The Body Composition Blueprint: Is Your Muscle "Toxic"?

Is your muscle "marbled" like a ribeye steak? 🥩

In this episode of Cell to Systems, we pull back the curtain on the metrics that actually determine your "Biologic Future." We move past the bathroom scale to expose Myostasis, a condition where fat quietly replaces your muscle fibers from the inside out, and why "big muscles" can sometimes be a sign of systemic inflammation.

In this episode, we reveal:
• The "Invisible Rot": Why your muscle quality matters more than your muscle size.
• The Phase Angle Secret: The #1 cellular marker you need to track (and why you want it above a 7.0).
• The 900lb Squatter: How an elite athlete got stronger by losing 30lbs of "fatty" muscle.
• The 30-Second Mortality Test: Why the "Sit-to-Stand" and Grip Strength tests predict your lifespan better than any blood draw.
• Peptide Black Market Exposed: The truth about $50 vials, endotoxin contamination, and"sneaky" research companies infiltrating medical clinics.
• The "Picked, Pulled, or Killed" Rule: Kristi Fury’s simple filter for a longevity-first diet.

🎙️ Follow the Cell to Systems Team:
• Leonard Pastrana, PharmD: Co-founder of nuBioAge & nuHx.Health /   / leonardpastrana 
• Franck Kacou, PharmD: owner of Progress Pharmacy; co-founder of nuBioAge, nuHx.Health, Source Pharmacy and nuCliniq /   / nubioagewellnessnetwork  /   / progresspharmacy 
• Suzanne Ferree, MD, FAARM, FSSRP: CEO and Senior Physician of Vine Medical Associates /   / drsferree 
• Kristi Fury, CFNP: A board-certified Family Nurse Practitioner; founder of Beyond Health. /   / beyondhealthabq 
• Craig Mullen, MSN, FNP, ACNP: Founder of Remedy Functional Health Solutions. /   / remedy.f

Transcript

SPEAKER_00 0:00

The Celtic Systems Podcast is for informational and educational purposes only and does not provide medical advice, diagnosis, or treatment. Listening does not create a doctor-patient relationship. Always consult a qualified healthcare provider regarding your medical conditions or before changing your health regimen. Do not disregard professional advice or delay seeking it because of something you heard on the podcast. Reliance on the information provided is at your own risk. Guest opinions are their own. Celda Systems may utilize affiliate links, feature sponsored content, or discuss companies in which hosts or guests have financial or advisory interests. Relevant disclosures will be noted during the episode or below.

SPEAKER_06 0:38

Okay, everybody, welcome back to Celda Systems. In this episode, we're going to cover the body composition blueprint. So we're going to talk about muscle quality as well as visceral fat and functional capacity. So VO2 max, the three kind of main things that are getting talked about right now. And as we cover this, remember we're speaking to you as a patient. That's me. And then we're also talking to providers who are out there thinking about being involved in functional longevity, cellular medicine, whatever you like to call it, and want to learn more about how to provide that at the highest level. So as we get into this, we're going to put some things into motion and talk about stuff at a deep level. So the first person I want to talk to today about all of this is Christy, because Christy, you are truly, you know, the athlete of athletes. You're just out there making it happen all the time. You're always moving. And I think you're doing it in a way that's really constructive. You don't over-train. You just get the right amount. You do it. How do you do this in the right way to make sure that you're tracking everything and staying in the right shape and have the long-term plan?

SPEAKER_01 1:53

Yeah, I mean, I think, you know, for myself, um, I really just go by how I feel. Um, that's how I make my adjustments. Um my biggest issue is usually my sleep. Um I need to do more um neurotherapy. Um, and and I realize that. Um, but you know, for patients, I think we, you know, I I always start with like muscle is your biggest wealth, which I know all of us here, you know, live that and and believe in that. And that you truly can't have lasting health if you don't have more muscle than fat. Um, so I just starting simple. And then my approach with patients is I in my brain, I literally kind of break them up in decades. Um, you know, like your third decade, your fourth. And, you know, when I have a patient that's in their fifth decade, for me as a provider, it's game on because I know if I can help a you know catch a male or a female in their 50s and get more muscle mass on, that that will absolutely convert to their 60s, 70s, and 80s. Versus if I fail them, if I don't recognize the um the muscle loss that might be occurring from a longevity perspective, or that they have more visceral fat as far as disease um risk, um, the body fat percentage as far as metabolic, and then just muscle balance. I think that's an area that I am very passionate about just being an athlete as far as the balance. Um, you know, I can tell by just simply how a patient walks in to me or walks down the hallway, um, you know, how they set to stand when I'm, you know, they always start in the chair, but then I will move them to the table to do a thorough exam or any procedure that might. And then another favorite one of mine is the um the phase angle um as far as on the in-body. Um, you know, that is a very exciting tool for me. Um, you know, knowing that we want that number above seven, like, you know, that's excellent. Not a lot of people are there, but that's where we would like for them to be. You know, six to seven is considered like cellular health. Um, five to six is average. But when I start seeing a patient in their fours, um my my radar is on as far as either looking at peptides, making sure that their hormones are optimized, and then you know, their their food um and their movement and their sleep are on point.

