Unveiling the SECRET Power of Peptides | Ryan Smith (Peptide Expert)

Our body, you know, starts with DNA. That DNA creates rna, which creates proteins and peptides. And so whenever we're designing these drugs, we're really mimicking body's natural processes as.

Far as weight loss. Of course, the growth hormone secretagues are very helpful. They help with body recomposition.

Those peptides which can increase growth hormone by encouraging your pituitary to release growth hormone. This is one that was done in athletes before it was really done anywhere else with the idea that if we can increase mitochondrial function, you could increase performance.

Okay, welcome to the Dr. Joy Kong podcast. I'm so excited to have Ryan Smith with me today. Ryan, you are a superstar. I'm just so excited to be able to learn from you. So first of all, welcome.

Yeah, thanks so much for having me. Excited to talk peptides.

Yes. So I know there are a lot of subjects that you can go into, so there are two things that we probably can talk about. But today we're going to focus on peptides. First, I want to introduce Ryan a little bit. Ryan is right now you're focusing on true diagnostic, but just going back a little further. You went to university studying biochemistry and then you went to medical school in 2013. So that was 10 years ago. And you passed the USMLE step one. And then you left medical school and opened up a pharmacy. You know, that's, that's quite interesting. And you were focusing on peptide synthesis and formulations. And that pharmacy happens to become hugely successful. Tailor made a beautiful company. You know, you guys have so much very nicely put out information helping a lot of practitioners. The company became the fourth largest growing company in healthcare in the US and grew to $80 million within three years. And with that pharmacy you saw the value of preventative medicine. And with physicians that Taylor made was working with, there was a lot of, you know, efforts in treating age as a disease. So that kind of prompted you to see a need for better tool to assess aging. Is that correct?

Yeah, absolutely.

And that's when you exited TaylorMade in 2020 and found it true diagnostic, which is very exciting because you created this biological age measurement testing and that has become very successful. You're working with, you know, huge number of patients in studies and, and very big reputable universities and institutions like Harvard and Yale and Duke. So, so that's why I say you're a superstar because you're still very young and to be able to found these two powerful companies and make them successful, I'm just so impressed by you.

Well, you two kind got lucky a little bit. As well. But I think that, you know, one of the, one of the fun things is always driven by really cool science. And so I think that that's what we'll get into today, at least to some degree, is why, why I was so excited about these two areas and hopefully why everyone else should be as well.

I need to hear the story of what happened when you were in medical school, taking your exams and then what happened? You just found a pharmacy. So there's a. There's a good story.

Yeah, well, you know, I just realized I didn't want to be in medicine, unfortunately. I think that it's a sad story. I think that the world of medicine that I knew existed was sort of treating sick care. You know, I was working at the University of Kentucky where we were, you know, seeing patients who were maybe seeing physicians for the first time in 10 years. You know, people who really, really only coming to the hospital because they absolutely needed it as an emergency. And it was pretty sad for me. I felt like I was just sort of managing care. I was sort of just checking off a list. And if I had known this world of preventative medicine existed, this market where people are trying to optimize themselves rather than trying to just wait for disease to occur, I think I would have certainly stayed with it. But I had no idea at the time that existed. And so really the pharmacy. A lot of my background in undergrad had been in peptide and protein biosynthesis. So doing recombinant chemistry, like growing up particular peptides of proteins and, you know, E. Coli expressing them, purifying them, doing things like X ray crystallography, as well as solid based synthesis for shorter chain amino acid proteins or peptides. And so I had some experience in that. And whenever, you know, I was trying to, considering this pharmacy, just sort of lucked into it. We knew we wanted to do some really innovative peptides that weren't widely available here. And we started launching a lot of products which people weren't really familiar with. So we had to do a little bit of education to the market. We tried to sort of teach physicians about all these different products. And then we just really hit a niche, I think. I think a lot of physicians and patients saw some of the really positive benefits of some of these therapies. And it really just grew from there.

Yeah, well, when I was in medical school, no one, no one told me about peptides, but it was going on. Right. So the Russians have been developing them since 1980s. How come you knew about it and I didn't know anything about it, you.

Know, so I hate to say it, but even I was never taught about it either. And even with the things I do today with epigenetics, I think I had one day on epigenetics as an undergrad and so a lot of these topics I was never necessarily taught, but always had a, I would say an eye for sport and biochemistry and you know, athletes particularly, even, you know, the Russian athletes, you know, have been using a lot of these products for, for performance related benefits for a long time. And so they had been out there not frequently well described or even widely used, but was always sort of an interesting.

In medical school you heard about these athletes using these peptides.

Yeah, well, essentially, you know, I was sort of, you know, doing this peptide research and looking for peptides to be interesting to make or create. And as I was looking for it, I was sort of, I guess drawn or attracted to some of that performance enhancing aspect of it. And so that's when I started to become a little bit more familiarized with it. And then it really started from there.

Okay, so this is around 2010, right? Is around 2010. And a lot of athletes were already using performance enhancing peptides.

Yeah, definitely. I mean, the growth hormone secretag receptors and growth hormone releasing hormone peptides are probably one of the best examples. Those have been really used even since as early as 1996 in athletes trying to do some performance enhancing related administration. So yes, and the field has only gotten much more advanced as this sort of expansion of peptides has occurred. And that is going now at a, at a very wide rate with more peptides approved than any other type of class of drug molecule.

I see. Yeah, I have a lot of questions about that. Just where do you think the FDA is at with peptides and what's big pharma's attitude when it comes to peptides?

