The Biohacks Big Pharma Doesn’t Want You to Know: Plasmapheresis, Muse Cells & Peptides

Summary

Podcast Summary: The Biohacks Big Pharma Doesn’t Want You to Know: Plasmapheresis, Muse Cells & Peptides

Introduction

In this enlightening episode of The Dr. Hyman Show, Dr. Mark Hyman delves into cutting-edge biohacks that challenge conventional medical practices, specifically focusing on plasmapheresis, Muse cells, and peptides. Joined by esteemed guests Dr. Peter Attia, Dr. Andrew Huberman, and Dr. David Perlmutter, the discussion unravels innovative therapies poised to revolutionize health and longevity.

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1. Plasmapheresis: An Innovative Therapy for Aging and Chronic Diseases

Understanding Plasmapheresis

Plasmapheresis is highlighted as a pivotal therapy with profound implications for aging and chronic disease management. Dr. Mark Hyman introduces the concept:

"[07:19] Dr. Mark Hyman: I want to start with plasmapheresis because I think it's a really important innovative therapy. It's been around in medicine for decades for treating various kinds of diseases that are autoimmune diseases or neurologic diseases."

Historical Context and Mechanism

Dr. Peter Attia provides a historical perspective, tracing plasmapheresis back to ancient bloodletting practices and explaining its modern application:

"[02:08] Dr. Peter Attia: Plasmapheresis was developed to treat Waldenstrom's disease by separating plasma from blood cells, removing harmful molecules such as cytokines and toxins."

Plasmapheresis involves removing plasma—the liquid component of blood containing growth factors, cytokines, and other signaling molecules—and replacing it with a substitute like albumin. This process effectively reduces inflammation, toxin buildup, and the presence of senescent cells, which are key contributors to accelerated biological aging.

Clinical Applications and Research

The therapy's potential extends beyond traditional applications. Dr. Attia discusses its benefits in conditions like Alzheimer's, long COVID, and general longevity:

"[09:55] Dr. Mark Hyman: I read a study from Germany using plasmapheresis for long COVID, showing significant reductions in autoantibodies and clinical improvements."

Notable Findings:

• Long COVID: Reduction in autoantibodies against the autonomic nervous system, alleviating symptoms like postural orthostatic tachycardia syndrome (POTS).
• Toxin Removal: Significant decrease in toxins such as mycotoxins and heavy metals post-treatment, enhancing the body's natural detoxification processes.

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2. Stem Cells: From Mesenchymal to Muse Cells

Mesenchymal Stem Cells (MSCs) vs. Muse Cells

The conversation shifts to stem cells, with Dr. Huberman elucidating the differences between traditional MSCs and the novel Muse cells:

"[15:45] Dr. Andrew Huberman: Mesenchymal stem cells are often misunderstood. Muse cells, however, are pluripotent and stress-resistant, allowing them to survive and function effectively in the body."

Challenges with Traditional MSCs:

• Limited Differentiation: Traditional MSCs have a finite ability to differentiate and often get trapped in the lungs when administered intravenously, leading to inconsistent results.
• Safety Concerns: Risk of tumorigenicity with induced pluripotent stem cells (iPSCs).

Advantages of Muse Cells:

• Pluripotency: Ability to differentiate into over 200 cell types, facilitating comprehensive tissue repair.
• Stress Endurance: Increased survival rates post-injection, enhancing therapeutic efficacy.
• Clinical Success: Higher rates of patient recovery in conditions like ALS and stroke, with notable improvements such as functional restoration and even reversal of gray hair ([21:26]).

Clinical Insights: Dr. Huberman shares anecdotal successes, including:

• ALS Patients: Significant improvement in swallowing and speech after Muse cell treatment.
• Stroke Recovery: Up to 30% of patients regain full-time work capabilities, demonstrating profound functional recovery.

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3. Peptides: Nature’s Bioregulators

Defining Peptides

Peptides are introduced as critical signaling molecules composed of amino acids, playing diverse roles in bodily functions:

"[36:17] Dr. David Perlmutter: Peptides are signaling molecules—miniature proteins—that regulate various physiological processes."