SPEAKER_06 4:44

Yeah, sleep being so, so important and diet, um, just having been, you know, getting so focused on diet recently for a specific goal that I'm trying to achieve, um, which Suzanne's funny. We talked about that the other day. Suzanne, uh, what's your thought process around what's important?

SPEAKER_02 5:02

So it's interesting. It's uh it's been really curious. You know, uh I come from powerlifting, that's my sport or has been my sport. And uh my team, my teammates are all huge guys. They're, you know, this guy that I that I train with place first nationally, uh I mean internationally, um, he squats over 800 pounds, like almost 900 pounds on his, I think it was like it's kilos, so I don't know what the math is. But anyway, it's very close to 900 pounds on his last uh competition. And this guy was before we started working with him, he was enormous. And not just enormous, like his head was big, his neck was big, his arms were big, everything was huge. Because you don't have to be balanced, you don't have in in powerlifting. All you have to do is be stable. That's what's most important. And so, in thinking about these guys and a lot of the guys that we see that are are um like this guy, he would walk past me and he would say, he'd say, Doc, I want to have arms like you one day. And I that got me thinking about like, this is not about muscle mass. This is about the quality of the tissue itself, right? What is the message that the muscle or the tissue is sending when it's full of fat? When we're talking about, and when you look at it on the on like a DEXA or whatever, you can actually see this sort of modeled appearance with lots of fat stranding in between the muscle fibers. So when we're talking about muscle hypertrophy, we're not always talking about hypertrophy of muscle. Sometimes it's infiltrated with fat. And so that we call this myostasis, um, and this can be really um toxic to the cells. So now that extra fat layer begins to communicate via cytokines with other cells, the healthier myokines, which we love, like irisin and BDNF, that's secreted helps with brain health. It helps with the neuromuscular junctions, which are kind of destroyed and things like ALS, et cetera. Those uh the BDNF that's secreted by an exercising muscle is actually gonna really help with the whole rest of the body and the function of everything. Those chemicals will go out to the body and say, everything's fine. This is a young, healthy body. Let's keep doing all the young, healthy things and producing in our sort of proteome the younger uh proteins. Um the concern is when we have that higher visceral fat, then we start seeing this um negative signaling and this inflammatory signaling that causes all the things. So sometimes when I see, like, for example, a higher CRP on people, I'm imagining that may be part of the situation. So thinking about not just looking at what the tissue is, the size of the muscle or the increase in amount, but also that very health. So we look also at things like, you know, the cell membranes of the muscle in every cell are made of lipids and fats in the cell wall, cholesterol in the cell wall. We want that all to be there and healthy and not oxidized. Um, this is the way that mitochondria function better. It's the way the cells function better. When those aren't happening, and we see that with that phase angle. I'm so glad you mentioned that, Christy. That's such a great marker because you're gonna see that cell wall not be as healthy as we want it to be. And when that cell wall is not super healthy because of oxidized lipids or other metabolic inflammatory things, um, you know, spike protein, et cetera, when we see all those things coming in, we see that the cells don't function as well. So there are the receptors for our hormones, the receptors for vitamin D, which is also a hormone, the receptors for uh moving fat in and out of mitochondria for energy production. All of those things don't work as well when the tissues aren't quite as healthy. And so as much as uh as much as we love seeing our patients put on muscle, be aware of that phase angle being so critical because it gives you really a great idea. And sometimes you may be adding a DEXA scan in addition to give you an idea of whether we're dealing with a fatty stranded myostasis situation. And then always thinking about is this, is the tissue that we have functioning in a young or in an aging fashion?

SPEAKER_06 9:20

Someone once said that to me, functional muscle, right? What is actually the function? You may lose some size along the way and think to yourself, oh, I'm I'm losing muscle.

SPEAKER_02 9:31

No, no, you're actually Well, we got this guy down 30 pounds of fat, and that was before he did his almost 900 pound squat. So he went like down, and yet still, because he lost mostly fat, um, he he still was able to do that competition.