Yeah, well, so I think that our definition in this space of peptides has been a little bit obscured because the FDA and big pharma wouldn't necessarily have the same definition. For them, a drug is a drug, whether or not it's a small molecule drug or it's a biologic drug, or if it's a peptide based drug. And so generally though, the big pharma world and even the FDA hasn't seen a lot of peptides. And the rationale for that is because small molecule drugs, which are more stable and more bioavailable, those drugs have always been pushed to market first by a lot of these big companies. So I always mention Viagra as A good example, right. Viagra is a small molecule drug that readily absorbs, it can be taken orally. It's really easy. And pharma companies have known this and so it has a great market impact, vice versa. Peptides have always had a little bit of a few weaknesses. One is certainly bioavailability. You know, most of them are not going to survive the transit through the stomach acid. So generally they have to be injected. That makes them a little bit less advantageous for wide market rollout. In addition to that, oftentimes they have very, very short half lives. So they don't stay around in blood that long. And that means you might have to do frequent injections. And so that has made them really, I would say big pharma and other companies sort of stay away from them because they have a little bit too, they're too hard to package or to control in a product that is very easy to distribute across the world. And so this has really been why small molecule drugs have really taken the focus for several decades. But now we're starting to see the shift. And the reason being is that all those weaknesses that we thought peptides had are now being corrected and we're left only with the peptide strengths and those things like being metabolized very, very predictably, not having a lot of drug to drug interactions, having a lot of specificity for individual targets. And so all those problems are now fixed, which now makes peptides very exciting and now one of a huge area of focus for, for big pharma and the fda. And so we're starting to see that peptide approvals are becoming a lot more frequent. Unfortunately a lot of peptides are really great products, but are in this sort of area of limbo where they're not being developed, but they still have really useful potential in the market. And so that's where compounding pharmacies really stepped in to be able to produce some of those products that were not technically FDA approved but still had a lot of great clinical application.

Okay, so are you saying that they're solving the problem? That is so it does not have to be injectable and it does not have to be injected frequently anymore.

Yeah, a good example of the glucagon, like peptides like the semaglutide, as everyone is familiar with now, probably the Ozempic. Prior to that, those drugs had to be injected once daily, like the liraglutide, and now you only had to do it once weekly. And the reason those are getting better are because we're making them more stable and longer acting in the blood. So that's a good example. And now you can even take semaglutide orally as well. And so, so we're correcting some of those issues with really great science. And that's making peptides much, much more popular.

Wow. So when they in the process of making these little bit more accessible and easier to handle, are they changing the structure to the point that is not natural anymore? You know, like the strictly natural?

Yeah, so, so these, that's a great thing about, I would say the biochemistry just generally is our body starts with DNA. That DNA creates rna, which creates proteins and peptides. And so whenever we're designing these drugs, we're really mimicking body's natural processes. And so they can be very natural. And at first they were some of the earliest peptides were things like insulin, right. You know, synthetic insulin, mimicking exactly what the body had. But then we got more advanced and by changing that natural product, we can make just a very small amount of changes, but for a large benefit. So going back to those growth hormone secretag peptides, those, those peptides which can increase growth hormone by encouraging your pituitary to release growth hormone, that started out just mimicking exactly our endogenous growth hormone releasing hormone that comes from our hypothalamus. But then we started to substitute some amino acids and by doing that we increased the half life. So Instead of just eight minutes of stimulation, we might get 30 or even longer. And so by doing that we are changing them from their natural structure. So we're getting rid of that, what is sort of equivalent for the body's production. But we're tweaking them just enough to have the same effect, but to have better pharmaceutical profiles.

Okay. That could be some people's pet peeve because, you know, so much of what we've been seeing with all these pharmaceutical drugs is unwanted side effects because when you tweak nature then you can end up having all kinds of unforeseen consequences. So do you see that as happening with these peptides?

For some of them, I think that's certainly a possibility. But I think that, you know, a lot of the peptides that are widely in use now don't have as many of those because they've gone through such rigorous testing. But there, there are quite a few. I think they would have some unintended consequences. But I think again, that's the great thing about these peptides is, is they have a wide range of applicability. You could go with the bioidentical use the exact same thing. You might mean you have to inject more, it might mean that you have to inject more frequently or inject it all. But you can really go back to those basic biochemical principles and really mimic what your body is doing.

Okay, so I'm curious. In our clinic, provide over 20 peptides. I do wonder how many of those have been slightly tweaked. What about otc? Because that's the one that you need to inject once a week. So that has been tweaked.

So the moth C is actually just like the endogenous moth C that mitochondrial pops out. So it is still identical to the one that's produced in your body.

Okay, that's really good news. That's very comforting since I just injected some into myself earlier today.

Certainly. Yeah, that is one of the few exceptions.

Okay. All right. So when you see, when big pharma start to tweak these peptides and then sell them as pharmaceuticals, do you see that as a huge, you know, step forward to help the peptide industry? Or do you see that as possibly squeeze out, you know, the. The more natural forms of peptides? Because I assume that the big pharma cannot patent completely natural molecules. Correct?

Yeah. When I think that unfortunately, to get a drug to market right now, it takes over $2.3 billion, and that is a lot and a lot of money that most people or most companies would not have. And so, unfortunately, a lot of what drugs are going to market are still controlled by the people that would have that financing. And that tends to be these large drug companies. And so what we're starting to see, I think, is a pattern is that a lot of early drug work is done and then sold or licensed to these larger pharmaceutical companies. And so generally I think that that's a relatively good thing because they have the time and resources to bring something to market. But as I mentioned, there are quite a few exceptions where we know that the products are really great, but they tend to be not brought to market. Ipamorelin is a good example, even early with Semorelin. I think that that's a good example as well. All these growth hormone secreting dogs, which have really good chemical impact but are never really brought to market. And so I think that there's some pros and cons of both, but I would say generally there's really no other way to bring them to wide use. And so I think you have to go through these pharmaceutical companies, companies, and.

It has to go a little bit of synthetic route.

Basically, it's almost Always synthetically produced, but it doesn't always have to be different from the product that we would endogenously produce in our body. But I would say that most of the time it is just to make sure that again we're eliminating any of those concerns that typically happen with the peptides.

I see, okay. Yeah. Okay. So you know, maybe we give people an idea of some of the peptides that that has been the most popular. So when you first got started, you said one of the earliest ones were the growth hormone promoting peptides. Right. So the Samorin was the earlier one. Right?

Correct. And that's just actually a, just a fragment of your natural endogenous growth hormone releasing hormone. It's just a 29amino acid fragment of that, of that same product. And so that would certainly, I would say that class, the growth hormone secret dogs were certainly the biggest class that we originally started with. And the reason being is that unlike growth hormone they were less expensive, they didn't have contraindications for prescribing off label like growth hormone does by the FDA and they generally didn't have a lot of side effects such as you couldn't overdose them for instance and have any of the side effects you might have if you dose growth hormone a little bit too high. And so it really was a good alternative to be able to help with adult growth hormone deficiencies while still avoiding maybe the more expensive and certainly the more heavy handed product and growth hormone.

