Everything You Know About NAD and Biohacking Is Wrong

Biohacking is all of the rage. You cannot avoid scrolling social and not seeing some new biohacking gadgets, something that's going to help our mitochondria, that's going to help with our energy, keep us youthful, make us slimmer, make us younger, all the things. And it gets very, very overwhelming. We don't know what should we actually be taking from this, what do we actually need, where do we need to be concerned, where do we need to be scared, what do we need to jump in and really start learning. Today I have one of my really close friends, and I call her the guru of regenerative medicine and peptide education. This is my good friend Dr. Sabrina Salt. She not only is one of my personal doctors, she's one of my best friends. And if you could see our text conversations, the stuff that I ask her brain all day long is nuts. And I thought, we've got to have a conversation about this. We most recently had a conversation about something around healing and input and downstream versus upstream when it comes to all of these biohacks. We're going to talk about that. And I had a lot of questions for her, which we're going to open up today about peptides. Where do we need to run? Where do we need to lean in? Are they here to stay? Is this a fad? Lots of questions. We're going to break it all down today. Thank you so much for being here today.

Thank you so much for having me back. It's always a pleasure.

I don't really know where to start other than I'll start with sort of the story as to the most recent text conversation we had. So if you all have been listening to my podcast for any amount of time, or you follow me on social, you know I share all the things. And I had started sharing several months ago about hive breakouts. Like, I was getting these hive breakouts. And if you didn't listen to those past episodes, it really stemmed— what set it off was a Bali infection, infection I got in Bali. But it opened up my mind to a lot of other questions, like why now is this infection causing a histamine outbreak, and what else is going on? And I considered myself somebody who was pretty educated when it came to detox and making sure I'm not, you know, using products or eating things that could create that. But I really went down this rabbit hole of toxic load and why all of these health hacks, these things that we do, can actually make some of us worse. Some of us have more problems. And once I got on top of the histamine stuff and I got that dialed in, I started looking at other markers with Dr. Salt here. We noticed that my cortisol was super elevated. We noticed that I had something called MPO, and I'm going to have Sabrina talk a little bit about that and why she tests for that in a second here. But mine was elevated, which put me down another rabbit hole with her on why is that elevated. That led me to removing a root canal tooth and looking at all other things. And what we realized together is pretty much half the supplements I was taking, including methylated B vitamins, was creating this incredible reaction in me, where in other people this could be helping them, but in me and some others, this could be creating a big problem with downstream. And we're going to talk about that first before we get into some of these other topics. Sabrina, let's sort of start with like, what are those markers? Like, what is— why is cortisol so important to check? And then why did— do you even look for MPO when most doctors don't?

Well, cortisol, in my opinion— so I've been in practice for over a decade, and cortisol is one of those markers that is prevalent in pretty much everybody and relevant in pretty much everybody. Because we are just in a constant state of stress and overload in the environment that we currently live in. Everything from our jobs to our families, to how we're being exposed to blue light, how our food is no longer nutritious. All of those things cause stress on our bodies. That stress can be physical, mental, emotional, chemical, all of it. When cortisol responds in the body, it's supposed to be short-lived, short-term, enough for us to get out of a dangerous situation to activate that fight or flight. When we have that chronic cortisol elevation, that can cause additional downstream issues. Namely, one of the things that happens is we actually get a reflexive increase in a hormone called prolactin. Prolactin is the hormone that promotes lactation in women who are usually pregnant and/or breastfeeding. When we have that elevation occur in somebody who is not doing one of those things, including men and women, it actually causes a decrease in our dopamine. Our dopamine is our neurotransmitter that does all of our motivation, our drive. It brings us happiness. It is the neurotransmitter that is naturally deficient in people with ADHD. And when we see this go down, this is when we reach a state of burnout. And people will come to the office in this burnout state, and they will just say, oh, I'm just tired. Oh, I just have low energy. Oh, I'm just not sleeping well.

Which was me, which is what I was telling you.

Yes, exactly, exactly. And most doctors, very well-meaning, very smart, they're going to look at these symptoms, they're going to be like, it's your hormones. At least a functional medicine doctor, right? Regular doctors, they might say your labs are fine, here's a you know, an antidepressant medication, here's some anti-inflammatory medication, they'll send you on your way. But your regular doctors are going to look at your hormones and they're going to see— they're probably going to see your hormones decline. Because here's the thing, the pathway that creates cortisol and the pathway that creates your sex hormones are one in the same, and they all start with cortisol— with cholesterol. And we're going to get into MPO because this is related, right? Talking about cholesterol, we're talking about MPO. The cholesterol is going to increase, it's going to drive this pathway, and the pathway can split. It can either create your cortisol or it can create your sex hormones, and it should be able to do both in a healthy system that's not making cortisol incorrectly. When that cortisol continues to drive, we of course do see that decrease in our other hormones. So for some women, this can look like irregular periods because their progesterone starts to decline. In women who are perimenopause, menopause, testosterone is going to go down, estradiol is also going to go down. So we can see an exacerbation of menopause symptoms— the hot flashes, the night sweats, the decreased libido. All of that.

Wait, hold on. I want to make sure we're— I'm following here and everyone else too. You brought up prolactin, and one of the things that you had pointed out to me when I came in was a lot of women have high cortisol, but it doesn't necessarily concern you as much unless you see high prolactin. So do all doctors check for prolactin, or is that not common?

Not common from what I see. I check prolactin because I use it as cortisol snitch. So cortisol can be elevated at 4 different times throughout the day, and it can follow this natural progression of, of where it's supposed to elevate and when. We check prolactin because if we do a random blood draw, the cortisol may or may not be elevated at that time, and it may also be a normal elevation. Prolactin tells us that cortisol has been misbehaving at a high level for a longer period of time because you don't get that prolactin elevation unless cortisol has been rampant for weeks to months.

Now, is prolactin jumping in to help protect us? Is it a way that your body— is it like a shutoff switch or what is it doing?

Not necessarily. It's that the signaling that comes from within the brain to tell your body to release that cortisol, that signaling has been going so hard and so fast for so long that it actually gets mixed up and your body starts producing prolactin almost on accident, just because the signal has been so intense for so long. It's not coming in as a help, if you will. Now, this is an interesting aside just because I find it fascinating. In the normal case, which is prolactin is increased in women who are pregnant and breastfeeding, and the decrease in dopamine happens. This is actually evolutionarily favored because it makes the woman slow down, and all she does is just nurse and take care of the baby. This is a desired effect. Now, the one thing that actually helps this situation and why these women don't get necessarily a negative cortisol effect from it is because when they're nursing that little baby, they get a dump of oxytocin. Oxytocin is this cortisol antidote. Now, it doesn't mean that women postpartum can't get into their, you know, a high stress state. Don't get me wrong, there can still be things like postpartum depression, there can still be a postpartum burnout if she's doing a lot and doesn't have a lot of support. But the oxytocin release from the actual act of breastfeeding is going to damper the cortisol that does get released with that. So that was—

yeah, no, that's great. Okay, so cortisol's high. So, and you can, by the way, ladies listening, you can feel when your cortisol's high. So if you start tapping and feeling like I— to me, it feels like you had caffeine, but you didn't have caffeine. And it's like a— it's a wired feeling, like almost a buzz in your body. So I could actually feel it. Like, I would— it would feel at 3 in the morning. I could feel it when I woke up in the morning. I could feel it throughout times of the day. And I want you to know, if you're experiencing that, that we don't want that. That is not a normal thing to have throughout the day. So when Sabrina pointed out, hey, your prolactin is high too, the question then for me— and it should not be, "How do I get prolactin down?" Because it's not like you take a supplement to get that down. It should be, "Why? What is driving this cortisol to be dysregulated?" Okay. So, let's get into now why— where MPO ties into that.

