Everything You Need to Know Before Your First Stem Cell Treatment

There are a lot of theories of aging and stem cell depletion is definitely a major, major contributor. Because imagine if you have toxicity, if you have tissue damage, you have mitochondrial dysfunction, but if your body and all your cells can replenish and multiply, then you can fix it, right? All of a sudden you're fresh and new. Okay, so you heard all about stem cells and you know, they are incredible. And you're thinking, maybe this is going to help me to heal from whatever I'm dealing with, or it's going to help me live longer and better and younger. But there's so many kinds. Where do I go, who do I choose and what type of therapy? So there's a lot of question, you know, I don't blame you because not only the public is confused, a lot of doctors are confused. So I want to kind of give people a little bit of broad stroke overview of what kind of stem cells are out there, what should you choose and why? First of all, I've never really talked about the history of stem cells, so it's kind of fun. So let me just give you a little bit of kind of overview. So first of all, what makes a stem cell a stem cell? So they have to have a capability of self renewal. So they basically can make more of themselves. And they usually go for asymmetrical cell division. They can divide into two identical cells, but oftentimes they will differentiate into a daughter cell which has further gained some functions. And then a copy of, exact copy of itself. So it replenishes itself. And then it produces whatever it needs to give, right to give to the organism, give to the local tissue. And it has to be able to differentiate, which means gaining function, developing and gaining new function. And then they renew the tissue, they populate. So that defines the stem cell. And how do we discover stem cells? It's not until 1961 that we found there were cells that can self renewal. This was discovered by Till and McCulloch at the University of Toronto. What they did was that they gave mice lethal dose of radiation followed by injection of bone marrow cells. And then they found out that these cells cloned themselves. And the fact that they replenished themselves and was the main reason that these animals actually survived. So that's how they found these self renewing cells, which are considered stem cells. And then in 1981, so 20 years later, scientists discovered ways to derive embryonic stem cells from early mouse embryo. So they found these stem cells from the embryo. And then in 1998, so again, this took what 17 years because of the study of mouse stem cells, they discover a way to get human embryonic stem cells. So growing the cells from an embryo in the laboratory, it didn't take long. So in August 9, 2001, George W. Bush actually introduced a ban on federal funding for research on newly created human embryonic stem cell lines. So really, it means that they, they're not going to give any funding to research that is using a newly destroyed embryo. Right. So when they're getting the cells from, you know, creating the embryonic stem cell line, that means that embryo is forming and really stay five to seven of the, you know, of the. After fertilization, that's when they can obtain some cells from the center of this, you know, ball of cells. Those are the embryonic stem cells. So in order to create these lines, then they have to destroy the embryo. Right. So they're getting the cells from the center of these newly formed ball of cel embryo, if you want. But you know, the loophole is that they can still do research or give funding to lines that were created prior to the date of this, this ban. So they can, they can still do research. They just can't destroy any new embryos and still expect any funding from, from the federal government. And then in 2006, that's when they found out about the induced pluripotent stem cells. So these are cells that you can obtain from somatic cells. So somatic, just so you can get it from. What they did was from skin cells. So you can get any cell from your body, a mature cell. Right. A functioning cell with its own particular capabilities. And you can give it certain factors or certain signals to trigger it to go back to the younger stage, to the embryonic stage. So they created cells that were very similar to embryonic stem cells. That was very exciting. Right. There is a lot of excitement. Oh, my goodness. Now we can get stem cells from a mature person and then can, you know, we can generate these early state, these primitive cells that are pluripotent, which means it can start to differentiate and make a whole new organisms, including the sperm and eggs. So the gametes, you can create a whole human being from something as simple as a skin cell. Right. But it has its own challenges. So we can talk a little bit about that. So it sounds great. What's the problem with embryonic stem cells? First of all, there are ethical issues in the US not in all countries. Some countries like Canada, uk, Spain, China, you know, some countries, they don't consider an embryo a kind of functional being. They don't consider that as a living entity yet. So. So