And then there are newcomers that came along. So in my clinic I do like the combination of ipamorelin and CJC 1295. So what do you think of that combination versus semorelin?

Yeah, so I think it was definitely a step in the right direction. So here we go to a little bit of terminology aspect. But CJC 1295 is also goes by the name of MOD GRF 129 and and so basically what they did is they took that 29amino acid sequence of, of Epimor, sorry, of moral and and they substituted out just essentially four amino acids. And so that's all that happened is four amino acids changed, but the binding time on the pituitary essentially almost tripled. And so you got a lot more secretion of growth hormone with really the same type of dosing. And so that was certainly a step in the right direction. People call it also CJC because technically it's slightly different than that MOD grf, but it was developed by a company called Conjugen and this is a company that does really one thing which they attach a small molecule product to these peptides to give it even longer lasting in the blood system. And so people might say CJC with DAC or the drug activity complex. And when they do, they're talking about, about actually that, that, that little addition given by Conjugem, which actually means that you only have to dose it once per week, a little bit more like that thermaglutide. And so, so those were certainly a step in the right direction. But I think ultimately it culminates in probably what I think is the best growth hormone, Secretag, which is the Tetzamorelin.

Oh really? Okay. We do use that in the clinic, mostly for weight loss purposes. But you think that may be even better than epramorellin and CJC combined?

Yeah, certainly. Well, I think that the IGF1 benefits are certainly larger. The average increase in IGF1 with Tesla is on average 181 points, which is a very large increase. I think that depending on how much growth hormone stimulation you need, it's certainly a good avenue. But the reductions in visceral adipose tissue, the improvements in cognition, the reduction in carotid intemidia thickness, all of those are benefits which have been really heavily proven with the Tessamorelin.

Okay, and does that one come with Doc as well?

It doesn't. So it is actually a 44amino acid peptide and it's got a small lipid molecule at the end. And that gives it a really good stability and gives it really good potency. That's why you're seeing such, you know, large increases of IGF1, because when you stimulate that pituitary, your recent growth hormone creates IGF1 in the liver and you have really, really potent effects.

So you personally, I mean, if you are going to take a growth hormone, you know, secretagog, you will go for Tesmorelin.

I would, yes. Yeah. I think that it is certainly the, the largest effect. I might not do the full dose. I don't know that, you know, my IGF one tends to be very low anyway. But I might do a half milligram instead of, you know, one milligram dose or a two milligram dose. But. But yes, I think certainly one of the most potent and effective.

Okay. And if somebody is buying something like Epramoril and CJC and you would, you would say go ahead and use the, the one with dac?

I would say without DAC actually. Yeah, yeah. So that's an interesting distinction and I'm glad you asked because I wouldn't have really gotten into it. But I think that sometimes that long term stimulation, a week of stimulation is not always what should happen. So in the case of hormone we have this very diurnal patterns. Right. So whenever we go to sleep we see the biggest increase and then you know, when we wake up it's generally much lower. With things like this cjc, with the DAC you get so much stimulation, you miss a little bit of that circadian rhythm generated pulse of growth hormone. And so it's a little bit less natural. I think going back to some of the questions you were asking earlier. And so I think that generally if I were going to do cjcfmoron combination, I would do it instead of the DAC and I would do it every night before bed to mimic. Mimic that natural growth hormone peak.

Right. And then how important it is to have a two day break because we tell people to do five nights a week.

Yeah, certainly so. So that is, we sort of started that convention very early with, with true diagnostic or tailor made compounding. And we did it because we didn't want to develop a resistance or tolerance to growth hormone secretion. And during that process we never solved that actually happen. But with that being said, I think that we saw that you can even dose sometimes more frequently. As long as it's not an extended duration, then you generally are probably not going to have problems with downregulation.

Daily injections.

Yeah. And at one point in time we had people who were dosing it up to three times per day, once in the morning, once in the afternoon, once a night for several weeks on end. And we still saw that they were having reliable increases in growth hormone with the administration. I wouldn't recommend that, but I think that it's probably best practices to still have two days off most days.

And what's your philosophy on how long a person should stay on? You know, let's just say that the growth hormone secretagogues.

Yeah, so I think every peptide is different. But for the growth hormone secretagogues I probably, I'm urging a little bit more caution than I used to whenever we were first doing this. And the reason being, I think is some of my priorities have changed a little bit as it relates to what outcome you're really looking to seek. You know, I think with growth hormone stimulation you're driving a proliferative growth process. And I think that that might not always be the thing that you want. You know, I think that there's now another side of the coin, especially from a longevity perspective where you Might want to sometimes have those periods, but then other times you might want to have more restrictive periods of growth where you're being more conservative in some of those processes for better longevity. And so I think that, you know, you could stay on them for a long time without really any negative effect. But I think, you know, my. My philosophy has changed. Maybe doing it, you know, three months on, maybe three months off, or something similar to that.

Okay, okay. Yeah, that's super helpful. Yeah. And what about some other peptides? I think, you know, of course, the most popular one, I would say, is BPC157, TB500. Right. They become very famous. I'm sure all the athletes are using it. So can you talk a little bit about these two?

Yeah, certainly. So the Thymusin beta or the TB500 is actually funny. The TB500 actually was named based off of a horse product, a veterinary product, which was given to help race horses recover from injury. And so that's how it became the name TB500, sort of like a brand name. It was really built in the veterinary world, and when it started in the veterinary world, it went to the bodybuilding world, which is why kept the name TB500. But the Thymus and Beta 4 is really the real name of that product. And that's a product that is. Mimics exactly the same product that is produced by our own bodies naturally. And it is a great repair product.

It is the same.

Yeah.

Is there controversy?

Yeah. So there's a lot of thymus and beta 4 fragments that still have biological activity that are sometimes shorter. And so the TB500 really is, I would say, a ubiquitous for anything that has to do with Dynamics and Beta 4. But technically, the TB500 as a technical designation doesn't exist. It's just a brand name.

Okay, all right, all right. So this is a brand name for TB4, correct?

It's correct.

Okay. Okay. And then the, you know, what do you think? The fact that a lot of people are using the two together, do you think that they are synergies when the two are used together? TB500?

