Episode 144: Peptides – Bleeding Edge Performance, Muscle, and Recovery with Dr. Andy Galpin & Dr. Ryan Greene

Today’s Flex Diet Podcast Episode comes to you from Spokane, Washington where I’m getting ready to help the Special Forces Experience as they work with candidates over an 8-day high-stress experience to facilitate post-traumatic growth. For the podcast, I spoke with Dr. Ryan Greene and Dr. Andy Galpin about peptides for performance and recovery and who can use them, how they are regulated, and more.

Episode Notes

• Dr. Greene’s background and creation of Monarch Club

• Dr. Galpin’s background and interest in human performance
• Barbell Shrugged episode for reference
• What are peptides and how are they different from HGH and Testosterone?
• Why haven’t we heard much about peptides?
• What are the problems with self-medicating?
• Can professional athletes use peptides?
• Peptides for recreational athletes?
• What Dr. Greene uses
• Cost
• Suggestions for general population
• Using before surgery
• More peptides for peak performance
• Any other uses or contraindications?
• Use of niagen?
• Dr. Green on Instagram
• Dr. Galpin on Instagram and on Youtube

Dr. Greene is D.O. (an osteopathic physician) specializing in human performance, sports medicine, nutrition, and cutting-edge recovery methods. Dr. Greene’s principal belief is that integrating a constantly collaborative, holistic, evidence-based practice amongst health and wellness practitioners is crucial for an individual’s sustained success.

Dr. Greene is the principal medical advisor at Monarch Athletic Club in West Hollywood, the first private, sustainable health and wellness facility delivering traditional training services combined with physician-directed, evidence-based integrative medical intervention.

Dr. Andy Galpin is a Professor of Kinesiology at California State University, Fullerton, and one of the foremost experts in muscle physiology- how do you increase strength, hypertrophy, and endurance performance. He has published numerous studies and works with several elite-level athletes across many sports, from UFC fighters to Olympic weight lifters. Check out all of his info below. http://www.andygalpin.com/

Optimizing sleep for athletes and high performers | Absolute Rest

https://www.absoluterest.com/

This podcast is brought to you by the Physiologic Flexibility Certification course. In the course, I talk about the body’s homeostatic regulators and how you can train them. The benefit is enhanced recovery and greater robustness. We cover breathing techniques, CWI, sauna, HIIT, diet, and more. The course is open for enrollment until midnight April 11, 2022.

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Full text below

Dr. Mike T Nelson

Hey there, what’s going on? It’s Dr. Mike T. Nelson here. And I’m actually recording this little intro from a hotel just outside of Spokane, Washington and getting in my car rented vehicle here and driving out to the mountains of Idaho and just a couple of hours to help out with the Special Forces experience. I’m one of their helpers there with the process, which is an eight day high stress event for all the candidates coming in, they spent about nine months preparing for it.

And the goal is to stress them out in a very intelligent and progressive manner to facilitate post traumatic growth. And I’ll have a full update, probably later once I get back. But the reason I wanted to get this audio intro out to you is I did an amazing podcast coming up here with Dr. Ryan Greene. And my good buddy, Dr. Andy Galpin. And he was on a very, very early podcast quite some time ago now. And I heard Dr. Ryan greene on the great Barbell Shrugged, show. So I’ve been on a few times, shout out to my good buddies there, Doug and Anders, if you haven’t checked out their show, highly recommend it. And it was great.

I’ve sort of at a periphery followed some stuff in the peptide space. But I haven’t taken any real deep dive into it at all, I was kind of unimpressed by most of the information and the so called experts I saw online. But once I heard the episode, I reached out to Andy and said, Hey, if you and Dr. Ryan greene want to ever do super deep dive into peptides, let me know you have an open invite to come on the show whenever you want. And both of them said yes, they would love to do that. So I’m super stoked to have them here. And if you have no idea what a peptide is, or hormone or SARM, or any, anything of these weird technical terms, that’s okay.

We had Dr. Ryan break down the difference between them, kind of what are peptides, which are these kind of small molecules you can potentially use for health, longevity, maybe some muscle gain faster recovery. We go into all of the pros and the cons of it. What do you need to do beforehand? Newsflash peptides won’t solve all your issues, but in some cases, they can be very effective. We also talked about who can use them? Are they regulated? What is the status of that?

How does this fall in terms of drug tested athletes, and much more. So enjoy this episode of The Flex diet podcast. And this one is brought to you by physiologic flexibility. So one of the things I did with the phys flex cert, which actually by the time you’re listening to this just closed yesterday, but you can still get on the waitlist for next time, is studying up ways to precondition or apply a small amount of stress to your body. And this will hopefully add more robustness to you and increase your chance of post-traumatic growth instead of maybe PTSD or other negative things when you encounter a future high stressor event. So I’ll have more experience with that coming up very soon afterward

But you can go to physiologicflexibility.com. For all of the information there. Any questions, you can drop me an email, I will get back to them as soon as I am. Back in communication, the land of the internet again. So enjoy this podcast here with Dr. Ryan green, and Dr. Andy Galpin, all about the world of peptides.

Hey, welcome back to the flex diet podcast. I’m your host, Dr. Michael Nelson. And today we’ve got two special people on the program. We’ve got Dr. Ryan green. And we’ve also got good buddy, Dr. Andy Galpin. And today we’re going to be talking all about peptides. And if you don’t know what peptides are then perfect. If you kind of do know what they are, I think you’ll probably learn some new stuff in this episode.

Dr. Ryan, do you want to start it off with just a little bit of your background and kind of how you ended up doing peptide stuff?

Dr. Ryan Greene

Yeah, so originally trained in the Ortho sports space thinking surgery was going to be my future working with athletes quickly appreciated my time and effort in the hospital system would be working with people that missed many opportunities to find, you know, optimal health and avoid surgery and looking at what my quality of life would be like and the ability I would have to impact patients.

For a long period of time, I decided my road needed to move more towards the preventive space. And so I took a detour at the Mayo Clinic for a fellowship looking at clinical research and contributing to that sector and I enjoyed it. But I realized, you know, not working with patients was something that was not what I wanted to make my practice long term. So I did an extra fellowship in what’s called integrative medicine through the University of Arizona with Dr. Andrew Weil, and kind of rounded out my scope from the complementary alternative nutrition and preventive space.

And then that period of time, I came up with the idea with some partners for what is now my startup in Los Angeles called Monarch Athletic Club, which is a one stop shop, comprehensive wellness offering. So every member gets preventive medicine, nutrition, physical therapy, and strength and conditioning to create a lifestyle modification program that can be tracked in real time modified, and is ultimately significantly less costly than if you tried to do all those things independently, and can also leverage the traditional insurance system.

I’m taking a little bit of everything that I learned, and I just pulled it all into one spot. So we can create an opportunity for people to literally just show up. And as long as they do that they should achieve reasonable health promotion. And during that period of time, just working with my my cohort of people in Los Angeles, you know, anti aging, longevity is a huge topic of conversation, and people kept talking about peptides, growth hormone optimization.

I started to look into it a little bit further. And, you know, I tried to introduce things that help the body, do what it’s already doing, versus supplementing or replacing. And that’s where peptides became a large area of emphasis for me, just because we’re using what the body already produces, and supplying it when needed to help just kind of optimize our our physiologic function versus introducing things that are kind of masking some of our, our less efficient health behavior. So that’s what brought me to this space. And, you know, I’m happy to discuss and teach and educate more about it.

Dr. Mike T Nelson

Awesome. Thank you. And a little bit about yourself there. Dr. Andy Galpin from California.

Dr. Andy Galpin

Well, I think I’ve, I’ve been on this program before. Yes, you have. That’s right. A few times. So I’m, I’m, I’m a full professor and scientist at Cal State Fullerton in the areas of human performance. And, you know, I’ve been out here for a decade or so. So I, I run the center, and we, you know, perform research on any area that we feel like could potentially aid in human performance. So this is classic exercise physiology stuff to even some slightly cuckoo stuff, like breathing that we thought was cuckoo at the time, but that’s not so much cuckoo.

Dr. Mike T Nelson

You mean, it’s essential and important, what are you talking about?

Dr. Andy Galpin

Then I also work directly with a lot of professional athletes across a lot of sports in a combination of roles, everything from strength conditioning coach, to kind of director of high performance consultants sort of thing to nutrition, blood analysis, interpretation kind of etcetera all over the place. So I’d say number of years back, I don’t know how many years back, Ryan I crossed paths through a very good mutual friend, a camera that dirtbags name so I’ll just leave it out. But anyways, it’s not that important.

Who was a part of helping Ryan get going with with his stuff and so basically escapes it you gotta meet this guy. Anything gives us like to think is complete garbage but none reluctantly met Ryan and found out actually gave wasn’t totally wrong about this one. So I’ve been fortunate enough to, to work with Ryan, together with athletes and a few different scenarios. And so, you know, recently, I was like, man, tell him some colleagues of mine, like you gotta get scanned your podcasts. It was really good stuff. He’s really smart guy. And so we did that. And then you listen to that podcast, Mike and me me up and you’re like, You got to get him on here. All right, we’ll do that. So that’s kind of a little bit of background of me as well as we were both on your show today.