Yes. So, what's interesting here is, like I was saying, the starting molecule for all of these sex hormones, including your cortisol, is going to be cholesterol. So, when we see these middle-aged women who have the cholesterol go up on their panel, because their cortisol is high and their other sex hormones are low, this is actually a welcome change because the body is trying to bring in more raw material to generate that pathway. The problem is, is regular doctors are going to look at cholesterol and they're going to say, oh, your cholesterol is high, we absolutely need to lower that. Well, this isn't the full story, and this doesn't necessarily mean that you actually have cardiovascular damage or cardiovascular involvement. This is why I check MPO. So MPO stands for myeloperoxidase.. And this is a marker of actual active cardiovascular damage. Now, if cholesterol is high and MPO is low, the cholesterol is high because it's there to be protective. It's there to be helpful. Now, cholesterol is high and MPO is also high. We actually have to consider there is some damage happening. What is generating that damage? Now, in your situation, there was an active infection, but I do see MPO also elevated from chronic stress or that chronic cortisol elevation because it generally becomes caustic to the inside blood vessels, and then the body does want to produce more cholesterol to actually help patch up that damage from the cortisol. We do see elevations as well from alcohol intake and certain dietary intake too.

Now, is there other inflammation markers that go along with this that you would have been concerned about too? I know with me it was MPO, but can you list out sort of anyone listening, like what other inflammation markers they need to pay attention to here?

Yes. So we also want to look at something called hs-CRP, which is a marker of generalized inflammation in the body, but it can also be cardiac specific. I also like looking at homocysteine. Homocysteine is going to be a waste byproduct of some of our energy production pathways. This can also indicate where and why some of the inflammation is being generated. And then I also like to run a PLAC. PLAC can also be an indicator of any sort of active cardiovascular damage as well.

So when these things are high, what is the thought process on, okay, let's start knocking out first, like, is it just from the cortisol? Is there another infection? Like, what are some of the things you would take somebody listening through of like, hey, check list of go check these things?

First thing I do is I look at dietary intake and lifestyle stuff. Easy needle movers are going to be removing fried foods and alcohol from the diet. And obviously, if somebody's smoking cigarettes, like, those things kind of have to go, right? We need to clean up the most obvious and likely offenders before we start diving into the more lesser-known things. Now, say we clean up everything. Say we get diet under control. There's no alcohol intake. Somebody's working out, right? Like, they've got everything dialed in. This is where we may want to look at things like hidden infections or chronic infections, like your situation where there was a possible root canal that needs to be looked at, which case a biological dentist would be my first referral for that. And sometimes we may even have to investigate things like mold and mycotoxin exposure. Um, and that is something that I do refer out because it isn't my area of specialty. I know enough to look for it, but it is not my like detox specialty.

So in my case, and you all a lot of you listening are super healthy, so you have the dietary down. You're not drinking, you're not smoking. Sabrina knew that about me, and so she started going down the checklist like, okay, it could be just the chronic cortisol, but what's driving that? What's driving that? So one of the things she did bring up was we've got to look at dental, and then we're gonna— we need to look at mycotoxins. Like, she went down that list. She didn't say go do everything at one time, by the way. She was like, let's knock out the obvious first. So I will tell you all that I have not retested yet, and I'm going to in the next few weeks. But I will say I don't have that cortisol feeling anymore. It's pretty instant after fixing two teeth. Um, so it was an old root canal and it was a chipped old crown, so I replaced that. And I took out methylated vitamins all kind of at the same time. So we're going to talk about what that has to do with anything. Um, and it was instant that like within a day of all that happening, being done, I didn't have that, that heart-racy wired buzz feeling. And my Oura Ring, I sent Sabrina a screenshot, it was really crazy. If you wear an Oura Ring every day, it would tell me like hours of stress, or it has for the last week and a half, it has just said recovered. Like there's no nothing that says state of stress, which is so not like my personality, which We, you know, you're told it's ADHD, it's all these things, you know, it's these things. None of that's showed up on my Oura Ring since we knocked this out. So I would be shocked if my blood work does not reflect all this. Okay, so back to sort of those things. You go and you test and you start asking and going down these things. Let's just say someone's like, okay, I don't have active infections. This is not a thing. Where do you go next with that conversation?

My most uncomfortable conversation that I've had with women where we've looked at everything else is actually, is your spouse or partner causing you chronic stress?

Tell us about that.

Okay, so I think this is something that I wouldn't have actually had the courage to look at if I hadn't gone through it myself. You know, obviously, because you know me, but I went through separation and divorce last year, and at the peak of it, I was in so much denial, I think, of the— what I was going through. I had gotten down to like 104 pounds because stress levels were so high. I couldn't eat. Um, I was a pretty big mess. And I started sharing about my story, my recovery, everything as I was going through it on social media. And with that, so many women made their way into my circle, into my little ecosystem, that also were going through similar situations as far as their marriages falling apart. And I would say in the last year I have had close to probably a dozen female patients.

Wow.

Like that I've worked with to help them navigate through this because we found, we literally found the destruction on their labs of what their partnership was doing to their bodies and how they were falling apart. And I have had honestly countless other women that have just sent me messages being like, you inspired my divorce.

Wow.

Like it's been I never intended to be a divorce influencer, but you can't deny the intensity of which— how your one partner affects you. If you are in like any sort of abusive or toxic dynamic and you're walking on eggshells every single day, your needs consistently aren't being met, you're always trying to re-explain yourself, there's fear, there's anxiety, there's depression— like, that's going to damage the system in ways that, I mean, Even like probably alcohol and cigarettes wouldn't touch. That's wild. It's continual.

Let's talk about what would happen if you ignore this. So you've got the high cortisol, you're like, I'm getting through, kind of like you were before you, when you were still married and you were like, I'm getting through, I'm, you know, functioning. So you have these things, you have high cortisol, you have prolactin showing up. I don't know if that showed up on yours, or you have these inflammation markers. What happens when someone ignores that and they're like, I'm just going to get through, or they medicate their way through with Xanax or whatever it is?

