The Peptide Expert: Big Pharma Are Hiding This Powerful Peptide From You! - Dr. Alex Tatem

It's absolutely wild.

And I think this is going to be a trillion-dollar drug when it comes out.

And I've brought you here because you're an expert on this subject matter.

And it's worth saying that there was some significant news about this.

Correct.

From the FDA saying that in July they are going to consider legalizing 7 peptides.

And by pharma's estimate, it might be the most dangerous thing to their entire business model.

So do you think it is plausible that Big Pharma didn't want these in the hands of regular people because they can't patent this and it's powerful?

110%.

Because the question isn't what can peptides do, it's what can't they do?

And we've got several peptides here in front of us.

I wanna go through all of them.

Let's do it.

So this is probably the most well-known peptide for skin complexion, and it improves quality of hair and nails.

And then epithalon is maybe, maybe not going to be the fountain of youth.

But I'm very skeptical as far as that goes.

Next, we've got this.

If you injected that at night, it would improve your quality of your sleep.

Next, Melanotan 2.

And this will actually end up giving you a deep tan in response to just a little bit of UV sun exposure.

It'll also give you some of the most impressive erections you've ever had in your life, so be warned.

And what else have we got?

Oh my gosh.

There's methylene blue, where people take it and they think it's gonna make them live forever.

Don't take this.

It literally will stain your nails blue and your hair blue.

These two here stimulates building muscle.

This one can aid with healing after an injury.

And then is this, this, this, this.

It's crazy.

It's wild.

So why don't I take it?

Well, we need to talk about that because there are trade-offs.

But also, outside of the world of peptides for a second, I've got these 3 vials.

Do you know what those are?

Yeah, this is unfortunately our future if we're not careful.

Explain.

So what we've got here is representing the fertility trajectory for young men.

And I'm so scared.

This is super interesting to me.

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[FOREIGN] Dr.

Alex Tatum.

There's this word that has exploded in society in recent times.

In fact, when I look at the data, people searching this word has increased by 400% just recently.

And that word is peptides.

I have no idea what peptides are.

I'm someone that wants to be healthy, that wants to optimise my health, wants to live long, doesn't love ageing.

Yeah.

And I'm told that this word peptides is somewhat linked to it.

So I've brought you here because you're an expert on the subject matter.

I've watched your videos on YouTube.

To start at the very beginning, Dr.

Alex.

Sure.

What the hell is a peptide?

Peptides are a structural class of medications.

The best way to think about peptides is that just like we have small molecules, which are drugs that are very small, taken in a pill, and have a wide-ranging effect throughout the body,

peptides are derived from little pieces of amino acids, which— think of them as the Legos that make up the human body, the Legos that make up proteins.

These are fragments of proteins that are designed to specifically target certain receptors and affect cells in a very targeted fashion.

Or a best way to think about it is a very specific targeted key to unlock a very specific lock.

So instead of a small molecule that may have a wide-ranging effect throughout the body, peptides are much, much more focused.

So you've got different types of Lego cubes here.

Would they be different types of peptides, or are they different types of amino acids that come together to make a peptide?

The best way to think about it is My son loves Legos, which is why I'm glad that we have these here.

But he can take the same set of Legos and he can build a rocket ship.

And then just a few minutes later, he can build a pirate ship.

And then he builds a race car.

And he's using the same Legos, but he's creating very, very different things that all do very, very different things.

And so peptides have become incredibly popular because yes, we have some really fascinating peptides that can help with anti-aging, with healing, and with tissue repair.

We're gonna talk about some of those hopefully.

But they can do so much more than that.

The first peptide that was actually isolated and used in medicine was insulin back in 1921.

And then all the way in 1985, in the world of urology, which is where I was trained, we had Luprolide, which is a different peptide that again also had peptide-like insulin, but instead

of having wide-ranging metabolic effects, it had an endocrine effect.

It was designed to shut down the production of testosterone for prostate cancer patients that needed to have their testosterone taken away.

Interesting.

Okay, so insulin's a peptide.

Insulin's a peptide because it's a Series of amino acids that are put together.

Okay, so you said that the combination of amino acids forms a key.

So what is the lock?

The lock could be a cellular receptor.

It could actually be regulating a certain pathway within the cell.

Okay, so let me repeat this back to you to make sure I understand it.

So yes, peptides are like a key.

Yes.

Which you can make by configuring amino acids in a certain way, and there's different locks in our body that these keys can go into?

So if I take, you know, we've got some peptides on the table in front of us here.

So a good way to think about it is this.

If you've got a hammer, right, which is what a lot of small molecules are, like you can do a lot with that, right?

Like you could hammer in a nail.

But if you try to use that hammer when you're trying to put in a screw or you're trying to put together, you know, a table that you got from IKEA, it may not always end the way that

you want to.

And that's the problem that we have with a lot of small molecules.

Is not that they don't do what we want them to.

They do a lot of other things while they're at that job that can have significant negative side effects, which is why a lot of these small molecules actually don't make it all the way

through the FDA approval process, because we find something, it does what we want to do, but it has significant safety concerns down the line.

All right, now what we see with peptides, for example, I've got in my hand right now a little vial labeled, you know, BPC-157.

This is probably one of the most popular peptides that we're talking about right now because BPC-157 is a synthetic version of a naturally found peptide in the gut.

But what this actually does is it enhances blood vessel growth in areas of injury.

And it kind of makes sense because if you think about it, our gut, our stomach is really just this

bag of acid that sits inside of our abdomen.

And yet somehow you and I are here talking to each other and our bodies aren't eating themselves.

Well, how does that work?

Well, it's because we've developed a lot of really robust systems to encourage healing of the gastric lining.