there wasn't such ethical issues. But that aside, these cells are a little wild. So they have so much potential to differentiate into anything. And also, they haven't really stood the test of time. Because if you are trying to form a full human. Do you know how many pregnancies end up in miscarriages? It's because something went wrong. There could be some genetic abnormalities and the pregnancy is not going to go through it. Just the organism, the fetus is not viable. It's just not, you know, the organs or different, you know, enzymes systems are not functioning in a perfect symphony. So the embryo dies. Which means if you're getting it, getting cells from an embryo, you know, as an embryonic stem cells, these cells have not withstood the test of time. So you have not shown that you're capable of forming a full human being. So a lot be wrong, right? The genetic imprint or the blueprint could be defective. So that's one thing. The other thing is that they're so wild that they can create new cancer, new tumors. That's called teratoma. So these cells can become very unruly. We've heard of women who actually, they thought they were pregnant, but they actually had tumor growing inside of them called teratoma. So that is one risk. But also another issue is that if you're creating some line of cells from an embryo, giving it to another person, certainly these cells are different from the recipient cells. Right? These are two different organisms. So if you're transplanting from this embryo that's obviously from somebody else or something else that's different from you, then there's a chance of rejection of immune reaction. So that's one thing. That's why there's so much excitement when they found induced pluripotent stem cells, because these are from yourself, and then it has embryonic stem cell potential. But there are also concerns regarding induced pluripotent stem cells because the way they are obtaining these cells, the way they are reverting them back to the embryonic state was by delivering these particular factors, mostly using a viral vector. So when they used these viral vectors to make genetic modifications, there are genetic modifications. So there are unforeseen issues. So during the time of how you create it, and also by the time you proliferate the cells, so you culture them, expand them, and then there can be a lot of genetic changes. So that's one thing that you can accumulate genetic changes and defects. But also these cells are wild as well, because they have embryonic characteristics. So they can also cause teratoma. And we've seen that not specifically from induced pluripotent stem cells. I know people have used embryonic stem cells as therapy. And then, you know, we've heard stories of people growing a tumor in areas where they got injection or, you know, just from the cells aggregating in certain areas. So you could get new tumor from these cells. So that limit their uses, their applications. So what are we using these days? Just to give you a little bit of terminology. So we talked about embryonic stem. The induced pluripotent stem cells. So what is pluripotency? Pluripotent just means it's so potent in so many ways that it can form all these cells of different germ layers. So ectoderm, you know, skin and forming skin and nervous system, and endoderm forming a lot of the internal organs, and mesoderm forming muscles, you know, bones and spinal canal and certain organs. So these. You can form cells from, you know, into all these different cells of the, you know, various organs. And you can also form sperm and egg in most cases. So that's what make them pluripotent, because they can form so many types of cells. And forming an entire organism. And a step above it as far as potency is totipotent stem cells. So they're completely potent. They're so potent, not only they can form a full organisms, but they can also form extra embryonic tissue. So that's the placenta and then some other, you know, tissues that. That's not part of the fetus. The embryonic stem cells are pluripotent, but the blastomeres are the early stages of the cells when the fetus is forming. So it's only for the first, first few days when there are up to about 32 cells. So those. Each cell is considered blastomere. So these cells can form an entire organism plus all these extra embryonic tissues. So that's kind of the. The, you know, so you understand what these terms mean. And then there's multipotent, which means that you can form cells into different germ layers. So you can form, you know, cells of many different organs. The mesenchymal stem cell is a multipotent stem cells because it can form cells of different tissue types. They can differentiate into various tissues, and they depend on, when you obtain them, they may have very wide potentials or less potentials. So they're multipotent because they can form, you know, cells into different organs and, you know, different tissue types. But some are much more flexible, like MSCs obtained from the umbilical cord have a lot more potential than MSCs that you obtain from the bone marrow from an adult or from the fat. Because you, when you get it from the younger source, they