Well, when you are elevating cortisol consistently for a very long period of time, it becomes a drain on your body's resources. Think about somebody just like having access to your bank account and spending all the time, no matter what, basically throwing you into debt. That's what's happening metabolically. So you're going to be using up all of your, your vitamins, your minerals, your amino acids, all of the things that you built up. I know personally, I actually ended up like borderline osteopenic because stress, high cortisol is a very, very big suck on minerals, and your bones happen to be a really great source of minerals. And so when I wasn't eating, my body still had to get those nutrients from somewhere. It decided my bones were a really great source, and I don't blame it. It kept me alive because it's ultimately the body's goal is to keep you alive. Well, when somebody is ignoring that for a very long period of time, they are going to continue to zap those resources. Those zapped resources can eventually end up in disease process disease. So you can end up with things like, um, the low hormones, those perimenopausal states or premenopausal states that aren't quite age-appropriate. If you are younger, it can make menopause worse. It can actually cause cardiovascular disease. It can cause osteopenia. And then one of the things that I actually see very, very common is women developing autoimmune disorders.

Wow.

As a result of the stress and the trauma.

Now, can this be turned around? So you've had high cortisol for a year or two. It, like, to me, I, I feel, because it's just what I experience, it like pretty instant once you figure out what the driver is. But I'm wondering if that's a normal thing, or does this usually take years to recover with somebody?

Both. So it depends on the factors, right? So you had things pretty much dialed in, like you, you've got a healthy lifestyle overall, all things considered. Some people have to re-engineer their entire lives to be able to get their stress down, and that can take a long time just from a logistical standpoint. But ultimately, the body is always trying to be in a healthy state. So once you give it the right environment, the right input, the right nutrients, it will want to go towards that healthy state.

I want to point out, and Sabrina said this to me, and then I basically almost punched her and she was like, "No, you're right," is one of the first things she had said is what a lot of doctors will say. And I said, "Well, what do I do to get the cortisol down?" And she said, I quote, "Breathe, sound bowls, yoga, meditate." And I'm like, like, really? Like, oh, really? When you're in that kind of state of high cortisol, that feels near impossible. So I'm gonna add to that. Um, I know that's well-meaning when your doctor, anyone listening, says that, and we have to say that. However, you have to figure out what the cause is, because if you don't find the cause and you're in that state trying to meditate, yoga, all that, it doesn't really go so well.

It's true. I, I agree with that. And it's one of those things where when we don't know yet, just doing something to at least even trick the nervous system into getting into a more of a sympathetic or rest and digest state is preferred because a lot of people, if they're just sitting high stress and they don't know what's causing it, if we can force it, like if we can get them to go lay in a sound bath, they're probably going to chill out for at least an hour, even if they have to go back into whatever is causing that stress. So I— yes, yeah, I get it. And sometimes we have to be palliative. And this is the other thing that I try to teach my patients too, is, okay, yes, we have to reduce the stress. But that's only half of this equation. There's two sides of it. The other side is we actually have to reestablish joy and your baseline dopamine levels because you've been running deficient for so long. So this is where finding things that make you happy or things that are going to generate dopamine are really, really important. For me, this actually was— this is music, this was weightlifting, and I actually even used small doses of nicotine to help with adjusting those levels too.

One of the things that Sabrina prescribed me, and I didn't— I wish more women knew about this, was an oxytocin nasal spray. Can you talk about that for a minute?

So like I was saying earlier with the prolactin and breastfeeding, oxytocin is that cortisol antidote. And this is something that you have to get as a prescription. And I know that there are some doctors that do prescribe it. Every doctor has the ability to, but some just don't know how to work with it. But oxytocin delivered as a nasal spray is going to drop you into that really, really relaxed state that is pretty much akin to that post-orgasm glow. Orgasms are another really great way of getting oxytocin. It just isn't always as convenient to do that as to just take a nasal spray. So we do that. And I usually tell my patients, you can use it up to 4 times a day because it'd be the same thing as having, you know, up to 4 orgasms a day, which could be healthy for some people. There is a— and everybody's going to be different on this, but there is an amount that can be too much for some people. It's just going to kind of put you into this like really relaxed, unmotivated kind of daze because again, it's taking that cortisol completely down. But if somebody wakes up and they're stressed out, they can use it. If they go throughout their morning workday and they're stressed out, they can use it. End of the workday, getting home, use it again. Before bed, use it again. Especially before bed. That is the one time that I tell my patients, like, this is definitely the time you should use it because that's when you really want to get yourself into that low stress state so you can get some sleep so your body can recover.

A lot of my audience knows a lot about DNA because we've had guests on talking about DNA and our gene expression and I would say, and I believe it's like 1/4 of people have an MTHFR variation, and we are told some standard advice about MTHFR, things like take methylated vitamins. But if you have a slow COMT or some other genetic variations, some of these things, biohacks included, and some of these special vitamins create a mitochondrial response. I think I'm saying this right, where you're almost overloading the system. Sabrina calls it you're putting too much, um, upstream and we need to focus on downstream. Can you break that down for us? I know we had— this was like a big aha moment for me around this, and then even you talking through this with me. So let's— can we open the conversation around that?

Yes. This is something that I pay attention to with a lot of my patients because what we're doing as doctors is we are giving you inputs. We're telling you, take this supplement, take this medication, do this thing, and then what happens on the other side should be a result. But there's still going to be a downstream process that has to happen because everything that you put in has to come out to some degree, right? Like we drink water, we pee, we eat food, we have a bowel movement. Everything has upstream, downstream, and input output. When it comes to things that optimize mitochondrial function, this was the conversation that we were having. It's the B vitamins, it's the red light, it's all of these things that are supposed to increase that kind of intracellular energy, that energy at that mitochondrial level. And that's fine. You can dump all that in. But if the downstream effect, which is basically how your mitochondria then process and release the byproducts of this process, is slowed or unable to keep up, you're going to feel the negative effects of all of that, the downstream byproducts building up in your system that your body can't effectively clear. And this is what you were experiencing.

So wired but tired.

Wired but tired. You had the input coming in, but your body could not keep up with the output. And there's so many examples that I can give you. And I would say one example that your audience might be interested in would be the input when it comes to hormones and then the downstream output. So testosterone, for example, you've dealt with, you put in the, the input for the testosterone and testosterone can be converted to estrogen. The rate at which this happens and how this happens in each individual has to do with their own genetic predisposition to how they do a process called aromatization. Some people are way more prone to that and they will actually create more estrogen and some people are less prone to that. So we do have to pay attention to— of course, we did this upstream thing, but the downstream is, hey, what's happening to estrogen over here and do we need to modify that too?

So I want to list off several things that I think a lot of my listeners use or do and talk about how that is part of what you're talking about. So one of the big examples is methylated B vitamins. I think too many people are doing them and they're not actually for everyone. Can you just speak on that? And then I'm going to list out a few other things.