Yeah, absolutely. They're both great recovery products for repair and recovery and have so many different applications. I'm really actually excited for the thymus and beta 4 because that one is actually very close to FDA approval, which is interesting. The bpc, on the other hand, is very far away. But I like both of them a lot, and I used both of them myself to repair and recover from sports injuries. I've seen miraculous changes to help prepare from surgery related outcomes. And so I'm a big fan of both of them, and they both act very differently. And so I generally would say that The Thymus and Beta 4 profile is a little bit more soft tissue and muscle mass, whereas the BPC is really good at reducing inflammation and better with tendons and ligaments. And so I think that together they can. Can both have a synergistic effect, have really great repair and recovery.

Interesting. Are they both good for bones or. Or the BPC is a better one for. For bone health?

Yeah, so I would say that the BPC is slightly better for bone health. But. But, you know, I think that there's very, very few studies for bone health for either of them. But. But again, I think for repair and recovery, they're both going to help anything that needs vascular circulation. The Thymus and Beta 4 is really a good product for.

Okay, so the thymus betaphore is good for circulation.

Yeah. So one of the main things that it's doing is increasing proteins like vegf, which help with angiogenesis and bringing blood flow to new areas. And so, yeah, anything that would require angiogenesis or accelerated wound healing, that is where Thymus and Beta 4 is really going to be a star.

And do you think that they're both good for cardiovascular health?

Yeah, much more. The thymus and beta 4? Again, I think the thymus and beta 4 has many studies in cardiac issues and improvements, and so, again, dealing with more angiogenesis. And so it's really perfect for a cardiac type of application.

Okay, and what about. I think there's a little bit of, you know, difference in opinions about whether or not to inject these peptides directly into the soft tissue or joints. Different practitioners have different ideas. Well, what are your thoughts?

Well, I will say that there aren't really any studies comparing one to the other, so I think that most of what we know tends to be anecdotal. And I would say that in my personal opinion, I haven't seen a ton of applications where injections into the tissue plays a major benefit outside of just dosing regularly. But with that being said, there are a few exceptions, I think, especially in avascular areas, and I think that even in particularly cosmetic procedures, there are some benefits of injecting locally, but I don't think it's absolutely needed.

Cosmetic procedures utilizing Thymus and Beta 4.

Yeah, certainly. So a lot of people will, I would say, use Thymus and beta 4 or even the VPC as it's going to help improve collagen synthesis, particularly that type 1 collagen synthesis. And so a lot of people will microneedle it, for instance, in the faces. A lot of people will, you know, after plastic surgery, try and inject it locally. So there, there are a couple cosmetic applications I've seen that have been really effective.

Very interesting. Yeah. Because of course we hear most about the GHK copper for cosmetic use. Do you think that copper component sometimes causes problems with patients?

I would say if you're dosing it too high, certainly. So one of the main features of this is if people start to see the Luna of their nails turn blue, that little white circle that you have way too much copper and you might need to chelate it. But generally I think that it's going to be hard to dose it that high, especially if you're doing it in a non injectable format like a topical application, then you're probably not going to have any issues with copper. But sometimes if you're injecting it, you can certainly have some of those issues where you're having too much copper. And I think there's an important balance between GHK regularly, the tripep side and then the GHK with copper. Lauren Pickard, who, who really was the creator of the ghk, talks a lot about their different profiles. He talks about GHK, for instance, increasing stimness of stem cells, making them more available, whereas the GHK copper more differentiating stem cells to be able to help repair and recover into the necessary tissue. So there's certainly a balance there that needs to be struck. But I think that it's very rare that people will probably overdose the copper too much. So that it would cause a problem.

Yeah, or adverse reaction to the copper. I'm not sure if that has, has occurred. So are they both naturally occurring, the GHK and copper?

Okay, absolutely. The copper is, is relatively well attracted to that tripeptide. So you have to really make a point to make sure that it's not binding to the copper.

Very interesting. Yeah. Well, I can only find out from a real biochemist. And then I want to ask you about weight loss peptides. Of course, that's hugely popular. Right. People, people are desperate for weight loss and now they have this exciting new tool that everybody is getting, you know, thanks to the Kardashians and to the point where there's now phrases like the. Was it called ozempic face. When people lose too much weight, then their face, you know, it's slimming rapidly and then there's drooping. I mean, there's a new cultural phenomenon. So in our clinic, as far as weight loss, of course, the growth hormone secretagogues are very helpful. They help with body recomposition. And then there are a few other ones. So that would be in our clinic, the ipo, Moreland, cjc, tessamorelin, and then there are these other ones that I want to ask you a little bit. The most famous is semaglutide, which is oz Epic. Some people have scoured Internet and looking for problems and have found a few in general. It's extraordinarily safe, right?

Yeah, certainly.

But there's been reports of pancreatitis. Correct. And what other things that may be of concern?

Yeah, so certain relationships to certain types of cancers, like the men cancers, are really big contraindications. But I would say on a daily basis, the things that people are going to experience the most generally tend to relate to those GI issues that accompany the semaglutide. And it's also why they tend to have to be titrated up. And so I would say that for the large majority, they're not going to experience some of the issues like any type of cancer related issue or even the pancreatitis, which is more common than some of those other relatively common effects like the GI effects, the constipation for instance, or nausea I think being the two most common.

Okay, you're saying the, the pancreatitis is very uncommon. Is that.

But yeah, no, I was just gonna say the pancreatitis happens. It's not unheard of, but it's not nearly as common as, as nausea and or constipation, which generally tends to be the biggest side effects.

Okay, and what about people also ask about rebound weight gain or just going back to their original weight or maybe even heavier than what they were before. But you know what I hear is that if they're eating healthy, they're not going to get back to the previous weight. So what are your thoughts?

Yeah, so generally I think the data shows that there is a slight rebound of weight, but I think that the assumption is that they're probably not having those same healthy eating habits. And the reason being is a lot of the effect size of some of these GLP1s are through appetite reduction where they're not eating as much, they're not intaking as much food. And so I think that when people stop, sometimes their diet also shifts. So it's always hard to have a controlled trial where you're incorporating that and seeing about weight loss. But I think that if you can keep, keep up those good diet and lifestyle related habits, I think that you probably will gain very little weight back.

Yeah. Okay, so what are the other benefits for Ozempic or Semaglutide besides the weight loss?