And so the idea is, well, if this is one of the compounds that can help do that— it's been proven in multiple animal models.

For example, they have completely transected the Achilles tendon in rats, and then they've cut across the Achilles tendon.

So not just a small injury that you or I might experience in the gym where we pull it or strain it, but actually surgically cut the Achilles tendon.

And then they administer it to rats, and they are healing spontaneously with administration of BPC-157.

If you have an Achilles tendon injury and you're a rat, BPC-157 is one of the best things that you can ever have.

Now, that is not a one-to-one translation to what we might see in humans, but as we talked about earlier with our point on safety, when they were studying BPC-157, we try to look for

something called the LD1 or the LD50.

How much can I give this to someone until 50% of the population that receives that dose doesn't do well or dies.

Okay, that's called the LD50 dose.

We have yet to figure out what the LD1 dose is for this, which is the amount that it would take to hurt even 1% of the population, because it is so incredibly well tolerated.

So just giving you an example of this is a compound that can have profound healing effects, at least in our animal models that we've seen so far.

But so far, we haven't seen any precipitous negative effects in human patients when taking this.

Okay?

But we need more data.

I am mind-blown and I'm very, very excited.

We've got all of the several peptides here in front of us.

I wanna go through all of that and understand which ones do which things.

Sure.

But there's a bigger question here.

Yes.

Which is why now?

Why have the subject of peptides suddenly exploded into society's consciousness?

What's going on?

What's the big picture?

So this is really interesting.

In 2013, there was actually a court case in the United States.

It was called Myriad Genetics case.

This was the company that actually patented the BRCA1 and BRCA2 genes.

They discovered the genes that cause breast cancer, all right?

This was mind-blowing.

They identified the specific genes that would predispose patients to developing both breast, ovarian, and since we've learned, also prostate cancer.

It was a fantastic discovery, but they patented it, and they said, we now own this intellectual property.

And then Everyone else said, no, no, no, that's the human body.

You can't patent that.

And the Supreme Court actually sided with that argument, saying that if something is natural, it's found within us, OK, I can't patent, you know, your muscle cells, right?

Which is a wonderful thing.

But the unintentional byproduct of that is all of a sudden pharma had no incentive whatsoever to pursue really promising compounds that they could not monetize.

So that happens in 2013.

At the same time, I believe it was around 2012, 2013, there was a terrible event that happened in New England where there was a compounding pharmacy that was not doing the right thing,

and they ended up having a bunch of contaminated specimens that caused a fungal meningitis.

A bunch of patients got really sick.

It was a huge scandal.

And all of a sudden, the FDA stepped in and said, hey, historically, all right, states have been allowed to regulate compounding pharmacies themselves, but we need some federal oversight

here because this is not acceptable.

Completely agree with that.

And they introduced a new set of regulations on top of compounding pharmacies, basically saying what you can and cannot make.

And what they eventually said is, well, you can only make 3 things.

You can make things that are in the USP, United States Pharmacopeia, okay?

Things that have been, you know, well described, already published.

Things that are already in drugs that are already on the market.

Or 3, things that are on a very specific list that we're going to give you.

Okay?

And in that list, they actually included a lot of these very promising compounds that were stuck in drug development, you know, limbo.

And you say compounding pharmacies.

You said that a few times.

What is a compounding pharmacy, just so I'm clear on the definition?

Back in the 1800s or early 1900s, if you ever needed a medication, you'd go see the pharmacist who had a shop down the road, and he would actually make your medication in front of you,

and he would do that custom for every single patient that came by.

All right?

And it was only since the advent of modern factories that we had the modern pharmaceutical industry come about.

But the truth is, is that again, that's kind of paint-by-numbers.

You're creating this one pill and it always seemed kind of crazy that the adult dose is one standardized dose for all adults.

Like if you look at what your body composition is versus some of my patients, why is the dose in your blood pressure medicine the exact same?

Like that doesn't seem to be quite right, but it is what it is.

So when patients fall outside of that and they need custom medication, we still have those people who make custom formulations of medications.

But instead of it being just your local pharmacist who's using a mortar and pestle and is creating something in his back office.

These are now large, sophisticated industrial operations that can make custom formulations for patients.

I think the important context for people that don't understand how drug development occurs is that to get chemicals like the ones we have in front of us on the table through FDA approval,

you've gotta spend millions and millions and millions of dollars.

Tens, if not hundreds of millions of dollars.

Sometimes hundreds of millions of dollars.

Yeah, an incredible amount of money.

And if you know you can't protect it once you spend $100 million, you have no incentive to just do charity work.

Absolutely not, okay?

Because you have shareholders.

You have to make payroll.

And so because drug development is so expensive, there is no incentive for commercial pharmaceutical companies to pursue the development of these compounds.

And then on the other side of that, well, we have compounding pharmacies that, you know, for them it makes sense.

What if we could just make these compounds and then sell them directly to patients?

We make a small margin when we sell it.

This makes sense for us.

Well, they could do that starting in about 2014, whenever that legislation finished.

All right.

What did it do?

Essentially what it did is

it gave an assignment to each one of these compounds.

It was either going to be category 1, which is you can compound this.

This is on our specific list of approved compoundable drug ingredients.

Number 2 was, hey, we see some negative safety signals here.

You cannot make this.

Okay, something goes in category 2, it's forbidden.

And then we have category 3, which is we just need more information.

And all of these original compounds, these peptides that we're so interested in now, were originally on that first list, category 1.

All right.

And so they were able to be compounded.

We could prescribe them to patients.

I prescribed them to patients.

All right.

From 2014 onward.