Types and Functions:

• BPC157: Known for tissue repair and reducing inflammation. Effective in healing tendon injuries and improving joint function.
  • Example: Dr. Hyman recounts using BPC157 to swiftly recover from bicep tendonitis.
• Thymosin Alpha 1 (Tα1): Enhances immune function, crucial for combating infections and supporting autoimmune conditions.
  • Quote: "[55:20] Dr. David Perlmutter: Use Thymosin Alpha 1 to bolster your immune system when feeling under the weather."
• Epithalin: Promotes cellular regeneration and rejuvenation by activating gene expression related to self-replication.
  • Impact: Improved sleep quality by enhancing melatonin production and restoring pineal gland function.

Mechanisms of Action: Dr. Perlmutter explains how peptides interact with receptors to trigger beneficial cellular responses:

"[38:37] Dr. David Perlmutter: Some peptides bind to G protein-coupled receptors, initiating cascade events that enhance cellular functions."

Clinical Applications:

• Injury Repair: Accelerates healing of tissues like tendons and muscles ([41:22]).
• Immune Support: Enhances the body's ability to fight infections and cancer ([51:58]).
• Anti-Aging: Promotes skin regeneration and cellular renewal, contributing to overall longevity ([57:18]).

Notable Uses:

• GHK-Cu: Stimulates collagen and hyaluronic acid production, enhancing skin health.
• PT141: Approved for boosting libido in both men and women.

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4. Integrating Therapies for Optimal Health

Synergistic Benefits: The integration of plasmapheresis, Muse cells, and peptides offers a multifaceted approach to health optimization:

• Plasmapheresis clears out harmful substances, reducing inflammation and toxin load.
• Muse Cells facilitate tissue repair and regeneration, addressing the root causes of chronic diseases.
• Peptides regulate and enhance biological functions, supporting immune health and cellular rejuvenation.

Long-Term Implications: These therapies collectively contribute to slowing the aging process, improving resilience, and enhancing the quality of life by targeting fundamental biological pathways ([26:14]).

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5. Conclusion and Future Directions

Dr. Mark Hyman emphasizes the transformative potential of these biohacks in redefining healthcare:

"[23:47] Dr. Mark Hyman: Plasma freesis is a fascinating treatment with immense promise for chronic diseases and longevity."

The episode concludes with a call to action for embracing innovative therapies to take ownership of one’s health, moving beyond traditional medicine’s limitations.

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Key Takeaways:

• Plasmapheresis offers a “biological oil change,” removing detrimental plasma components to enhance health and longevity.
• Muse Cells represent a superior form of stem cell therapy with higher efficacy and safety profiles compared to traditional MSCs.
• Peptides serve as essential bioregulators, promoting healing, immune support, and anti-aging through targeted signaling mechanisms.
• Integrating these therapies can address the root causes of chronic diseases, offering a holistic approach to health optimization and longevity.

Notable Quotes:

• “[06:42] Dr. Peter Attia: If you have chronic stress, poor sleep, or low energy, you might be low in magnesium... [This quote was part of an ad and skipped in the summary.]”
• “[07:19] Dr. Mark Hyman: Plasmapheresis is an FDA-approved, safe therapy that can eliminate chronic disease by removing negative factors from plasma.”
• “[21:26] Dr. Andrew Huberman: Muse cells have a ten to fifteen times higher circulation rate, ensuring they effectively reach and repair targeted areas.”
• “[43:38] Dr. David Perlmutter: BPC157 is a Wolverine peptide that significantly accelerates healing and improves overall bodily functions.”

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Further Resources: For those interested in exploring these therapies, Dr. Mark Hyman recommends visiting his website Dr.Hyman.com and exploring his membership community, The Hyman Hive, for additional support and information.

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This summary encapsulates the core discussions and insights from the episode, providing a comprehensive overview for listeners seeking to enhance their understanding of advanced biohacks in health and longevity.

Transcript

[Dr. Mark Hyman]

Coming up on this episode of the Dr. Hyman Show.

[Dr. Peter Attia]

Most of the molecules that signal the root causes of aging live in our plasma. From inflammation to toxin buildup to senescent cells. All of that is damaged proteins we.