Yeah, so I think that number one of which is insulin sensitivity, being responsive to insulin. And this is something that has received a little bit of controversy lately because some people think that it might be actually worsening some insulin resistance problems. But I think that, you know, again, it's controversial, but I think that, that anything that is helping improve your insulin response is great. I think, you know, now that I work in, specifically in the field of longevity with true diagnostic, I think that, you know, we have a saying that, that almost everyone develops diabetes if they live long enough with this insulin resistance related issue. And so things like the Semaglutide which help improve our response to blood sugar or even some other diabetes related medications like some of the SGL2 inhibitors, which help you sort of pee out glucose in your urine, all of those things tend to have, I would say, a positive impact on longevity. So that's one of my favorite things about the Semaglutide.

Wow, that's great. And what about MOT C? I remember we talked about that before and you do you do like that peptide quite a bit.

Yeah. So I love the MOT C and actually this is one that was done in athletes before it was really done anywhere else with the idea that if we could increase mitochondrial function, you could increase performance. And so we really even started in athlete use before it was even widely available to the medical field. So I love the MOT C I think, especially in theory, but I think that the practical application of dosing is sometimes difficult. Know how much to dose and how frequently to dose. A lot of those studies really haven't been done to the point they need to. And I think that probably at the moment, people are probably underdosing the Motsi, not doing it as frequently as they should or not doing it to the high enough dose. And I think that to get to a really great therapeutic effect, you probably would have to spend a lot of money to be, to be able to dose that appropriately.

Well, what will be a really good dose then?

You know, so I think that again, it's all conjecture, unfortunately, because we don't have much data. The data that we do have is from, for instance, even people like children who are developing type 2 diabetes early in life and then have suppression of their endogenous MOT C production. And so it's Difficult to say, but I think that whenever we rolled it out of TaylorMade, we were doing very, very light at dosing, and we were doing it three times per week. And I think that generally 10 milligrams, even twice a day, would be more toward a dose that I think you'd start to see really good efficacy, especially even for performance. And so I think that instead, one of my favorite products for mitochondrial benefit outside of the moth feed, given those issues, is the SS31. The SS31 is hard to find sometimes, but I would say it tops my list of all of the peptides.

Okay, well, okay, the back to Moss C, the 10 milligrams. The recommended dose I've seen was 10 milligrams, once a week.

Yeah.

What's that doing then?

Well, it's certainly not hurting. Right. I think that, you know, what we know with the MOD C is that it's encouraging a lot of processes that are beneficial for, as you mentioned, weight loss and also performance, you know, leading to acar increases, which, you know, increases mitochondrial metabolic function. And so I think certainly 10 milligrams is nothing bad about that. But I think to really see some of those benefits, you would want to dose it much, much higher and much more frequently. Again, the half lives of these things are very, very short. In the case of the MOT feed, once you reconstitute, degradates by 90% within four hours. And so it is highly unstable and quickly degraded, not just outside of the body once it hits liquid, but even inside the body. And so I think that dosing is probably a little low.

Okay, I've heard other things about the degradation, but you guys have tested it in the lab, I assume, about the 90% degradation.

Yeah, certainly. For what it's worth, that wasn't even our testing. That was actually published in one of the mod C papers. 90% degradation within four hours.

Okay. I think I've heard some other opinions on some podcasts. But you're pretty certain that that's the case because that makes a big difference about what you give patients.

Yeah, 100%, certainly about the degradation. I'll even send you that trial so you can see it.

So do people feel a, you know, as far as energy level? Because a lot of people suffer from low energy by increasing their mitochondrial function. Do they notice an improved energy on MOT C?

Yeah, certainly. So I think that especially, again, a good dosing, but, you know, with the Motsi, you'll improve your insulin sensitivity, you'll improve your protection against diabetes. But I think Some of the biggest things that people see is it's sort of like an exercise mimetic, because what we're doing, whenever we give them OD C, we're then sort of starting de novo purine synthesis, which leads to a byproduct called Acar. And this is Acar has been a product that she's been in sports scoping for a long time. Because what that does is it sort of activates AMP kinase, which is the same process which is activated with exercise. And once AMP kinase is activated, you can also activate something called PGC1 Alpha, and that increases mitochondrial biogenesis. And that's really what we want because it's driving those cellular energy processes. And so that sort of loop and pathway is just sort of positive regulating. And so you'll certainly feel that in terms of energy.

And then there's another weight loss peptide, 5amino 1 MQ. What are your thoughts on that? And that also increases NAD level, right? And also help with mitochondria health, correct?

Yeah, certainly. So I was actually the first person to ever take the 5 minute 1Q. And at that point we were trying to do it as an injection and it was awful. One of the most painful injections I've ever done. But I had seen the data by Dr. Waterland come out of the University of Galveston and it was right around the same time that I would say that NAD and sirtuins were gaining a lot of popularity. And so the injections didn't work at all. But. But the oral products certainly are something very good. And technically it's a small molecule instead of a peptide. But it's one that I'm a very big fan of.

So you don't think the injectable is a good form?

No, I don't. And the reason being is that one and Q is very difficult to solubilize in water. And so I think that the ROE version, perfectly fine, you get bioavailability and it certainly works. You know that we're even doing NAD testing with True Diagnostic. I've seen the 5Amino 1 and 2 increase that intracellular NAD level. Beyond that, some of the effects it has on muscle regeneration are pretty exciting.

Okay, and do people also notice increased energy level?

Yeah, I would say that some people might. I think that one thing that I that was certainly unique is just improvements in performance. I had some of the craziest increases with performance that I've ever had with any type of product with the five amino. And again, I had no idea why at this point, one of the first Studies really just described it as a way to increase nad. And I had no idea why it was so much of an effect on me from a performance aspect, but I loved it. And then shortly thereafter, a couple other papers came out showing the impact on skeletal muscle, and that made a little bit more sense. It activates the satellite stem cells and muscle. And so I think that although some people might experience some energy benefits, I think the performance impacts are certainly something that I think most people will feel.

Yeah, fantastic. Yeah. You know, maybe I have an improved version of the 5Amino 1 MQ. I'm not sure because it's highly soluble, looks beautiful. Not painful when I inject. So I'm wondering if things have changed.