have so much wider capabilities. For example, they can form liver cells or even neurons when you get it from umbilical cord source, the mesenchymal stem cells. But if you get it from an adult bone marrow or fat, you probably can only differentiate into the muscle cells, you know, cartil, fat, etc. So you're much more limited, even though by name they all sound the same. So that's the, the broad category. So even if you are using mscs, let's just say we're using, we know we're using these particular cell types because that's all the rage right now. Because it's very low in its capability to cause immune reaction. It's very calming for the immune system because modulates the immune system actually is so calming it can be used in conjunction with organ transplantation to reduce the rejection rate. So these are mesenchymal stem cells and they're everywhere. Anywhere you have blood vessels, you have these mesenchymal stem cells. So the question is, do you want to get them from the, from yourself or do you want to get it from a younger source? You know, I see no point in getting it from somebody else that has already matured. Right. If you're getting it bone marrow stem cells from another adult, there's just no reason to do that because there's much higher chance of rejection. But you can get it from a much younger human. Well, it's really the waste product from this human. So when the baby's born, it's obtained from healthy life births. So when the baby's born at the time of birth, the umbilical cord is cut, right. Usually the cord and the placenta is tossed into the biological wastebasket. In the past, until we found out, oh, there are all these stem cells in these tissues, so now we can extract them. What's interesting is cells from these tissues are actually younger. The stem cells from these birth tissue are younger than the baby's stem cells because when the embryo was forming, all these cells were trapped in the birth tissue, right. Instead of just going into the baby and keep developing with the baby, the they were trapped and kind of arrested in their development. They were like a, you know, they were paused. So they retain a lot of the early characteristics. They actually have embryonic stem cell markers that are no longer present in the baby's stem cells. So they're kind of in between the embryonic stem cell and the baby's stem cells. I presented some research specifically looking at the differences between different cell sources because when I first came to the stem cell field, that's about eight years ago, I was faced with the possibility of using a person's own stem cells or using birth tissue derived stem cells. Those are the main options. Those are the main therapies carried out in the U.S. of course, the bone marrow stem cell therapy was the earliest. Right. We found out about the Bone Marrow 1961. That's, that's where the first group of stem cells were discovered. And for a long time scientists thought that's the only place that humans have stem cells still. And then they found out, oh, they are everywhere. So they were able to get it from fat. So fat derived stem cells also started to become popular. And then there's the birth tissue derived stem cells is kind of the latest in its usage and popularity, but it's gaining popularity drastically because years ago when I talked about in the early, earlier episode in 2016, only a small amount of stem cell therapy were carried out using umbilical cord derived stem cells, but so only about 20%. But now it's close to 50% and the trend is only increasing. So if you're looking at using any of these sources, I was faced with the choice of what works the best, right? I only want to give people the best for their own healing. Not only the most effective and potent, but also the safest. So as a doctor, first do no harm, right? I want to give people whatever that's the safest. So I looked into research from around the world and just, you know, scoured the publications and to see what have people found out about these various sources and what may be better. So that collection of studies was presented in this video that I put together. It was originally a lecture that I presented at various conferences, but I wanted to make it available for everybody. It's called Our OMSCS Created Equal. It's a 40 minute lecture, talks about the differences. So I really broke it down. By how many generations do these cells have left? You know, how much is left in them? How long are their telomeres, how much waste product have they accumulated? What about senescent markers and how much growth factors can they secrete? How neuroprotective are they? So with looking at all these factors, it's pretty clear, the research is pretty clear that the younger stem cells are just more potent. They have More potential to differentiate into various cell types. When older MSCs have lost a lot of those potentials, and then they're just more capable, they are more active, metabolically more active. And. But when it comes to safety, it turns out that they're safer even though they're from somebody else. That's what's fascinating about this. The earlier mesenchymal stem cells actually have