But then in 2023, the FDA at that time switched all of those peptides, 19 of them that were popular, to Category 2, and then they were banned overnight.

We got notifications in our email inboxes from our compounding pharmacy partners saying, hey, we can't make this anymore.

We're sorry.

So I've got 2 questions.

Yes.

The first is When you were prescribing these peptides to your patient— Yes.

Were you seeing incredible results?

Very much so.

Very much.

Again, you have to use the right key for the right lock.

Okay.

But I think a really good example.

All right.

So there is a compound that is not technically a peptide.

It is a small molecule, but it was lumped in with all of these and was the victim to the same process.

Something called MK-677, also known as ibutamoren.

So this is a small molecule, but when a patient takes it, it's orally available, it binds to this receptor called ghrelin, and it actually stimulates the release of significant growth

hormone.

But what was really interesting is that it would actually stimulate hunger a profound amount.

And all of a sudden, patients that were struggling with cachexia, okay, so being very, very thin, very malnourished, maybe they're going through cancer treatment.

Ghrelin's the thing that makes us feel hungry.

Absolutely.

Yeah.

Yeah.

So they were able to stimulate the hunger response.

And patients were actually able to eat more to meet caloric goals.

And so this was a medication that was fantastically effective at that.

Again, it had gone through some clinical trials but was never taken all the way to commercial.

And so it was never going to be available from CVS or Walgreens, but you could get it from a compounding pharmacy.

And so that was one that made a big difference for us.

We also had other peptides.

So GHRP-2 and GHRP-6 were some of the ones we were using at that time.

Those are growth hormone-releasing peptides that stimulate the release of your body's natural growth hormone, which can help with tissue repair.

It can also help with fat loss and with building muscle.

We also had BPC-157, and we had derivatives like thymosin beta-4.

These are also compounds that can help stimulate angiogenesis, so making new blood vessels, all right, and tissue repair.

So if we have a patient that's injured themselves, maybe we could help them get back at life faster.

These were all things that were used very commonplace for many years, and truthfully, they weren't super popular at the time.

We were just using them, and then they were banned overnight.

And they were working.

And they were working, and they were working, and we were not seeing adverse events, which is the most important thing.

What's an adverse event?

An adverse event is a patient has a terrible side effect.

They call you, they have an allergic reaction to something.

They call, they've got shortness of breath, and it's a direct result of the medication that you gave them.

It was working.

It was working.

And by all accounts seemed to be incredibly safe.

And then they banned it.

And then they banned it.

Why?

That's a great question.

So officially what happened is there was a meeting where they brought together the experts at the time and they said, "There is insufficient data for us to say that these are safe,"

because again, they had not gone through the full FDA approval process.

And so as a result of lacking that data, we're gonna say that they're too dangerous.

Now, there wasn't any evidence of any of that in the population.

These were widely used at the time.

Potentially we had commercial pharmaceutical companies saying, "Well, hey, this is people spending money on a compound on something that isn't coming to us.

So hey, like we love medicine, but maybe only when it's our medicine." And so there's concern that that was at play as well.

And so there is not a great paper trail and there's not a great explanation why.

And that's something that's been iterated by our current administration from RFK himself.

You know, he himself has characterized that move done in 2023 as being illegal.

With everything you know about the medical industry, do you think it is plausible that Big Pharma— 110%.

Didn't want— 110%.

These in the hands of regular people because they can't patent this and it's powerful?

So ultimately, the way to think about it is this: pharma may not have a compound that directly competes for BPC-157.

PBC-157.

So this is the medication or the peptide that can aid with healing after an injury.

Okay.

So it's not necessarily there's direct competition, but at the end of the day, your average patient going throughout their daily life only has so much money that they can spend on medicine.

And $10, $15, however much money that goes to this doesn't go to a prescription drug from a commercial pharmaceutical company.

And so there is real concern that potentially that was at play during that decision.

You said 110%.

Yeah, well, you know, it's interesting because, you know, I try to walk a very fine line between what I can prove versus what I suspect after being in this space for a long time.

And, you know, ultimately, you know, I don't think it's accurate to characterize pharmaceutical companies or really any other entity as being, you know, evil or bad.

The truth is maybe a little bit more ominous.

The truth is, is that they are these large machines that are designed to prioritize profit over everything.

Yeah.

And that's everything.

I think this is one of the really interesting observations I've had the higher I've gone in my career is that oftentimes, you know, we heard about the Illuminati.

Like when I was growing up, I was like, oh, there's this Illuminati.

Yeah.

And you think of it as these like shadow hooded people that get together and decide evil things.

But the further I've gone in business, the more I've realized that the Illuminati or these evil forces are actually just machines that were designed to optimize for profit.

Correct, correct.

So like corporations are the Illuminati.

Yeah, and so I don't actually think that there's necessarily, you know, a group of maniacal individuals, you know, the Legion of Doom, you know, plotting to like take away your health.

But at the same time, I think that there are these large organizations that really couldn't care less about your health.

You know, they are prioritizing what's important for them and regular people just get caught up in the mix.

And what's challenging is that as a physician, you know, I took a Hippocratic oath.

I care about my patients.

And so those are the people that are in front of me every single day that are seeking to improve their lives, to recover from injury.

I have fertility patients that are just dying to start their family, and I have patients that are suffering from hormonal imbalances that haven't felt right in years.

I treat erectile dysfunction in men that have been struggling for years after prostate cancer treatment.

I mean, these are people that are broken and hurting.

You want to be able to help them.

And so I feel that as a very strong personal calling that I have to be the advocate for that patient, both in the room whenever whenever I'm treating them and taking care of them, but

also when I'm talking to others and I'm, you know, speaking out about these issues.

