58: Ozempic Isn’t a Magic Fix – The Truth About GLP-1 Drugs & Lasting Weight Loss with Dr. Aaron Hartman

So it's interesting, when you use a GLP1 drug, you're getting 10, 15 times your body's normal physiologic doses when you take it as an injectable drug which okay, that makes sense why some people just do horrible with it. And even when you do microdosing, which we've been using now in the mast cell world for a bit and it's getting more popular, that's still three to four times higher than physiologic doses. So I want to talk about some of the newer cutting edge uses for, for GLP1 medications. This trend that's popping up quicker and faster and faster, what that really means. Now the term GLP1 glucagon, like peptide has become super popular. People are using these medications more and more and become more. They're kind of like a, I don't say a fad fad medication but in many ways that this is your tirzepatide semaglutide. But people forget Byeta victoza, there's an oral semaglutide. These medications have been around for quite some time but some of the newer indications they, they recently got approved, FDA approved to use with patients with end stage renal disease, diabetics with end stage renal disease. Some studies coming out showing that probably coming approval for obstructor sleep apnea and some even some interesting stuff with rheumatoid arthritis. So these are blockbuster medications making lots of money for pharmaceutical drug companies. That's one side. The other side is they have a huge, huge clinical utility. So what I like to do with things like this is take a step back and actually ask some questions and think about the whole process. And one thing, the first thing to think about is you never really hear about something a novel pathway, you know, treatment things until there's actually some marketable, patentable item out there. You know, glucagon, like peptides, you know, butyrate, which we use in functional medicine all the time, different bacteria. There's actually now a GLP1 probiotic, metabolic pro as well as glucose control that actually help. And they're using bacteria. So this idea of using these peptides for a whole host of things is not novel. What is happening is just this one blockbuster medication is getting super focused on because it has so many different utilities or uses. And so the first question you have to ask yourself is why does this one thing have so many potential uses? Well, it's anti inflammatory. Well that's huge. We know inflammation is a root cause for a lot of diseases. It helps with insulin sensitivity, which, you know, 80% of Americans are insulin resistant. And now even cancers, we're seeing insulin resistance as a part of the metabolic cause for different cancers. They actually help stabilize mast cells and mast cell activation syndrome, which according to Dr. Mouldering's research, 19% of Germans have some form of mast cell activation syndrome. So all of a sudden, this peptide, which our body has currently over 7,000 peptides that we've identified is having all kinds of clinical utilities. And you're going to hear about it everywhere. You're going to hear about in the news, you're going to read about in articles, and now it's getting fame on social media because all these utilities stuff. So point, the point of first point is that you have to think about, you know, are we talking about so much now? We weren't talking about peptides several years ago and some of the, in the functional medicine world, I've been noticing that peptides were taken away from us a year or two ago. We lost access to thymosinophil 1 TB4 lazarotide, which is actually being studied right now for celiac disease, was available. Cerebralysin was available here in the United States. And we, in the last two years, we've lost access to a lot of different peptides simply because. Well, I shouldn't say simply because, but strangely enough, some of these are actually getting ready to become marketed as medications. Thymosin alpha 1 currently is, is a drug overseas that's quirky approved, manufactured in Austria. The stuff I've gotten actually has come from Austria. They have manufacturing of it in Russia, Mexico as well and in Thailand. You can buy as a prescription drug here. It's not available. It's, it's in trials right now to be used in Europe. It's actually used for increasing the white blood cell count in Switzerland, especially in chemotherapy patients, cancer patients who have suppressed white count. So these things, unfortunately what happens is you don't hear about something until there's a marketable, patentable use of it. And all of a sudden it's like, you know, the biggest new thing. And in the functional medicine world, using butyrate berberine, which kind of acts like nature's metformin, these are things we've used a bunch, the whole senescent cell thing, you know, if you've heard the zombie cell talk, if you haven't, then that's. We've been talking about that in the functional medicine world, longevity world, for maybe 5ish years. Data goes back even longer. But these are things that just now I've heard some articles from some cancer doctors talking about this as a metabolic precursor for cancer, which is the case, which is true. But going back to GLP1s, their use is exploding. You can hear more and more about them and they are, if used rightly, they have a lot of benefit. Now, a couple things to think about. First, you know, I was at a conference this past November and they were actually showing charts of GLP1s and the levels. And so it's interesting. When you use a GLP1 drug, you're getting 10, 15 times your body's normal physiologic doses when you take it as an injectable drug, which, okay, that makes sense why some people just do horrible with it. And even when you do microdosing, which we've been using now in the mast cell world for a bit and it's getting more popular, that's still three to four times higher, higher than physiologic doses. So think about these things. However, using them, using them at super physiologic doses, which is what pharmaceuticals are using. You can take a natural substance like curcumin or megathers fish oil, and you take what you'd consume in a diet, you multiply it 10 times and now you're seeing curcumin being used for pre multiple myeloma, which is a kind of bone marrow cancer. So you know, or fish oil being FDA approved for ADHD or being used in traumatic brain injury. So the idea of taking natural substances and bumping up the dose to make them into a drug, and that's not a new concept either. But you're just going to be hearing more and more about GLP1s. So the question is, well, how do GLP1s help with sleep apnea? Well, the primary treatment of weight loss has always been, I mean, the primary treatment of sleep apnea has always been weight loss. So if GLP1s can help you lose weight about the same ballpark as a gastric sleeve, then sure, it could help sleep apnea. Sleep apnea also is a part of metabolic syndrome, has an insulin resistance component and inflammation component. Well, GLP1s help with this as well. They've already been. We actually, My research company, Virginia Research center, did some of the original studies on GLP1s to be used for cardiovascular risk reduction and just makes sense. Again, if it decreases small vessel inflammation, if it improves insulin resistance, you know, the four horsemen that kill us, you know, cancer, heart disease, neurological issues and metabolic issues, you know, if you're affecting metabolic issues, insulin resistance, then you have a mass impact on people's health, regardless of its, you know, what part body part there is. They're currently doing research with gopn, ones with neurological issues as well, like Alzheimer's and Parkinson's. And for you that were familiar with Dr. Dale Bredenson's work, he's delineated out six, you know, five major and one minor. What the minor still a big one. Six classes of Alzheimer's and type 1.5 is glycotoxic, that is, and some people are using the term to refer to certain types of Alzheimer's as type 3 diabetes. So if you have a medication that improves insulin resistance, that treats inflammation, it just makes sense that it helps with that as well.