Dr. Mike T Nelson

Excellent. Yeah, and if people want a little bit more background, they can listen to the Barbell Shrugged episode. Dr. Ryan was on that’s originally where I heard about him and was like, wow, this is cool because I’m pretty much a walking idiot in terms of peptides, I don’t know much of anything. So this is perfect to answer some questions.

And it’s anything I think that’s kind of on quote, the bleeding edge is always interesting. But at the same time, you’re always trying to balance like, what data do we have? Is it efficacious? versus, you know, what is all the hype and everything around it, because everyone’s always looking for the next shiny new object. And a lot of times there isn’t anything really new.

But sometimes there is stuff that does actually work. So you can’t really just throw it all out and go, Oh, it’s all garbage. It’s like, no, there’s some stuff that actually works. It’s a new kind of sift through all of it to figure out what is potentially efficacious. And what of it is just bunk and trash and don’t waste your time on this podcast. So Dr. Ryan, how would you describe for people listening, like, what is a peptide? And the follow up question is kind of the difference between a hormone a SARM, and a peptide? Because I think a lot of people kind of mix those three terms up and use them, unfortunately, interchangeably, and they’re kind of all different categories.

Dr. Ryan Greene

Yeah. So peptides. To answer your first question. We’ve been using them for a long time, you know, 5060 years insulin is a peptide, Dr. Galpin, HERBIE talked about this before, it’s, we’ve we’ve used this science for a long period of time, but it was for more, you know, acute, life threatening health conditions such as diabetes.

Since then, the discovery of more peptides specifically for human performance, longevity, anti aging, inflammation, tissue recovery had been discovered, synthesized and intermittently have become available for use. And now more regularly in the US. Peptides for the most part are secreted God’s meaning they’re being introduced to stimulate the body to produce something that will allow us to heal tissue, reduce inflammation, recover from, you know, movement, things like that basically help us build resilience against stress and things that can contribute to the aging process. So some peptides can be hormones, but most are like pro hormones, they’re stimulating the body to produce a hormone, which is different than if someone was prescribed HGH, which is very common, and LA, which is a synthetic, non bio identical compound that is similar enough to bind to, and contribute to growth.

But it’s not with with it not being bio identical. Essentially, if you’re taking it to help with muscle recovery, or weight loss. If for whatever reason, you have heart inflammation, or you have some sort of tumor growth, somewhere that you may not even know is present, the body is going to take that compound and use it wherever it needs to be used, you don’t get to direct where it’s going to go. And that’s where the potential risk for adverse effects, which is commonly seen with growth hormone can be problematic.

The other thing that peptides traditionally are different than in terms of hormones is there’s really no negative feedback loop. So for instance, testosterone is the most commonly prescribed hormone, if you’re taking it, the body knows that you’re getting testosterone. So it decreases its own natural production. Which if you need testosterone, or you’re not producing it, you have common syndrome, something like that, then it’s reasonable to continue to take for the rest of your life, if you’re just using it for anti aging, longevity, you know, potentially some sort of tissue healing issue.

Typically you can’t stay on or you shouldn’t stay on testosterone for a long period of time, which then requires when you’re completed with your course, you need to essentially re initiate your own physiologic mechanisms to start producing your testosterone again, and a lot of people don’t know that they’re not monitored Well, or they’re going to clinics that are not overseeing their patients as well as they probably should. So people get meds, they take them and then they just stop.

And they wonder why they feel like garbage, especially when they’re not on the hormone. And well, it’s because you basically told your body for the last three, six, or however long, you don’t need to do this anymore. So your machinery, the factory shut down. And it takes a while to reengage those components. If they come back at all. I mean, usually they will, but sometimes, you know, it may take a long time. So peptides bio identical stimulate the body to do certain things that will help with recovery are a multitude of positive physiologic outcomes.

If they’re not going to be used, because they’re made up of strings of amino acids, the body can break them down and use them for other things. So the potential adverse effect and risk profile is significantly lower than if you were to use a synthetic, you know, growth hormone or something like that. And again, there’s no negative feedback inhibition for the most part, with many of these peptides in terms of SARMS Hmm, those are essentially just molecules that bind to receptors that either are agonist or antagonist basically making something happen or not happen depending on what you’re trying to achieve, whether it’s you know, stimulating muscle recovery or, you know, stimulating a testosterone effect or preventing the breakdown of testosterone, whatever that’s, that’s doing. So they’re there, they’re all similar. But there is a difference in terms of all three. And I think peptides in terms of longevity, safety, efficacy,

I like to think that they are one of the healthier things that you can introduce to help optimize human performance with a fairly low risk. And also from a cost standpoint, they tend to be significantly less, in terms of overall cost very rarely are anything in those, you know, realms that we talked about hormones, peptides, or SARMS. Are they covered by insurance. So the other thing people have to think about is like, if you’re going to do this, are you going to be able to do it effectively for the treatment course that’s required, and are you going to be able to afford it, which sometimes people can’t, and then they, you know, it’s like, you’re doing half of a treatment protocol, which isn’t going to elicit the outcome you want, and may actually introduce a little bit of risk. So that’s kind of peptides from a macro level, and their difference between those other, those other components you mentioned.

Dr. Mike T Nelson

And they’ve been around for quite a while, but is one of the reasons we haven’t heard a lot about them. Because from what my understanding is that they’re not necessarily patentable, pharmaceutical compounds. So they exist in sort of this limbo, land of it might be efficacious, who’s gonna pay for the research to look at it, because if I’m a big pharmaceutical company, I can’t patent it. So there’s not a lot of incentive to run a whole bunch of trials on it. Because at the end of the day, we all know someone’s got to pay for that. And if they’re paying for it, unless it’s just NIH funding or something else, then they want return on their investment.

Dr. Ryan Greene

Yeah, that’s exactly correct. So it’s essentially like something that goes straight, generic. And from the pharmaceutical standpoint, and, you know, the goal of a pharmaceutical company is to make as much money as you can, while you have the patent on it for its proprietary value, and then, you know, inevitably, it’s going to go generic. So because it’s bio identical, because it’s something your body already produces, it cannot be patented.

Thus, the research, at least in the US to demonstrate efficacy as as rigorous as we would do with randomized controlled trials. For other medications are phase one, two or three studies. I don’t know if they’ll ever be done maybe someday. But for the most part, we’re essentially amalgamating case reports, retrospective analyses, things like that, that smaller entities are doing independently.

And then we’ll may do meta analyses here and there to pull as many studies as we can together and try to make a determination of are these things efficacious or not, and for the most part, we’re seeing a shift in at least in the medical side with plastic surgeons, orthopedic surgeons who are acknowledging their efficacy and some independent practitioners are starting to recommend utilization of peptides, postoperatively, because they’re seeing benefit in terms of tissue healing, recovery, time, recovery, efficacy, their outcomes are getting better, you know, people are able to return to a similar level of performance as pre injury versus and in many cases, you may only get 80, or 90%, back to where you were after an injury and, and a surgical intervention.

So it’s, it’s one of those things where it’s going to be a little bit of a grassroots campaign to get people to better understand what we’re doing. But literature and, you know, academic and clinical study is going to be necessary, and it’s just going to be smaller in size and scope. But, you know, with the work of you and Dr. Gap and trying to increase awareness, I think people will then have the opportunity to evaluate or at least, you know, seek some sort of clinical guidance in terms of could this help me?

And the next part from my end is educating other practitioners in terms of what should be used, when should it be used? Why should it be used? And then how can it be used effectively? So? Yeah, it’s not going to be as as robust a rollout as Viagra, because we don’t have the funding that those entities do, but we’re moving in the right direction.
On another note, sildenafil 100mg has been studied for potential benefits in muscular dystrophies due to its vasodilatory properties and potential to increase blood flow to muscles. The research in this field is promising but still in early stages.

Dr. Mike T Nelson

So I’m not gonna see peptides being advertised during the next NFL season.

Dr. Ryan Greene

Definitely, definitely not in pro sports. One, it’s a good point because we’re seeing this movement in social media where essentially, like, it’s not illegal to seek telecon salt. And if someone says, Hey, you know, CJC HIPAA Morlan would be great for recovery for you. Like, you may never meet a practitioner, but all of a sudden it ends up at your doorstep. Are you doing it appropriately? Are you doing it for long enough, isn’t it When following you and guiding you to make sure like it’s working, probably not, and they don’t have to. And it’s we’re seeing that in erectile dysfunction. We’re seeing that in hormone therapy. And it’s a, it’s a little bit off putting, because I think we’re, we’re creating a narrative for a lot of people that sort of these things may not be as effective as they could be.

Because they’re not set up for success. They’re just like, oh, I have low energy, I think I might need testosterone. And then I got this online prescription, and it showed up at my door. So like, that’s, that’s where it could go. I hope it doesn’t. But I mean, it’s not impossible. So hopefully, we can generate more awareness, education and understanding before. You know, businesses recognize the opportunity for profitability.