Yeah, I would be a little careful about the injectable. I know from experience, but one of the other things is that the 5amino 1q is usually given as an iodine salt. And sometimes, much like we talk about with the copper, if you give it too frequently or you bypass that first pass metabolism, you might increase iodine levels a little too high. So something to take a look at there as well. But I should also mention there are new generations of the 5amino 1 MQ. So shortly after its development, actually Dr. Waterland created a spinoff company just to develop this product and they very quickly got pharmaceutical interests and are now on second and third generation versions of the same molecule that are in pharmaceutical development and will hopefully hit the market over the course of the next decade.

Is that why the solution is like amber color is because of the iodine?

Yeah, it is.

Okay, interesting. And then the last weight loss peptide is melanitan. So there's of course one and two. Do they both have weight loss properties?

They do, although the two has much more weight loss properties. But I always like to mention that the melanotan one is actually FDA approved as alpha melanotide.

How often do you, do people get hyperpigmentation? You know, the, the fact that they're, they're, they're, you know, pigments are getting a lot darker. You know, that may upset a lot of people.

Yeah, I would say that it's something to expect with the melanitan too. You would, you, you would not see it as much with the melanotan one, which is usually given as a pellet actually for vitiligo. But, but with that being said, yeah, the Melanotan 2, almost everyone should expect it, but it is also dose dependent. And so for instance, I would say that the more melanocytes you have, so generally the darker you are at Baseline, the more you're going to experience that as a side effect because what it does is it stimulates your melanocytes. But obviously everyone has a very different amount of melanocytes and so it'll affect some people differently. And I think that generally the biggest complaints are some of those mucus membranes will start to turn purplish like your tongue or your lips and so, or the sort of even make you the under your eyes a little bit darker.

Then the very important question is that reversible?

Yes, absolutely reversible. It takes time, you have to lose that melanin and that can take some time certainly. But they're also, for what it's worth, peptides, which also can help lighten your skin as well. And so some of those are infrequent and cosmos suitable ingredients. But, but some really interesting things happening there too.

Yeah, yeah, okay, very cool. And then there are some, you know, a few other categories. One is the brain peptides which are very much in need. I see how challenging brain conditions are and they're absolutely important. So in your mind, I mean there are various ones. I've seen research looking at different extracts from animals brains. So I guess the most well known one is the cerebral lysine. Right?

Yeah.

And of course people raise the question how safe is it is a pig brain extract? And how would you answer that?

I would say very safe, very safe. The cerebralysin especially we're getting it from a good source, which is important. The cerebralysin is approved in now over 70 countries. The United States is unfortunately not one of them. But it has been approved by multiple countries for things like stroke or traumatic brain injury. I am certainly a big fan of this rubber lights. And I think it is very, very safe. One of the things I should mention is one of the big fears about brain related products or extracts are things like prions or mad cow disease type of things. And something that is interesting is that pigs are actually naturally prion resistant. They almost never get prions and so you don't have to worry about anything like that. And most everything else is thoroughly tested for in these pharmaceutical batch ingredients. And so I think truvlycin is very, very safe.

Wonderful. And if you're treating somebody with stroke, either acute or chronic a long time ago, what would be the dosing would you recommend daily dose for? I've seen protocol of like 16 weeks. What do you think is ideal way of, of using that?

Yeah, so most of the clinical trials which have been done using the cerebralysin do it as an IV infusion. And those IV infusions can get to very, very high doses, you know, upwards of 50ml infused on a daily basis for every day, for multiple days. And so you can take very aggressive approaches. But I also think that it sort of shows you that there's, you really can't overdo it. A lot of these, you're not going to overdose on these products. And so I think that it also has, I should say in the research setting really only been used or studied really acutely, usually within the first three to six months after some type of event. And so a lot of what we might be able to do chronically and at what doses is still a little bit of a guess. But I think that what we've seen at least anecdotally is that, you know, 1 milliliter of the, of the solution, which is usually at 215 milligrams per milliliter, is consistently used and has gotten some really great effects. But again, hasn't been widely studied as much as a big IV infusions.

Okay. And something like daily injection of that one milliliter for 16 weeks. That sounds pretty reasonable.

Absolutely. Yeah, definitely. As I mentioned, you're not going to overdose it. And I think that I've seen that dosage work for quite a few people.

And what kind of conditions have you seen people have that have gotten help from this?

Yeah, so definitely post stroke it's been probably one of the most frequent applications. But even post tbi, any traumatic brain injury of any type, but even things like peripheral neuropathy I've seen have some really great effects. And so I would say those are certainly the three most common. But I mean I've seen it used in Alzheimer's and Parkinson's. There's some good studies on maybe some of the ApoE4 biology which it might have some beneficial effects on. So I think it has a lot of really positive effects across the neurological spectrum and can really help with a lot of different things. But mostly I would say definitely in stroke or tbi.

What about ALS or ms?

Yeah, so I certainly know a lot of people that are using in those conditions. I myself don't have, I would say a ton of experience there, but I've heard certainly great things.

Okay, great. And then another interesting peptide is dihexa is one of the few that actually is taken orally. I mean it's widely available. So you know, people talk about the was it 10 million times produce help you produce 10 million times more brain derived neurotropic factor. Well, that sounds great. But in practice, does that actually promote that much benefit?

So yes. And so yeah, 10 million times the potency of BDNF. It is mimicking angiotensin 4, which we've known is a great sort of nootropic product for a long, long time. And some of the results that I've seen with Dihexa have been extraordinary. One of my favorite things, if you're, if you're listening to this right now, I would recommend pausing it for a few seconds, going to Vimeo as a platform and searching Dr. Joseph Harding Dihexa. And I recommend looking at it because there's a certain part of that video which is astounding. It's really one of the first times I came across Diehexa. And what they actually are doing is they're inducing Parkinson's in mice. And so they have three mice here. They have one mouse that's normal. They have one mouse who Parkinson's has been induced bond. And then they have a mouse that had Parkinson's induced but has been treated with Dihexa. And one of the ways that they test this is they encourage the mice to hang from a rope. So they put their front two paws on a rope, almost like you're doing a pull up and then they just wait and see how long you can stay up. It's extraordinary to see because as you would imagine, the Parkinson's mouse drops very, very quickly. It's only really got one arm that can do it and then it sort of drops off. Then you have the Dihexa treated mouse and then the normal mouse mouth and the normal mouse actually dropped second but by a wide margin. The, the Dihexa treated mouse probably stays on that line twice as long as even the normal mouse. And it's. Yeah, it's incredible to see. And even before that you can see some amazing pictures of, of the, the neuron growth with, with Dihexa and some of these animals. And it is astounding how powerful it is. And so in, in a lot of times brain diseases are very hard to treat a lot of times because they don't have a lot of the blood brain barrier having targeted approaches. And just the nature of these conditions are sometimes very difficult. So sometimes a heavy handed tool like the Dihexa can be really good. But other times I can see that you probably wouldn't want as much stimulation there, especially for things that are more of just nootropic based benefits.