the capability of destroying cancer. These stem cells were given to somebody that has existing cancer, which most of us do. We all know that cancer cells can form naturally, right? But if your immune system is strong, you get rid of it and then you are healthy and nothing is festering in you. So if we can produce these kind of cancer cells by ourselves, and then if you put something into the body that has the potential of making these cancer cells flourish, you know, helping them to grow, then you have a problem. And that is exactly the issue with the fat derived and bone marrow derived stem cells, that these cells are older, which means that they have senesced. So I gave the term of cellular dementia. It's almost like they forgot. They forgot that certain cells are pathological, they don't belong in the body, they need to be destroyed. But these cells, somehow they think, okay, I'm here to help everything to grow. Then I secrete growth factors. So I just, you know, help cells to proliferate. Unfortunately, they can help cancer cells to proliferate. You know, research have shown that that has been reported. That's a real possibility. But umbilical cord derived stem cells, MSCs, the overwhelming evidence is that they're anti cancer. So they've been used as an anti cancer modality to treat people with cancer. And a very interesting study and very convincing is that they were looking at fat derived MSCs versus umbilical cord derived MSCs, and they put it next to cancer cells. So in this case it's glioblastoma, virulent form of brain cancer. So when they put the mscs either from fat or umbilical cord next to the cancer cell, they did it on a petri dish and then also did it on the live animal's body. So in both cases, the fat derived stem cells made the cancer grow. Yet the umbilical cord derived stem cells made the cancer shrink and go away. And that's how different they can be. So I just want people to be aware that if you're going to do stem cell therapy, that you know the risks of using your own stem cells because your own stem cells have lost certain intelligence that's it, you know, you've lost not only the number of stem cells as you age, you also lost capabilities of your stem cells. That's one reason that you are lingering in your inflammation, right? There's pain, swelling, discomfort. Why aren't things healing? Why are you repairing? Even for osteoarthritis, People think, oh, it's because I hurt my knee. Well, you know, remember when you were a kid, when you were seven years old, five years old, you hurt yourself all the time, right? But you repair like that because why? Because you were full of stem cells and they were working really well. So they help you repair really fast. Because I, I remember how fast my skin heals, right? I can have a cut and heals right up. It was fantastic. And then as I got older, I was like, why is it still here? Why am I still trying to heal? This simple cut is because your own stem cells, one, have reduced in number, two, have reduced in function. Just to give you an idea, we're all born with lots of mesenchymal stem cells, right? I mentioned they're all over your body. Anywhere you have blood flow, you have these stem cells hovering around the blood vessels ready to work, because they are sensing what's going on in the blood. So they're, they're like holding onto the blood vessel wall, so they're sensing what's going on in the blood. So if there are signals that require them to go to a particular site, they can squeeze themselves into the blood vessels and start swimming upstream to find the place where there's inflammation and injury. They're also sensing, they have all these, you know, kind of tentacles. They're sensing what's going on in the environment, so they can decide what signals to secrete to send it to the immune system. They can recruit immune cells, hey, come over here. You know, get rid of some of the cells that, that are not functioning well. Let's, you know, let's take them away and then send signals to local stem cells. We all have local stem cells. You don't have to rely on these cells to become your new cells, your local stem cells that are tissue, specifically, let's say liver. Liver have liver stem cells. So those cells can be stimulated to replenish the tissue. So, so the mesenchymal stem cells can tell the local stem cells to, hey, you know, wake up, start replenishing. So when we're younger, we have a lot of these, a lot of these mesenchymal stem cells. So every one in 10,000 of our cells, when we were born, was the mesenchymal stem cells, MSC for short. But when we reach our teenage years is already 1 in 100,000. So you have tenfold less. As far as the ratio, right? How many of these cells are to how many total cells are in your body? So it was 1 in 100,000. And when you reach your 40s it becomes 1 in 400,000. So you're a quarter of the amount of stem cells you had when you were a teenager. And when you reach your 80s is 1 in 2 million. So you're one fifth of what you had when you were in your 40s. So you can see the decline is a cliff, is a sharp, you know, falling off the cliff. So you just simply have a lot less is a fact of life. We