Dr. Mike T Nelson

Nice, do more questions, and I have some stuff for Dr. Andy. Because of that, so you’re saying that, my fear is that people will try to, especially in the fitness realm, sort of self medicate themselves and go like, Oh, look at this website, I’m an order, blah, blah, blah, and we’ll just be shipped to my door. Exactly. Because I highly doubt they have the training to know what protocol to do. And my limited understanding is that there’s probably a lot of shady companies that are trying to make money off of peptides. And if you’re not really being followed by a physician, they haven’t checked the background of manufacturing, etc. Correct? How would you know, like, you don’t have the equipment near your home to test it?

Dr. Ryan Greene

You do not. And I think that’s the knock on the peptide space to date. And Dr. Galpin can can either confirm or deny, but like, it seems like peptide pharmacies are shut down every day in terms of they used to be able to produce something, yeah. Randomly their websites gone. And you’re like, alright, well, what happened? Why did it get shut down? And, you know, should I actually be using the stuff that I got from them. So it’s, it’s becoming a little bit more complicated, but there are, you know, validated, certified places that are producing high quality products, you just need to find them and find who works with them. Because technically, you can order these things over the internet. But what I would do is work with a practitioner that’s been trained and, you know, peptide therapy and Cellular Medicine.

So yeah, that’s, that’s where we have to do some work in terms of building that network, and allowing people to gain access to people, you know, for a reasonable cost. Because the other thing too, is, you know, anti aging, longevity, like the cost associated with these things is astronomical, like, and it doesn’t need to be like the cost of peptides is for all things considered relatively reasonable, a couple $100 a month, for the most part, and you’re seeing people paying multiple $1,000 a month, and I don’t know, I don’t know why. Other than, you know, added costs for who knows?

Dr. Mike T Nelson

Well, so it didn’t in terms of the FDA, it seems like the FDA has kind of looked at him as again, this sort of gray area, and does the FDA sort of frown on peptides or because I know there’s sites that say it’s a research chemical, it’s for your your lab rats at home, then you’ve got legit sources that are through a physician and kind of seems a little bit more wild wild Westy. To me,

Dr. Ryan Greene

Well, yeah, it’s it’s mixed. So there’s about 60 ish FDA approved peptides for introduction into, you know, the human system. There are plenty that are not technically FDA approved, but you can get from third party sources that are technically designed for laboratory or, or research use. So you have to be careful where you’re ordering who you’re ordering from, you have to Ask and inquire with your physician, like where are you sourcing this from?

Because they may be pulling from a third party source. And then you know, again, it seems like every month different states Boards of Pharmacy medical boards are either allowing things to be used, or then all of a sudden, they’re prohibited to be sent into the state. You don’t really know what why or, or the rationale behind those decisions, but it is a little bit of a moving target. So we are not in a space where I would be confident that anything is going to be available for any period of time, but there’s a handful that are pretty well documented in terms of their efficacy. And for the most part, I don’t think anything’s going to change in terms of access to them such as CJC, a femoral and BPC 157. A couple of things like that. So yeah, it’s it’s we’re still very, very early in the space but a lot of exciting stuff to come from it.

Dr. Mike T Nelson

Awesome. Any comments on that? Dr. Andy?

Dr. Andy Galpin

I just want to reiterate that If we’re gonna get a lot of stuff details here in a second, but yeah, if you go down this route friends at home, just please don’t do it until you get it through somebody like Ryan. Yes, that’s the only I’m gonna say like you really, really, if you’re paying $26 for the month supply or something, you just you better know what you’re getting.

And it’s not what you think you’re getting. So just please don’t do whatever it takes to find someone who’s qualified. Just work right if you want to, and go that route, it’s gonna go to peptide. You’re not playing games here. There can be serious consequences on this. You’ve taken normally, the Secretary supersafe generally a lot. Most peptides are very, very, very safe, as Ryan talked about earlier. By buying things on internet from, you know, who knows where better expect you’re playing with hormones hormone like things. Yeah, this case peptides, but still, they work.

Dr. Mike T Nelson

Yeah, I always get nervous when I see companies. And this has happened in the supplement world to like, pop up, tried to sell something that’s super sexy, and then they just all of a sudden disappear again. And then another company pops up and disappears. I always think I’m like, okay, so what is the incentive for Sid company to go through all the hoops to make sure it’s legit to make sure if it’s an injectable, it’s sterile, like that costs money, right.

So if you’re doing it legit, and you’ve got a brand name, and people are associated with it, you’ve got something to actually lose, if you screw up. If you’re a brand new company that just pops up, you don’t really have a lot to lose, and it just makes me nervous. Like you guys were saying, when you see companies show up, they disappear. God knows what’s in that vial, you’re not gonna be able to test it. And you know, a lot of them are injectable. So if it’s not sterile, you’re gonna run into those issues. Plus, what are their contaminants? Did they put in it? Like, maybe you get lucky? And it’s just sterile water? And it doesn’t do anything, but it could have God knows what in it. So yeah, I I agree. 100%. Yeah, and they are these? No, go ahead.

Dr. Ryan Greene

Good. Yeah, I was gonna say like, same thing with the nutraceutical space, like the Yeah, the threshold for any company to participate is participate is it gra is generally regarded as safe for human consumption. And as long as they pass that, you know, minimum required barrier, like who knows what’s in it? And so, you know, I don’t I like to believe in the best of humanity in the sense that, like, companies aren’t going to send out cyanide, right? But you know, you may you may be getting, like you said, sterile water, like, great, you’ve spent a couple 100 bucks a month for nothing. So you don’t, most people don’t have a mass spec to access their products.

Dr. Mike T Nelson

Now, that might be even on the nice side, right? You could have heavy metals in and you could have contaminants that may not be sterile. It’s like, who knows? Who knows? Yeah, I agree. And Andy, are these if someone is a professional tested? athlete, I’m assuming these are on the banned list of compounds, correct?

Dr. Andy Galpin

No, no, they aren’t. So this is where, like, they’re not okay.

Dr. Mike T Nelson

Because they are not all the time. So that’s why I’m asking.

Dr. Andy Galpin

Well, it’s because it’s a moving target. This target moved on us on a couple months ago. It depends on also what professional organization, so the PGA Tour other folks that are under USADA or water? It’s a different thing than Major League Baseball, CBA, NBA CBA, and oppose CBA and UFC, etc. So, number one answer is it highly depends on the sport and their testing battery.

NCAA, I don’t think has really any legitimate testing for most of this stuff. Which is, I guess, my subtle way of saying take whatever the hell you want, we’ll get caught just getting up onto that. Getting code. And then it depends on each individual one. So actually, the one of the first things I was going to ask Ryan, I know that PPC 157 was just put on the list for use on water. But do you happen to know offhand some of the more effective ones? Yeah, generally legal, and we’ll start there or maybe whichever we want started generally like yeah, so

Dr. Ryan Greene

I’ll start with the illegal so anything that’s a growth hormone secrete a god so anything with the suffix morale and EPA morale and Sermorelin those are all out BPCL seeds can be the same boat, right? Yeah, yep. Yep. Yep. So CJC. So those are the common ones that I mean, those are probably the most well known most efficacious and commonly used and those unfortunately, if you’re WADA USADA, whatever testing agency those are out BPC 157, unfortunately, just fell under that realm which is unfortunate because again, like most people are using it for you know, injury healing and instead of anti inflammatories, opiates, things like that, like this is far more safe and and but they can still get a cortisone shot. You can still get a cortisone shot, you can still take opiates and you can still I mean, they’re still doing toradol like, we’re all lined up and turtle. Yeah, going out of style.

And that’s a HUD medic toradol is 100% illegal in most professional sports, but it’s still happening all the time. It’s just they’re not testing for, you know, anti inflammatory utilization. So, unfortunately the ones that are most efficacious the Merlin’s PPC out. Some of the newer ones a piddle on thymosin, alpha, beta, G, HK, CU, which is like a copper supplement used for tissue healing hair regrowth. Those are still technically illegal because I just think they haven’t gotten to the point to to make them banned in sport. So some of the newer ones that help with you know, potentially energy, cognitive function, inflammation other than BPC 157, you’re probably still okay, based on my most recent research, but the ones that are most commonly known these days are unfortunately, not available for use legally.

Dr. Andy Galpin

For athletes, or athletes for athletes on that note. For the non athlete, maybe I have some people that listen to Mike’s program are athletes without pro athletes similar, like the train hard they work out and compete, maybe they’re not yellow. So are the ones that you’d say like, again, are, are generally safe. You’re generally not going to ruin your entire income system. Generally effective for performance enhancement for non downs athletes.

Dr. Ryan Greene

Yeah, I think the two that I use the most frequently are CJC HIPAA Morlin. So CJC 1295. It from Harlan is great for tissue repair, muscle recovery, body composition improvement, helps with sleep, which is you know, usually a huge issue for a lot of people getting good quality sleep. BPC 157, was initially isolated in gastric juice, and it was identified as something that can help with intestinal epithelial repair. So basically individuals with irritable bowel inflammatory bowel issues. It can be administered orally to help fortify the body’s ability to repair inflammatory related issues of the gut. But systemically used, it’s been wonderful for tissue healing, specifically, ligaments and tendons are areas that are, are notoriously poor for blood flow and healing time.