Yes. Widely accepted, I would say, protocol is that if a person has an MTHFR defect and again, the MTHFR defect, there's multiple different ones. There's two different main MTHFR genes, but then there's also the MTRR ones. And people say that, oh, if you have any variation in these, you have to take B vitamins. Well, the variation can change whether you have one of each, two of each, one of one, zero of the— like it makes a difference. And when you're putting in those B vitamins again, it can really push that pathway. So you can end up with an increase in that energy production. Which may be efficient for some people, but for others who don't have the clearance of it at the other side of it, like you, you can end up as kind of that wired but tired. Now, sometimes the methylated versions can be the thing that's too stimulating because it's the methyl donors that will feed into that pathway. And sometimes you can actually modify that by instead of using, say, like a B12 with methylcobalamin, for example, some people might do better with the hydroxocobalamin version.

Good. Okay. So I want to list out a few things that like I figured out, and this might help somebody listening. So I, like, for me, because I had this exact problem, there was a lot of things I had to take out of my supplement regimen for right now. I took out anything with methylated B vitamins. I took out CoQ10. I took out bergamot. I took out any brain support, any mitochondrial support supplement I was taking, like anything that said it was like special mushrooms or anything to help with that brain, because that's all doing that upstream, I took out excessive use of red light. So we're told, you know, you do red light 5 minutes, 10 minutes a day. I would sit in front of my red light for 45 minutes not thinking that that's harming anything, but red light in itself is supporting your mitochondria. So it creates— it, I mean, it creates this surge in energy that you might not associate with that, but we can overdo that too. What I added in, which is more downstream support, is I kept my urolithin A. That's, you know, I've talked about Mitopure many times because urolithin A actually cleans out old mitochondria. So that's a good thing. I kept my sauna, but I turned the red light off in that. So using infrared instead, which supports downstream. And then I added things again, like broccoli sprouts, which helps support downstream. And then I added supportive soothing supplements, like 3 milligrams of glycine every night.

Yep. And those are all great because all of those are actually going to be affecting how your liver is going to metabolize and excrete any of those byproducts that are created. So now your upstream is kind of running at your baseline level, but your downstream, which was where your genes may have been a little bit naturally deficient anyway, has that additional support. So everything is going through very, very smooth, like there's no wood in the dam, if you will. It is just one smooth canal.

So for people that crash around 2 or 3 in the afternoon, which was definitely me, can I want to explain what's actually happening there and have you help here? So when your cortisol is super ramped up and running and you've got this high prolactin, everything is like full speed ahead and it feels like this adrenaline and this craziness, your body will actually kick in— I don't know what it's kicking in, but help us with that— it kicks in something to basically protect you. And that's why you feel wiped out, exhausted, done in the afternoon. What is actually happening?

A couple things can be happening. So your body can— it's really only going to produce so much cortisol before it decides, hey, we need to rest. So it can kind of force that. But the thing that I actually see most commonly in patients, then why they hit that afternoon slump has to simply do with meal timing. So, but so some people that are in this state, they're used to fasting in the morning, they have their afternoon meal, and then they hit that wall. Well, you just forced your body into rest and digest, and it really wanted it. Like, it really, really wanted it. So it's going to take that opportunity whether you like it or not. And then this is where I see people start reaching for that, like, early afternoon energy drink to get them through that slump so they can continue working. And all that's doing, of course, it's going to give you the caffeine, but that's going to increase more cortisol. It's going to increase more of that stress hormone. And now that's going to stay in your system for at least the next 8 to 10 hours, which means now your potential to get good restful deep sleep at night has gone by the wayside. And so we continue to get this repetitive cycle.

And you're also borrowing energy when you start adding in like, I'm going to add in nootropics or I'm going to add an energy drink. You're literally borrowing and you're masking.

Yes, absolutely.

What happens when you're in this state and you're like, well, I'll just do Xanax or I'll just do, you know, wine? Like, what's happening when you do that?

You're not quite getting the actual relaxation and rest that your body needs. You're getting rest from Xanax the same way you'd be getting rest if you got like hit in the head with a baseball bat. Like it's forcing it, but it's not truly recovering because you're— again, it's just knocking you out. It's not allowing your body to get into a rest and digest state. 'cause it's still coming in like a stressful molecule that now your body then has to process and get rid of. There are certain things that you can take that will naturally allow you to rest. I know that, you know, and your audience probably knows, like magnesium is a big one. Magnesium is another thing that's very, very powerful for reducing cortisol levels. And the grand majority of people are magnesium deficient. Like there really isn't such a thing as a magnesium-rich diet unless all you're eating is like avocado and chocolate.

Um, which I don't think I'm not opposed to that. If you tell us we need to have more avocado and more chocolate.

But it's still usually not enough for the average person, especially when we're considering the abundance that we need to blunt the cortisol from our unnaturally high-stress lifestyles. But that one's really important. Glycine, like you were mentioning, it is a neuro— it's an amino acid that actually plays into neurotransmitter production. That's going to be more of your relaxing neurotransmitters. So that can help with especially the like brain shut off at the end of the night. I don't know if that's something that you've noticed, but it helps with this kind of like your brain just going, going, going and convinces you to relax some more. You can actually get a nice combination if you use magnesium glycinate. So it is a form of magnesium that actually has the glycine molecule already bound to it. That's a really great option for many people to take at bedtime.

And then GABA and taurine, right? Both those two. Okay.

Yeah. GABA is an inhibitory neurotransmitter. There are some people where it can actually have the opposite effect, where it can actually be too stimulatory. That is something that can show up in genetic reports, but sometimes it's just a trial and error and you just have to see if your constitution is one that works and one that doesn't. I will say it's very rare to see the one that doesn't work. Then you also said taurine.

Yes.

Yeah. Taurine is also very, very relaxing as well as far as an amino acid goes. And I will also add, so another— if we're going to talk about ones that can help with this, during the day, tyrosine as a molecule is actually a precursor to dopamine levels. So if you do find yourself in this high stress sort of lifestyle and pattern, and you know that you need to get more dopamine, tyrosine as a supplement, usually about 500 milligrams taken in the morning, can help get your dopamine levels up.

There's two other supplements I left out that create more of that upstream that super common and I would say most people feel amazing with it. But if you have what we're talking about here where you need to support your downstream, these could be very problematic. And I want to bring them up because they're like in every IV at every wellness center, and that is glutathione and NAD+. Can you speak about that and why that— like, for me, I got to run from those things. I cannot— there's no way I could put that in an IV. I would feel like I'm on speed.

Yeah. NAD+ is like— it's a fantastic molecule when used correctly at the right dosages in the right person at the right time. Besides that, I think it can be very irresponsibly used and it can actually be at worst borderline quite dangerous when it's used in high doses that are delivered too fast. You actually do run the risk of a potential cardiac arrest, which can lead to death.

That's scary.