SPEAKER_04 9:48

Yeah. It's wild, right? Suzanne, there's this new, I don't know if you heard about it, it's called Springbok Analytics, where they you can send the patient to get a full body like MRI, and they can now measure fat infiltration in the muscle. And you get this, and you get this scan. I was trying to get them to come to Calm, and but they were like new, because they're in research and they're trying to get into the longevity space. And I was like, you guys, you don't understand. Our doctors would love to find to have this information. And you have markers or percentages of fat infiltration all over the body, um, all over muscle. And then you they can actually look at injuries because when you have injuries in certain muscle, there's more fat infiltration there. Or if there's more density of the muscle, it looks like you have more muscle somewhere, but it's really like an old injury. And um, so really cool data that's going to be coming out around body composition, even outside of in-body indexa scans. So really excited to see that because one of the things that we talk about a lot is people lose a ton of muscle when they're losing weight. And if they come in like your patient, like well muscled, and people are like, oh, this is anti-longevity, they just lost a bunch of muscle. It's like, well, what was the quality of muscle that they lost, right? Because sometimes they need to get rid of some of that fat-infiltrated muscle and kind of rebuild it. So it's a there's a lot of nuance to this body composition.

SPEAKER_02 11:00

He has much healthier muscle mass now than he had before. And so he's able to lift a greater amount of weight than he was because we were able, and this was all without a GLP one. This was all with diet and and changing up his ex his activity.

SPEAKER_04 11:17

Yeah. And that reflects like the literature because the literature tells us that strength is an even better indicator. And so you're you're you're you're describing the opposite of what most people think about is like once you lose muscle mass, you lose strength. And you have this perfect example of someone setting these like almost like records um of squatting so much weight.

SPEAKER_02 11:36

I can't imagine what that what that's can you imagine on your back when it feels like this guy's like no.

SPEAKER_04 11:41

My lower back hurts just thinking about it.

SPEAKER_06 11:46

Yeah, that is wild. So, so Leonard, what it this technology is is in research, but do you think by next year at Calm it'll be out and available for people to really see?

SPEAKER_04 11:57

Yeah, I think we created a buzz around calm because that conversation went silent. And as soon as I got home from Calm, I got an email from them. Hey, let's revisit that talk. It's like, yes, you guys needed to be there. You know, this is what doctors want to know. They want to know the quality of muscle. Um, and and then with injuries, there's there's so much implications with this thing because if you look at somebody that has like more dense muscle on one side due to an injury, some people like the left side of their body hurts because the injury happened on the right side and now they're favoring the left side. And so now when we're thinking about certain peptides that you can inject um, you know, uh by certain locations with the injury, now you have an MR MRI showing exactly where those injuries are. So I'm like, we you have to come, we have to have start having conversations with these brilliant doctors because um this is gonna this is gonna make a big impact.

SPEAKER_06 12:45

That'll be your best crash test dummy ever. Uh nine nine orthopedic surgeries later. Um I'm I'm uh I'm a walking injury model.

SPEAKER_04 12:55

Yeah. This person, this person that read the model for me, he's he saw um where my symmetry was off and where I had more dense muscle. And he's like, You did you did some type of a sport where you're leaning in one direction because I've always had really tight hips. And I was like, Yes, I used to snowboard a lot, and I was always on my back leg, always on my right hip. And that's why that my flexibility is completely off. And it's, I think, why I have certain injuries. But he had a whole report telling me about what sport I probably played just by looking at this MRI and looking at like where I was favoring things static, like not moving. It's an MRI, uh, which was which was incredible.

SPEAKER_06 13:31

That's wild. That's totally next level. That is so cool. Uh, Craig, I I want to like bring it over to you now and and talk about um, you know, you're you're a pretty active uh guy in the water. You surf. How do you approach all of these things when you when you think about VO2 max and visceral fat and um and then uh muscle mass? I love what Christy said, the notion of by decade. I've never thought about it that way before, but it makes such sense, right? Hey, a 50-year-old male or female, and if you can have an intervention there and stop them, you know, from having these problems where 60, 70, 80 things really start to fall apart. Uh, I'm just curious how you approach this.