Like, I want access to these medications because I care about the patients who benefit from them.

So they banned these peptides that we have here.

Correct.

And we're sat here 2 years after the ban, I believe roughly 2 years after that ban.

Yeah.

And suddenly everybody's talking about peptides again.

Yes.

Why?

What's going on?

So I think what we're seeing is the forbidden fruit effect.

Because this was banned and all of a sudden, oh, well, why'd they ban it?

Well, they wouldn't have banned it if it weren't working, right?

And we're also seeing the effect of TikTok and short-form content being spread very rapidly, very virally.

And that's been going on for 2 years now combined with new emphasis from administration leadership and HHS and RFK.

What is the most incredible impact that you've seen peptides create in a patient?

Oh my gosh, I have the best story for you.

So one of the most frustrating things about my practice is treating infertility in young men that have significant metabolic dysfunction.

These are young men that have a low sperm count, right?

So they can't get pregnant because they just don't have the numbers to make it happen.

And you're looking at them and they're morbidly obese.

Okay?

They have high insulin resistance.

All right.

And their endocrine system has been damaged by that obesity.

So they don't have low testosterone levels and their brain is not making enough of the signals to stimulate their testicles.

Now, we have medications that we can use to help stimulate that, to make more of that signal stimulate the testicles, right?

But really, what is eating at them, what is causing this, is not that chemical imbalance.

That's the, the symptom.

That's not the, the problem, okay?

And treating symptoms doesn't really get you very far.

And so I would have patients that I would take care of, and we would never see a significant improvement in their numbers because losing weight is really, really hard, you know, regardless

of all of the education and resources I try to give them.

But now we have peptides in the form of GLP-1 drugs like semaglutide and tirzepatide.

And I just saw a patient last week who increased his sperm count 10 times over and is now in a normal range because he's lost 100 pounds due to using tirzepatide, exercising, and improving

his diet.

And he has totally changed his life.

And that started with a peptide.

It started with a peptide.

So I— we've got lots of peptides on the table in front of you.

We will go into them individually, but just can you give me a high-level view of the types of areas in our health and life that these peptides can help with?

So we've talked there about infertility as a downstream consequence of the weight loss and fixing metabolic health.

What other parts of the body do peptides touch?

The best way to think about it is like this.

So peptides are almost like an app on your phone.

So imagine before we had apps.

I'm old enough to remember trying to log on and do my banking online before we had apps.

And gosh, it was so painful, right?

There were ways to accomplish things, but they were very inconvenient and in a roundabout way.

And now all of a sudden we have these apps on our phone phone that can do just about anything except fold your laundry, right?

You know, there's some limits to it, but I mean, really, the sky's the limit from an electronic standpoint.

And really, that's what peptides are.

So the thing is, is that we have peptides that can help you lose weight, like the GLP-1 drugs.

We have peptides that can improve skin quality, like GHK-Cu.

We have peptides that can help heal your gut, like BPC-157, particularly effective in ulcerative colitis, which is something that's being investigated with the FDA's planned upcoming

meeting it.

We also have peptides that can help with sleep and with recovering the gland in your brain that's responsible for melatonin and regulating your sleep-wake cycles.

So the question isn't, you know, what can peptides do?

It's kind of, well, what can't they do?

And if they can't do that yet, can we develop a peptide that can accomplish that task?

And the answer is probably.

And simultaneously, while there may be resistance from pharmaceutical industry in these peptides, the ones that we're most interested right now, They have signed multibillion-dollar

deals with other pharmaceutical companies that are involved in peptide development aided by AI to try and fast-track their own peptide products.

Interesting.

And so we are going to see exponentially more of these products come down the pipeline from pharmaceutical companies in the form of commercial products.

And it's worth saying that there was some significant news today.

Correct.

What happened today, but also what's going on?

And just for anyone that doesn't know, it's April 15th.

July 15th.

Yes.

So today we got a press release from the FDA saying that in July they are going to consider 7 peptides for removing from Category 2 back to Category 1.

Legalizing them.

Legalizing them, okay.

And some of the heavy hitters from that list include BPC-157.

Which is the one we talked about to do with like repair and injury.

Absolutely, okay.

And then we have the brother to that, which is TB-500, this vial over here.

This improves blood flow to an injured area.

You could think of this as sending the soldiers, as sending the cells that are required for rebuilding that tissue matrix that was damaged by a tear or a cut.

All right.

On top of that, we're also getting something called KPV.

May not have it here, but that is another peptide that has been linked to angiogenesis and tissue repair.

We're also getting MOTS-C, and then, you know, some patients will call it exercise in a vial.

It improves your VO2 max and your exercise tolerance and by upregulating the energy pathway, basically making more ATP, the energy that we all use to move, it makes more of that available.

All right.

We're also going to get DSIP, epithalon, and Semax, which are all peptides that affect cognitive function.

So improving thinking like Semax is a great option for that.

And then DSIP and epithalon both have roles in regulating sleep.

Sleep and recovery.

Wow.

Yeah, pretty wild.

And I've got to say, how does— so some of them are becoming legalized, but even the ones that aren't legal right now, a lot of people are taking them anyway.

Correct.

So my question is, how are people getting them?

Listen, I don't want to promote illegal drugs here.

This is not that kind of show, but I just want to know what's going on.

No, this is— well, this is important to talk about, right?

Because we have to understand, like, what's going on in the marketplace.

The moment that these drugs were banned, or these medications were banned in 2023, it was kind of like the United States experiment at banning alcohol.

It didn't go

very well, right?

All of a sudden, you know, they— you know, the mob came around and we started, you know, seeing unregulated saloons and unregulated alcohol production, and it was contaminated with

all the stuff that you didn't want.