I’ve actually started with my patients who are doing DPC. The traditional guidance is just you know, injecting belly fat and let it go where it needs to go. But I’ve actually found a little bit more of a localized administration. So if you have rotator cuff tendinopathy, you’re injecting in the delt, if you have a knee issue, we’re going in quad. So a little bit more localized administration, I’ve actually found it’s a little bit more efficacious in terms of, of healing, but that’s great for individuals that are dealing with chronic inflammatory issues, especially of musculoskeletal tissue.

Dr. Andy Galpin

An interesting one now, that’s, I mean, I don’t I don’t think it was as relevant as when we were on barbell shrugs, but semaglutide So I don’t know you guys have been have been following that. But oh, what is that? Okay, so semaglutide is legit, actually, like this is a real legitimate, like, exciting thing.

Dr. Ryan Greene

Yeah. So semaglutide is a molecule that helps with weight loss, essentially, and the FDA approved a couple different things, but the most the notable one was on in June of 2021, we go V, which is the the brand name of semaglutide, essentially, is a GLP, one agonist that helps with regulating appetite and food intake, food intake, excuse me. And so basically, the studies show that if you’re taking this GLP one agonist, in addition to my monitor, diet and exercise, people are losing a significant significant amount of body fat and keeping it off for a long period of time. My question with the data is these people that were doing it also exercise and ate a little bit better so like, is there a confounding factor of just like better lifestyle optimization? Probably.

But semaglutide alone now is available with many peptide pharmacies and the we go V which is the brand name is roughly $1,300 a month and you need to do it for 12 months, a three month course of semaglutide from a reputable peptide pharmacies around $400 a month. So it’s almost you know, you know, 20% the cost of what you’d be getting if you had it prescribed and got the brand name. So that’s pretty exciting because when used appropriately, which is once per week, again for a three month course, and then if you need to cycle it multiple times you can, it is pretty effective when paired with diet and exercise modification.

Dr. Andy Galpin

So that’s when I’m starting to use a little bit more because it’s very helpful with weight loss that’s announced the New England Journal of Medicine stuff to somebody that’s not in clinical Yeah. Journal Club.

Dr. Ryan Greene

Yeah, that’s the GLP. I have. I have a lot of patients that are our medical professionals that are Doc’s that are just like, they’re critical care attendings are like, I work 24 hours on 24 hours off, I never sleep, I’m having a hard time maintaining body weight. So they’re starting to look into this because, you know, it’s helping amplify the results that they’re appreciating from the, you know, limited exercise and dietary modification that they can sustain based on the stress of their job. So that’s pretty cool.

And then the other one is mots C mot S dash c, which is similar to a growth hormone like substance, essentially, it’s improving insulin sensitivity to help with blood sugar metabolism, lipolysis, and fat utilization for energy. And that’s usually paired with b 12, which people have been using V 12, for energy and weight loss forever. So it’s, it’s essentially amplifying the synergistic effect of, of B 12. So those are like the four right now that I’m using pretty regularly, I do have some patients that are using thymus and alpha and thymosin beta.

Your thymus is essentially an organ that dissolves or becomes inactive, roughly around the time that you complete puberty and its purpose is to essentially produce immune cells to grow them, and then release them into the body. But once you’re an adult, your immune system for the most part is fairly competent.

We have found over time, though, with the amount of inflammation in general lack of health that we’re experiencing as a population, we start to have immune cells that are less than functional may become, you know, problematic in terms of leukemia, lymphoma, and things like that. And so essentially, what you can do is stimulate your RE initiation of thymic activity through thymus and alpha and thymosin beta.

And individuals who have chronic inflammatory issues, gut issues, things like that, tend to see your resolution and a lot of those inflammatory issues because it basically what their body is doing is like, you know, sending in new soldiers that are better, higher performing and more effective than the current population that we have. So I have a lot of people with like, Crohn’s, ulcerative colitis, those are I mean, they see some some impact. But, you know, inflammatory bowel issues seem to be prodigious amongst especially high performing individuals, because there’s a direct link between stress systemically and gut health. So those things can be effective, too. So there’s probably about six that I use pretty regularly.

Dr. Mike T Nelson

So that actually so the gland doesn’t completely disappear then right, it can still be stimulated with the peptide to kind of work again for Yeah, that simplistic view.

Dr. Ryan Greene

Yeah, yeah. And so you know, some people may not, you know, reinitiate, its production, but for some people, it does.

Dr. Mike T Nelson

Okay, cool. And the GLP one agonist, you were saying is the peptide version? Is that literally the same as a pharmaceutical version? Or is it just doing the same?

Dr. Ryan Greene

Same exact thing? Literally, it’s exactly the same.

Dr. Mike T Nelson

Exactly the same, Huh? Interesting.

Dr. Andy Galpin

Yeah, if you want to pull up some numbers on next and it this is actually relative, I could pull up that paper in the background. I’ll put it this way. You know, like we’re on the same page here. I should suppose we should have started it in terms of lifestyle is king. Whole Food nutritional factors like these are everything right? Like these are real systemic trade all that stuff. True.

And all of us are as anti diet in a pill as you could possibly imagine. Right? This is the first thing I’ve seen where you’re like, oh, shit, like we may have stumbled upon something that actually might work. And I have all the same concerns that Ryan has, like we need replication we need stuff but there’s a reason why a lot of people that I know that space have started using it with their general way lost population, especially the really obese ones. Like the power so here’s here’s basically like some numbers I got from this single study.

Two groups lifestyle, same one got placebo one got the treatment, right. You’re talking 2000 people in the study. Something like that, and they did 68 weeks. So there’s not like a six week trial, right? Like at this point. So is it alright? How many participants lost 5% out of 5% weight reduction, or more? Right? in the treatment group, about 1000 patients in a non treatment group about 200. So about a 5x increase in man who just lost 5% of body mass, the amount of the last 10%, about 800 versus 80. So we’re talking like a 10x. And then the other one 15% or more 600 people, versus 28. And so like in terms of the actual amount of weight loss, you’re talking about 15 kilos versus two, between the group so yeah,

Dr. Mike T Nelson

yeah, yeah, that’s very significant.

Dr. Andy Galpin

You can see why people got so Ultra excited about this, because it is something that Ryan maybe, actually, I don’t remember the dosage is, but it’s a weekly shot.

Dr. Ryan Greene

It’s a weekly shot. So the typical recommendation is like 1212 and a half units, the first week, we 24, then 25 units, then it bumps up to 50 units. The only downside I’ve had some people got a little aggressive and bumped up their dosage, because they were excited a little too quickly. And it can cause a little bit of diarrhea, some people get hypoglycemic. So it’s not, you know, completely devoid of potential adverse effect.

But it is effective. And, you know, again, like, in terms of people that are definitely, like, as Dr. Galpin said, like, my takeaway from the study is, yes, it’s effective. But it was also effective, because people were actually changing lifestyle for a year. Like, you know, I don’t know how many patients you guys work with, that can commit to anything for a year. And it’s not a lot, and most people don’t even stay a job in a job for a year. So that’s where the work needs to be better described and explained to patients in terms of like, this will work. But it works if you do these other things, and you cannot cut corners.

And that’s I think, you know, an analogy I was thinking before we jumped on here is like, think of it like golf, right? If you suck at golf, and your swing is terrible, it doesn’t matter if you have the best technology, you’re not going to hit the ball any further or any straighter. And that’s how we have to think about like peptides. Like if you’re not doing the base groundwork, these things are not going to contribute to the the efficacy and impact that you’re looking for, like, you have to have the foundational elements dialed in, in order for these things to be as effective as they can be.

And that’s the conversation I unfortunately have to have with a lot of people, which is like, just because you have money and you can pay for it doesn’t mean it’s going to cure all your ills. So that’s, that’s the other thing about peptides is like they are super effective when used appropriately in an environment that’s conducive to, you know, your your intended result, which typically includes some lifestyle modification as well.

Dr. Andy Galpin

Yeah, I don’t ever see myself asking someone to go on or looking for someone to prescribe anyone I work with some like lutein, like this, this is never gonna happen, right? From the general population. This is much more like in line with what they’re after. Um, but just in case people are interested. I don’t even have a clue. Do you have a rough idea of what like a month? Let’s say like a five or six month or whatever? What would that cost someone?

Dr. Ryan Greene

So yeah, like a vial right now, which is a three month supply is roughly like $400. So that’s yeah, that’s not bad at all. No, no, it’s not bad. Some of the peptides we’ll talk about maybe or are a little bit more expensive. But yeah, for the most part, I mean, I mean, if you’re gonna do the brand name, I know it’s 12 to 1300 plus, and insurance usually is not covering it. So it’s a significantly greater expense. You know, it’s almost 10x the cost

Dr. Andy Galpin

all things that you see, this has been one like, I think insurance has been jumped on this one pretty quickly.

Dr. Mike T Nelson

Yeah, you would think they would, right? It’s yeah, we’ll see.

Dr. Ryan Greene

Yeah.

