying themselves as a compounder. And so my message again to regulators were Hymns is not a compounder. Hymns is a multi-billion dollar PE backed conglomerate that already had struck a backroom deal with Novo Nordisk to bring onshore Novo products in a cash pay market, and that was a Trojan horse. I really truly believe that. What do you mean? Why wouldn't why would a multi-billion dollar company with a full legal team go out and violate the law in a way that got them turned into the DOJ unless you were working the deal the whole time? Well, I don't understand. Do you understand?

SPEAKER_03 1:11:55

Oh, to have a cash pay model.

SPEAKER_00 1:11:57

No, yeah. So what happened is Hims literally had a deal struck with Novo to provide the commercial name, but the deal hadn't been publicly made. So they advertised during the Super Bowl as a compounder using the commercially available name. Novo files a lawsuit against Hims. Hymns then gets turned into the Department of Justice by the FDA as a compounder. This is what compounders are doing. Look at them. Look at them out there. They're out there making claims, doing Super Bowl ads, and they're they're using the commercial name, but they're a compounder. They shouldn't be doing that. They shouldn't be advertising. They're violating the law because they're advertising. They're violating the law because they're using the commercially available name. It sets the compounding world up.

SPEAKER_02 1:12:38

But you're telling me that Novo Nordis was part of it? Bingo.

SPEAKER_03 1:12:42

Because now it puts a negative uh vibe towards compounding when Hims was never a compounding.

SPEAKER_00 1:12:47

Why would Hems do it, though? What did they have? Because Hems struck the deal to bring forth the Novo deal a week later. Now they're selling the commercially available drug for Novo, but they set a bomb off in the compounding industry that now is going to have to be unwound because regulators are put painting all of us with the same brush as Novo and Hems. No, this was a Novo Hems backroom deal that intentionally damaged the pharmaceutical industry, setting them up with a golden parachute to ride off into the sunset and go, Well, okay, we still provide it and we're doing the brand name. Screw those compounders when you're the one that created all this chaos for compounders.

SPEAKER_02 1:13:28

But but who said they were a compounder? Hems? They branded themselves as a compounder. And then they said afterwards they're not.

SPEAKER_00 1:13:36

So no, wait, how Hems, it HIMS owns or recently in the last 12 months, bought and signed deals with compounding pharmacies. And so they are making and compounding, they were making and compounding GLP ones. Right. They decided, and this is my point, as a multi-billion dollar conglomerate backed by PE with high-end like Ivy League attorneys. You can't tell me, and this is what I told the administration, because this all played out over two weeks. So I'm telling you, like, as it was playing out, the administration is like, this is what we're talking about. These compounders are out there doing Super Bowl ads where they're claiming that they're making the commercially available drug and it's ruining everything. And we're gonna have to regulate the hell out of compounders because it's the Wild West right now. No, it was one company, Hems, who is not a compounder. They're a multi-billion dollar PE conglomerate. And my point is, I don't think they did it by accident. I don't think that was a mistake. I don't believe for a second that somebody comes into your living room and takes a dump on your living room table and it's an accident. I just don't. And then lo and behold, a week later, ho, Novo and uh Hems settle their dispute, drop their lawsuits against each other, and now they're business partners and allies selling Novo's Wagovy product in America for cash through Hymns. So you did two things. You strategically set off a nuclear bomb on all compounders, which created a cascade effect of drama from regulators, where now they think we're all the bad guys, and then at the same time you gave yourself a golden parachute where now you have a sweetheart deal with Novo to sell these products in the United States.

SPEAKER_02 1:15:12

Yeah, but if you figured this out, why wouldn't the regulators figure it out? We'll see.

SPEAKER_00 1:15:18

I mean, there is a class action lawsuit that got filed that is uh qu it questioning an antitrust. Is this an antitrust violation? Did you just try to build a monopoly for the who's filing it? Uh I'm not sure which uh it's it's a guy named Lee Rosebush, but uh he represents a I think he's doing it on behalf of uh one of the compounding pharmacies that was making product for HIMS. That's like, hey, wait a second, we didn't agree to any of this, and now you turn around and do all this and it hurts us type deal.

unknown 1:15:44

Yeah.

SPEAKER_03 1:15:45

I want to switch gears a little bit.

SPEAKER_00 1:15:46

No, it's that's nuanced, but it's yeah, and it would have to be a big thing. And you can edit it or you can cut it out. I'm just giving you the all of it.

SPEAKER_03 1:15:52

So you're investing a lot of time, money, and resources in regenerative medicine and psychedelics. So what excites you about the future of what you're working on?