And so we're like, people are traveling.

Yeah, exactly.

It's just— it's not a good idea, right?

And so what happened is we banned these and the gray market stepped in.

And so these are companies that will sell peptides that have on the label "for research use only." family, all right?

And the idea is that that takes them out of the FDA's jurisdiction because they're not selling it for people to inject into themselves.

Out of the FDA's hands.

I'm just creating a vial of this magical juice that you can use for your rat, okay?

That's the idea.

We all know that's not what's really happening, but because there isn't any quality control, it's kind of like getting gas station sushi.

Like, yeah, you can do it, but you don't really know if it's sushi, and it may not end very well for And so again, not saying that there aren't some people who have gotten good results

with research-use-only peptides, but again, it's not standardized, which is why I think moving this back into the 503(a) compounding world is the best thing for everyone.

Which is the legal framework.

Legal, correct.

Okay, so how does one take a peptide?

That's a great question.

So what's interesting is that, as we mentioned, you know, peptides are just made up of building blocks of amino acids.

And, you know, if you were to go make yourself a protein shake, you know, what is that going to look like?

What does it look like from a Lego standpoint?

It just looks like this, a handful of Legos in your hand, right?

All sort of ground up.

All ground up in individual pieces, right?

Okay.

And the thing is, is that your gut is designed to break up any sort of protein that you ingest orally into these little pieces.

Okay.

And so if you were to say, I don't know, drink some of, you know, this TB500, your body wouldn't be able to tell the difference between that and a piece of chicken.

'Cause it would break it all apart.

It would break it all apart.

Now there are some very unique exceptions to that.

There's a form of BPC-157 that actually is tolerated in the gut.

But by and large, the overwhelming majority of these have to be injected either subcutaneously or into the muscle.

And that's usually a preference.

Subcutaneous being my belly?

Just underneath the skin.

You know, as I tell patients, just pinch an inch, inject under the skin.

We do that for a lot of other medications as well.

Is that what this is?

Yeah.

So this is a prescription Mounjaro pen.

So Mounjaro is the brand name for tirzepatide.

All right.

Tirzepatide being the leading GLP-1 product right now from Lilly.

So this produces more weight loss per milligram than any other product that we've got out right now.

Is this the mechanism in which people inject peptides?

A little bit different.

So different.

This is an auto-injector pen, and so what you do is you're able to actually ratchet the dose there on the right side, and then you pinch an inch in your skin and then push it up against,

and it'll auto-deploy.

So there's nothing that you need to do.

You don't have to learn how to draw up medication and inject.

Whenever you're administering peptides at home, especially for patients that have obtained them from research-use-only markets, they usually come them in just little vials that need

to be drawn up with a needle.

Okay, now the benefit of that is that you can do custom dosing, all right?

But the drawback is, is that, well, you have to know how to calculate that and put it together.

This may be the most controversial thing we have on this table, and by pharma's estimate, it might be the most dangerous thing to their entire business model, because this is tirzepatide,

the exact same thing that you had in that pen, but this is made by a high-quality 503(a) compounding pharmacy.

And the reason why this is so controversial right now is because it offers an incredible amount of flexibility because what you have in your hand there is very standardized and you

administer it once a week because that's what's approved by insurance.

This is like the Ozempic thing everyone's been talking about.

Exactly, right?

But think of that as paint-by-numbers, okay?

You are— this section is this color, this section is that color, all right?

Think of this as— The thing you've got in your hand.

Right now, yeah, exactly.

Just a vial of tirzepatide as being— having infinite permutations and dosing ability because you can draw this up with a small syringe and do microdosing.

So instead of one large dose once a week, because what many patients will experience is they'll have a return of their hunger by the end of the week and they end up losing ground, you

can actually, instead of doing a full dose once a week, you could do multiple mini doses throughout the week with this formulation and with this presentation of the medication.

All right, but the challenge is, is that that is the benefit that allows this to be compounded by compounding pharmacies because they are able to provide something that is similar to

what's in your hand, all right, but it offers more flexibility that may be the right choice for some patients.

So personalization of medicine, okay?

But the challenge is, is that if you spend however much money on this, you're not giving it to Lilly.

And so as a result, we have seen an unprecedented crackdown in the United States from the FDA and trying to shut down compounding pharmacies and prevent them from making these medications,

even though that ability to customize, the fact that this is not an exact copy of what's in your hand right now, should protect it under current legislation.

But there is now enough pressure from the powers that be and from lobbyists from both Lilly and Novo Nordisk, which are the two companies that make the GLP-1 medications, that we're

seeing Marty Makary, the FDA commissioner, has now tweeted more about cracking down on compounded GLP-1 medications than he's tweeted about diabetes or heart disease in his entire time

in office.

And just so I understand, I want to play this back to you to make sure I understand.

Sure.

In my hand here, I have

trizeptide on my left.

Yep.

And this is made by Lilly, which is a corporate company who patented it so they can make lots of money from it.

Correct.

In my right hand, I have trizepatide?

Trizepatide with niacinamide.

With niacinamide.

Yep.

And this is not patentable.

So Lilly has a patent on the trizepatide molecule in that formulation in your hand.

Mm-hmm.

Okay.

And if anyone violates a patent, that can be pursued in US court.

Yeah.

Patent law, right?

But what's interesting is that Lilly and Novo Nordisk know that that's different in your right hand.

It doesn't look the same.

You can dose it differently.

And they know that if they were going to fight that in court, it would cost a lot of money and take a lot of time.

So you know what's a lot easier?

Calling your friend at the FDA and getting him to step on the competition so you don't have to.

And then who's paying for that enforcement?