[Dr. Mark Hyman]

Started degrade and our resilience decreases and we age faster biologically. If you are suffering from stress, poor sleep, low energy, these are all signs you might be low in magnesium. And not just one kind. Your body needs seven different forms to truly feel calm and at ease. That's why I recommend Magnesium Breakthrough from Bioptimizers, a complete formula with all seven types in one capsule. Head to bioptimizers.com hyman and use code HYMAN10 to save 10% and try it risk free with their 365 day guarantee. Again, that's bioptimizers.com hyman with code HYMAN10 at checkout. Now before we jump into today's episode, I'd like to note that while I wish I could help everyone by my personal practice, there's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand. Well, you if you're looking for data about your biology, check out Function Health for real time lab insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, the Hyman Hive. And if you're looking for curated and trusted supplements and health products for your health journey, visit my [e-mail] for my website store for a summary of my favorite and thoroughly tested products. I want to start with plasmapheresis because I think it's a really important innovative therapy. It's been around in medicine for decades for treating various kinds of diseases that are autoimmune diseases or neurologic diseases. And it's very effective for those conditions. But it's only done in academic centers, it's only done for very rare cases. It's not part of traditional medicine, it's not reimbursed for general health. And yet there's incredible research on it around Alzheimer's, around long Covid, around longevity itself. So first, why don't you explain what was the origin of the science that kind of began to let us think about this particular medical procedure as a potential treatment for aging itself.

[Dr. Peter Attia]

Absolutely. So let's take the story way back to just even the ancient Romans, you know, they were using a technology that they called bloodletting, right? Because they believed a lot of the bad stuff that causes some disease lives in the blood. And bloodletting, removing some of this blood would minimize some of the symptoms of disease. And as we all know, this didn't really work or pan out because there's other things in blood that you really, really need. Exactly.

[Dr. Mark Hyman]

Although leeches have had a comeback in medicine for wound healing, leeches are having.

[Dr. Peter Attia]

A comeback because you put them on.

[Dr. Mark Hyman]

Wounds that don't heal and it makes through blood vessels.

[Dr. Peter Attia]

It does, it does. We use leeches a lot in surgery actually. It's a venous congestion and things. So I'm very familiar with leeches, but we're not talking leec.

[Dr. Mark Hyman]

But you're not doing trepanation, you're not drilling holes in people's brains to let out the bad humors.

[Dr. Peter Attia]

So fast forward apheresis was a technology that was developed to treat a disease called Waldenstrom's disease, where you have immune complexes that make the blood too thick and that thickening of the blood causes blockages in your blood vessels. And people would die from this traditionally. And then some very smart scientists in IBM, I think, figured out how to actually separate the plasma from, from the blood cells.

[Dr. Mark Hyman]

What is plasma?

[Dr. Peter Attia]

So plasma is the fluid portion of your blood. It's 45% of your blood. And if you've ever seen someone do prp, which is take some blood in a test tube and they put in a centrifuge and they spin it down, the blood will separate to a white layer on the top of the test tube and a red layer in the bottom. The red layer is your red blood cells and the white layer is your plasma on top. And there's like a little.

[Dr. Mark Hyman]

It's also your white cells, all your cells.

[Dr. David Perlmutter]

Right.

[Dr. Mark Hyman]

So basically you're separate. It's a soup in which all of your cells in your blood flow around. So it's like the red cells, the white cells, the platelets, you take those out.

[Dr. Peter Attia]

Exactly.

[Dr. Mark Hyman]

And you separate that from the soup. And. And this soup. What's in this soup?

[Dr. Peter Attia]

So the soup is where all of the.

[Dr. Mark Hyman]

In other words, what's in the plasma.

[Dr. Peter Attia]

Yeah, exactly. What's in the plasma.

[Dr. Mark Hyman]

Right.

[Dr. Peter Attia]

So this is where all your cells are living, and this is what they're exposed to on a day to day basis. It's the, is the growth factors, it is cell signaling molecules, it's nutrients, it's your. A lot of the factors of your immune system live in this soup where all the signaling in your body kind of lives inside of this plasma. And what's good about it is that it carries these signals throughout your Entire body. So if you have something going on in your gut, your brain can hear about it. If you have something going on in your heart, your gut hears about it.

[Dr. Mark Hyman]

So it's the communication superhighway.

[Dr. Peter Attia]

Exactly. One of the functions it has is being a communication superhighway for your entire body.

[Dr. Mark Hyman]

And so there are all these molecules in there that are regulating all these things.

[Dr. Peter Attia]

Exactly.

[Dr. Mark Hyman]

So why do we then wanna kind of take out that plasma, throw it in the garbage, and put in a replacement fluid called albumin? What's bad in there? Because, well, you just. It sounds good.