SPEAKER_00 1:16:01

Well, are you investing in psychedelics? I didn't know you were doing that. Yeah, yeah. We did a research study with Dell Medical on psilocybin. Um I think ibogaine's really exciting for trauma, for depression, for anxiety from years of covering and carrying those medications. Right. The data with ibogaine is is extremely, extremely impressive. And it's like one weekend session of Ibogaine, has like a 90% success rate on addiction, depression, anxiety. Um, but there's a heart risk there. And so we have to be like cognizant. This isn't something that we could roll out to the masses. I do think there are treatments and modalities that are available that have kind of been hidden.

SPEAKER_03 1:16:36

Brigham, you've probably on a roller coaster of emotions during this podcast. Is your message one of curiosity, optimism, skepticism, conspiracy? Like, what is like how can I bottle this up when I leave this through? I don't think it's conspiracy.

SPEAKER_02 1:16:52

No, I don't think that's the right word. It's not conspiracy because it's out there in plain daylight, and that is there is a there is contention between you know what's good for patients, right, what's good for big pharma, yeah, what's good for the bottom line, and what the government, where the government wants to put themselves.

SPEAKER_00 1:17:10

And I love I love the way you worded that question because I feel all those emotions, literally every day.

SPEAKER_03 1:17:16

Like, hi, I'm low.

SPEAKER_00 1:17:17

Yes. And it's like, I'm so optimistic that for the first time compounders have a voice, but the fight is real, it's not going away. There are big, powerful forces at play that do not want telemedicine happening, they don't want compounders.

SPEAKER_02 1:17:35

But are we back to the old adage of just follow the money?

SPEAKER_00 1:17:38

Yeah, oh, 100%. 100%. But I am also optimistic like getting to meet clinicians and talk to and know people like you guys and people who are on the academic side of the world that do believe in these modalities. Everything I've preached, I've learned from fucking PhDs.

SPEAKER_02 1:17:55

But you've got to you've gotta you've gotta understand something. When the NIH semi-closed down because of problems with funding, all the academic institutions were panicking because so much of their money comes through at grants. So, you know, there is a control mechanism from Washington over all your academic centers.

SPEAKER_01 1:18:16

Yeah.

SPEAKER_02 1:18:16

So you have to be very cautious. Yeah.

SPEAKER_00 1:18:19

I think there's a lot of challenges in our healthcare system, but I'm more optimistic than ever about the brilliant minds. And so, like, my dream and my vision of what I want to do is go more down. I I had this epiphany the other day. I'll never be able to out lobby big pharma. I will never have the budget to compete with big pharma on lobbying or marketing or their sales force. But where I do see big pharma failing is they do not honor and revere the relationship of a clinician and a patient. They do not honor and revere the men and women at the bench, the PhDs that are working their asses off to change the world. PhDs get no respect. I mean, they're the creators, they're the ones providing these pipelines and these products for all these pharmaceutical companies. And I say that not disparagingly, like it's an opportunity because I want to engage and employ and reward PhDs. And I look at what they pay the PhDs and how they treat the PhDs, and there's an immense opportunity there for somebody like think about if a guy like Elon was really wanting to get Elon, if you're watching this, yeah, he could truly impact human health span and longevity. And there are brilliant, like Ryan Rossner's another PhD that I work with. He worked for DARPA, building X-Men. Literally, his his quote to me was we live in the era of X-Men. Like it's beyond just peptides. Like, we now have the ability to turn on the gene that tells your body to secrete more GLP1s. We can turn on the gene that would upregulate BPC production through gene activation. The gene is already there. You just have to find it and you have to activate it. Not that easy. Yeah. And geneticists are already doing this in certain levels, at certain levels of success, too, with things like false statins for military operators. Uh the point is like the future is bright, but it comes back to where it always was, which is people. It's people. It's not the government, it's not these big cartels, it's clinicians standing up for patients, patients standing up for themselves, PhDs and academia working together in unison to fight back and to say we won't be silenced and we won't be suppressed and we're gonna fight for truth, which is where I was going with that Eisenhower speech earlier. The second half of that speech is where we are today. We are unfortunately living the warning that he heeded. Yeah, and we're in it. We're in the middle of it.

SPEAKER_02 1:20:42

Well, people like you are certainly making inroads and helping.

SPEAKER_03 1:20:45

Yeah.

SPEAKER_02 1:20:45

Thank you.

SPEAKER_03 1:20:46

I think that's a great way to finish off this.

SPEAKER_02 1:20:48

Yeah, so thank you so much. We learned so much, and hopefully, people out there are going to learn equally as much.