Dr. Andy Galpin

That’s a conversation for a different podcast, and that may not happen but yeah, all right. Fair. Fair. Fair. Fair. Okay, so maybe we’ll hear is there any other ones? For general health? For like the only skip this part? Like if you’d like people to like your birth? No, that’s good. Go for it. Yeah, and a general ones like for the average person. Okay, they’re gonna commit they’re gonna work with you. They’re gonna work out a couple times a week they’re gonna eat better, but you want to just like give them some shit that was gonna boost the results a little bit semaglutide to clear one anything else.

Dr. Ryan Greene

That’s I mean, that’s right. For the most. For the average American like body composition. Obesity is a is a pretty common issue. I think Sermorelin is great in terms of not only muscle recovery, but also body composition improvement. The one downside was Sermorelin. Although it’s effective in terms of those two things I mentioned, there is a little bit of an issue in terms of hypoglycemia, associated with administration, meaning, when people take it, you’re producing insulin growth factor your insulin sensitivity is, is increasing, thus, people’s blood sugar tends to decrease.

And if you don’t take it right before you go to bed, some people develop a hypoglycemic state, which is essentially a low blood sugar. And unfortunately, people then run to their, their pantry and start that’s not going to contribute to the result that we’re looking for, which is usually a decrease in body fat. So I have had some patients that after a month, they’re like, how am I gaining weight? And I’m like, Well, you know, are you taking it the appropriate time? Like, yeah, but like, sometimes I get really hungry.

And the next thing you know, I’ve had a whole bag of chips, I’m like, well, then you know, Sermorelin may or may not be the best thing for you, especially if we can’t get past that or you can’t control yourself to to not not eat when that happens. So for the most part right now, I think the you know, the morale and family is great. And then most people have aches pains, you know, they’re they’re constantly dealing with injuries that they’ve you know, even though they’re not severe, they’ll little bumps and bruises that they’ve introduced through the weekend warrior syndrome that they have. So BPC 157 is one that for the most part, like pretty much everyone should be doing this.

Dr. Andy Galpin

Alright, cool. So let’s leave those ones and go to more of I want to talk more about kind of performance enhancement stuff. But before we get there, like maybe the injury was pretty cool, too. So let’s say somebody is going to go in for a procedure, even if it’s a small scope or something on their knee or ever worked on a big one. You’ve talked about PPC 157. If you’re not a professional athlete, you’re still good to go there. And I actually read I know a lot of surgeons who are now just making that kind of common practice. They’re just putting it directly and post surgery doing something differently. So can you talk a little one little bit more about BPC 57157? Again, what’s the kind of cost? What’s the risk? What’s your

Dr. Ryan Greene

yeah, relatively low risk, all things considered. Essentially, it’s just helping, you know, college and repair and tissue repair specifically of ligament and tendon. So, the administration is typically in the morning to an insulin syringe, you don’t even feel it, you’re doing it Monday through Friday, typically, I tell people, you know, two to three months is the minimum time that you want, you’re going to want to do it.

Dr. Mike T Nelson

So it doesn’t matter if they fix you in two weeks, told me

Dr. Ryan Greene

some people experience an impact pretty quickly. But yeah, it’s usually two to three months is kind of the timeline where you want to use it and then reflect back and say, hey, you know, how frequently Am I feeling inflammation? How much pain Am I feeling in the joints that initially I was using this to treat is a completely resolved as it reduced, you know, a certain percentage. So that’s, that’s typically what I tell people is if you’re going to do this commit to two or three months of use, and then we can gauge efficacy. And the cost per month is usually around 200 to $250 per month all in.

Dr. Mike T Nelson

So again, like,which is not honestly bad, if it saves, you know, some bad surgery, especially if you’re doing it in place of like some of the non invasive to test out first.

Dr. Ryan Greene

Yeah, I think that’s one thing to consider. And then to, you know, again, you have to look at the big picture, right. So there’s a really good book for people listening called the price we pay by Marty Macquarie, which talks about everything that has to do with costs and medicine, both from the hospital side, also from the patient side, people do not understand how much money they’re spending, or we’re losing in terms of doctor visits PT medications they’re taking regularly and what that accumulates over a long period of time.

So if you have the opportunity to try something that can help effectively heal, you know, these common musculoskeletal issues tendinopathies, inflammation, things like that. gut health issues, whatever, and you’re spending 700 bucks over a few months, and then you get years and years of higher level performance with you know, minimal issue. That makes more sense to me than paying you know, 50 to 100 bucks for anti inflammatory meds or pain meds or whatever that looks like or even over the counter stuff, in addition to accrued cost of doctor visits, physical therapy, insurance costs and things like that. So we’re close to the loss all that work.

Last year, yeah, yeah, like what’s the what’s the opportunity cost of not being able to play a sport that you love being able to play, you love playing, you know, into your 50s 60s and 70s? And that, that those things aren’t necessarily quantifiable, but it’s it’s a quality of life issue. So I think there’s two things you have to consider, like, you know, what are you willing to give up to potentially completely heal? And what does that what does that? What does that mean to you?

What’s that what cost is associated with that, and I, I can’t force people to think the way that I think but in my mind, you know, investing and doing it the right way, the first time will always save you money in the long term, versus trying to find shortcuts and cutting corners, I guarantee you’ll end up spending more money more time, trying to piecemeal things that are less efficacious.

So that’s kind of how I frame it for most people. And again, you know, reminding them that, if they’re dealing with issues that have to do with, you know, just degeneration of the body, like, you know, if you’re not sleeping, if you’re not cutting down on alcohol intake, if your diets still garbage, you know, again, these things aren’t going to be as effective as they could be. So you might as well give yourself 60 to 90 days to really dial it in. Because what’s the worst that can happen other than you completely change your life, and you have, you know, decades of higher quality living,

Dr. Andy Galpin

and you need to like PPC before the surgery.

Dr. Ryan Greene

So, essentially what we’re doing now, and I’m working with a group out of LA, we’re creating a program called surgery as a sport. And in brief, some of the work I did as a resident was was regarding this pathway called Eros and has enhanced recovery after surgery. Because what we found is people are showing up for elective procedures, and not understanding the physiologic and metabolic impact that a surgical procedure has on your body. So any brief, right, yeah, so being in a hospital terrible, terrible for recovery, terrible for your your, your HPA access, stress.

But even if you have to have an elective procedure, people need to understand the metabolic impact of tissue manipulation, surgery healing, it’s like running a marathon. And if I told you, hey, you’re gonna run a marathon this weekend, you’d be like, nope, like, I haven’t trained for it, I haven’t done the right preparation. But if you did, on the back end, you’d probably in complete disarray, your body’s gonna break down, you’ll feel terrible. So people understand that surgery is basically the same thing.

So if you know you have to have a procedure, and you are not preparing as though it were a race or an athletic performance, your outcomes may not be as effective, they may take longer. So a lot of practitioners in the group we’re working with is basically saying, Okay, if you have to have an elective orthopedic procedure, we’re not going to do it, unless you come to me get pre op labs done, optimize nutrition and make sure you’re getting enough protein, make sure you’re monitoring inflammation, potentially starting peptides prior to procedures so that you can, you know, have that process already in place. postoperatively, so that you’re healing both tissue and otherwise, is more effective and can be, you know, shortened potentially, so that you can have a better chance of a high level outcome, which is great for the patient, and also the practitioner, because practitioners are graded based on patient outcomes.

And if they’re showing up in a bad state, it reflects poorly on the practitioner, even if their skill and their their technique is top notch. They’re at the behest of with WHO ARE THEY operating on? And what are they doing on a daily basis. So there’s some interesting things that are happening in that space. And in terms of essentially treating surgery, like you were going to run a marathon or half marathon, but you have to think about it similarly. So in that case, Dr. Gap, and yes, I would say some people should think about starting prior to a procedure just to get that, you know, healing process going,

Dr. Andy Galpin

but you would probably be talking, like a few days or a couple of weeks before.

Dr. Ryan Greene

Because realistically, like if someone tears their ACL, they’re not going to want to wait six months, like, you know, get an optimization program really dialed in, we have to be reasonable with what patients are willing to do. So you know, usually we start four to six weeks in advance and just say, hey, like you want a great outcome from this procedure. I don’t think anyone goes in says, Yeah, I don’t want the best possible outcome. Well, if you want to do that, you need to dial in movements, sleep hormones, you know, supplementation diet. So yeah, it’s a it’s a pretty cool experiment that we’re running and hopefully it’s something that we can then expand to other practitioners across really interesting.

Dr. Andy Galpin

I know a lot of folks who are actually look that same same space and be like, Man, why are we not? Why do we not have pre surgery? Like it totally makes sense. Like, well, yeah, so for.

Dr. Ryan Greene

So for instance, right. I’ll just give you a brief example. So if you were to have a surgery, right typical protocol says don’t eat, you know, 1216 24 hours before a procedure, then you have your procedure lasts a couple hours, postoperatively you don’t really feel like eating, you’re coming off of anesthesia. So realistically, we’ve introduced a significant metabolic insult to your body. And you’ve also been in like a fasted state for like 24 hours, right? And then you’re might be nauseous, you may not be eating a lot, you may be on pain meds, your bowels aren’t moving. So a lot of people get, like terrible nutrition for a couple of days, you know, after a procedure, why would you expect that your body is all of a sudden going to be like, yeah, we’re going to opposite, you know, we’re gonna function at peak performance. But you haven’t been sleeping, you’ve been in pain, you haven’t really felt like eating, you showed up?