So yeah, so I— again, safety profile on that one, like it has to be done, done right. But this one is like literal gasoline on a fire. Like it's going to amp you up. Whether you like it or not. And for it to run most effectively, you do need B vitamins for those cofactors to feed into those pathways so that you can get the smooth run with it. So some people are just taking it by itself. They're not taking any cofactors. Some places are just giving these like massive amount of IV drips solo and they're just like zapping these people. Wow. And it can, again, it can be negative. Now what NAD+ is going to do is it's going to, it's going to basically help with something called mitophagy, which is going to kill off any mitochondria that are like old and damaged and dying. And it can— it'll do this. And when it's delivered too fast, this is where we see the problem. People who have done this and they've done it too fast, they'll notice that they get like the heaviness in the chest and like their heart starts racing. Well, the heart has one of the highest densities of mitochondria in the human body. When it's delivered too fast, it's actually killing off those mitochondria in the heart. And this is where we can run the risk of that— any cardiac events, cardiac arrest, cardiac episode. So kind of scary.

Yeah, this is— I'm thinking like full circle to when I first started coming to you and you were like, I really want you on NAD+. And we— but we didn't know all of this yet. And so like now it's like coming full circle, making so much sense to me, like why that's like— it depends. It's like it always depends. And you have to listen to your body. Everybody listening, like when you're doing something from your doctor, if you're not feeling right, if something's feeling off, you've got to bring it back up so they can help adjust with you. It's really, really important.

Yeah.

What about glutathione? Because that's a big one. They say a glutathione push or they're adding that at the end. Why does that do that in some people?

Glutathione is going to be basically like a force eject switch on your detox pathways. When you're force ejecting detox, it's going to pull all the toxins from pretty much everywhere in your body. And if your system isn't prepared to handle that onslaught of things coming out of your tissues and having to be processed, You're going to feel miserable. There can be such a thing as too much. So we all take in toxins every single day. And this is actually one of the things that I discuss with patients who are dealing with what I would call weight loss resistance. Like they've tried everything else, weight's still not budging. And I think, okay, logically speaking, the body is always trying to protect itself. And if we're taking in toxins every single day, the body does actually preferably store toxins in our fat tissue. So if a person's weight loss resistance, they have a lot of extra fat on them. I always like to look at what is their toxic burden, like what are they being exposed to on a regular basis that would make their body want to store in here? If you have a patient like that that has any sort of excess fat on them, like to a meaningful degree, you give them a shot of glutathione, all that stuff is being pulled out of their system. Their liver is going to get overburdened. They're going to feel miserable for a good chunk of time as their body is then forced to handle all this. This. If the body is not dealing with the toxin right away, it's because it can't. It's because your, your pathway is already backed up. Maybe your gut's damaged, maybe your liver's damaged. Like, there's a reason why, because ultimately we should be able to detox, we should be able to process.

Is that a Herxheimer response? Is that what that is?

I would loosely call it that. The actual, like, Herxheimer definition has to do— I'll say loosely, yes.

Okay, loose, so the same idea. Okay, I want to get into the trendiest topic of all right now, which is like everybody's talking about is peptides. And Sabrina was teaching, doing, understanding peptides before it was ever a trend. Like, I just want to kind of say that this was like her life's work, like regenerative medicine and peptides. And she just, like me, is bothered by how much this has become like the social media trend versus like a doctor-directed conversation. And she also feels like me that if you are going to experience or play with peptides, you want to add them in, you have to be your own. You have to research yourself. You have to educate yourself. You cannot just take it from an influencer on social media. Like, you have to really understand what's going on here because these are still medications. They're signals. These are— they can be very helpful. They can also be very dangerous. So I want to get like kind of a Peptide 101 from you. Like, we need help here because it seems like every scroll somebody is promoting some type of peptide. And I gotta be real, I even have a little peptide FOMO. Like, should I— I texted you the other day, should I be doing a copper peptide for my skin? Like, I have so many questions, like, and they still scare me though. Like, I want to help us understand, like, first of all, what— like, what's— give us your opinion and then teach us.

I love peptides. I've been using peptides, prescribing them, using them personally for about a decade at this point. And because they're powerful and they do work, and they've gotten really popular lately, and I feel like we have the GLP-1 to thank for that, even though we don't dive into those today, because they opened the conversation on a really big, like, nationwide or even international scale because of all the headlines about them, what they were doing to people, for better or for worse, I will say that. And so when they started talking about it being a peptide, it opened up the conversation for peptides as a class in general. Now, what's happening right now in the federal and legal landscape of peptides is that a couple of years back, the FDA basically removed a lot of the really amazing peptides from a doctor's doctor's ability to prescribe them, which then almost forced this whole gray market to happen where companies started creating peptides at their labs, not pharmacies, um, and selling them to people direct to consumer.

Well, hold on, why did they remove them? Like, and, and because it— like, insulin's a peptide, right? I mean, like, we— that's what was going on. Because I think that's, that's the first misunderstanding. Like, people go, did they remove them because they're dangerous?

Like, what, what— why did they get No, they're not. They're not. They weren't dangerous. There was no real reason why. And whatever they tell you, it's not the full story. There's always a little bit of, I would say, tinfoil hat reasoning as to why things are.

What would be your guess? Like without, I know I, I wanna keep you with what you're allowed to or what you're comfortable saying, but what would be your guess?

Is that the FDA can't make money off of them. Okay. At this time, cuz they're not patentable, so they were gonna remove their competition.

So it had nothing to do with safety.

So I'll give you an example. One of the peptides that they removed is something called thymosin alpha-1, which is a really strong immune system peptide. Okay. In other countries, like in Europe, they'll actually offer this peptide as an injection for like instead of an annual flu shot because of how it positively impacts your immune function. I've used this peptide successfully to basically eradicate my seasonal allergies. I've used it in patients with autoimmune disorders to put it into remission. Those are some really big things, right? Autoimmune patients, they're supposed to be on basically like immune modulating drugs. Yeah. For the rest of their lives. People with seasonal allergies, they're supposed to be taking over-the-counter stuff for the rest of our lives. Uh, all like, these are big deals.

Okay. So that's thymosin alpha 1. So that's like an example of one. Let's, I'm gonna kind of run down the things that we hear about BPC-157, which I've definitely used post-surgery. So did Brooks when he hurt his shoulder. We use it for cycle, but, and you're a big fan of BPC-157. What is that?

It stands for Body Protection Compound-157, and it is a really broad spectrum peptide. It can help with healing gut function. It can help with healing soft tissue stuff, joint stuff. And it is pretty darn safe as far as peptide goes. And I feel like this is a really nice entry-level peptide for patients. They really haven't found like a known upper toxic limit of it. So there really isn't any risk of that sort of toxicity. I will say though, this is one of those peptides that you have to make sure that you are dialed in with diet and lifestyle. And you know what, in fact, I will say pretty much all the peptides you should be dialed in to some degree on diet and lifestyle because they're not like supplements where you take something and you hope it works. You turn the switch, like it's going in and it's going to do the thing, but you have to have power going to the system for it to work. Cause it's going to utilize resources. So if we're telling, if we're putting in a signal that says, hey, heal this knee joint, and you're not getting in enough protein to get in the amino acids to rebuild that cartilage, it's not going to work, if you will, even though the signal is there. So you do have to have the necessary raw materials for the body to utilize these effectively.