SPEAKER_00 1:20:53

Thank you so much for having me. It was fun. And Larry, thank you seriously for all you did for me personally. Of course. My pleasure. Do it again.

SPEAKER_03 1:21:04

Larry, I think I need to go hang out in fetal position for a little bit to recover.

SPEAKER_02 1:21:10

This this flattened you out.

SPEAKER_03 1:21:12

Yeah, the more I learn about insurance companies and pharmacies and big pharma and our healthcare system and politics, the more I sometimes want to throw up.

SPEAKER_02 1:21:23

Well, it was that disturbing. I just thought it was kind of eye-opening.

SPEAKER_03 1:21:29

Yeah.

SPEAKER_02 1:21:30

And at the same time, negatively impacts your overall view of government and the FDA.

SPEAKER_03 1:21:36

Are you surprised though? Because you've been in this field for a while. You've been you've been to the FDA.

SPEAKER_02 1:21:40

Yeah.

SPEAKER_03 1:21:40

You know, I mean, you've sat on these panels.

SPEAKER_02 1:21:42

Right.

SPEAKER_03 1:21:43

Are you surprised?

SPEAKER_02 1:21:44

I I th I I think I'm surprised about how bad it's gotten. Because, you know, has it always been this bad? I don't think so. Because I can remember being on one of their expert boards uh evaluating new medicine. And I don't know, it was not as serious and it was not political at all. You know? It was just science. Yeah. Now the science is like relegated to second place, and what they're all worrying about is politics.

SPEAKER_03 1:22:10

Yeah. And you've been working with compounding pharmacies for a while now.

SPEAKER_02 1:22:13

Yes.

SPEAKER_03 1:22:14

So how do you think that landscape has changed? Has it always been this polarizing?

SPEAKER_02 1:22:19

No, it wasn't. I mean, it was never polarizing. It was an option that you could allow your patients to use to both save money and get medications they couldn't get other places.

SPEAKER_04 1:22:30

Yeah.

SPEAKER_02 1:22:31

But now it's become this, I don't know, turning point in medical care where you either love it or hate it. Yeah. And it's not at all focused on what patients need. Nobody cares, it seems to me, beyond physicians, about patients.

SPEAKER_03 1:22:49

Yeah.

SPEAKER_02 1:22:50

And they're in positions, these people are in powerful positions to impact the cost of medicine, the availability of medicine, uh, the price of insurance, the ability to get procedures done. And nobody's worried about the patients. Yeah. They're all worried about their stockholders.

SPEAKER_03 1:23:07

Yeah. When I was in Iowa, I was prescribing HCG from a compounding pharmacy in Houston, which was totally legal, like from my standpoint. But actually, someone reached out to me and said, Why are you prescribing HCG from out of state? And I said, Because they have a price that my patient can afford. And they said, Well, that's not a reason. I'm like, I mean, that is like the reason. I mean, how do we take not keep, you know, put that into the equation? But they said, Well, that's not a reason that a pharmacy can compound a medication, which I get from like maybe like a legal standpoint, but that's the freaking problem with a lot of these other entities, is they don't consider the burden on the patient when it comes to costs.

SPEAKER_02 1:23:45

And then you say from a legal standpoint, but who is making the laws and why are they making the laws? Uh the laws are supposed to protect people.

SPEAKER_04 1:23:53

Yeah.

SPEAKER_02 1:23:54

Not to protect big entities to enable them to make more money. Yeah. And that's what it would assume, especially when you listen to Brigham, is that's what's going on.

SPEAKER_03 1:24:03

Yeah, yeah. So disturbing, but he also highlighted some optimistic points. So we'll maybe end our podcast episode on optimism.

SPEAKER_02 1:24:10

Yes, even though it could be ill-founded.

SPEAKER_03 1:24:13

All right. So how about an F-word for today's episode?

SPEAKER_02 1:24:16

Is the FDA could be a potential problem.

SPEAKER_03 1:24:19

Okay. That's a good F-word.

SPEAKER_02 1:24:20

Yes.

SPEAKER_03 1:24:21

All right. How about some foreplay, Larry?

SPEAKER_02 1:24:23

So we will From the next episode. Yes, I know. That always sounds so bad. So our next episode is going to be with Dr. Alex Tatum. Uh who is We're bringing him back. We're bringing him back for an encore. And this time he'll be addressing innovative therapies in men's health. And it's it's going to be really good.

SPEAKER_03 1:24:46

I can't wait to see him again.

SPEAKER_02 1:24:47

Yeah, me too.

SPEAKER_03 1:24:48

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

SPEAKER_02 1:24:52

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

SPEAKER_03 1:24:56

Until next time.