SPEAKER_05 14:19

Yeah. So I mean, um, lots of things run through my mind right now. I've learned so much just in this episode so far from you guys. But um, you know, I am we we're all aware of the fact that, you know, as we age, we lose, you know, some density of our um fast twitch muscle fibers. Uh, you know, we're much more prone to uh risk for injury and and things of that nature. I love bringing it back to what Christy and Dr. Faree mentioned about the phase angle. It's you know, wonderful to see these numbers being suboptimal, or this uh number being suboptimal on a measurement and then making some change, whether that's optimizing, you know, fatty acids, reducing the inflammatory milieu, but then coming back, you know, on the next assessment and seeing uh, you know, that after somebody's hormones are balanced and any other interventions that they've had an improvement in that phase angle, which can correspond to, you know, cellular fragility and um cells that are gonna be less resilient to uh oxidative stress and even things like viral infection if we think about it. So um, you know, definitely looking at phase angle, always trying to reinforce to patients that, you know, what we can do here in the clinic, whether it's the in-body or whether we refer you out for a DEXA scan, that's so much more important than what you're gonna get at home, you know, from just standing on your bathroom scale, right? So, you know, somebody could weigh 150 pounds and have poor muscle integrity, high visceral fat levels, and declining bone density versus somebody else who has the opposite picture weighs the same amount. And those two phenotypes are associated with very different biologic features. So, you know, it's not gonna be about the number, it's about what is in the data that we see in those more advanced tests. Um, you know, from a simplified standpoint as to what we can do just on the physical exam or in the office, you can use something like a simple sit-to-stand test, right? Um and you can really just say, hey, 30 seconds, you're gonna cross your arms, you're gonna sit in this chair and you know, as much as you can, as many times as you can, uh pop up from a seated position to a standing position. And it really, if it's, you know, 12 or less, you're kind of looking at somebody who's got an increased risk for frailty. They have an increased risk for mortal mortality and and cardiovascular disease. You can also look at things like um, you know, dynamometer results, right? And and grip strength. This was another topic at calm. You know, so if we have a gentleman whose uh you know grip strength is lower than 30 kilograms of force, you know, this is something that we need to pay attention to. So um, you know, simplification of things and just doing some really taking it back to the physical exam and and seeing what somebody's gait looks like and um the readiness uh to move, you know, and um, you know, helping's helping to uh evaluate their current health from from those little assessments.

SPEAKER_03 17:12

It's to me, it's scary. It's almost like a like the most like the most dangerous patient, you know, in your in your practice, uh, Craig, right? Is the one who looks like you know, he's not the one that looks unhealthy, you know, it's the one that looks totally fine, you know, but their muscle is quietly being just replaced by a bunch of fat from the inside out, you know, and and they have no idea. You know, it's it's it's absolutely, you know, and this is what people need to really now understand is like, you know, you might look perfectly fine, um, but you know, you you you you have a problem, you know, because you have fat infiltration inside your muscle and you have no idea about that. You know, and you'll take things like MRIs and C2 skin indexa, crib strength, you know, gate speed to figure those things out, you know, and where else can you go to get those things, right? You gotta go to very smart clinician like you guys to get this thing done.

SPEAKER_06 18:09

Yeah, Frank, along those lines, I mean, there's a lot, there's there are all these different agents that people are using now to, you know, cut fat, right? Uh and there's a lot of dangerous stuff of this going on with regards to that. The one thing I would say is, hey, if you're new to this and what you're hearing is something that you've never talked to your primary care doctor about, there might be a reason why. Uh and you might be finding out right now that um this is a totally different ball game, a totally different way of looking at things. And um, so Frank, going back to some of the stuff we talked about um in the last couple episodes, and I think it's tightening up now, closing. Like these windows are closing. We saw somebody voluntarily close their company just recently. But I'm curious what your thoughts are with regards to people and using agents and and all of that.