Now, like BPC, for example, when I was having my surgery and I asked you, can I have some BPC-157, you asked me first, you said, why aren't you wanting to do the oral? So can you explain to me why would someone choose oral versus the needle?

Usually preference. There hasn't been a lot of solid data, especially with BPC-157. I will say some peptides, they have to be one or the other. But with BPC-157, you can take that one either orally or injection because the actual BPC-157 peptide is found in gastric juices. Basis. So it is not negatively impacted by stomach acid, and it is directly absorbed in the gut.

Okay. TB500, what is that, and why do people combine that with BPC?

So TB500 is going to be responsible for something called angiogenesis, which is the creation of more blood flow. So anytime we want to heal something, healing is directly related to and dependent on how well you can get blood flow to an area. A lot of people need help with this, especially if they have any degree of history of cardiovascular disease or diabetes or any sort of insulin resistance.

Do you have to do them together? Like, I've never done TB500. Like, do you— is that recommended to do it with 157, or does it matter?

You have to. Just knowing you and your constitution, this is why we never really had to add it in, because you're active, you're vascular. Like, I've seen your forearm veins. I know that you don't necessarily need that extra blood flow. And then you're also in the sauna a lot of the time, which is going to still be enhancing enhancing that blood flow as well.

Got it. Okay. KPV, that was something I took orally when I had my histamine response. I don't even know what the heck it was, but our friend Laura Frontero told me to take KPV. So it was an oral peptide that I went through 2 bottles of it to help with stomach. What— tell us about that one.

It's basically like a mast cell stabilizer. So it's going to help to stabilize your mast cells, which are going to be more active in certain exposures, like with— and they will release histamine. So anytime somebody has some sort of inflammatory gut issue, that can be a really, really great peptide to help kind of calm that down. I also like KPV combined with the GHK-Cu peptide, which is the copper peptide. A lot of people when they inject the copper peptide are going to have a reaction to it, and it usually will produce like a redness and itchiness, like a sore welt. And it usually has to do with a histamine response or a mast cell release, and the KPV can calm that down so you don't get that.

Okay. Speaking of GHK-Cu, I've never tried that one, but I've heard that it's a copper peptide and it helps with skin age reversal. Is this like real or is this like— help us. And why, if it is, I feel like this is a midlife woman's dream. Like, tell us more about that.

It is a really, really great peptide. This is one of the things where you have to be very kind of mindful and cognizant of your own copper and zinc nutrient balance because it is going to utilize those as resources. And it's not only that it stimulates collagen production, it actually stimulates your genes that are responsible for collagen production. So you actually get the stimulation at the genetic level. It also does have some activation of anti-aging genes as well too. Um, it is great for blood flow. It is great for overall healing, skin texture. It's a really, really awesome one. There are a lot of companies out there that are selling topicals for skin and hair, and those can be useful for sure. But in my experience, the injectable is definitely superior.

So I asked Sabrina about it for me in particular, and she didn't— for me, she said no to the injection because she said with my histamine response before, she doesn't want to risk that. So she did say I could try a topical. And you said if you're going to do a topical, you recommended you said the highest dose, I think that was 3%. Tell me what you— tell us about that.

It's the highest percentage concentration that you can get just because it's going to be that much stronger. And I just don't— there isn't really great research showing that the lower percentage concentrations are going to get you the results that you want. But yes, so like I was saying, you had such an intense histamine response or histamine issue and your system is still within like 3 to 6 months of that episode happening. I didn't want to risk you going back into one of those episodes, like, even if we were to combine it with like the KPV or something. Just, yeah, it's a caution.

When you look at topical, um, like, I maybe— I don't know if you'll know this or not, but like, let's just say, because a lot of the like face creams and stuff are starting to have it, can you still do that? Like, if— because a lot of women do like retinols, or they do, um, they do different, like, uh, niacinamide. Is that what it's called? Uh, yeah, they— can you still do it with that? Or is this like replace that?

You can. I don't know enough about aesthetics and dermatology to know about optimized delivery systems because you ultimately still have to get it delivered to the cells.

Okay.

And I don't know if— I just don't know enough about those delivery systems to know for sure.

What about things like Semoralin, Epimere? Are those peptides too?

Yeah. And those are growth hormone-releasing peptides. These are phenomenal for women in midlife who have gotten to the point where they're like, you know what, I feel like I've lost muscle. I feel like I'm concerned about my bone density. I wanna make sure that like my skin's good, my hair is good because all of these are going to release growth hormone but in safe amounts. This varies from taking growth hormone by itself, which, you know, a lot of bodybuilders do. And that can be dangerous because if you do that in too high amounts, you can get something called organomegaly, where your internal organs will actually start to grow, and that can be dangerous. The growth hormone-releasing peptides do not have that negative side effect. Um, this is because they'll stimulate your own natural production, which will never be in excess of what your body is capable of. But we still do monitor something called IGF-1 levels, which is insulin-like growth factor 1, on labs, because this is going to give us an indirect indication of what your own natural growth hormone levels will do. We monitor this because when you take a cycle of a growth hormone-releasing peptide like a sermorelin or epimorlin, you're going to get an extended period of time of continued growth hormone signaling even after you're done with that cycle. So you cycle maybe for 2 or 3 months, you may take a 6-month break before your growth hormone levels go down enough to the point where you may need another one. We still don't want to do an excessive amount. We still do want to give those receptor sites a break so that when you do use it, you still get the most powerful response.

When I tried, it was like a trochee, uh, for one of those a couple years ago. I stopped, and I'll tell you why, and maybe this is made up in my brain. Uh, one, I felt like it made me ravenous hungry, like could not, and I was like, that's not gonna work, like waking up in the middle of the night starving. Two, I had this thought, if it helps with growth, couldn't that also grow cancer cells?

Yes and yes. I will say the increase in appetite is something that I do talk to about sometimes because I'm like, yeah, you may wake up in the middle of the night and want to eat your fridge, but it's because when you're growing things, you need raw materials and resources to come in. So your body's like, hey, we need fuel, we're doing all of this stuff. And that's an indication that it's working. But sometimes you're like, too much, it's too inconvenient. And then yes, there is this theoretical potential that yes, if you do have some sort of cancer growing, could it worsen it?

Yes.

Which is why I think working with a doctor, making sure they understand your medical history, making sure that they have looked for, I would say, basic cancer-concerning markers. There's no one universal test that says yes or no, this person has cancer, this person doesn't. But a doctor that's known you, that has taken your history, they should have a general idea of whether it's going to be safe for you or not.