Dr. Andy Galpin

Because fasting is anabolic?

Dr. Ryan Greene

Yeah, sure. So, yeah. But like, a lot of these things that we’re doing on the medical side are somewhat archaic, and were introduced 100 years ago, and everyone’s like, well, that’s what we’ve been doing. So why would we think about it differently? And we’re seeing in Europe and other places, especially from the surgical side, they’re like, is it actually good that these people haven’t eaten in 18 hours before surgery? Is it good that we’re giving them pain meds, and not encouraging, you know, efficacious bowel function and real reawakening of the gut tissue after the surgery? So, in Europe, they’re a little bit more advanced than we are in the US. But we’re trying to usher in a new thought process in terms of what happens for people that do need procedures, how can peptides play a role? How can other lifestyle optimization practices take a role or play a role? So we’re moving in the right direction, but it’ll just take some time.

Dr. Mike T Nelson

And hospital food is just so nutritious, right?

Dr. Ryan Green

I think I saw a stat, like 40% of all hospitals have fast food locations, like on site. And that’s, that’s basically what people are, are able to, to order.

Dr. Andy Galpin

So I didn’t intend to go this route. But since we’re here, I feel like people listening would be like, What the hell? Do you have any best practices then that you’re willing to share of like, what what should they eat? Should they try to have as much protein as possible? Yeah, I’m sure they tried to get collagen in. Yeah.

Dr. Ryan Greene

So like, anything like that vitamin C, vitamin D are super important. caloric intake is important, you know, you essentially have to appreciate that your metabolic rate is going to increase like one and a half to two times its normal level after a procedure because the body is going to try to heal tissue. So if you’re not changing your caloric intake, protein, and collagen, obviously are super helpful for tissue recovery. Those are the two areas where I try to work with people the most, which is like understanding, okay, you know, how much do you normally?

What’s that quantity? And how much do we need to increase it to match what your body’s going to be asking for postoperatively from the supplement side, you know, vitamin C glutathione, tumeric, or curcumin, whatever you want to use. Vitamin D is very important for inflammation and tissue healing.

Dr. Galpin has been beating on that one for a while now in terms of vitamin DS role and inflammation. So those are the areas that I typically work in optimizing for people and then creating so creatine is another one that’s been recently pretty well elucidated in terms of its impact on muscle protein synthesis, muscle maintenance, even in elderly populations that aren’t moving a ton creatine looks like it’s, it’s pretty effective for almost everybody. So I try not to bury people in like supplementation and things that they have to do but yeah, like, it’s, I think those are pretty simple to administer and introduce,

Dr. Andy Galpin

what about like a greens drink green like that, like kind of us? Like?

Dr. Ryan Greene

Yeah, I try to get people in all honesty, to, to work on reestablishing healthy gut function. Because anytime you’re, you’re under anaesthetic, taking pain meds, which is inevitable for the most part, your gut function is going to decrease. And, you know, your gut is essentially one space for digestion and absorption. So if things aren’t moving, you’re not digesting well.

And two, it’s also excretion, right. So you want to get out the waste products that you don’t need, you don’t want them sitting in there, ruminating and stewing for the, you know, the potential re exposure of these things that you don’t need. So, green juice is like, okay, in terms of I understand, like the delivery of vitamins and nutrients, but realistically, we want to get people trying to reawaken gut activity as fast as possible. And the way you’re going to do that is reintroducing foods that, you know, are in their more natural state higher and fiber as long as they can tolerate it.

Dr. Andy Galpin

Lovely. Yeah. So then, maybe if you can eat we can venture down into like, peak performance stuff.

Dr. Ryan Greene

Sure. Sure. Sure. Sure.

Dr. Andy Galpin

Yeah, so Yeah, anything you want to add anything to you?

Dr. Ryan Greene

Yeah, so I think there’s a couple of peptides that are pretty interesting in terms of like the peak performance space like, obviously the ones we’ve talked about CGC BPC are helpful. There’s a couple that are coming into a little bit more awareness and understanding amongst practitioners and then hopefully patients that has to do with like cognitive function, immune function, neural regeneration, things similar to anti aging recovery like a pedal on.

I don’t know, if Dr. Galpin if you’ve ever heard of a pedal on but it’s basically like a pineal peptide that helps improve resilience. It’s an antioxidant. It’s been shown in some studies to help maintain telomere length, if you believe in terms of aging is actually just the degradation of your DNA. It helps with immune system function, prolactin levels, pancreatic function, so insulin sensitivity, blood sugar control. And some studies show that it may help with melatonin production, natural melatonin production, because it’s coming from the pineal gland.

So to help promote healthier, more efficacious sleep, especially as people get older, because we know the pineal gland decreases function as you age. And as part of that people, when they get older, they tend to sleep less. That’s one of the things that accelerates aging. So a pedal on is a pretty interesting one. It’s not inexpensive, it’s like 300 ish dollars per month. So it’s definitely one of the higher price peptides. And then the other one is C max SC, ma x, which it’s a, it’s an Adreno cortical tropic hormone. So basically, it’s kind of like supporting your HPA axis, hypothalamic pituitary adrenal axis.

So it’s helping manage stress, it’s helping immune function, a lot of people in the peptide space are using SeaMAX as a nasal nasally administered spray, because there is a correlation with these types of hormones in terms of neuronal protection, pain control, in terms of people that are dealing with chronic pain, because again, pain is literally just a signal that’s being interpreted by the brain. And if we have the ability to modulate, you know, the, the severity of these pain responses, sometimes that can be helpful.

So those are pretty interesting ones, piddle ons and injections C max can be an injection, it can also be administered nasally, because it gets sent to the venous plexus in the nose, which then circulates through your your cerebral circulation. So those are pretty interesting ones in terms of like, quote, unquote, peak performance. And there’s another peptide, and I just want to make sure that I have this, this right here, so I’m gonna pull it up, but it’s called a muscle growth factor, which you know, as kind of the name would indicate muscle growth factor helps with muscle recovery. So it’s a variant of IGF one.

And it’s very specific for facilitating repair and hypertrophy, specifically musculoskeletal tissue, so it’s already expressed in microsites in terms of repair muscle cells, facilitating growth of new cells. So it’s, it’s very similar to an IGF one response. But it does, its halflife is is very short, and it does oxidize pretty quickly. So that’s one of those things where if you’re getting mgf, from a peptide provider, like you want to make sure it’s fresh, that it hasn’t been stored for months on a shelf. Because if you’re getting it, you know, after months after its its creation, or its synthesis ation synthesis, I don’t know how what is that word synthesizing information synthesis. It may or magnetization. I don’t know if that’s a word, we may have just made one up there. So sorry. So those are a couple mgf SeaMAX, piddle on and then there’s also like ghrp, six and ghrp. To which those stands for growth hormone growth hormone releasing peptide number six and ghrp to their growth hormone analogs that cause your body to produce more more growth hormone, they’re usually paired with a CJC or an EPA Morlan or a Sermorelin.

But especially for people who have issues with tissue healing ligament healing, you know, for some people like scar formation can can be improved, especially if you’re taking these ghrp six and ghrp Two. Those are all things to think about. So there’s Those are a couple for for peak performance that I think are reasonable, especially for people that are looking for more longevity. You may want to think about, you know, a pedal on or a C max, something like that.

Dr. Andy Galpin

What’s the status make that muscle one?

Dr. Ryan Greene

I’m not heard of that one. mgf? Yeah,

Dr. Andy Galpin

yeah. No human trials? Lots.

Dr. Ryan Greene

It’s more, it’s more animal stuff. The tough part with mgf is it breaks down very, very quickly. So, yeah, realistically, like people are making it and using it right away. So what’s the applicability from the human standpoint, like, if you’re, you know, you’re getting it. And it’s, for instance, like a lot of peptide manufacturers will make something and they’ll freeze it, and then they’ll thawed and send it to you.

And you need to use it pretty quickly. If the, the practice controls are not as efficacious as they should be in terms of quality control, you may be getting something that is essentially inert, and it’s not really going to impact. Sometimes I use peptides from this group in South Carolina, Craig Conover is a physician that’s been using peptides for a long period of time he worked with on it and Aubrey Marcus and that group.

And they work with a group actually called peptide sciences, who makes all their peptides, and they’re pretty good about making freezing, thawing, ascending and using right away. So yeah, that’s, that’s where I get most of my mgf. But yeah, it’s definitely on the newer side of the peptide.

Dr. Andy Galpin

You’ve had good experience with us so far, what would you say? Yes, most benefit for it? Yeah, what’s the biggest thing we’ve seen?

Dr. Ryan Greene

Recovery and performance, right? So the reason it’s illegal in pro sports is you can, if you’re using it consistently, you can basically get up day after day and hit two days and not be as debilitated or sore as you would if you were not using something like this. So in terms of training volume, it can definitely increase your capacity for training volume. Is that necessarily a good thing? Like, is it too much?

