Peptides in Practice - Beyond the Hype

Today we are going to talk about one of the most exciting topics that I think is available in functional integrative medicine right now, and that is peptides.

BEYOND TREATING SYMPTOMS - STIMULATING ROOT CAUSE WITH EFFECT

And I feel it's misunderstood. Maybe I underdosed, underutilized. A lot of docs don't know how to use them. But we're going to talk about peptides in clinical practice and we're going to go beyond the hype and really talk about which ones are good, how they're used, and I'm going to break this into sections. So for our next podcast we'll do some more peptides. So we'll start with some of the basic ones that I use on a regular basis and then we'll start to move towards other ones that I don't maybe use as frequently but are good adjuncts and what we call life jevity in our world, in Dr. Lori world to talk about extending lifespan and health span so that you feel better. And yeah, so we're going to break this up and let's just kind of dive right into it. You might have seen peptides pop up on wellness blogs, athletic circles, maybe even social media with claims that they're miracle cure for everything from weight loss to anti aging. But as with most things in medicine, the truth probably lies somewhere between the hype and the hard data. So today we're going to go behind the scenes of some of those peptides and talk about them maybe not as magic bullets, but as powerful tools that can help with healing, recovery hormone, hormone balance, and longevity and lifegevity when used on the right person with the right timing and the right monitoring. So let's talk a little bit about that and what that looks like. So let's talk about what peptides are. And the simple definition of peptides is they're amino acids. They're small chains of amino acids that are basically small pieces of protein. They're signaling molecules. So think about them as little communicators or text messages in our cells and our tissues and to our hormones that act and help to restore normal physiology. So they're actually like little nudges. Think about them as kind of little stimulatory effects that are trying to restore or amplify a signal that might be deficient with aging or illness or hormonal decline, getting sick, having chronic bugs, that kind of thing. And it can trigger a cascade anywhere on the cell surface inside the nucleus. It can regulate gene expression. So it can turn on and off genes that might be working defectively or that are maybe over exaggerated or over-express. It can work on enzymes or other hormone releasing effects. So really they're natural. Think about them as the mimicking pieces of hormones or fragments of protein that have shorter half lives than our hormones and are much more targeted. So very, very specific in how they work.

THE MOST COMMONLY USED PEPTIDES:

HGH STIMULATORS: IPAMORELIN & TESAMORELIN

So let's break down some of the peptides that I find most clinically relevant or useful in my practice. And the first two that I love are growth hormones. Hormone secretagogues. That means in English is something that stimulates secretion. And for the growth hormone we all know, or a lot of us know, HGH.  HGH is a growth hormone which means it's going to lean you out, it's going to help with sleep and it's going to help with metabolism. It's also going to help with cortisol regulation.

The first one we're going to talk about is Ipamorelin. They all end in orelin. I like to tell my patients that means basically a growth hormone stimulator. And this one is an agonist or it stimulates GH and ghrelin. So ghrelin, growth hormone stimulation receptor hormone, GHSR1 in the pituitary, which is actually up in the brain.

This triggers a pulsatile release of growth hormone. So what does that mean? Over and over again you're gonna get these little pulses of growth hormone and downstream that's going to increase something called IGF-1, which is going to help with fat loss, lean mass promotion and tissue repair. So what are we going to get out of this you're going to get a lower body fat, you're going to get actually healing mechanisms and you're going to start to better sleep. So unlike some of the older peptides like GHRP-6 which is another one that it basically they used to increase cortisol and acth which is another hormone that regulates water and your cortisol levels. So they would make you hungrier and sometimes even gain a little bit of weight. Prolactin is another one that we used to make you increase. But now these are cleaner. This epamorin is a much cleaner profile. It supports sleep quality recovery, like I said, fat loss and leaning out, getting some lean muscle. And it's safer than your growth hormone injection. So you're not going to have that issue with increasing too much growth hormone or actually like we talked about prolactin or ACTH or cortisol increase.

So great for fatigue, great for menopause, perimenopause, andropause issues, recovery. And just think about this hormone or this peptide for helping instead of sometimes or an adjunct to testosterone, other hormone replacement therapy. Okay. It's sister product called Tesamorelin. Again it ends in that orelin Tesamorelin is a synthetic analog growth hormone releasing hormone ghrh, which actually binds to. Yep. GHRH receptor in the pituitary, giving you a more sustained stimulation of growth hormone instead of that pulse. So you're actually going to get a longer sustained release unlike the Tesamorelin. What makes that so great? It boosts breakdown of fat, what you call lipolysis and IGF1 signaling which works stronger on adipose tissue on the belly. So your visceral adipose reduction so that belly fat goes down much more easily with Tesamorelin. Stubborn belly fat metabolic syndrome, meaning insulin resistance. It works great for this. It's actually FDA approved for HIV lipodystrophy, which means essentially what it sounds like is fat in the wrong places. And it actually will show, like I said, a reduction in belly fat specifically, but also your cholesterol profiles. And here's the cool thing, it's actually has emerging data with cognitive function.