didn't know that. We knew we age. But why, of course there are a lot of theories of aging and stem cell depletion is definitely a major, major contributor. Because imagine if you have toxicity, if you have tissue damage, you have mitochondrial dysfunction. But if your body and all your cells can replenish and multiply, then you can fix it, right? All of a sudden you're fresh and new. But if you have this declining source to replenish your tissue, then the repair is not going to happen, or not happen very well and not going to be complete. So aches and pains accumulate, organ dysfunction accumulate. So if you can replenish the stem cells and then the final step of, of regeneration can actually happen and even mitochondria, what's cool about, you know, you, you probably, it's going to be very hard to do anti aging therapy using your own stem cells because you're just, you know, recycling the, the old and the dysfunctional, right? It can help to some extent because there are still stem cells. But you're not going to anti age, you're not going to reverse your age because you're giving yourself the, the cells of the exact same age as you. And then when you take your cells out of your body and you process it and give it back to your body, yes, it can produce certain effects. But guess what? You also just depleted your own cell supply. Because every time, when you activate, when you process and when you reintroduce the cells to go back to your body to do work, you have activated these cells. And no activated cells live forever, will have a lifespan. Just like all humans. We all lift for a certain amount of time. Same for cells, they're not immortal. They, they, they come alive, they work for you and they die. So then you have reduced in your own stem cell supply. But if you use a younger source, then you are not depleting your own supply. You're adding, you're adding younger cells with younger and clearer signals, more intelligence that are still retained in these younger cells. So they're more intelligent and they're not depleting you. And they can also perform mitochondria transfer, which is really cool because imagine the very, very young cells with intact, vibrant mitochondria. Like a reset, right? Every time we are, you know, newborn, we, there's a reset. So you're getting reset. It reset mitochondria. So fresh mitochondria that's going to go into your body and you know, there's mitochondria transfer. So these cells can actually donate mitochondria to your cells, helping your organs and your cells to function more optimally. So it can help elevate your capabilities of healing drastically. So that's kind of the difference. You know, looking at cell sources, you know, I would really advise people to look at the differences between these cells. So I don't want to take away from doctors who are doing bone marrow or fat derived stem cells because it's. I know they've done a lot of good work. They've helped a lot of people and a lot of people swear by it too. But as a provider, as a doctor, you know, faced with choices, the field is always evolving. I'm not saying umbilical cord stem cells are end all, be all. It is probably one of the best options we have right now, if not the best. But things are changing and I'm going to continue to update my knowledge so I can share with you. Because things can happen very fast. You know, just like the discovery, right? Somebody discovered the induced pluripotent stem cells. So things can happen fast. But it wouldn't be wonderful if we really can control these induced pluripotent stem cells. We can actually utilize it a lot more than how we're utilizing it now. But there may be more barrier. Why? First of all, if you manipulate cells and create a new cell line in the FDA's eyes, then you are making a drug. So when you make a drug, then you need to go through FDA clinical studies. So all that takes a lot of resources and a lot of time. What we're doing right now in the clinic is considered a tissue transplantation, not a drug. I'm not giving you a drug, I'm giving you a tissue transplant. Just like as a doctor I can give you blood transfusion, right? So helping you replenish Your blood supply, or I can transplant a lot of different things. Heart, you know, liver, kidneys, and. And lungs. So we can do a lot of transplantations. None of these transplantations are under the purview of the fda. So the FDA does not govern whether or not a doctor can transplant tissue because that is regulated by the American association of Tissue Banks and also each state's medical board. So that's called the practice of medicine. So we're not making a drug. We're just utilizing our medical knowledge to replenish supply of useful cells and tissue. So cells is part of the tissue, so it's considered tissue transplant. So that's what we're doing. And that's one reason why we can utilize it right away. That's why in 2017, the FDA guidelines, which is not a enforceable document, but is a guideline that FDA says, okay, you. If you are doing tissue transplantation and you're not creating a drug, then, you know, under these regulations, if you're not manipulating the cells and you're using the cells the