SPEAKER_03 18:59

Yeah, it's funny, Jock. Every time we talk, every time we meet every week, there's something new, you know? Um it's it's absolutely crazy. Um but yeah, you know, you know, the the block market exists right now, everybody's using it, things are changing. Well, it's still there because, you know, um legitimate supply chain are failing, right? Um regulatory um forces are pushing pressure on us, pharmacies, pharmacists, physicians, to to do things differently, to stop access, or you know, creating more difficult ways to get patients to get the good the good stuff, right? Um so it's it's very, very difficult. Um I mean the core message is is still the same, right? A peptide uh or compound is only as good as its sterility, its purity, is potency, right? If you have to remember one thing, that's what you have to remember. Um you know, when you have things like endotoxin uh contamination, you know, um, well, if your peptide or compound is designed to enhance your muscle mass, but it's got a lot of endotoxin in it, well, it's gonna trigger some type of systemic inflammation that's going to create the total opposite of what you're looking for, right? So you gotta be very, very careful as you're navigating this. And we, you know, we talk about it all the time. Um, you know, and and and it's just it's just becoming more and clearer and clearer and and and people are you know starting to actually understand those things. Um you know, that same peptide sold in, you know, in the research chemical site, you know, you know, with with no you know no standard um is always problematic. And there's no sterility testing, again, there's no new toxin testing, nor static of analysis, you know, you can't actually verify it. You know, and and the analogy here is, you know, you know, will you go on an airplane, you know, uh if the captain has no license, you know, uh, but he can show you a document that you learn to fly in the flight simulator. It's the same concept in the pharmacy. You know, will you use a COA from a research chemical place because they tell you to trust it. You have no other way to actually trust it. You just gotta trust them. Um, and there's no accountability towards it. So it's just it's just very interesting. You know, one of the things that was uh that's so in the news I wanted to talk about, guys, is is on the um on the black market, like call it, on the on the research chemical side, is there there's a big push right now for you know for what they call uh TFAs. So there's a lot of there's a lot of uh uh products inside compounds, inside sterols, uh ster sterile drugs, or inside um APIs. APIs is is your is your actual raw ingredient that pharmacies are getting from from the manufacturer directly, right? So when you get your raw ingredient that comes in. um you know you have to you have to make sure and ensure that you know the manufacturer has removed certain bad products from it like you know nothing is perfect you're not getting this powder is just like perfect there's always something in it right they always uh there's traces of elements that are toxic for you so um it's the uh manufacturer's due diligence i mean that's their that's their job to ensure that they remove all those bad things from them and what we're seeing is we start to see a lot of TFAs in there TFAs TFAs are are are really bad products a pretty bad ingredient that's actually sometimes inside those products and what we realize is that they're not testing for TFAs uh they're not testing for those products which are extremely dangerous um but very often part of the ingredient you know and and I was doing some more research on it and you know what and what we'll develop on that if we have time later on but and and I noticed that a lot of the C of A's out there don't even include TFAs testing um which is extremely scary um because it's a it's it's it's a toxic um product you know and and and over time will affect so many things like your brain your liver your kidneys you know um and and to me that's uh that's just one of the other you know one of the other things that people need to be aware of as they're making those decisions around around peptide and compounds and pharmacies and such certainly don't want to scare anybody but it it is pretty scary out there.

SPEAKER_06 23:41

Well you just said Frank is so important for people. I mean we've known this in the supplement industry um for those who've been in the fitness community for all these years uh lifting and all that stuff that the supplements have been full of like bad stuff uh it's it's been fraught with that I mean I think that's one of the things uh sorry just have to call it out uh it's your company but new bio age where you guys are doing every or progress pharmacy where you're doing everything at the highest level you're really calling out the the industry and saying hey you have to you have to hold yourself to the highest level and a lot of people don't want to do that. We've seen that people get away with this for the longest time and it's really detrimental to people uh and now is the time for that to change um now more than ever in my opinion. I mean I I I can I can only imagine how much garbage I've taken over the years. Especially you know Suzanne going back to you Dr. Furry in the powerlifting community right you can just imagine I was I watched bigger, faster stronger again over the weekend. So good you know I mean you just think about those guys and um and you know it's a sad story in many ways um but you know that notion of hey they're just trying to put on and you see these guys in the gym it's crazy. I mean they are just trying to get I you know one guy kind of strutted down the the uh way the other day and it was like he was like get out of my way or I'm gonna run you over. Um not to say all power lifters are like that. But the point was like you know that you they wouldn't be running. Yeah I mean they're just massive massive guys uh and um and it's it's it's it's wild to think but I think Frank you just bring up such a great point and people really need to know this uh you said you've talked about it um in the COAs you've talked about it in in all of the stuff before it's we just have to keep draw drilling that into people's head that you really the stuff that you put into your body whether it's you take it orally you inject it whatever it might be however uh topically it needs to be that the highest quality and it's just so so important. You know, Leonard I want to come back to you um because you know once again there's some you know when somebody's you come in they've got that toxic visceral fat and um they're trying to figure out okay well what do I do? You have some products that that are designed to supplement and and help address that. But I I think it's important to kind of talk about what what do people do? What what's the right approach when somebody's in that in that kind of situation?

