Advancements in Regenerative Medicine

Hi, Dr. Molt. Today's 2025 and I'd like to know how you're seeing the field evolving over the next five to 10 years in regenerative medicine practices. Well, that's a great question. So the entire regenerative medicine is pretty much a recent specialty or recent recent concept. And it's the idea of getting your tissues to self heal or restore things. And I think there's a lot of different ways we can think about regenerative medicine. The classic one is stem cell therapy or platelet rich plasma. But there's also other regenerative techniques that we offer. And a good example I think of regenerative medicine would be a woman goes through menopause, her ovaries are no longer functioning, and we see a rapid decline in health. Weight gain, decreased energy, more brittle bones, more cardiovascular disease, more rapid onset of neurocognitive decline. And by simply putting a pellet in of testosterone and estrogen and maybe some progesterone, this is, your body doesn't even know it's lost its ov and those tissues actually can regenerate. The metabolic syndrome can be reversed. Estradiol actually reverses cardiac plaques and burden of atherosclerosis on your heart. It helps with maintain weightness, helps with maintenance of weight, it helps with bone density, helps with energy, libido and sex drive. Same thing can be said for men. The thing about weight loss is being regenerative because if you are metabolically unhealthy and you lose weight, your liver, your brain, your, your tissues, your kidneys, all these organs improve. In fact, even just taking somebody who's not diabetic, but maybe they're pre diabetic or maybe they don't even fit that criteria yet. And they take a medicine used to treat diabetes, they outlive their peers. Taking nothing. Sometimes I hear the badge of honor of not taking any medicines. That's great if you're not taking any, but if you're in a borderline disease, your blood pressure is borderline, or your weight is borderline, or your diabetes is borderline, you should treat it as if it really exists because you'll live longer and that's regenerative. We, we do a vein procedure where people have sores in their legs and we react to blood with a vein surgery that's regenerative. We have people with sleep apnea and their airways changed over time. Maybe it's genetic, but usually it's from years and sometimes weight. And we can regenerate those tissues, open up the airway Help people breathe better and sleep better, have less sleep apnea. So those are all regenerative. And the classic one is both platelet rich plasma and stem cells. And that's the kind of the classic regenerative medicine. That's where most of the interest is right now. That's really what people, I think times think about when thinking about regenerative medicine. So we talked a lot about platelet rich plasma, which platelet rich plasma and platelet rich fibrin. The discussion between those two is not necessary in this video. But I would tell you that they're basically the same thing. Most doctors were using PRF and calling it prp. Some doctors were using truly a pure PRP, which is not as effective as prf, but most of us were already using it. The term just came around more recently to differentiate activating or inactive platelets. When the platelets are inactive, it's technically prp. When they're active, it's prf. Doctors have been calling PRF PRP even though it's prf. So platelet rich fibrin versus platelet rich plasma. But that's most people are using platelet rich fibrin. And this has the ability to heal things such as cuts or wounds. When we do laser resurfacing in somebody's face, we put PRP on, they heal better and actually get a better result, faster healing. And now we're seeing a big world of PRP into joints for arthritis. And that's really exciting because years ago we knew it did something to help with pain. And now we're seeing restoration of cartilage, decreased inflammation, normalization of function with just simple prp, which is or prf, which is taken from your blood process in a very simple method through an FDA approved, FDA cleared device. And you can insert this stuff into the joints and if you have arthritis or tendon injury inflammation, they get better. Now the more you get the procedure done and a couple months later, typically function starts improving, pain starts improving, the last three to five years, somewhere in that order. Whereas the platelets might have to do more services, more treatments, and it's probably going to be more like nine months to a year. So there's a little difference in durability. And one time we were thinking people with more severe disease should go to stem cel cells and more mild disease go to platelet rich plasma. There's some truth to that, but there's a difference in cost and if that's a concern or it's your first time doing something you don't want to get the fat taken out, you can start with platelets. It's gonna typically work anyways, more than 80% effective. So it's a good option. I think really the message that I would like to say is if you have arthritis and you're thinking about knee replacement, you're probably gonna put that off for a while because there's major problems with knee replacement. And you can do platelets or you can do stem cells. Generally speaking, you're gonna get response. Most people do. And you don't have the problems associated with knee replacements such as, you know, you can't go