So actually helping with cognitive decline and memory. So that's a really cool one. What is great about these two, they're using conjunction a lot. They're put together in the same vial. So you get a little bit of both. So you get the benefits of both peptide and they are done five nights a week or five days a week with two days off, usually three months on, three months off or three months on, one month off sometimes depending on the patient, and they're nudging your body to restore its own natural rhythm.

DECREASE INFLAMMATION & IMMUNE BOOSTERS: BPC-157 & TB-500

So we use these in isolation quite frequently, or we use them in combination with these next two that I'm going to talk about as well. The next two. One is a very popular one called BPC157.

This BPC is actually your body protection compound. It is derived from a gastric peptide. It naturally protects the gut. So again, it's. It's nothing that is not already in our system, but it supports gut healing and tendon and ligament repair. So not only do we use it orally, like some of our products that are on our website, but we also use it as an injectable for tendon and ligament repair and injury.

So oftentimes you're going to see people use this with inflammatory bowel disease, other gastric disorders, Crohn's, celiac food sensitivities, or just a lot of heartburn and things like that. Right. And gut issues. But you'll also see it a lot for post healing and recovery from surgeries. Musculoskeletal knees, joints, shoulders. We use it a lot for our shoulder injuries, a rotator cuff tear, a knee injury, a back pain or back injury, things like that. Why does it work? Promotes angiogenesis, which means blood vessel growth via what we call veg F, which is a growth factor to help blood vessels grow up, regulates nitrous oxide, so dilates those blood vessels, improving that microcirculation. So you're going to again get that good blood flow. And then last but not least, it's going to stimulate growth hormone expression in the tendons and ligaments. So right at that tendon ligament interface, there's actually a little receptor for growth hormone. If you upright regulate that receptor, your growth hormone is going to actually hit that more effectively. So and it suppresses our bad, what we call cytokines or signaling molecules such as TNF, Alpha and Interleukin-6. So we have this great synergy with actually the Ipamorelin and Tesamorelin, because it actually modulates and increases those growth hormone receptors. So a lot of the times we will see this used with the growth hormone stimulators, which we're going to talk about in a minute. It also helps with doing both tendons, ligaments and bone. So you can see this improve bone repair, especially with enhancing the time or decreasing the time for fracture healing or difficult to heal fractures. We use it for that as well. Also injected five nights or five days a week. And it can be done in the subcutaneously, meaning tiny little shots in the belly, side of the buttocks. And we also will cycle this depending on what we're using it for. If it's for gut or a long term injury, we'll use it longer. If it's for just right post operatively, sometimes we'll use it in short stints of two to four weeks. Okay, let's talk about a partner in crime with it a lot of the times, which is called TB500. TB500 is a fragment of what we call thymosin beta-4, which is a naturally occurring thymic peptide. And it works with BPC-157 really, really well. So for stubborn injuries after surgery, to accelerate that Recovery, we mix TB-500 and BPC-157. They come together a lot of times in the same vial as well. And they promote again angiogenesis, that word again, that blood vessel growth, tissue repair and anti inflammatory effect.

And they do that by working on something called the actin cytoskeleton, which is the little parts of our muscle that actually will move back and forth. And actin and myosin actually is what makes the muscle move. And we enhance cell migration and repair cells, cells that actually create the repair to that actin cytoskeleton. So it's going to call in the troops over to that muscle. It's going to actually stimulate that blood vessel growth like I said, and still decrease what we call those bad inflammatory infiltration cells in those damaged tissues.

So you're going to actually get a much more rapid wound healing effect when you combine this TB-500 with the BPC-157.

It actually we use it a lot with cardiac issues. So if it's cardiac tissue damage, MI CHF, we also see it with cardiac surgery. We see this used and corneal repair. So eye mucous membrane repair. What do we do? We synergistically use this, like I said, with the BPC-157. Again, think about that athlete, that tendon rupture, that rotator cuff tear. I just sent this out to a friend in Texas also for a tendon rupture. So we want to think about this with acute and chronic injury. All right, again, five nights a week or five days a week. All right, let's talk about these last two.

MITOCHONDRIAL HEALTH & CELLULAR ENERGY: MOTS-C

One is very different. It's called MOTS-C.  MOTS-C and it's a mitochondrial and metabolic repair peptide. It's actually in our body naturally encoded by mitochondrial DNA and it activates our cellular energy pathway. So Our AMPK pathway -- what we do to take glucose into the cell and use fatty acids for energy.

And by doing by affect pathway, we're going to actually lose weight, we're going to improve our glucose metabolism, our exercise tolerance and exercise performance, because we're going to affect our ATP production, which is our cellular energy, and how our mitochondria are able to make that energy.