SPEAKER_04 26:11

Yeah I think it's really important that you work with um a provider because um it's it's very uh it's very personalized, right? When people come in, we've been talking about body composition um they they can come in like what I call four different phenotypes, right? It could be you know like skinny fat like we're like Frank was talking about earlier um that that that gets mismanaged all the time people come into a doctor's office they say you have a normal BMI they put them on the scale they move that little weight thing to the side and uh it's like oh you're doing great and um and actually they they can be in in some of the most danger um because they have low low fat uh low muscle and uh high high fat um that's one phenotype right that's one way there's there's there's a recommendation when it comes to nutrition a form of exercise what type of compounds we potentially want to use um for that person and then there's the obese muscular which is a little bit more of what Dr. Free's been talking about is those patients that um are are muscular um that have high fat and they have uh high muscle and so you might have a different strategy there um compared to someone that's like more frail where it's uh low low subcutaneous tissue and low muscle. So it really it really depends on you know where you start. And I think it's important that you work with somebody because how you exercise um your calories the amount of protein you take uh what compounds you use is going to be different depending on uh on where you are um and the one thing that you actually jock I think you mentioned at the beginning of the podcast was that um whatever you start initially with like that that initial um uh protocol that you're using to initiate weight loss is probably not the same one that you're gonna have three to six months down the line. Because especially if you're working with one of these doctors or one of the ones that we're talking about is that you know things change and they change quickly. So the prescription changes, the exercise prescription changes, the um the the nutrition might change, uh the, the, the, the compounds you use might change, right? If we if we see somebody is um in one of those scenarios where they lost a lot of muscle and they lost a lot of fat, but we're we're not we're we're not upset about it. They're now metabolically more flexible. They lost a lot of dangerous fat tissue but now we might want to pivot and start thinking about okay what are the things we're gonna do to help this person regain that quality muscle. And so I do think it's um it's important there's a lot of different supplements and peptides you can use but I think you you need help you know guiding you. I mean I I I need help as well too you know I I pay for a trainer just because that's their expertise and I tell them hey what goal that I have right now and the injuries that I have right now and they help guide me through what type of exercises I need to be doing, what type of stretches I need to be doing. And that completely changes for me from time to time depending on what my goal is it might be performance, it might be body composition. And so I think it's it's important that you you reach out for help and that you you have you help work with somebody that can guide you through that.

SPEAKER_06 28:58

Yeah so true. And there are so many resources available within the right provider groups like for instance Veronica at your clinic uh Christy is a coach and nutritionist dietitian right um and she's she's phenomenal so she's able to help people really uh achieve the right goals um around the very things that Leonard's just discussing. Um how does that fit into your clinic?

SPEAKER_01 29:23

I meet the patient where they're at um you know you have some patients that walk in and they're clueless about food. You know kind of my analogy that I use a lot because people will remember it is if it's not picked, pulled or killed we probably shouldn't be eating it, right? Um and so I I say that because one, they get a kind of a chuckle but they will remember that. And um you know our I think so much of our food source is just tainted, you know, it's crap. And and sadly unless you're just growing your own food um it's really hard to to get quality food. And so it's having you know my our nutritionist and she actually has her masters in um dietitian but having someone that can help her walk through that. And then you know we also do a food allergy testing that's because sometimes for instance there they might be eating a meat beef that's inflammatory to them and they just don't know it. So you we use that test uh quite a bit um probably as our next test that we layer up um if needed um after just the basic kind of 25 pound that um Dr. Free was referring to um and then you know I think the other thing is then also having a health coach involved so that they can help assess like what are truly their day-to-day barriers to health um you know is it like my health coach they'll she will literally go follow them their day um and like try to understand um you know is it is it a stress issue that they're dealing with is it you know a a time management is it poor time management on their part or is it also just lack of preparation because you know some people I mean you know you you you can't you have to prep right you you have to have a plan to have a successful week um not to say you have to have all your meals prepped I mean that's great but but you there there has to be a a a plan in place to have success. And then we move to that next layer of actually getting them with a true coach like a a trainer um someone that's really looking at their functional movement their strength mobility and you know their ability to you know get off the floor. You know sadly I'm kind of dealing this with my mom right now. She's had a couple of complications from eye surgeries and you know she's having a hard time literally going from set to stand. But it's something that we will work on for improvement.

SPEAKER_06 32:12

Dr. Faree, a quick question for you with regards to all of this when you think as we've listened to everybody today, when you think about the key takeaway here, what comes to mind? Is there anything that's like buzzing in your head right now?

SPEAKER_02 32:26

It's the um the health of the cell it's getting it's realizing that just because that appears a certain way we have we we need to be looking a little bit deeper. Just because you have enormous muscle mass may not be that that muscle mass is giving us what we want. You know, one of the things that's really important, the other piece that's really important looking at the that at the um bioimpedance analysis is looking at their intracellular water qual uh content, making sure that they're well enough hydrated intracellularly so that all their systems function well and so that we're turning down that sympathetic drive because a dehydrated cell is going to trigger a high sympathetic response. So that's also going to trigger all kinds of cascade of inflammation in the body and that's where we run into all to lots of problems. So making sure that you're doing things like osmolites, like like minerals, um, that where you're getting intracellular hydration and we can monitor that uh progress over time with these uh these testing modalities that we have in our clinics.

SPEAKER_06 33:29

That's super cool. Oh um Craig, uh anything uh that you want to add to it before we go?

