Beyond Ozempic: What GLP-1 Peptides Actually Do — Weight Loss, Brain Inflammation, Mast Cell, & More

Welcome back. Once again, we are talking all things peptides. In today's episode, we're going to dive into the GLP-1s, which is the most well-known of all peptides, probably as a group, the most sold drug in the world at this stage, and lots of controversy. So we'll dive into that. Quick, before we do that, if this information is helpful, if you've been following us, most of the people who actually listen to the podcast aren't subscribed. So if you could subscribe below, that'd help us so much just for getting the word out there. So anyway, now we're gonna talk about GLP-1s. So the question about GLP-1s is first, like, how long have they been around? I actually personally started using them while I was still in the military back in 2006, and that first one was Byetta. But how far does the science go back? You know, scientists noticed gut signaling to the pancreas before blood sugar rises, and they called these incretins back in 1902. So, you know, the glucagon gene sequence, GLP-1 structure was identified in 1983. And then, so the point is that we've known about these things for quite some time, way before they became a drug. And it's interesting how just in the last year or two, they've developed some public consciousness and become controversial. But people who've been in this world for decades, and I'm one of those, just, it's not new. Okay. Byetta was the very first one. It actually came to market in 2005. I started using it in 2006. And it's a great, great medication, but you have to use it twice a day as an injection. While, while they're trying to figure out how to make that molecule look a little longer, Victoza, also known as liraglutide, came to market about 2010. And then semaglutide, which is the Wegovy and Ozempic, came to market in 2017, and the weight loss drug came in 2021. So even with those drugs, and finally tirzepatide came to market. For diabetes in 2022, and then as a weight loss in 2023. So, you know, been around for a bit. So the question becomes like, how safe are these things? And the answer is they're super duper safe if you do them the right way. And that's where I think some of the issues are with these is starting too fast, too quick, ramping the doses up too fast. And that's where you get people who get problems with gastroparesis, intestinal obstruction. One of the early concerns early on was parathyroid tumors, which we were seeing in lab animals, in lab rats. And so when I first started using these medications, people would hear about that and be like a little concerned about it. But we're again, 20 years in, there's been millions, tens of millions of people, depending on what you read, maybe 10% of the population or more in America are using these right now. And that's not, that's, you know, not worldwide. So a lot of people using it and we've yet to see a case, as far as I know in the literature, of someone getting one of these weird tumors. So they, they do appear to be pretty safe if used appropriately. Now, tirzepatide is probably the most popular one right now. It's a dual agonist. It's a GLP-1, which is a glucagon-like peptide agonist, as well as a GIP, which is a glucagon inhibitory peptide. Because of this dual action, it's actually more potent than other peptides. And I've actually noticed it actually helping more some of my more chemically sensitive mast cell patients, but we'll get to that in a second. There is a newer one, um, retotruglutide, which is a phase 3 study right now. And it's, it's a GLP-1, GIP, as well as a glucagon receptor agonist. The, the, and it's right now available through compounding pharmacies. It's not quite yet on the market. The problem with this one is I've had a couple of patients use it and have horrible responses with it. I think what this is, this class is in general is very powerful, has a lot of great uses in the right hands, the right way. So what are some things that the GLP-1s actually help with? Well, we know about diabetes. That was one of the first FDA-approved indications. But some people may not know it's also FDA-approved to treat sleep apnea. It's been FDA— some of the studies we did in my clinical research company, we did it in regards to the cardioprotective. So it actually, if people have heart disease, it's actually cardioprotective. Some newer indications, it's actually kidney protective. If you're a diabetic patient, you have kidney disease, the GLP-1s actually are renal protective. And I was actually listening to the president of Eli Lilly last year talk about some of the new indications for in the mental health world as a brain anti-inflammatory in people with depression, anxiety. In my, in my world, in the functional medicine world, the question is, will this bleed over into rapidly neuroinflammatory conditions like schizophrenia, bipolar? Great questions. But in my world, we're already seeing it being used in patients with microinflammatory conditions, which I just made that term up. That's not really a thing. It's your chemically sensitive patients, your mast cell activation patients, your POTS, dysautonomia patients, people who react to chemicals, react to foods, react to the environment, and tend to get these rashes, hives, and as well get flares of POTS and dysautonomia. If you don't know what that is, that's, that's, that's fine. But it's basically an imbalance in your nervous system. And in the mast cell world, which is the world of those people, we're seeing some pretty profound responses in microdosing. And the funny thing about microdosing is when I talk with my compounding pharmacists, even today, they have no idea how to even address that because as pharmacists, they're bound by the medical literature. And one of the advantages of being a practitioner is we see changes in medicine before they get to literature. Like I will see— I'll— long COVID's a great example. COVID's a great example. Lyme disease are great examples of things that in my world, we saw people getting sick. We started having to figure out how to help them way before the medical establishment said this is a thing. And that's the same thing with microdosing. And so, it was