So it's so wild that like peptides has become this trendy topic that people are talking about and they think it's new. But like, I think back to some of the ones I named, like the Semaglutide, the BPC-157, And these are things for years and years and years other doctors had suggested to me, or I had tried. I didn't even put it in the category of peptides. I didn't know. So it's like, I think that's happened too a lot. Like, I think some of the things, just like insulin being a peptide, is that— I mean, I think that everything's getting lumped into it now, but it's not like these are brand new.

No, they're definitely not new. They've been around for a very long period of time. And in fact, like, I would say some of these for decades. I mean, a lot of the research that we're getting into the United States now now has just been translated from research that had been done decades ago in like Germany, you know. So it's— they're not new. And a lot of these, again, they are more widely used in these European countries where they, they are not— they're not criminalized, they're not spoken of negatively, and people have access to them.

So the way that I said that about the growth hormones and those could, if you have an underlying problem, grow cancer cells, is that the same? Would that be the same with like KPV or GHK or BPC with any peptide, or is it just growth hormone? Ones?

I would say you don't want to mess with peptides at all if there is a concern of cancer, because we simply don't know what they're going to do. Yeah, um, peptides in my opinion are the cherry on top of an already optimized system, no matter what. So you should be going into peptides making sure you're getting enough protein, that you're sleeping at least 7 to 8 hours each night, you're lifting weights in a meaningful way, you know, a few times a week, pretty heavy, like 30 minutes at least, um, and just that you're ready for them and you're optimized, because then you will get the best benefits. Because again, they're flipping a switch, they're going to use resources. You need to be resourced for them.

I don't want to get too off track into GLPs, but I just want to touch briefly on GLP because there's so many different ones, and those are peptides. And the way that you prescribe GLPs is very different than the way the weight loss industry. So you, can you just speak into that a little bit, like how you use all of that for people?

So I started microdosing, microdosing, uh, GLP for my patients back in, must have been 2022 or something like that. It was a while ago. And it started with this one patient that was just like resistant to everything that we had done. And I was like, hey, well, these things came out, they're supposed to be for diabetics, but like, let's just see if we give you like a tiny bit, like what's going to happen? And she lost weight. And so I started— I was doing them for, for a while and then like they started getting really cool, really mainstream. And I was so grateful for that. And our mutual friend, Dr. Tina Moore, she kind of like led the charge on getting these things out in the mainstream, which is— which has been awesome. But my way that I approach them is low and generally pretty slow and spaced out. Like we start very, very small. And I'll— we can, we can decide whether we want to use something like the semaglutide or the tirzepatide. And I usually prescribe them from a compounding pharmacy so that we can be more selective and precise about our dosing strategies with them. But we'll start slow, and sometimes I'll have people do them once a week, sometimes every 10 days, sometimes twice a month, depending on what we want to get with them result-wise. Because ultimately, yes, appetite suppression can be favored, but I still want them to to eat enough to get enough protein to their system.

What about retatrutide? That seems to be like really popular in the fitness industry. What is that?

Retatrutide is going to be the third generation of these GLP agonists, and it's going to have the GLP, GIP, and glucagon receptor action on it. Here's the interesting thing. That medication has been developed by the main pharmaceutical company, I believe it's Eli Lilly. And they hold the patent to it right now. Now, of course, people know that it exists because there are studies that have been released on it and what it's able to do, and the studies are very, very encouraging as far as the results, and I think it will be a game changer. What we're seeing right now in the gray market or other places that are making this, they are guessing at what the actual formula is because the company has not released that data yet. Now, the compounding pharmacies that are making the semaglutide and tirzepatide, they are doing the exact formula because a while back there was a national shortage, so the company had to release their recipe so that they could serve the patients. That hasn't happened with Retatrutide as it exists right now. It only exists as the company's initial, um, recipe that they haven't released yet because they still have the patent to it. It's still not even out yet, not widely available yet, but companies are making up their own formula and selling this to people and saying this is Retrutiide.

Wow.

It's really GLP-3, but their version of it.

So to me, if I'm reading between the lines, that one would feel a little risky to you since we don't— they're guessing.

Yeah, because yeah, sure, you get this one from a company, they're calling it Retrutiide or they're calling it a GLP-3. And yes, I'm sure it has a triple action, but is it the exact recipe that the company has made that is actually producing the results? We don't know. So you are taking a gamble because none of these things are neutral and high dosing them can come with side effects. The most notable, like, I would say one of the most concerning side effects that I actually see in people is something called anhedonia. I don't know if we talked about this last time, but—

No, what is that?

Basically, this dramatic drop in baseline dopamine levels that causes somebody to become completely uninterested in life. They lose their zest for life. I've seen these, like, funny— they're supposed to be funny reels going around even on Instagram, and it's like talking about not being in love get it, like breaking up, taking Reddit to Reddit.

Wow.

The gray market stuff that's out there. And it's like, okay, so say that happens. That happens on a wide scale. Maybe this is positive. Maybe people stop drinking and they stop gambling. They stop doing these other dopamine-seeking activities. But then do they stop seeking partnership? Do they stop having children? Do they stop having sex? Do they stop like doing the other things that brought them joy? Do they stop working out? Do they become bumps on a log? At the cost of what? To lose weight? Like, to me, that's not the game that we want.

What peptides did I leave out of the conversation that you're like, these are important? Like MOTS-c. What is that?

I love MOTS-c. MOTS-c is a potent mitochondrial optimizer, but this is actually one where we need a one-step-above upstream process to be optimized, and that's the actual integrity of the mitochondria. So if the mitochondria itself is kind of decrepit and like unfunctional, this is another one that can produce that wired and tired situation. Sometimes we have to use a peptide called SS31 first to basically heal up the mitochondria so that it's ready for the MOTC. So somebody ever takes MOTC and they're like, I feel way too wired on it. That's why they needed the SS31 first. But MOTC is phenomenal. I will usually prescribe for people to take 2 days a week right before their heaviest workouts, and it's like lifting next level. You just are so much stronger, recovery is so much easier. You just feel good. It's really good, high clean energy.

Did I miss any peptides that you're like, "This is what I predict is going to be a big one"?

I would say, I mean, not— So, the mitochondrial ones we kind of talked about, like the SS31, the MOTC. There's another one called 5-Amino-1MQ that is still another really good mitochondrial enhancer that's a lot more gentle than the see. So your option, that's stimulating. But then the cognitive enhancing peptides are really cool too. So this, uh, CMAX and Selank. So CMAX is going to be more for the people that are already running high but need to like hone in that focus. Okay. The Selank is going to be for the people that are more tended towards like an anxious or almost depressive state who need to kind of even themselves out and still focus. And some people can use both. So some people can take like one in the morning, one at night, But those are awesome because they're not just going to provide like symptom relief. They're actually going to help with kind of repairing the brain too.

If you were to make a prediction on what you would love to happen, like, do you see that this stuff would replace pharmaceuticals? Do you think that this is safer than pharmaceuticals? Like, what's your— just, I'm just curious what your thoughts around peptides.