So for what conditions would you, I mean, Parkinson's. That sounds like that would be Very appropriate. I've heard doctors who treat kids with autism, they give them Dihexa. So what kind of conditions have you seen people using it for?

Yeah, I've seen people use it for the broad spectrum. Everything from those TBIs and strokes we talked about to Alzheimer's and Parkinson's, to even just trying to maintain cognitive function with age. So I've seen people use it in a variety of circumstances. I think probably the people who are generally the most positive about it are the people who have the most serious conditions.

And have you heard of great results from practitioners?

I have, but I would say that sometimes it's a little mixed in terms of the responses. Some people might not experience anything. Other people will say it's life changing. And so I really think that maybe we're not sure, maybe the best indications yet, but I know that we, we. It's certainly a strong, nootropic and powerful brain product.

Yeah. So the. The po Dihexa goes across the blob brain barrier. That's no problem. Very easy, I assume.

Correct. And it was made that way. And like I said, to mimic angiotensin 4, but to be orally bioavailable and to get across the brain.

Okay. All right. And then there are three other brain peptides that I use in the clinic. C Link, C Max, MP2228. So, and that's covering some grounds, and I would love to hear your thoughts on these three. So let's say somebody comes in with anxiety. Which one would you grab first?

Certainly the one with the most data on anxiety is the C Link. The C link has been studied a couple times for anxiety. And with the C Max is one of those Russian peptides that's been around for quite a while.

Mm. Yeah. And then if somebody has cognitive issues, adhd, then definitely C Max.

Yeah, certainly. It's got definitely more studies than that as well. Again, another angiotensin mimicking product. But. But yes, the C Max is definitely more for that acute nootropic effect.

Yeah. Are you a fan of the PE2228 alleviate depression, what, in four days?

Yeah, certainly. So, you know, I think that. So we were the first to roll out the PE22 28 as nasal spray. A tailor made. And I would say it never really took off like we would have expected it to. And so I think that the mechanism of action is certainly one that's exciting because unlike the SSRIs, where you have to wait several weeks to see any type of benefit, this is rather immediate. And with people now going to things like ketamine for treatment resistant depression, it seems like there might be a really great middle ground where it can be positive. But to be honest with you, we never saw it uptake that much. And with the frequency and prevalence of depression, that surprised us a little bit. So I do love the mechanism of action. But you know, so to be honest with you, I don't remember as much now. It's been a while since I've used it, but if I remember correctly, it is. I'll have to. I have it here, right here. So I'm not sure but, but I know that it's, it's working again in almost in a realm like ketamine in terms of its Trek 1 inhibition. But. And I'm not sure sort of what activity that has directly on the brain, but I know it's Trek 1.

Okay, fantastic. And then we come to like a couple of immune boosting peptides, so the T Alpha 1 and LL37. So I'd love for you to you know, give your, your thoughts on that. You know, a lot of people, I mean, autoimmune conditions or Lyme disease, you know, these are rampant and it's devastating. So what are your thoughts on these two peptides?

Yeah, so I'll start with Thymusopa1 because after the SS31 it is one of my favorite products. You know, it again is like the super Lysin approved in multiple different countries and it's just again a great product for improving the immune system. You know, even early in Covid it was hypothesized to have a beneficial effect. With COVID it was actually even nominated for FDA approval here in the United States to be given as an adjuvant to vaccines to make them work better as well as to be used with certain types of cancer to help the immune system fight your own cancer. And so the Thymus Stop one as an immune stimulant is a product I certainly like. Again, it's a natural product as well. One of my other anecdotes that I always like to mention about that is that Thymus Alpha 1 is upregulated significantly during pregnancy as a way to sort of help the body's immune system function for essentially two people. And so that's actually one of the biggest times we see massive increases its own production naturally. So I'm a huge fan of the Thymus Alpha 1. I think it's very hard to dose it incorrectly or too often or for conditions, almost any condition. It has a sort of an immune normalizing effect. So I'm a very, very big fan.

Well, my question is, if you're coming down with a cold, if you ever come down with a cold, will you grab a Tavo one right away?

Certainly, yeah, certainly. Yes. And definitely in those days of COVID I was keeping it around, I'll tell you that for sure. But yeah, so I think that its ability to help with a multitude of viral infections, to help even with cancer, improving the immune system and decreasing that immune essence that we see with age. Definitely a big fan of the thymus mouthworm.

And what about the LL37? How well do you think it has worked for chronic infections? From what you've seen?

I am not as big of a fan of the LLP 7. Yeah. So again, we were the first people to start doing this at TaylorMade, and it's one of those ones I regret launching a little bit because it's really, again, it's an endogenously produced antimicrobial peptide, something that's naturally produced by our bodies. But the problem, I think, is dosing it systemically, because the L37 can activate seven different types of receptors, all with different mechanisms of action. And so knowing what receptors is actually activating and where it's actually activating is very, very complicated. And there have now been even more recent studies showing that LL37 has been linked to things like Alzheimer's, among others. And so you mean causing. It does look to be causal instead of just correlative. And I can imagine why many people would think it'd be correlative because your body might want to upregulate antimicrobial peptide in types of situations that might also then induce Alzheimer's. But it does look to have some cognitive effects and mechanism rather than just correlative. But again, it's so hard to say because it has so many different impacts on receptors. And these are big G coupled protein receptors that have multitude of downstream effects. So knowing what you're Getting with the LL37 is sometimes very tough. But I think for things like topical administration to fight staff or some of those other things I certainly don't think is a bad idea. But antimicrobial effects are probably one of the biggest growing areas in all of peptide development. And so I'm sure that if LL37 is not the one we like, we'll certainly find more.