to the regular screening at the airport. Less risk of the complications associated with knee surgery, A lot less expensive. And it's an option for people. And I think the fact that it's not covered by health insurance turns a lot of people off. I think a lot of people love themselves more than their possessions and they might prefer to take care of themselves first. I think there's also skepticism because of insurance doesn't cover it much, Must not work. It doesn't really work that way. There's a couple reasons why insurance coverage will not be coming soon. One is it's a little too new to be standard of care. Number two is there's multi billion dollar companies making medical devices that really aren't going to promote something like stem cells. That's got to come from somewhere. Thirdly, stem cells and platelets come from your own body. And none of us have the money to spend billions of dollars to get or at least tens of millions, hundreds of millions of dollars to get FDA approval for a certain type of procedure or to get insurance coverage. It's very hard to do. So it's not like a conspiracy thing. It's just that it's a perfect storm where this is not going to happen. Now we see certain governments are offering their employees regenerative therapies, certain countries are. But in general we're not going to see Medicare or Blue Cross cover this anytime soon. So it is out of pocket. Fortunately, it's not that expensive right now. And even though it was expensive at one time, with more rapid, say acceptance of this, doctors are able to do more procedures, get more efficient, really bring the costs down. Remarkably, even the cost of us preparing the platelet rich plasma has dropped by over 90% in the past five years from the kits that were available and the ones that are now. So it's really been a, been a game changer. How much fat do you need to get a stem cell treatment? It's not very much A few teaspoons and we have the ability to send your fat to a lab with a bank and store your stem cells for rest of your life or a fee that you pay the stem cell lab. Then we order them, they send us a little bottle of say 10 million stem cells. So that's the state where we're at now. And I've been involved with this for about 14 years. I was the first patient. I had a rotator cuff tear subscapularis. 70% is supposed to be repaired. And a friend of mine's orthopedic surgeon was to do the surgery. And there's going to be open surgery shortening the bicep tendon. And I read about different athletes getting prp. So I learned how to do it. I had a friend, another friend of mine, this orthopedic guy, inject my shoulder into the tendon and it grew back 100%. It's been 14 years, perfectly normal, no symptoms at all. I'd have to re injure it or just fix forever and injury that hurt in the first place. So this has been something that's been with us for a while. Very excited about the impact it has on longevity. And I think regenerative medicine does tie into longevity. Now it's not going to give you a better epigenetic age or change other factors of aging that we can measure. But if you look at measurements of aging, we can look at, there's blood screening tests, biologic aging, there's companies like Function Health and Inner Age. You can pay for blood tests and see how your chemistries are aging compared to other people. Your age group. I'm like 13 years younger than my age in terms of my blood chemistries. There's something called epigenetic age that measures the age of your DNA. I've been working on reversing that age. You can measure your, what's called VO2 max, your ability to say, perform endurance or high intensity exercise. There's a way we measure that. The higher that is, the longer you will live. Muscle strength relative to your weight. The more strong you are for your weight, the longer you'll live. More metabolically healthy you are, which you'll measure through this biologic test. And if you're having immobility issues where you can't really go out and take a brisk walk or ride your bike, you're going to shorten your life materially. Yesterday I took a hour long 18 mile bike ride. This morning I got my elliptical. It was kind of like an elliptical, but it's actually got wheels on it. Literally aggressive 40 minute high intensity workout. And I'm able to do that because I don't have any knee pain. Even though my mother was impaired at this time, I don't have a rotator cuff pain anymore. And that was really through regenerative medicine. So very bullish on it. And I want to get this to a price point where virtually anybody can do it. And you'd be silly not to. If you have that condition, it's kind of a no brainer. Again, it doesn't work for everybody, but high degree of effectiveness. So it was a study done in Thailand where they looked at what they called survivability and they measured. They had people that were scheduled for total knee replacement because these are people with advanced arthritis. And they were scheduled for surgery and they put them into a program where they do PRP into the joint. They actually PRF and they put it into the joint. And at two or six months, I can't remember exactly when they would measure their pain scores. And if it was improved by less than 50%, they went on to surgery. If it improved 50 to 70%, they gave them another shot of PRP. It was proved 70% or more. They said, okay, let's just see how you do. And you can get another injection whenever you want to fall below that 80% at the end of three years. Three years, right. About 80% of the people that were scheduled for surgery never had surgery. 