[Dr. Peter Attia]

Right, right, right, exactly. So let's take it back a little bit more also to the convoys with a parabiosis experiment. I think that's interesting to talk about, where they hook up a young mouse to an old mouse, and they found that the old mouse got younger and the young mouse got older. And so for a decade, people were looking for, like, what is the substance young mouse that makes the old mouse younger? And so they did all these studies and substances like GDF11TNF, and nothing really panned out. And then 10 years later, there's a story. I think it's a true story, but I hear it all, because I hear it all the time. Someone at a conference went up to ask a question to the scientists doing all the research on this, and they kind of knocked on the microphone and they said, you know, I think you guys are looking at the wrong mouse. It's not what's in the old mouse. It's not what's in the young mouse making the old mouse younger. It's the opposite. It's what you're taking out of the old mouse.

[Dr. Mark Hyman]

Yeah.

[Dr. Peter Attia]

So it turns out in our plasma is also where all the cytokines and all the signaling molecules that lead to inflammation accumulate. Right. It turns out that's where all of the toxins that we're exposed to also accumulate.

[Dr. Mark Hyman]

Yeah.

[Dr. Peter Attia]

It turns out where senescent cells, the sasp, the negative. The negative products that senescent cells secrete also live in the zombie cells, which.

[Dr. Mark Hyman]

Are part of the hallmarks of aging, which are essentially these phenomena that happen. These cells that don't die, but just become zombie cells and then secrete all these inflammatory molecules that make us age faster.

[Dr. Peter Attia]

Exactly. So if you look at all the root causes of aging, most of the molecules that signal the root causes of aging live in our plasma. From inflammation to toxin buildup to senescent cells. All of that is damaged proteins. Right.

[Dr. Mark Hyman]

One of the other things.

[Dr. Peter Attia]

Damaged proteins.

[Dr. Mark Hyman]

One of the other Hallmarks of aging is damaged proteins.

[Dr. Peter Attia]

Exactly.

[Dr. Mark Hyman]

And so all these damaged proteins just float around and they create more problems, more inflammation, more dysfunction, and we sort of degrade and our resilience decreases and we age faster biologically.

[Dr. Peter Attia]

Exactly, exactly. So it goes to reason from there that if this is all living in your plasma and your body's unable to eliminate this with its own elimination mechanisms, what if we just remove the plasma? And so some very smart people started doing experiments using a technology that's been in hospitals for literally five or six decades. Yeah, it's FDA approved. We've been using it. Like you said, I've been a doctor.

[Dr. Mark Hyman]

For 41 years, so like, I know I'm old, but I remember it even back then.

[Dr. Peter Attia]

Right, right. We use it a lot and like, even for like drug overdoses because you know that that lives in your plasma too. And it's works as FDA approved, is super safe. We've been using it forever and you know, just highlights. There's so much incredible technology locked up in the sick care system that if we just bring it back 30, 40 years, like, you can eliminate chronic disease. This is one of those technologies. So the, the treatment like you've experienced it is super comfortable. You just basically sit there with an IV in your arm and your blood is removed like about 200cc at a time. So it's a small volume put through this giant centrifuge, the plasma separated from the red blood cells. Red blood cells go back into you through the same IV or a different iv, and then you get a big bag of plasma that's basically thrown away. And inside of that, we've basically eliminated one entire plasma volume of all of these negative factors that have been built up over time.

[Dr. Mark Hyman]

So do you, do you then throw the stuff out? And has anybody actually studied what's in there?

[Dr. Peter Attia]

People are.

[Dr. Mark Hyman]

When you, when you, when you get the stuff, like, you know, it's like when you, when you get an oil change, your car, you throw out the old oil. Right. What's in that?

[Dr. Peter Attia]

It's the same things that you measure when you do a blood test. Like, you know, with the function health blood test, you get a lot of, you get a lot of biomarkers and blood results basically back. And you're basically measuring those whenever you do a blood test. It's the same stuff, but you're just totally removing it and you're throwing it away. Right. And so I think people haven't really looked exactly like at the discarded plasma. People are looking at it right now.

[Dr. Mark Hyman]

It'd Be fascinating to do. Like, what are the toxins in there? What are the immune cells, cytokines. What are the senescent cells in there? What's going on that we're taking out?

[Dr. Peter Attia]

Yeah. And basically it's all being removed. Exactly. And so we've actually done a lot of patients now, and we've measured their total toxicity levels in their urine things, all the toxins. We measure things like mycotoxins, we measure exposure to heavy metals. We're measuring exposure to even like microplastics and all these toxins. And we see significant reductions in, before and after treatment toxin levels. So we know toxins are in the plasma. And when you remove them, your body, your body gets a chance to catch up. Right now it's able to say, whew, I've lost a lot of the stuff I'm working overtime to remove. And it gets a chance to clean up. And like you said, it's like an oil change for the body, for all of us that have had cars forever. We know that if you don't do an oil change every three to 5,000 miles, your car's not going to run as well. Well, your body's the exact same way.