Yeah, it's very popular in the Lyme community. Everybody has heard about LL37. So, you know, now I'm a little concerned whether or not this is the best thing for these patients.

Yeah, I'll send you some information. But there was actually even just a study that was published last year, 2022 which shows that how it might have some negative effects in that human microglia.

Wow, okay, good to know. Two more peptides. I know we're covering a lot of ground, but yeah, so the epitalon and of course is a lot of people's favorite as well. Right. That's a bioregulator, very powerful molecule. And then there's another one, Pinealon. So both are pineal peptides. So can you talk a little bit about the difference and would you use both and what are your thoughts?

Yeah, so I would say that I'm not an expert on the pineal and so I can speak a lot to the epidural and I think that I tend to be a bigger skeptic of those bioregulators than most. And the reason being is that in Russia they're done a little bit more as a multi level marketing type of application and none of the sequences of the actual products are released. So it's not really, I would say as scientific as some of these other approaches are where we know exactly what the amino acid sequence are, we know exactly what the receptors are which is targeting. And so for some of those bioregular I tend to be more skeptical. But the epitalin is one that I think has a lot of great data and I am a big fan of. I think that there are some studies on epitalin I don't particularly think are the best one in particular being the one that is widely noted which is that it increases telomerase and telomere length. In one study it increased lung fibroblast telomere length by 33%. And, and so I think a lot of people early on started doing it as a way to improve telomere length. But unfortunately I can say that I've tested now quite a bit of telomere length with epitome and I don't see that big of a correlation. I actually don't see it having much of an impact but I think I am a huge fan of it. For all the other effects that it has, even those 15 year follow up studies where we're seeing some really drastic improvements in in lifespan and reducing cardiovascular disease, I think that there is certainly some benefit, although I think that mechanism of action is still a little bit un elucidated.

I see. So you're collecting a lot of data with the true age testing. Have you seen any Peptides that's making a dent on biological age.

We're doing a study right now, a controlled study on the epitalin and unfortunately a lot of our data on the peptide, peptide is not very strong because most of the time people are doing one peptide, they're usually doing several. And so it's always hard to pull around which one is having the biggest impact. And so we're actually going to be start doing that right now. I'll study on epitalin to look at some of the biological age impacts and the methylation effects.

Yeah, wonderful. Yeah. So maybe we'll just quickly talk about kind of the looking at the grand future before we wrap up. You know, I have this, this thought that if, if the government and big pharma doesn't stand in the way, I think peptides, peptide therapy can, you know, peptides can replace probably about 70% of the medications that we're using. So that's just kind of, you know, just my sense looking at the natural abilities for the body to heal and the incredible number of peptides that exist in our body. So what's your thoughts on my conjecture?

I think you're certainly right. I think that really in order to make that a realistic possibility, we have to go back to treating preventatively. Right. Hoping to restore dysfunction before it gets so out of control that it becomes something else comes a disease entirely. And so I think that a lot of peptides are great at having some marginal gifts to a more natural state. And I think that that's certainly a positive thing. And, and unfortunately I think that the United States doesn't have a really great legal or system at the moment which would really advocate for the use or exploration of these. I think that we're really going to be reliant eventually on big pharma because compounding pharmacies like us, for instance, a tailor made compounding are being forced to stop a lot of compounding of these products. And so I think that's a very sad. I've seen how much they help a multitude of people. So I'm hoping that changes. But I think peptides is a class of molecule whether or not it's being brought by big pharma or compounding pharmacies. I think it's going to be hard pressed to find an area where we don't see many new peptides being developed.

Right. So I see that you also work with international pharmacies. Do a lot of them see much more at latitude?

Certainly, certainly. So yeah, I'm compounding with pharmacies. In Mexico and in Thailand. Now we're starting one in Philippines as well as several in the Middle east. And, and thankfully, yes, they have a much more latitude. And so we're actually, I would say expanding the frontier of peptide products really. Since we stopped tailor made, there haven't been any new peptides introduced into the market. None of the compounding pharmacies are doing really anything innovative. They're only doing what we did at TaylorMade Compounding. But with some of these international pharmacies, we're able to do some other really exciting things. We're doing the Rediscrutide, sort of a new GLP one a little bit more advanced than the Tirspatide or even the Ozempic or the Semaglutide. We're doing some things like growth hormone screen. So some really cool new products that are happening and we're starting to learn a little bit more. So I think a lot of development we're seeing now is going to be more international than it is going to be domestic, which is unfortunate. But at the same time I think that I'm glad, glad to see the development continuing.

Yeah. This is so exciting. Well, you are making a great contribution to humanity. A lot of people's lives. This is just incredible. Using your knowledge and your, your, your courage and, and your resourcefulness.

Yeah. Well, thank you. You as well. I, unfortunately I quit when the going got tough, but I'm glad to see that there are still people out there using these in patients lives to improve them and so, so I'm glad that to see that it's still alive and well.

Yeah, I'm just so excited that I finally brought in Peptide to my stem cell therapy. You know, I think stem cells is very powerful in this overall elevation of the capability for the body to heal. Of course there's some targeted action too, but the peptides just add so much, you know, tools for me to pinpoint what area I can further address. It just, it's making it really fun. Yeah. So thank you for paving the way.

Yeah, no problem at all. For what it's worth, I actually have a presentation on all of the peptides to use a stem cell. So I'll send that to you as well.

Oh my God, I love that. Okay. Fantastic. Yeah. Okay, Ryan, so where can people find you and follow you? And I'm sure people are very impressed. I remember the first time I heard you on a podcast, I was like, well, okay, this guy is super sharp. Yeah, this is very smart guy. Yeah. So I'm sure people will be interested in. Keep learning from you.

Yeah, Well, I would love to share any information that I have. The best way to contact me now is with my new company, TrueDiagnostic, @ryanrudiagnostic.com and again, although I'm not doing peptides all the time anymore, I still have a ton of information. So a ton of literature, a ton of presentations. And so if I can share any of those to help anyone, I'm more than happy to.

That's fantastic. Thank you so much for all you do. Yeah. And I'm so glad we're having a. We had such a detailed and interesting conversation.

Yeah, certainly. Thanks so much for having me, Dr. Kong.

You're so welcome.