So we're working on protecting our mitochondria, the powerhouses of our cell, against what we call metabolic stress. Anything that stresses out the metabolism by helping it to get rid of toxic exposures and regenerate. We're helping with what we call mitochondria, mitochondrial biogenesis, which really just means the repair and re-synthesis of the mitochondria organelles inside the cell. By helping with that particular organelle, we are supporting energy production, fat metabolism, especially in those midlife andropause menopause patients struggling with fatigue primarily and weight. Fatigue is key because with fatigue we need to work on our actual energy productions of our cell, which is through that mitochondrial and ATP. I use this a lot in my bug, chronic bug patients, my chronic inflammation patients, my chronic autoimmune patients. Anyone that has a chronic illness that we've been working towards or detoxing them, I will cycle MOTS-C. MOTS-C is cycled usually about three times a year. And these are pulse dose, so they're not done like every day like the other ones. Usually you'll do them for about two weeks and then you're done and then you do it again in about four months or so. So again, this is for your stubborn patients or your chronically ill or chronically detoxing patients, or just for longevity. It's great for overall what we call our Lifegevity Program, just to kind of keep the mitochondria on the up and up, as healthy as they can be. 

SEXUAL DYSFUNCTION: BRAIN HELP FOR LIBIDO - PT-141

Okay, all right, last but not least, let's talk about a really interesting one. It is PT-141. And PT-141 is for sexual health and quality of life life. But it doesn't work on your sex hormones. That's why I love it. It actually works through the melanocortin receptors in the brain, in the central nervous system, and so not on your hormones. It modulates your brain circuits involved in arousal and desire. So it's independent of actually treating sex hormones. Someone that maybe doesn't want testosterone, someone that doesn't tolerate it well, someone that's on testosterone, that maybe never gets better, they never feel like their Libido goes up.

This happens in a lot of women because a lot of women, their brain is a big part of sexual desire disorder. So it works for men as well. It comes in a nasal spray and an injectable. I tend to like the nasal spray a little bit better for men and the injectable a little bit better for women. But they both can be used pretty effectively and usually they're taken about 30 to 40 minutes before sex. The injections can be done on a regular basis, which is why I like them a little bit better for women because it does take some time and some prompting in the brain for women's arousal and desire to work a little bit more than men. So I do like the injectable a little bit more for women. It's particularly our postmenopausal women. And like I said, it works on the neurologic pathways. So very different than your Viagras and your cialyses of the world too, which work on dilating blood vessels and very different than that testosterone or hormonal pathway. It's actually FDA approved for postmenopausal female hypoactive sexual desire disorder. It's a mouthful, so I wouldn't expect to get it covered by your insurance or anything at the pharmacy. But I would say that for some people that really that testosterone either isn't enough or they're getting there once they have sex, but they don't have the desire to have sex. This is a really, really great adjunct, not just for desire, but for confidence and relationship and connection and everything else. So I love PT-141. I'm using it more and more in my practice especially I'm telling you for my women who really they're on pellets or they're on hormone replacement. Maybe it was good in the beginning and then they start to kind of not get that same effect. I'm using PT-141 or for men that can't have testosterone, prostate cancer. They're still in their five year post prostate cancer phase. We use a decent amount of PT-141 for them as well. So just to keep that in the back of your head, I do love that for men and women. And actually all of these peptides I use in men and women, I would say that the MOTS-C is the most ubiquitous. You can use it for anyone one at any time because it really does have the most longevity enhancing protocols as far as our Lifegevity Program. But I use Ipamorelin and Tesamorelin quite frequently together.  BPC and TB-500 almost always together. And those two combinations I will use as like basically two peptides in combo with all four ingredients almost all the time for my weight loss patients.

NOT QUICK FIXES:  CREATE REAL PATHWAY CHANGE

So that's our good starter pack to peptides, guys. Just know that they're not quick fixes.

They're adjuncts to lifestyle, nutrition, sleep, stress management, hormone balance, and that they really need to be prescribed from a good physician that understands these from a trusted compounding pharmacy. Especially with the new regulations, we like to do them in longer batches. I really don't think one month at a time is enough. So we sell combo packs where you can mix and match these as 10 packs, which I strongly recommend because then you're at least getting a couple months worth of these therapies. So I encourage you to do these bundles, these 10 packs, and really getting them and making sure you can see certificates of authenticity on all of these products. They're available from us. So the takeaway is that peptides are maybe not all about chasing the fountain of youth, but helping your body to return to balance. Whether it's healing, restoring, metabolic flexibility, sleep, sexual arousal, they're transformative when used thoughtfully. So, if you're curious about peptides, I encourage you to work with a provider, like I said, that's trained, who understands how to personalize these therapies. Track them. Labs are really important. We can track our progress, make sure we're doing it safely and effectively.

Until next time, I'm Dr. Lori Gerber, helping you, as always, aid your way with science empowerment and integrative medicine. Don't forget to live life the way you want to with Lifegevity.