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Foreign interesting things that's coming out with that actually I was reading in the medical letter several months ago is that the. I believe it's tirzepatide, just got approved for semaglutide. They're very similar, a little different for patients with end stage renal disease or ckd because of its, you know, you know, the question is why does it help? And that's where you get into the same thing. Inflammation, small vessels. If you improve small vessels, you know, could it help with eye people with retinal issues? Potentially. I mean anything with his vessels, which is every single part of your body. So you know, I could go on and on. And the other thing is like rheumatoid arthritis, there's actually some, you looks like there's some utility with GLP.1s with rheumatoid arthritis, which is quite fascinating to me. But then I think if it's stabilizes mast cells, if it's anti inflammatory, you know, one of the biggest drivers of inflammation is obesity. If it helps with weight loss, take a little side note. Well, let's finish the rheumatoid arthritis. So, so it makes sense that you might, it might help with inflammatory conditions of which rheumatoid arthritis is a big money maker. Gangbuster. Right. So it just makes sense how and why you're going to hear more and more and how these, these medications are becoming more popular. They are fairly safe if used the right way. And if you overdose people too quickly, if you bump them up too fast, yes, you can have gastric obstruction, yes you can have gastro, if you have gastroparesis, slow stomach, it can mess up all those things. If you have dysautonomia, which is a dysfunction in your autonomic nervous system and your GI tract isn't working quite well, you can get horrible constipation with it. And then there are the rare parathyroid tumors which I've never seen in my clinical career. I've never actually heard of one happening but they happen in lab animals. So it's on the package insert. But the medications are used appropriately in the right patients and that's the key. Are you using it appropriately in the right patient? You know, are there alternatives? Can we work on diet, lifestyle, exercise? Ultimately the way these things are working through anti inflammatory effects, we have lots of nutrients, lifestyle modifications can help with that. Insulin resistance. We have lots of lifestyle things we can do for that other nutrients, it helps with mast cell activation. Again lots of things we can do for that. And even on the obesity side we know that there's five different kinds of obesity. You know, caloric, inflammatory, toxic, metabolic, and then I refer to as a trauma which is your nervous system is just ramped up. High cortisol, which could be from trauma, big T or little T trauma, but the GLP1s address three of those five. So it makes sense that these are gangbusters. But at the same time are there other ways to do it? And if you take a GLP1 and you don't change anything else, are you going to be on this medication for the rest of your life? And I think that's where the rubber meets the road. Do we plan on being on these medications for the rest of our lives instead of changing your diet? Removing inflammatory foods, removing petroleum based dyes, removing sugars, that come from or find from genetically modified beets, which is where the sugar in our country comes from is gently modified beets. Removing these kind of things, removing diet coke, diet soda, the artificial sweeteners and those things are actually neuroendocrine disruptors. They mess the hormones up. So maybe it makes sense to remove these kind of things. If you're not doing that stuff with the GLP1s, are you going to take these expensive drugs for the rest of your life? You know, and there are some concerns with muscle mass loss with long term use. Sarcopenia, which as you get older, particularly women, sarcopenia is a big, big thing that can adversely affect their health. One of the biggest factors of whether someone will leave the hospital alive when they're admitted is their amount of muscle mass. So again, plan on hearing more about GLP1s, especially as the new indications are coming out. But the reality is these are big money makers. Big. You know, we, the American Academy of Pediatrics was even at one point in time they still may be doing, recommending these for kids for obesity. It comes out a lot of it comes down to his money. They're big money makers. You don't hear about them. They. So hopefully the next three, six months there's a shift in the sentiment in our country with health. We're actually removing dyes and chemicals, petroleum based dyes. It's kind of amazing. The government has to make companies remove petroleum based dyes from food. That's kind of, kind of weird. But the point is that people need to take charge of their health. You'll be hearing more and more about this, but the reality is that there are other ways to address these things. And the question is, do we do that or do we just go down the pharmaceutical route? If this helps get you over the hump to change your diet, to change your lifestyle, if it helps get rid of the hump to get you on a healthy trajectory, if it helps lower your inflammation so that you have the margin to make all the changes to get out of the moldy building. Yada, yada, yada, Starcholo dose naltrexone for your autoimmune diseases, including rheumatoid, then I think these are really super helpful. But we shouldn't use them as a crutch. I think the gist of we should not use them as a crutch as a replacement for the foundations of health which are diet, exercise, sleep, you know, stress reduction, meaningful, having meaning and value in your life. It's just amazing how calming and centering, having a stable family, having a close community around you can be as we forget these things. It's hard to get long term health changes. That's where I think if you use these to like get yourself in the right trajectory, that's huge. But ultimately the foundations of good health are still the foundations and we can't use drugs to replace that. So hopefully this information was helpful and it just helps with your perspective as you're hearing more and more about GLP1s, which you will continue to hear more and more about them. Take care and we'll talk to you soon.