I think in my perfect world, all doctors would be equally educated on these. And the pharmaceuticals so that they could really truly match the best tool for the job that's needed. Um, I really do think like somebody comes to me with an acute UTI and I'm scared it's gonna go to their kidneys and they're gonna end up septic. I'm not gonna be like, oh, you should try this.

Yeah.

Immune boosting peptides. So you just, this doesn't happen to you. Like, no, I'm gonna give them the antibiotics. But I want, I want it to be education at the doctor level first so that people actually trust going to their doctors. Cuz this is the other part of the conversation that I don't think enough people are having. It's that people are going direct in this gray market because they don't trust their doctors. They don't have anybody they can go to that they're going to be like, yeah, can I take this? Is this safe for me? Because their regular doctor is going to spend 5 minutes with them. They're going to spend hours looking up this stuff on YouTube, Instagram, TikTok, Google, ChatGPT, and they're going to be far more educated than their provider ever will. Doesn't mean they still know enough to do it safely and fully and completely, but they don't have that trust. And I wish that that was the thing that could change.

Why are doctors so many of them so against and shut down to peptides?

All because they don't know enough about them. That's at least my experience, because I've never met a doctor that started to do peptides and was like, oh no, I think I would rather go back.

Really? So the ones that are really knocking it, it's more— you think it's more of an education thing? They just don't know.

I think it's ignorance.

Do you think the pharmaceutical industry is threatened by peptides?

Oh yes, yes. Anything that's going to take away from their bottom line, that's going to get people off of medications, definitely.

Do you think we need to be worried about peptides? Like, as— like, because I will say I have a little bit of peptide FOMO. Like, should I learn, you know, should— like the copper thing I just asked. And then part of me is like, well, we haven't needed them. I just want to stay away from them. It's confusing. So is that a just fear or concern?

I don't think that peptides are a need across the board for anybody. Like I said, I think they're a cherry on top of an already optimized system because we live in a really cool age right now where I think that aging does get to be optional and you can use these tools to enhance processes or to create a result that you want. And I think that this level of being able to precisely manipulate our physiology is a privilege and a really great responsibility too, because just, and also doesn't mean that you should, right? Like, like you're saying, do I need to be on this? Well, No, nobody needs it, but do you want that result right now?

Yeah. My concern is the long-term. So, a lot of people, you'll see somebody on social media mixing together 20 different peptides at one time and they're not a doctor. But they're all buff and jacked. So, other people are like, "What's your stack? What are you using?" And it kind of reminds me of when steroids were a big thing. —big, you know, big thing. Yeah.

So I will say the thing to look at with that, to say you see an influencer right now and they started taking peptides 3 months ago, even a year ago, and they look a certain way, they didn't get there from peptides. Like, very likely no, they were already jacked and buff. So like, don't think— like, don't get FOMO in the sense you think like, oh, this person, this, and this is exactly what happened, unless they are tracking that specifically. Like, I will say I started a peptide that's relatively new, very, very research searchy. I'm not even gonna like mention it right now because I don't necessarily want people to like go into it, but its goal is to pack on muscle. Because like I was saying earlier, I went osteopenic, like I lost muscle, I lost bone density. So I'm really consciously trying to rebuild that back, and I have been tracking with DEXA scans to see what is it doing and is it working. So that is something like, yes, if you're following an influencer who is purposely doing that, pay attention. But if it's somebody that's brand new to it, like don't get the FOMO.

Yeah, okay, people are going to want want to know like how they can learn more or work for you. Can you first, first, can you speak into the kind of patient you actually want before everybody's messaging you asking if you could be a patient and do you take their insurance? So just speak into like the, your ideal patient so people hearing can self-select. And then if they're not your ideal patient, any advice you can give them in looking for a doctor?

So I will say I do not take insurance. Um, I do currently have a waitlist and we are kind of selective about who we allow in because because my brain, my level of expertise is at this higher level. I'm not the doctor you come to if you need me to tell you to stop drinking, to stop eating gluten, and to lift weights. Ideally, my ideal patient is already lifting weights. They're already pretty fit. They're already pretty healthy. They don't need me to tell them that gluten is bad, and they're actively avoiding stuff like that, and they're really ready to take their stuff to the next level. Like, I'm here to—

You're fine-tuning.

You're fine-tuning, and I'm going to make you the most optimized, best version of yourself so you can kick butt in your daily life. Now, if somebody is like, okay, I'm not quite there, where would I start? Like, bare minimum, you need to be eating at least 100 grams of protein a day. You need to be sleeping 7 to 8 hours a night. You need to be lifting weights at least 3 days a week. If you can do that consistently for 3 months, many of the issues that you're probably considering symptoms or what's wrong with you will likely go away so that we're left with just a handful of things that we're like, yeah, we can be super precise, we can super dial this in, and then we'll take it to the next level.

Any advice for them on looking for that, like things that they should look for when they're looking for a doctor? Like, I like that question I just asked you. I almost feel like everybody should ask like doctors they go to, who's your ideal patient? Because that way, you know, there are— every doctor has a different ideal patient, I would imagine.

I would say you want to look for a doctor that's honestly walking the talk and that they are doing what they believe in. And it's because they— that chances are they've trialed and errored on themselves. Yeah, first, before they ever even give you a suggestion. And it means that like what they say actually works, so you can trust their judgment. Because the worst thing you want to do is you want to go and pay thousands of dollars to a doctor and then not do what they say because you don't believe them. And people do not think that like, you know, the looks and integrity thing matter, but our subconscious is always registering whether we can trust somebody or whether they're a danger to us. And physical appearance does play— this is the whole psychology thing, I don't think we need to go into the weeds on this, but we're always judging by physical appearance. So if you see a doctor that is fit, they know what they're doing, that would be somebody that I would consider working with.

Perfect, that's amazing. For those of you wondering like who I go to, what I do, what I do, uh, Anna Cabeca, who I've had on many times, she does all my hormones, Sabrina cross-checks them, so they both are actually looking at them. Sabrina helps me monitor my labs every 90 days to like fine-tune and go, what are we missing? And she, and she also helps me deep dive with my brain with like, this is what I'm thinking. And I happen to love that type of relationship. I have a regular like gynecologist and stuff that I go to just for like those checkups, but that's not who I'm asking these questions to, just to let you all know. Sabrina is going to be putting together, and I'm so grateful grateful she's doing this. She is going to be putting together an educational membership, it's my understanding, around peptides where you can actually go in and learn for yourself and learn the types of things that you should be asking your own doctor, or how to like find these yourself so you can teach yourself. I think for me personally, I encourage all women to be their own health detective. So I love hearing that you're creating something like that. I love that we can actually go and learn and deep dive and, and get greater information around things. I'm hoping by the time we release this she's got that all ready. So if so, we will put the link below. You can find Maura, but I will put a link below where you can reach her, where you can find her. And if you do think you're self-selecting to be a patient of hers and you want to go on her waiting list, I'll put that information below too. Thank you so much for being here.

Thank you, it's always a pleasure.