You know, like Dr. Galpin came up and spoke to my team, it was like, you know, there is a point of diminishing returns in terms of how much your training how you’re training. So for some people, they assume like if they’re doing it, and they feel great, they can work out three, four or five hours a day, like, is it actually good for you? Maybe maybe not.

But I think for people that typically, you know, aren’t as consistent and they hit, you know, hard workouts, and then they have a couple of days of decreased activity because they’re sore. This allows for the opportunity to continue in terms of training intensity and volume a little bit more regular, which can will then lead to, you know, muscle growth, greater strength, you know, better performance.

Dr. Andy Galpin

Any potential concerns that one that?

Dr. Ryan Greene

Not really, yeah, no, not really, again, like, it’s it’s a, it’s a compound your body’s naturally producing at the musculoskeletal level to help with tissue healing and growth of new muscle neurons. So, you know, again, I think over time, as we gather more data, I don’t suspect that it will contribute to tumor growth. But it’s something that if you’re going to do peptides, you want to monitor with a physician by checking your bloodwork regularly, and if something doesn’t feel right, obviously, being able to consult with somebody to try and troubleshoot that I have seen patients not on on my watch have developed, you know, malignant neoplasm, secondary to long term use of growth hormone, it just wasn’t monitored. Well. And that’s unfortunate, because then you have to go down the road of treatment for that, which is is not easy.

Dr. Andy Galpin

Yeah, but this sort of No, no, of growth hormone for a while, though, like you. We have we know that one’s coming.

Dr. Ryan Greene

Yeah, yeah, for sure. And it’s, it’s one of those things where you don’t think about it until it happens. And you’re like, Shit, I probably shouldn’t have been doing this. But if people can get it, and they have the money, they’re going to do it. So it’s, you need a voice of reason, which is where a physician who can guide you on utilization is helpful actually pays attention to you over time. Yeah, we try.

Dr. Mike T Nelson

Is that one specific to skeletal muscle, not cardiac or other types of muscles and skeletal muscle only correct?

Dr. Ryan Greene

That’s correct.

Dr. Andy Galpin

Yes. Nice. And that doesn’t need to be local injection.

Dr. Ryan Greene

no systemic so you can just put it in belly fat. Yeah, I mean, that’s the other thing too, right. And like, that’s, it’s the same conversation I have to have with people that are looking to do PRP stem cell stuff like that is like, if I’m going to do PRP on a patient, and I know it’s going into articular, meaning in a joint, I have reasonable belief, it’s going to stay there, it’s not going to seep out and then go somewhere else.

But with stem cells these days, man, like there’s clinics everywhere. It’s like if you do an IV of stem cells, like we guarantee it’s gonna help with your back pain or your muscle recovery. Like, you have no idea where the cells are gonna go once they’re in your system, they’re gonna go wherever they get called. So that’s where peptides can be a little bit more beneficial versus like a growth hormone meaning like, growth hormone synthetic.

Commercial grade is going to make anything that needs to heal, heal, that could be skeletal muscle, that could be heart, it could be tumor could be bone. Peptides tend to have more specific localization to certain tissue types. Yeah, whether that’s gut, brain, skeletal muscle. So I think the safety profile is a little bit better. But again, if you’re doing these things for 1015 years at a time, like we just don’t have the data to understand like, what’s, what are the potential ramifications?

Dr. Andy Galpin

Well, that one in particular, we don’t, but we generally know, it’s probably not gonna be good idea.

Dr. Ryan Greene

Probably not. So yeah, I try to I try to get people on for three to six months and then have them taper off for a while.

Dr. Andy Galpin

So yeah, yeah, what I’m asking is Barbell Shrug. But I always think it’s kind of interesting. For the other ones. Are there any one set that other people are really, really excited about? They use a lot that you just like, I just don’t think this one’s very good. You know, you talked on the Barbell Shrug about somebody just continued. Why? Because once they’re popular, but you just don’t, haven’t seen work well, for your patients. To?

Dr. Ryan Greene

I mean, to be honest, not really. I mean, most people that are coming to me who have any knowledge of peptides whatsoever are usually talking about the common ones that I kind of spoke of before. The only variation I’ve experienced is kind of the localization of use of certain things such as localized localize PPC, one thing, I guess that I would say is I have a fair number of people that have found BPC oral tablets that they can get for 60 or $90 mail order.

We know almost unequivocally anything that’s PPC that’s going in your mouth is not going to get into your systemic circulation. It’s going to stick with your gut because that’s where it was originally identified and and acknowledged as its place of, of initial physiologic use. So like when when people do that, like I’m on a BPC oral supplement and like, yeah, it’s probably not doing anything for you from a tissue healing standpoint. So if you’re going to do PPC, you should do it systemically administered.

But other than that,let’s think of tissue healing unless you’re trying to heal you’re trying to heal gut. Yeah, for the most part. peptides are so relatively new in the space. The only thing that people really talk about or like this for morons IP or Morgellons, BP sound thymus, and occasionally, most people don’t even know what’s available. And that’s where, you know, I have the opportunity to educate them on some other things that may be helpful for them. But for the most part, it’s like such a novel space that there’s really not a lot people are, are just seeking out and ordering from, you know, a Russian lab and then I got you know, clenbuterol from Russia.

Dr. Andy Galpin

That’s outside either. Yeah, cuz there’s, like you said, the beginning there’s peptides or not, it’s this sort of these kind of applications are new. But, yeah, insulin, we can give you 100 examples of things that people turn up for, like, oh, shit, oh, no. So it was a peptide. Yeah. Right. Yeah, it’s been around for a truckload of years. So these are not like, I think it’s one of the reasons why the safety profile is generally pretty good. And it’s actually yeah, because they, they borrow for a long ass time. It’s just like, creating new ones and trying to make it more relevant. Um, any other use of peptides? Besides, we talked about fat loss, like talking about muscle recovery regeneration was the any, like you talked a little bit about kind of quickly, maybe some sleep aid stuff and

Dr. Ryan Greene

yeah, inflammation, cognitive function. Sleep. That’s where like the C max may be helpful. You mentioned sleep. I mean, the the longevity one like the piddle on is an interesting one and in like the sense of like, potentially reducing DNA degradation, antioxidant impact. There are a couple zinc related peptides and copper related peptides.

Again, I mentioned one called G H k dash CU, which is to use the periodic table for copper. That has some potential benefit for inflammation, muscle pain, nerve pain, potentially muscle recovery. There’s a couple of zinc peptides that have been hypothesized when they’re, they’re usually there. It’s like a cream for the scalp can help with potential hair growth for hair loss. I haven’t seen a lot of that vaccine people that have used that. So I don’t really toss that out first, but it’s out there. So some people are using it. But for the most part, I try to keep my my peptide protocols relatively tight with the things that I know are effective. And again, only try to introduce them. When I know that someone is also doing the other components that’s going to optimize basic health and wellness,

Dr. Andy Galpin

the vast majority of these are going to be injections. Right. Like you mentioned, one is a cream that unless Yeah, PPC, right. But yeah, injections

Dr. Ryan Greene

for the most part, Conover has a couple transdermal patches, where you can get a couple of their peptide formulations, administered transdermal a for people that are completely adverse to injections. But you’re looking like $100, a patch, and you need to use a patch a day again for months. So like, I tell people, like let me teach you how to do this injection, I guarantee after one, you’ll be okay with it. And then it’ll also save you a significant amount of money. So there are a couple other options, there’s some sublingual sprays that may be helpful. I’m just not a huge proponent of things that have to be orally administered, because you have no idea how it’s going to be processed, digested or absorbed. So if you’re going to do something, if you’re going to spend the money on something, in my opinion, it needs to be subcutaneous intramuscular or intravenous if you really want to, to gain maximum impact.

Dr. Mike T Nelson

And most of them the injection is just a small insulin needle, right? So for weirdos like me that hate needles, it’s, it’s not like needles.

Dr. Ryan Greene

It’s three sixteenths of an inch.

Dr. Andy Galpin

Yeah, you don’t even feel it. It’s what like 30 gauge or something or smaller 31 gauge,

Dr. Ryan Greene

it’s a very, very small, very

Dr. Andy Galpin

tiny mount, you have to be a little bit of a chemists yourself kind of got to fill it yourself and inject the ACE really? Yeah.

Dr. Ryan Greene

I mean, it’s I think people think it’s cool. Like they think they’re, they’re doing something cool. You know, they’re drawing syringes injecting themselves. So yeah, it’s pretty cool.

Dr. Andy Galpin

Oh, anything else that like you thought about, or think it’s interesting. And

Dr. Ryan Greene

I think it’s just one of those things where these are absolutely. supplements that are effective in the right individual who’s doing the right thing. So it is not a cure all. It’s not a panacea for your bad behavior. So if you are not participating, or at least trying to improve other aspects of health that have contributed to the conditions that you’re trying to treat, it’s not going to change a lot, right?

So if you don’t change your diet, you don’t change your sleep habits, movement, hydration, all those different things like these are not going to cure all of your ills. If they were we would have known about them a long time ago. So I think they are most effective in people that are also engaging in improving lifestyle behaviors. And if you can do both things, you will see a significant positive result. And if you don’t, you may get a little improvement.