same way as how the cells were function in the body before transplantation, that they perform similar functions, then it's considered tissue transplant. Then as doctors, you can provide the treatment under the regulation is called 361, then these products could. Are considered 361 products. But if you start to use enzymes, you start to expand the cells, which means growing the cells to large numbers in culture, then you're creating a drug. And that will make the product switch category into section 351, which means that you will have to get a drug approval. You know, going under ind. That's called investigational new drug study. And that does cost a lot of money, a lot of time, and which is one reason. So I don't know if folks are aware, this is one reason so many labs and clinics are overseas because they are growing the cells, but they can sidestep the regulation from the U.S. i think the regulation has its merits because when you start to grow the cells, even if you just expand the cells for one generation. So it's called one passage. So one passage has a lot of generations of cells, but each passage it means that you put the cells in a container, you know, whatever culture medium. Each time when it's filled up, it filled up the, let's say the petri dish or whatever structure you have the cell suspended in. Once it's completely filled up, then you have to change to a different. Right, you have to divide the cells and make this, you know, divide them and Then let them grow separately so they can get, they can fill up again. It's called confluent. They could become confluent. So each time when you divide and allow them to grow again, that's one passage. So even with just one passage, there could be genetic changes, not to mention a lot of studies. And people say, oh, if it's within four passages, probably, you know, not much change. But I know there are clinics who are expanding them to 30, 40 passages. I mean, it just. That's what of the problems, because when you start to expand the cells to that degree, the cells, first of all, they have a tendency to express surface markers and to gain function because they're in a strange environment. They, I mean, they're stem cells. We're just talking about dividing to daughter cell and the stem cells. So one is identical, the other one is gaining function. That's their tendency. That's how they want to divide. So when they start to divide into that daughter, daughter cell with more function, those daughter cells can result in immune reaction from the recipient because then you're gaining function. What does it mean, gaining function? You're gaining fun. You gain function by expressing proteins. So all these different proteins that your cells are making allows the cells to carry out certain, you know, activities, you know, that's the function. Right. More functions that they can perform form. And by expressing proteins, those proteins are encoded in different DNA, right? Different expressions of DNA. So when your DNA, one person's DNA is different from another, then these DNA, different DNAs will produce different protein expressions. And those different proteins can cause immune rejection. And then you're heightening the recipient's chance of having a reaction. Not to mention, these cells, when they are in the culture medium, they are stressed. It's not the Garden of Eden as what I've heard some people call it. It's not, It's. It's a stressful environment for the cells to be in a culture medium. You cannot give it enough nutrients. And everything it needs, just like is in the human body. You're guessing what the human body is, you're guessing what the cells is. It's never going to be as ideal. So the cells are stressed. When they're stressed, then they secrete inflammatory molecules and these molecules will end up causing people to have a reaction such as a cytokine storm. So when Tony Robbins talking about cytokine storm. Yeah, you can expect to have a cytokine storm. You know, that's normal. No, it's not normal. I don't want people to think that you have to have cytokine storm. You know, that, that, that's part of the, what you're going to get with stem cells. That is a problem. That is something that you shouldn't have if things are done right. So I have never seen cytokine storm in any of my patients. And you shouldn't. And that should not be something you expect because if that happens to you, then you know, the process of how the cells were made was causing problems. That's why you're having these, you know, malaise, shortness breaths and fatigue and, and just, you know, a lot of discomfort in your body, you know, fever, they're not normal. So that's a problem with cell expansion, is that you are allowing the cells to differentiate and express inflammatory molecules and cytokines and allowing them to express themselves so they can cause rejection type of reaction. So that is an issue. So is it better to have more cells? Cells? The answer is in what kind of cells? Right. If you're giving more, but of lower quality of causing problems, then it probably is not better. But if you're giving unmanipulated young, what we call native cells that have not been