It's not the lawyers that the pharma company is paying for.

It's the taxpayer paying for the FDA through taxes.

And you seem to imply that this was actually better because you could take it in a more flexible dose.

You could take a little bit, a lot, you can take it when you want, whereas this is kind of once a week.

Well, I mean, you know, what is better, right?

So I like this option for many of my patients because it's flexible.

All right.

So that is something that works for most patients.

All right.

But then again, this works great for patients too.

Okay.

But what you want is you want an ecosystem where you have choice so you can make the right choice for the right patient.

For a lot of patients, they're going to do exceedingly well on this.

And there's so much data to support that.

But I also have a lot of patients who get really ill after they do a large dose of Manjaro or of, uh, GLP-1 med.

And if we take that same dose and we just cut it into multiple doses within a week, we can avoid those side effects.

So you've told me that these peptides we have on the table in front of us can improve your skin, weight loss, muscle, energy, chronic illnesses.

You talked about the cognitive upsides, and you talk about it very passionately.

Yeah.

So So one should ask you.

Yeah.

Presumably you're taking some peptides.

I am, yeah.

Which ones do you take?

So I will tell you that as of right now, the only peptide I'm taking is a small dose of tirzepatide, all right?

Which is the one we were just talking about.

Yeah.

Okay.

Because back a couple of months ago, I was probably close to about 240 or so, and I was into powerlifting.

You know, I still am.

But you know, it's really great to be able to deadlift 500 pounds, but then stairs become really hard when you're trying to walk up.

And you're like, ah, I don't know.

I kind of like, uh, being able to not take a break after 2 or 3 flights of stairs.

And so I was like, okay, all right, longevity is a priority of mine, I'm going to slim down a little bit.

I was like, let me just try this for a little bit.

And what I found is that it is incredibly potent and at a very low dose, very, very tolerable.

Why didn't you take some of the others?

Honestly, because right now there is not a legal framework for me to obtain them.

And the truth is, is that I want to be an example for my patients, and that's why I'm out here advocating that we get access to these peptides in a legal, safe way again.

All right, and 'Cause it's the best thing for everyone.

If they were legal, which ones might you consider?

Oh man, I will tell you this, as some, like, I don't know how old you are, Steven, but I'm like— 33.

33?

God bless you.

I will tell you, once you get over 35, man, that is brutal, all right?

I sleep on my neck in a wrong way and I need like a fricking brace for like 2 weeks.

And so as someone who spends a lot of time in the gym, you know, working out, like you start to accumulate all these little aches and pains.

And so the idea of, for example, For example, I have a very finicky right shoulder.

If I try to do a really heavy bench and I haven't warmed up, I can tweak this and it takes me out of the fight for at least a month, okay, and I have to do other things.

I would have killed at various points in time over the past 2 years to have had BPC and TB-500 to hopefully speed that sort of healing, all right?

Also, for example, I suffer from really bad rosacea.

It flares constantly.

What's that?

So just redness of the face, okay?

That, you know, it makes me look like I'm sunburned.

And then I come in on the office on like a Tuesday, and then my staff's like, oh my gosh, you go out in the yard and do some work this week?

I'm like, it's just my face.

Um, you know, for example, that's something that a lot of people have reported benefits from GHK-Cu from.

So again, another compound, another peptide that could be beneficial for a patient like myself.

What about muscle mass and gaining muscle?

Yeah, so that is an interesting misnomer because that has been a common selling point you'll see on social media.

But as of right the only peptide that you might construe that way would be this guy right here in my hand, IGF-1 LR3.

Okay, now IGF-1 LR3 is basically the longer-lasting version of IGF-1, which is the downstream effect of growth hormone.

I'm sure you've heard of bodybuilders taking growth hormone to increase size and, you know, lose fat.

In higher doses, it can help contribute to muscle, uh, mass.

All right.

But truthfully, if you're trying to gain significant muscle mass, this is, this is not the way to do it.

And so the— right now, one of the things that peptides can't do for you is independently put on significant amounts of lean mass.

You still have to go to the gym.

You still have to go to the gym, believe it or not.

And guess what?

Well, that's the end of the podcast.

Yeah, I'll tell you.

And but something that blows my mind is that I have so many patients that think that they can just take testosterone and just put on muscle naturally, and it doesn't work that way.

You might get a tiny little a little bit, but you still have to have stimulus.

You still have to get in the gym.

You still have to put the work in.

And so I tell patients that I am not a replacement for a personal trainer.

I'm your doctor.

You also need your personal trainer, and most of you need a nutritionist, man.

And so I'm lucky to work with some great people in the community who partner with me on that.

But, you know, it's a, it's a full-court press when you're trying to get people to, you know, live the highest quality life.

What about some of these metabolic disorders and diseases in terms of, like, insulin?

Yeah, resistance.

People on the Diary of a CEO, the audience, are are very interested to learn about insulin.

I see that a lot in the comment section and a lot of the data.

Yeah.

So how can— if someone's struggling with their insulin levels or their glucose response, how do these peptides help?

Honestly, the best peptides for that right now are the GLP-1 drugs, hands down, because what you're doing is you are slowing gastric emptying, and so you have a slower absorption of

that bolus of food that you've eaten, so your glucose doesn't spike.

And so as a result, that increases insulin sensitivity significantly.

Frequently.

Now, again, you have to be careful about what peptide you're using for what.

A lot of these peptides that boost growth hormone and boost, let's say, IGF-1, those can actually increase serum glucose, and that may not be what you want if you are someone that is

trying to work on your insulin sensitivity.

And do any of these peptides come as, like, creams or as pills or anything like that?

If you look online, you can probably find a version of everything.