Dr. Andy Galpin

Actually, my sort of last question here that I want to ask lesson forgot. Most of these things have a direct effect on a cause. So you take PPC, the tissue is going to heal correctly, they’re not actually solving it, they’re not enhancing physiology, physiological ability, or they’re just they’re just kind of directly causing a solution to a problem. So are you aware of any of that outside of growth hormone, of course, that are actually going to enhance physiological state like, like it would if you had a micronutrient, like if your carpet was super low, or zinc was super low, and you improve that status, you’ll see this is like well rounded improvement in hormone profile and sleep and recovery and growth, like, are they fixing anything? Are they just kind of like, just filling that hole that’s there?

Dr. Ryan Greene

I think they’re supporting. I think they’re supporting physiologic function in the process, they’re supporting physiologic function within the scope of other lifestyle improvement. So I think it’s not a long term solution. So for people that may have inflammation, tissue healing issues, potentially cognitive dysfunction, people with concussion, traumatic brain injury, C max, things like that can help support with neuro inflammation and regeneration. But again, like none of these things are, are meant for long term use.

So I think if you’re if you’re not removing the variables that are contributing to your detriment, then you’re going to probably have to use these things for a longer period of time. But yeah, so it’s nothing like, you know, a vitamin D deficiency or something like that, where it’s going to hopefully correct and then your body, you know, maintain some sort of, you know, ineffective hormone production. Yeah, or like it An iron deficiency where you have low hemoglobin and you take iron and all of a sudden your body produces more hemoglobin, then you’re good. Like it’s nothing like that. So they are absolutely an adjunct component that can can help facilitate more efficacious recovery or whatever result you want. But it’s nothing that’s going to change physiology.

Dr. Andy Galpin

Yeah. Okay. My true last question, I forgot about this great. Anything, any contraindications? Not necessarily, like with disease patients, there’s always that but just in terms of like, Oh, if you start taking these peptides, you don’t want to also take creatine, or you don’t want to also take not magnesium or like any other stuff, it’s like you got to take care of,

Dr. Ryan Greene

nope, nope, nope, there’s nothing that’s been so significantly notable that it’s, you know, basically be become applicable across the board. So, for the most part, these things, you know, kind of do what they’re meant to do. And you can introduce them in addition to other things that you’re trying to, to improve. But yeah, there’s no significant contraindication. It’s not like taking antibiotics and not drinking alcohol, because you’re going to decrease the efficacy of the antibiotic. It’s nothing like that.

Dr. Mike T Nelson

Cool. That’s awesome. My My only last question is not necessarily a peptide, but more of a curiosity. Should you use, like as a supplement and our Nn? And if you do, yeah, orally or by IV, because I know if I don’t ask, there’s gonna be tons of people are gonna email me like, why didn’t you ask him? It’s not a peptide. But yeah.

Dr. Ryan Greene

So I personally use true nitrogen, which is nicotine on either either side? Yeah. Has it helped me? I don’t, I don’t know. To be honest, I kind of just take it because I get it sent to me and it’s not harming me.

Dr. Andy Galpin

I have seen patients where we’ve administered any D intravenously notice. And inflammation I did direct. Yeah. But again, that’s not a comfortable process. And it’s also very costly. So I am not a huge proponent of anything that’s administered orally, I just don’t think we have the understanding in terms of is it really being converted as it being digested, absorbed, processed appropriately, once it gets through the liver?

I think in animal studies there, there’s reasonable belief that it might but again, like you’re looking at a population that’s in you know, in an animal model that’s pretty controlled, and it’s pretty regulated. Humans are a completely different beast. Pun intended. So yeah, I’m not a huge fan of those things. I have noticed some people appreciate some benefit from like, transdermal NAD patches, because it’s a little less uncomfortable than an NAD IV. But again, cost is a factor there. So I’m not a huge NAD guy, unless you’re doing it intravenously.

Dr. Mike T Nelson

And intravenously, would you be looking more for potentially after TMI, or TBI or

Dr. Ryan Greene

GBI general people with chronic inflammation, chronic pain issues associated with addiction? Yeah, things like that. So that’s where I’ve seen it more, more beneficial. But again, it’s it’s not comfortable. And it’s also quite costly.

Dr. Mike T Nelson

So and what is about an average cost for like one session? I have a revised $500. No idea what it is that people listening.

Dr. Ryan Greene

So yeah, like five, five to $700. Usually, per treatment.

Dr. Mike T Nelson

Yeah, that’s what a 350 was a cheapest 750. That was per per session, so to speak. Yeah. Yeah, that’s all right. Well, awesome. Well, thank you guys so much for all your time. I really appreciate it. Thank you, Andy, for all the great questions. So we’ll start with Ryan first, where can people find out more about you? Because you said you do this as telemedicine now, too. So people don’t necessarily have to be in California to work with you. Correct? Sure.

Dr. Ryan Greene

Yeah. So the easiest way to find me is Instagram, Dr. Underscore green with an E at the end underscore do Doctor underscore green, underscore do our facility websites, Monarch Weibo, W E. H o.com. So those are the two best ways to reach me. And from there, I’m pretty responsive and we can set up consultations and things like that.

Dr. Mike T Nelson

Awesome. Dr. Andy Galpin. If people want to find you or maybe you just want to stay hidden and they should just follow your educational stuff.

Dr. Andy Galpin

Just recently, like I didn’t want to plug plug, plug away for himself. Actually. He mentioned this but i The the approach that Mark is taking I think is fantastic. I think that represents the best blend of scientific best practices while also trying to push the forefront, right? It is not just workout neat. Like we know that’s true. It’s also not just here’s your $1,000 IV, that’s gonna reverse you’re killing your life. Right?

So it is, it’s a great model. Having been in their facility, a lot of times it’s is like they push the training hard, like their personal lifestyle stuff, the checkpoints very, very hard. And it’s not just lip service in terms of him saying, like, Hey, you gotta do something productive lifestyle, that’s a core of their practice. And this stuff just gets the attention and gets a lot of people in the door. But that is really what they’re going after.

Dr. Ryan Greene

So if you are in you guys are in, of course, our West Hollywood and then we have Brentwood opening in the summer. So we’ll get east side of LA and west side of LA and then beyond.

Dr. Andy Galpin

And then your telehealth stuff say that they can jab you in but I’d say don’t reach out to Brian, if you’re just gonna reach out to him asking if you can order VPC, whatever. That’s not that that’s not the model he uses? Do you really want to make a change? Great. You can lead you through that. But this is not your guy who’s going to sell everyone who wants a GH? No. No. Yeah. He’s got a very large insurance policy behind him. But still.

Dr. Ryan Greene

Yeah, I practice. I practice what I preach Long story short, if you’re not going to do the simple things, like I’m not going to waste your time money. Doesn’t look good on me. It doesn’t look good on you. So I’m not going to waste anyone’s time. Yep. I didn’t want anyone kind of walking behind the scenes being like, Okay, I think what they’re saying is this guy will No, no, no, I just call him. No, that’s awesome. I appreciate your audience. That’s not what you do.

Dr. Andy Galpin

That’s perfect. Appreciate it.. So you can find me everywhere. Instagram, Twitter, all that stuff.

Dr. Mike T Nelson

Cool. Awesome. Well, thank you guys both again, for all your time today. I really appreciate it. And I would encourage everyone to check out both of you for all the great stuff that he put out. Thanks, again, really appreciate it. Appreciate it.

Dr. Mike T Nelson

Thank you so much for listening to this podcast, as always, really, really appreciate it. If you want to help us out, as you’ve noticed, so far to date, don’t take any other sponsors or outside ads. I’ve had a few requests. Now in so far, I’ve turned them all down. I’m not saying that I’ll never do this. But right now, the only sponsors I have are programs that I’ve created myself for for things that I do. So not against any other sponsorship. But if I ever did, one would have to be a really good fit. So if you want to help us out in the meantime, you can get on the newsletter list via physiologicflexibility.com.

All the information about the course there. The main website with everything is Mike t nelson.com. If you liked this episode, give us a review even a short few sentences makes a huge difference with the old iTunes and podcast algorithms, subscribe to it and send it to someone who is looking for information about peptides. So one of the things I want to do with this podcast is have sort of their constant free reference. So if you have a buddy or friend who is like, Hey, what are these weird peptide things, and you can send them this episode. And if they want to go down that route, or discuss the pros and cons, I’d highly recommend that they contact an expert like Dr. Ryan green.

And the goal is to have high quality references that are free for you. So any comments, place them below in your favorite iTunes or podcast player. Thank you so much for listening. I really, really appreciate it. Any feedback for the show? Let me know. We will talk to you all next week. Big huge thank you to Dr. Ryan green for taking time out of his day. Be sure to check out his information there.

And like I said, if you are looking at using peptides, I would highly recommend you get in touch with him or at least another physician who is up to date in that space. And they are out there but they’re really hard to find. For great educational material. Check out Dr. Andy Galpin. He’s got wonderful stuff. Also for free on his YouTube Instagram everywhere else. Thank you so much. I will talk to you next week.