expanded and you're giving more, yes, there's a little bit more, could be a little bit better. There's a dose response. That's why in our clinic and how I train other physicians is that there's a dozing, right, that we, we talk about. You know, for example, 1cc for every 60 pounds of body weight. All the research are based on body weight of the animals. We also add more cells when a person's older because you're way more depleted in your stem cell supply. We also add when a person is more ill so you have more inflammation and more repair needed. You know, just think about if you have 10 places that are problematic and you only have this many cells and you think you want these cells to cover all these places? No, you need certain amount of cells to really produce the kind of effect you're looking for. So if they are dispersed among 10 places that each place is not going to get enough to produce the kind of healing that you can notice. Right. So we want to give you enough cells. So yes, there's a dose response. In a sense, more is better until at certain point then you come to a point of no further benefit. So, you know, you, you, you've reached point of maximum return, then I, you know, I advise people not to keep going because that will be just a waste of money. I would rather people do multiple treatments instead of Putting all the cells into one there. It makes no sense. Your body can only repair so much. There's a biological rhythm. So you wanna do a treatment, and if you have a severe condition, do another treatment in a month or two and then do another one. So for chronic severe conditions, I usually advise people to do three sessions. Then we can really look at, you know, what the cells can do. If after three sessions you don't notice much, I tell you, stop. We may be barking up the wrong tree because I don't want you to spend money on things that maybe we have not looked at. What's really causing your problem. I mean, those cases are rare, so majority of patients are getting really good results. But there are cases where people say, well, I haven't noticed much difference. Okay, then there may be other things at play. You know, are you toxic? Which, what I mean is, do you have heavy metal or other toxins in your body? Do you have microbiome imbalance? You know, no matter how much stem cells we throw in your body, if you don't have the right critters inside of you to help you with all various functions, biological functions, we, we know that, that these critters can, can help tremendously. Then again, we're not solving the, the basic problems. If you are deficient in amino acids or in certain minerals or certain hormones, and we just keep throwing stem cells at you, you still are deficient in those. So you're still not going to have full recovery. So you have to address those. So that's the, you know, that's the dosing. You don't need to have huge amount of subpar cells. You need to have the right amount of the highest functioning cells and then hitting the body in intervals. That's what I see as the best protocol for patients. Because we've seen people with one treatment, maybe there's not enough of response, maybe there's a little bit of response, but after the second treatment, all of a sudden there's significant response. And after third, even more so. You want to give the body the time to make the shift. I want to give you just, you know, last, you know, food for thought is just think about when you get sick, right? If you get sick with anything, something simple flu, you know, you say, oh, yeah, I got sick yesterday, I got sick, I started to, you know, sneeze and, you know, I just felt terrible. But no, but you did not get sick yesterday. You probably have been getting sick for at least a week or so, but you just didn't know because there's a biological process, right? Until the time that you notice. Then there has been proliferation of these, these agents, you know, pathological agents. And then there has been tissue damage. That's why you're noticing it. But think of repair as something that's similar, right? Just because you're not noticing that you're getting better doesn't mean that your body is not working hard at getting better. But just symptomatically, a lot of things still feels the same. But you've got to let the body do its work because one day, all of a sudden, you're going to wake up, oh, I don't feel sick anymore. It's because your body has been working hard at it so that you don't feel sick on that particular day. So that's it for today. And thank you so much for listening to me chatting with you. And if you have any questions, please, you know, post and comment the YouTube video. I always respond. I love interacting with, with everybody. If you have suggestions of topics, I'm happy to cover them. If you think this will help people to have a better understanding of stem cells and all the various aspects, please share with people you know that are searching for answers and really want to get a better understanding of this very cutting edge field of medicine. And it's, it's so exciting. It's going to keep changing. So thank you again and I look forward to talking to you next time.