SPEAKER_05 33:35

Yes. Just want to pivot back to what Franck was saying um which you know is on the topic of the the research compounds and so forth. So uh I find it fascinating that these companies they're becoming more sort of like discreet or sneaky in the way that they uh approach clinics, you know, and the language that they use to sort of say, hey, you know, this is what we offer we can help you increase your margins. These uh you know compounds are are uh you know proven safe they're they're very effective we'll give you all the COAs and whatnot um you know it's just getting sneakier and sneakier and for practices at the at you know the practitioner level we have to maintain that integrity. You know we're not here at the end of the day for us. We're not doing this for us. We're doing this for the patients, right? We enjoy the science behind this. We enjoy helping seeing people thrive and and so forth. But at the end of the day it's always about the health and the safety of the patient. And so um you know as practices cave to these research peptide companies and they start you know utilizing uh those compounds in their practices we just we got to maintain a strong line against that and um make sure that we keep the integrity high. So um I guess my message is to all of the clinics out there, you know, don't falter, right? Just continue to work with reputable compounding pharmacies, progress pharmacy, other other pharmacies across the country, you know, and um make sure that we're doing right by the patient.

SPEAKER_03 35:05

As you were saying that no joke I just got a text message from a doctor, a local doc in the side on in Florida and he's like I just um I just got a rep that came in my office I can't say the name of the drug here, but it is the hottest one in in on the market right now for weight loss, right? It's about to get approved obviously it's not AD approved yet but it's about to get approved start with R. Can't say it he's saying um I got a guy it's a text message I got a guy he's asking me telling me right now that he can he can get me uh 50 vowels for about $50 a piece.

SPEAKER_04 35:40

Oh my gosh.

SPEAKER_03 35:42

And so he's like yeah he's like he's like and he and he's also designing my my my three month protocol and commitment what do you think I should do? FY this guy that's texting me this right now is a very well known plastic surgeon in Palm Beach area. Okay. And and I'm like wow you know wow and and Craig's just saying this I'm like and I'm seeing this I'm like holy you know he has no idea he's out there doing surgery all the time these guys are being sneaky he's walking the office is telling the girls up front hey you know I can get you this 50 bucks for for you know totally okay you're just a C of A. Next thing you know he doesn't know any better. Right? It's like oh I can get this oh no problem. Here's the money. You know so yeah it's just you this is so right.

SPEAKER_05 36:33

It's so true what you just say that Craig is just they're making it so enticing too you know we all here know that blend's generally a no-go, right? And they're putting like three, four agents into one vial and oh my God, you know this the it's just preposterous.

SPEAKER_06 36:50

Uh so I actually want to ask you guys about this because the other day somebody said hey um you know in our business uh they said uh hey we're ranking number one across the country for this one particular thing not gonna mention what it is and uh it's four agents it's four different peptides all mixed into one and I'm like do you really believe in that I mean are you are you gonna really have that you really want to have that in your clinic? He's like well you know I mean uh uh uh I I guess uh you know I mean that's something I think it's out there and you know uh and I was like kind of blown away by that um that anybody would want to actually do that. Frank, what are you what are your thoughts on that?

SPEAKER_03 37:31

It's unbelievable man you know I mean you can't even s get anything you know you can't even get you know I don't know if I'm allowed to say this, but an NAD to be in the same drug as another peptide, you know, because we try this many times you know to get you know in the GLP1s mix with another product right to but then you have to go prove stability right you know so you say okay let's do it let's find something that we can add to a GLP1 to enhance the pathways and things like that. This is very basic compounding but then it's like it's it sounds amazing but then you got to make it and then you got to go prove stability in a lab right that this thing is stable together. You're not creating a new drug which you actually you are creating a new drug they're binding.

SPEAKER_05 38:20

So when you tell me that there's a people out there selling things with five or four different peptides as a as a stack together then you're creating this long chain of amino acid that I don't even know I was going to bind you know just a bind to receptor so I was going to bind it's not gonna bind first of all that's that's just from that side and then the second piece is um wait are you going to keep stability of this product you know because they all you know work differently different pH right you have to have different active ingredient one of them is stable at this pH the other one is stable at the other pH so if you have one pH they're not gonna be all stable at the same time I don't want to bore you guys but this is insanity yeah that just I was like wow okay in the same you know line of thought uh a lot of times you know these companies will sprout up to from very prominent individuals in this industry right so um recently was approached by rep for a company that's relatively new in the past few months and um you know the mastermind the brains behind this operation is somebody who uh owns a very prominent PRP concentrating system right and owns you know several other biomedical companies and whatnot.