actually introduced to me, to me by one of my friends who's a PhD nutritionist. And then, it fell into our world and I've been using a lot in the last year in those individuals. But as I did like a little literature search, like what other things is this being used for? It's almost as if It's been used for everything, any inflammatory conditions. There's some interesting literature on protection, Alzheimer's as well as Parkinson's patients, lung issues, people with lung problems, infections, people with inflammatory gut issues. You know, the GLP-1s are not just a metabolic medication. You know, one of the spiels I give patients is there's 5 kinds of obesity, right? There's just the caloric in versus out, and typically just eat less and you lose weight in that situation. But you also have the drive aspect of it. There's inflammatory, there is metabolic, which has to do with your gut microbiome, the bacteria in your gut. There is toxic, which has to do with chemicals in the environment, things called obesogens, chemicals that induce obesity by acting like pseudo hormones. And finally traumatic, which is how to do with your nervous system and feeding cycles and drives. And just, it's an interesting fivefold way to look at it. Your GLP-1s address all 3— I mean, sorry, they address 3 of the 5, which is one of the reasons why they're so powerful, but they don't address the other 2. But we now know that GLP-1s as a general anti-inflammatory can help with POTS, dysautonomia, multiple chemical sensitivity. I've had multiple patients, one of them, several of them were actually alpha-gal patients, which are people who get a near-death reaction to any kind of mammalian sugar called alpha-galactosidase. Galactosidase. And so you can't eat anything from any cows, lamb. It's a really horrible thing to have. And some people actually will get, you know, anaphylaxis, near-death kind of things just from eating something and going to exercise, or just it happens spontaneously. And I've had really good results with the GLP-1s and these people calming down that mast cell inflammatory state. Same thing with a lot of my patients with POTS and dysautonomia. What we know now is there's a certain type of mit neurological issues that are actually histamine driven in your central nervous system. You know, I knew that back when I was doing my training with schizophrenics. I remember seeing some patients in the hospital. Nothing worked for them. And they were actually doing shots of hydroxyzine and Benadryl to actually help calm their nervous system down and break their psychosis. Well, GLP-1s actually help calm that down as well. And our mast cell patients to a lesser degree, the people who have this dysautonomia POTS. The point is that GLP-1s have a lot of utility, and because of their renal, cardio, neuro, anti-inflammatory, everything, you're going to see them becoming more and more popular. But at the same time, you're seeing them more and more abused, which is where you get into problems when people start the drugs too high a dose. I was— I got one of my social media feeds recently, you know, it was from some weight loss clinic and the ad was, don't lose weight slow, lose it fast. We start everybody on 7 to 10 milligrams of tirzepatide. You too can start here. And I was thinking, oh my gosh, this is part of the problem. Because the starting dose is 2.5 milligrams and microdosing, I'm starting people on 0.25 to 0.5 milligrams, which is even less than that. So no wonder you're hearing about some of these bad side effects. But the medication can be quite powerful when used in the right hands. Back to the retatrutide, Trutide. It is currently in phase 3 trials and it may be out in the next next several years. But who knows? Because right now things are going so fast. You never know. But that's, that's kind of my spiel about, about the GLP-1s. They are super flexible. They can be used in a lot of different situations. But I think having used them for 20 years in diabetics and then in weight loss and seeing how they're expanding now in my functional medicine clinic to my Kimberly sensitive patients, my mold Lyme patients, they really are a flexible medication. And every peptide, I think this is the key. To me taking a deep dive here. Every peptide's like this. All the peptides are multimodal, multifunctional molecules. The BPC is, and I'll talk about a few of these in the next episode. They're all like this. They all have multiple utilities. The question is how safe are they? And the answer for most of them is pretty safe. There are some nuances. You have to be careful with some of the growth hormone things, things act like growth hormones and some of the, the anti-aging mitochondrial ones can be kind of toxic and too much. So you have to be careful with those. But in general, if used in the right hands, these can actually be really helpful. And then the other caveat before I sign out here is that peptides are in addition to foundational stuff. In addition to eating real food, in addition to adequate sleep, in addition to removing chemicals from your environment, in addition to, um, all the foundational health things, the lifestyle stuff that gives you 80% of outcomes, right? On lifestyle, you know, diet and exercise. Alone can prevent 80% of heart disease and 70% of most cancers. So when you start talking about people with multiple health issues, it's like the peptides can be helpful just like hormones can, just like a lot of other things can, but it's always laid on top of the foundation. So, I hope this information was helpful about, about the GLP-1s. And we're going to talk about a few other peptides that are really popular right now, including BPC-157. So, hope you enjoy the additional information. And on a side note, if You know, we do listen to people's questions, um, however you engage with us, whether it's YouTube, podcast, social media. So if you have a question, please drop it there. That's what's led us to do this. And even if you're, um, enjoying this podcast, but not following us, please follow us. That helps us get the word out there and super helpful to, um, my entire team to keep high quality stuff like this coming. So take care and we'll talk to you soon.