But if we're talking about actual legitimate formulations, The best example of a topical cream is going to be GHK-Cu.

And this is interesting because this is a copper tripeptide that has been found to decrease in expression and concentration as we age.

But when it is applied topically, it's highly effective.

Topically.

Topically.

So putting on a cream on your face.

All right.

It's been found to be extremely beneficial in regenerating the quality of skin.

So complexion.

All right.

Increasing the amount of collagen and elastin, the things that we need to keep that keep our faces taut and youthful, the things that people will pay lots of money to go get lasered

to get improvements.

Not that it's a replacement for that, but that's a topical form that, believe it or not, you could go out and buy today because topical GHK-Cu is regulated very differently than the

injectable form.

Is it expensive?

Usually.

You know, growing up, I thought all these sort of anti-aging creams were bullshit, but, but you're telling me that this has actually been associated with improving signs of aging.

I will tell you this, when I was going through college and medical school, I was the biggest skeptic.

Like, I did not believe any of the health or wellness claims that we saw coming out at the time.

And again, you know, that was at a time where we were getting bombarded with stuff about the Atkins diet and this, that, or the other.

But then all of a sudden you start having patients come back to you and they're testifying as the benefits they've seen from these things.

You start to actually look at the biochemistry behind them, you're like, there's a lot of science backing this up.

This isn't just mumbo combo.

And so believe it or not, yeah, there are creams that can slow the process of aging, at least from a visual standpoint, when it comes to your skin.

I have yet to figure out anything that, uh, you know, makes me as energetic as I was in my early 20s, but you know, I'm working on it.

But on that point of energy and cognition, if I wanted to become a better podcaster— yeah, and you know, I sit here sometimes, sometimes we do 2 in a day, which means I might sit here

for 8 hours.

Once we did, I think a couple of times we've done 3 in a day.

That's brutal.

Which is 12 hours of recording.

Yeah, but what would you recommend if I was trying to improve my cognitive performance?

So again, as a physician who likes keeping my license, I wouldn't say necessarily recommend, but I would say if we're looking at how these medications have been used, and potentially

one that may be legal again coming this July depending what the FDA says, intranasal Semax.

And this was one that was originally studied actually in Russia many years ago, and what they found is that this 7-amino acid peptide when it was administered after a TBI, so a traumatic

brain injury, all right, or acute injury, that patients tended to bounce back faster.

Also, they saw evidence of it improving outcomes after stroke.

And it also seems to upregulate the same sort of factors that help with cognition and with connecting sentences and bits of data in your brain.

And so it's also one of the, interestingly enough, one of the ones that is available intranasally because it goes through the mucous membranes and gets right where you need it.

Need it.

And so that's going to be a really, really fascinating compound to see back on the market, and then we can actually get more data regarding efficacy and across a wide population.

So interesting.

And you sniff that through your nose?

Sniff it like you would for any nasal decongestant, right?

If you have allergies or something like that.

Also, for someone like yourself, you travel a lot.

You know, you're going in between different time zones, you're balancing multiple obligations at different odd times of the day.

I shudder to think what your circadian rhythm looks like, my friend.

But that is what we have some of these other compounds that are going to be available for.

So if we look at

D-SIP, OK, that has been shown to be helpful with regulating your circadian rhythm, all right?

That is one of the ones that's going to be approved hopefully here soon, again, in July, right?

And then on top of that, you've got things like Selenc, which is another one that can help calm you as you're going to sleep about an hour ahead of time, and again, help those deep

delta brainwaves that are so restorative whenever you actually are, you know, resting.

Where will we be able to buy these when and if they are legalized?

So from 503(a) compounders here in the United States with a prescription from a physician.

So you still need a prescription?

Still need a prescription, correct.

It's gonna be quite a crazy world when everybody is gonna be injecting themselves every day.

I mean, we're already getting to that point now with the Zempac where I've got loads of people people in my, my friendship group that are.

Yeah, and they're— yeah, and they're doing great.

Yeah, they're doing great.

They're doing great.

And that's what I like about, you know, the advent of these GLP-1s is they're removing the stigma of a needle.

And I look at some of my friends who have been on it, I can't recognize them.

They look awesome.

Are you concerned with any of them?

You know, I've got a couple of friends in my circle where I'm a little bit concerned.

I don't even know if I should be concerned, but it's just when you see someone you know change so dramatically, so quickly Yeah, I think there's something in us which— something prehistoric

in us which goes, oh my God, there's a problem.

Yeah, one thing I'm— I am concerned about is the rapid weight loss with GLP-1 medications, because the problem is, is that when you go into such a radical caloric deficit, your body

goes into catabolism, which is breaking down tissue.

And you want to break down fat, right?

But your body isn't that judicious.

It's going to break down muscle, and muscle is the most metabolically important tissue that any of us have.

And so if you really want to optimize your insulin sensitivity, well, you need to maintain your muscle.

And right now, really, the only compounds that we have that are really good at preserving muscle with resistance training is testosterone, right?

But that isn't going to be a good option for our male patients that want to get pregnant because testosterone turns off fertility in men, all right?

It's also not a great idea for our female patients, all right, depending on their age.

Testosterone, TRT, is a thing in older, you know, women, menopausal— won't go into that But truthfully, testosterone is not the right answer for everybody.

And so what we are gonna see come down the pipe very soon is kind of the older brother of peptides, the more complex form, biologics called monoclonal antibodies that are specifically

designed to inhibit the enzymes that break down muscle.

So these are specifically called myostatin inhibitors.

There are 3 that are coming down the pipeline.

There is one called bimagromab, which is owned by Lilly, that is going to bind the peanut butter to myostatin's jelly, which is called Activen.