SPEAKER_04 39:50

So uh you can't you can't be fooled and uh again just you know I noticed when the the one research peptide company went down everybody of course was you know posting it and I couldn't believe that some of the people that um you know have their own research peptides like you know wrapped around with their brand and logo on it and then they're making posts saying like yeah guys you got to get this from a credible source it's like you just were doing that you know um but I guess you know people they rely on people just not checking up um and so like the same even educational places that are you know we're pushing people towards these places um are just now they're just okay that's gone well we'll just pretend like we never did it or never care you know and they'll just um so it is you're Craig you're right it's it's hard it's hard to um it's hard to navigate because um I don't know every everybody's really busy everybody's working you know like you said you have the plastic surgeon he's he's doing surgery everybody's working they're trying to you know keep track of their businesses someone comes up and says it's FDA registered facility it's X, Y, and Z. Um we've just never faced this at this level before in medicine in medicine. There's always been gray areas but never you know just these sales reps and multi-level marketing schemes and affiliate marketing you know just coming from every angle looking legitimate. It's like medical practices are being attacked right now. And um it is it is at least you know we have to talk about it and I think that's what changes it and that's what we're doing.

SPEAKER_02 41:16

And I think you have to rem remember what we're you know the the legality of this, right? The the the changes that happen with peptides and certainly Leonard you're the expert in this is um did not affect whether or not they could be prescribed. They merely affected whether or not they could be compounded. And so so we're still held to a standard if I am prescribing something that is a research chemical only and the patient has a bad outcome, I am ultimately responsible for that choice. And um so we have to real realize you probably won't have a leg to stand on if you're coming back, if the patient has a bad outcome that's going to completely come back on me. And um this is the reason so this is the trouble. And then then then you have to have a whole additional layer of consenting and explaining and and I think for us there's so much already consenting that goes along with these chemicals that we that's not that's an another level that we're not willing to go. So we have clients that um that come to us and we'll just say look I can't guarantee your outcomes but I really can't guarantee your outcomes in fact I'm concerned about the health the safety of your outcome if you're using something other than what I'm recommending.

SPEAKER_06 42:35

Yeah. I mean Suzanne what do you do when you have a patient that you've got them on a protocol and then they're out on YouTube and wherever and now they're, you know, or like Frank you said the other day, you know, it's kind of that trust me bro culture that's in the gym, right? That shows up it's like, oh yeah, well you get this from this guy over here. What do you do when somebody shows up and says, oh I want to take this and I've gotten this do you you discharge that patient?

SPEAKER_02 43:03

Um that's a hard question. Uh I uh my typical practice is not to discharge the patient. I have a lot of conversations with them around and then I'm just gonna keep an eye on them. I have a guy who is a bro gym doc. That's his thing. He's actually the guy from whom I learned peptides first back in like I don't know 20 2009 something like that. Came to the office he's like oh doc you got to get on some peps you got to do the things and um so then I went and actually learned about them which was great but uh it was so he took a lot a lot a lot and way higher doses than anything is recommended. And um you know he he's he had a lot of side effects let me put it that way he had a lot of problems as a result. And and I, you know, as much as I love him, I we continued to monitor things like his liver function and his kidney function and we kind of worked around them. It's sort of like you're dealing with an alcoholic Are you gonna discharge the patient because they're an alcoholic? Or are you gonna work around and take care of their alcoholism and sort of like, and this is this is where you go. And you say every time you see them, you make the you make the comments, you make the the notes in the chart. And if they're eventually not responding, then yeah, they do get discharged from the practice. But the idea is, hey, let's work with what we've got. Kind of like our our you know, patients who aren't willing to change their diet or they're not willing to change their stress factors in their life, they're not willing to cut out the caffeine in the morning, whatever the circumstances are that they're doing, you know, I'm gonna work with you, especially if you're my been my patient a while. And now I'm gonna say, hey, let me explain to you why this isn't working. I make I draw a lot of pictures in my office with patients so they get to see what I'm talking about, um, about the the resin and the TFA that gets put on and it has to be then pulled off. And if it's not actually pulled off, that's what's toxic to your liver, all that sort of thing. You know, you these are you gotta have, you gotta be, you're you're the educator for these people.

SPEAKER_06 44:59

That's a lot of work, I would imagine. I mean, obviously I I never have to do that, but I would imagine it's a lot of work. Well, this has been a phenomenal episode, and I just want to thank all of you once again for um putting the time and brain power behind it. Um in the next episode, we're gonna talk about um dysregulation of the autonomic nervous system uh based off of the talk that took place at Calm, uh, the presentation that Dr. Faree made. And so we're gonna go into a deep dive on that. I think it's going to be super interesting to discuss that because one of the things that you said, uh Suzanne, was that hey, maybe if your longevity medicine isn't working, it could be this. It's certainly a topic worth digging into. Really excited about that. I want to thank all of you again. And for those of you who are new to sell the systems, please remember to like, share, and subscribe. Also, leave us a comment. We want to hear from you. We want to know what you're thinking about, and we want to be able to address the things that are most important to you as the show progresses. Uh, from all of us at Sell the Systems, we wish you uh a great week, and we'll see you on the next one.