80%, four out of five did not have. And their threshold was so low, if somebody had a 40% improvement, I would have given another shot. In this case, they actually did surgery on them because they were trying to figure out from a public health standpoint could they save money on a public health and or universal healthcare in that country. So even with that low threshold 80% success rate, that translates probably in real world a little higher success rate. But could four out of five knee replacements be avoided for at least three years? That's really good math. And of course you can continue to study on it as long as you want to. What happened is that the people that failed usually failed in that first round. Instead of giving them a shot, they just did surgery on them. But the average person got something like two shots over the three years. So really good success. And the studies that are coming out are really numerous and they're generally all showing benefit versus anything else with steroid shots. The HA injections, these are actually regenerative versus just palliative, Don't grow, don't replicate and don't die. And when this happens, your stem cells become more or less paralyzed. They're not doing anything. Some people call them zombie cells. When we put the stem cells from another tissue that are not syntic or not senescent, they wake those back up. They send out different signals, exosomes through the exosomes, different cytokines and stuff, and they wake them back up so they can start growing again and cartilage can grow back. This is what we understand to be happening scientifically. We have a long ways to go and understand all that's happening. So those are the two tissues. Now, what's the difference clinically between the platelets and the stem cells, be they from fat, umbilical cord or bone marrow? The stem cells are typically kind of like a one and done, where you get the procedure done and a couple months later, typically function starts improving, pain starts improving, the last three to five years, somewhere in that order. Whereas the platelets might have to do more services, more treatments, and it's probably going to be more like nine months to a year. So there's a little difference in durability. At one time we were thinking people with more severe disease should go to stem cells and more mild disease go to platelet rich plasma. There's some truth to that, but there's a difference in cost. And if that's a concern or it's your first time doing something, you don't want to get the fat taken out, you can start with platelets. It's going to typically work anyways, more than 80% effective. So it's a good option. I think really the message that I would like to say is if you have arthritis and you're thinking about knee replacement, you're probably going to put that off for a while because there's major problems with knee replacement. And you can do platelets or you can do stem cells, generally speaking, you're going to get response. Most people do. And you don't have the problems associated with knee replacement, such as, you know, you can't go to the regular screening at the airport, less risk of the complications associated with knee surgery, a lot less expensive. And it's an option for people. And I think the fact that it's not covered by health insurance turns a lot of people off. I think a lot of people love themselves more than their possessions and they might prefer to take care of themselves first. I think there's also skepticism because of insurance, doesn't cover it much, must not work. It doesn't really work that way. There's a couple reasons why insurance coverage will not be coming soon. One is it's a little too new to be standard of care. Number two is there's multibillion dollar companies making medical devices that really aren't going to promote something like stem cells. That's got to come from somewhere. Thirdly, stem cells and platelets come from your own body. And none of us have the money to spend billions of dollars to get or at least tens of millions, hundreds of millions of dollars to get FDA approval for a certain type of procedure or to get insurance coverage. It's very hard to do. So it's not like a conspiracy thing, it's just that it's a perfect storm where this is not going to happen. Now we see certain state governments are offering their employees employees regenerative therapies. Certain countries are. But in general we're not going to see Medicare Blue Cross cover this anytime soon. So it is out of pocket. Fortunately, it's not that expensive right now. And even though it was expensive at one time, with more rapid, say acceptance of this, doctors able to do more procedures, get more efficient, really bring the cost down. Remarkably, even the cost of us preparing the platelet rich plasma has dropped by over 90% in the past five years from kits that were available and the ones that are now. So it's really been a, been a game changer. How much fat do you need to get a stem cell treatment? It's not very much. A few teaspoons and we have the ability to send your fat to a lab with a bank and store your stem cells for the rest of your life for a fee that you pay the stem cell lab. Then we order them, they send us a little bottle of say 10 million stem cells. So that's the state where we're at now. And I've been.