And then you have boretosumab and trevogumab, which are two other compounds owned by a different pharmaceutical company that are all designed to maintain muscle even in a significant

caloric deficit.

This is getting interesting now.

Yeah, yeah.

So you're, you're telling me I'm going to be able to inject myself with a Zempac to lose the fat and then inject myself with something else to keep the muscle?

It's wild.

It's wild.

And, and I'll tell you, you know, one of the hardest things that I'm sure you've heard being on the receiving end of this is just the complexity of it.

And there are so many levers that are moving at once, and trying to get your head around it and balance it all, like, it requires nuance and it requires a thoughtful discussion with

your doctor who is well-educated on them.

And that's one of the challenges, is that there isn't broad, great education on these products right now in the medical space.

And so that's something that I'm very passionate about about is improving education across my colleagues so that they're not afraid of these anymore.

What do you say to people that are listening to this now and go, "Fuckin' hell, why don't you just like eat your greens and go to the gym?" Yeah.

"And just be more human and you'll be fine." I love that.

I love eating your greens and going to the gym, okay?

But the unfortunate reality is that here in the United States, it depends on what database you look at, but obesity rates are estimated to be 40 to 70%, okay?

Whether you, depending on what BMI cutoff you're using, okay?

Okay, BMI's not perfect, but it is what it is.

And so the thing is, is that, well, eating greens and going to the gym are not working for us as a society.

And we could talk about how we don't have real food anymore, we have food deserts, we have this calorically dense but nutritionally poor food.

I'll tell you, the most disturbing thing I see as a surgeon is I'll see a patient come in the door and they're morbidly obese, they're a large individual, but I have to do surgery on

them.

Connective tissue, the stuff that's made up of protein that makes them them, that literally holds them together, is paper, paper thin because they're eating an incredible amount of

calories, they're gaining fat, but they don't have any protein in their diet.

And that's not something that's rare.

I see that on a daily basis.

And so the truth is, is that, you know, we're talking about this from the angle of biohackers and people that are super engaged in our health, but the truth is, is that this is going

to be able to be used to help our population population at large and, you know, ultimately hopefully avoid a lot of the terrible disease states that we're seeing overwhelm the medical

system right now.

How big is the peptide industry right now?

If we look at the top 4 large language models companies, all right, so all the heavy hitters and how much revenue they're generating, it's estimated between— be between $58 billion

up to maybe $62 billion.

Yet the income and the revenue from just semaglutide and tirzepatide alone is gonna be over $55 billion this year.

And so what we have is peptides, without even considering all of this happening in the research space or the research-use-only space, without even considering the peptides that we'll

see come from compounding pharmacies, we're already approaching parity with what we're seeing in AI as far as revenue goes.

That is the demand that we're seeing in the marketplace.

I run multiple companies that have multiple sales teams, and one of the things as a founder of a company that's often confusing is you find it hard to figure out where sales are.

About 10 years ago I started using Pipedrive in my former company, and it's also the reason why I switched over all of my commercial teams in my current media company called steven.com

to use Pipedrive as well.

Not only do they sponsor this show, but they've been an incredibly effective way of scaling our sales engine over the years.

Pipedrive is an easy-to-use intelligent CRM, and at its very core, it makes your sales process visible through one dashboard, a visual pipeline showing every deal, what stage it's in,

what needs to happen next, and it's all in real time with no delay.

It doesn't magically close the deal for you, of course, but it does replace complexity with clarity.

If you want to join over 100,000 companies already using Pipedrive, you can use my link for a 30-day free trial with no credit card payment needed.

Head to pipedrive.com/ceo to get started.

That's pipedrive.com/ceo.

I'll see you over there.

When your patients come and see you, Dr.

Alex, what are they What are they asking you most frequently as it relates to peptides?

What are like the top 3 questions you get asked the most?

The first thing I get asked is, what peptides do I need?

And then I just look at them, I'm like, well, what's your problem?

You know, like, what's bothering you?

And what do they say?

You know, and then they'll come in and they'll start talking about energy, sex drive, and that sort of things.

And I'm like, okay, if that's it, well, we need to check your testosterone levels, brother.

Okay, so instead of looking for peptides, right, you know, you don't walk into a Home Depot or a Lowe's, you know, like, what tools do I need?

And you're like, what are you trying to do, right?

And then you start to talk to someone there, like, well, I'm trying to build this.

Okay, you need a saw, you need a screwdriver, you need this.

And some of those tools might be peptides, all right?

But some of them may be hormones, you know, some of it may be diet and exercise.

And so peptides are just another type of tool that we can use.

We all want a shortcut though, doctors.

We all want a quick way to be better.

Yeah.

And ideally not to have to do hard work.

That's like what most, you know, the average person is looking for.

And we hear about these peptides, we hear other people are taking them, we hear the fantastic results in skin, hair, muscle.

Yeah.

And we go, fucking, what me.

You know what I tell patients?

I'm like, me too, man, you know, but my alarm still went off at 4:45 this morning so I could hit the gym before I made it to clinic.

Because there are no real shortcuts.

There are things that can help, right?

GLP-1's the best example of that, right?

Okay, this is the closest thing to a shortcut you're gonna get, but the truth is, is that this isn't going to go to the gym for you, and it's not going to lift the weight so you can

maintain that muscle mass so you get the best possible result and try to hold on to your muscle while losing the fat.

One thing I've learned from doing this podcast that has really grown with me over time.

People ask me all the time, like, what's the one thing you've learned from the podcast?

One of the answers that I've never given that I'm gonna give now is that I've learned that there's no such thing in life as a free lunch.

No, absolutely not.

And what I mean by that is like everything is a trade-off.