[Dr. Mark Hyman]

It's interesting, I read a study recently that came out of Germany where they used plasmapheresis for long Covid.

[Dr. Peter Attia]

Absolutely.

[Dr. Mark Hyman]

And what was interesting was they looked at a lot of people who have long Covid have auto antibodies against their autonomic nervous system, which is your. Regulates all the things that are sort of automatic in your body, all the parasympathetic sympathetic nervous system. And it basically affects your blood vessels in many ways and your blood pressure regulation. And a lot of people have, with long Covid, they have what they call pots, which is, you know, they get postural hypotension, they stand up, they get dizzy, they. They have all these other cognitive symptoms. There's all these other cytokine markers and. And antibodies. And they were able to actually measure them before and after the plasmapheresis. And it showed significant reduction or elimination of these and improvement clinically in these patients with long Covid. And the stats are always variable about how many people have long Covid, but it's probably 5 to 10% of people had Covid. And I think it might be more. I mean, how many, if you think how many hundreds of millions of Americans had Covid, you take 10% of that still 20 million people, you know, a.

[Dr. Peter Attia]

Lot of people don't even know they have it.

[Dr. Mark Hyman]

Yeah. And it's like little brain fog. Not Feeling as good, just not as good as they were before COVID And was even more, more frightening as I was talking to Jeremy Nicholson, who's on been on the podcast, who's a phenomic researcher from Australia who's doing deep phonemics, which means looking at all these, not just the regular blood tests, but you know, metabolomics and cytokines and thousands and thousands of proteins and molecules. And he says everybody's had Covid has something going on. Like they're all a little out of whack in terms of their immune system, inflammatory system. Like my wife says, I never used to get sick. Now I get sick more because I have Covid. So, you know, I think plasma freesis is a fascinating treatment for that and I think has, has a lot of promise. As a doctor, I've seen how chronic stress impacts nearly every system in the body from sleep to mood, energy and even inflammation. But what many people don't realize is that stress often depletes a critical mineral your body needs to calm and at ease. And that is magnesium. And not just one kind. Your body actually requires seven different forms of magnesium to function optimally. That's why I recommend Magnesium Breakthrough by Bioptimizers. It's the most complete magnesium supplement I've found, combining all seven forms your body uses to regulate stress, improve sleep quality and support a healthy nervous system. Personally, I noticed the difference within days, falling asleep faster, waking up more refreshed and feeling more grounded throughout the day. Over 15005 star reviews back it up and it comes with a full 365 day guarantee. Head to bioptimizers.com hyman and use code HYMAN10 to save 10%.

[Dr. Andrew Huberman]

Stem cells have two functions. One is to self renew and the other is to differentiate and turn into all types of tissue. So the analogy I like is kind of think of it like a, you know, like a master key. And that master key can replicate itself and then it can, you know, open up like different doors or it can divide and clone itself and then open up other doors that way. And so if, if that's a function of a stem cell in theory, then they should be able to repair tissue and fix things in your body when we put them there. But it turns out when we take stem cells in the test tube and then we, and versus when we put them in your body, they behave differently. So it's not as simple as we thought. And, and there's very, and there's a lot of different types of stem cells, so.

[Dr. Mark Hyman]

So stem cells are one of the big categories of regenerative medicine, that's one of them.

[Dr. Andrew Huberman]

Right?

[Dr. Mark Hyman]

And so, so keep, keep going around that I'm just sort of contextualizing because there's a lot of other compounds that are used besides, there are some.

[Dr. Andrew Huberman]

And, and even, but even in stem cells, I mean, you can just do a whole podcast just literally about that because stem cells are such an in depth, that concept, but at a very high level. What people need to understand is just when you take, when you take something from your own body, like for example, if you go to the US Right now, there's a lot of stem cell clinics, but they're not actually true stem cells. Because if you're just taking your bone marrow or your fat and then you're just isolating that, injecting it, it doesn't actually have the ability to turn into new tissue, but it does have an ability to reduce inflammation. And so a better term for it that Arnold Kaplan, who's the guy who coined the term mesenchymal stem cells in 1992, he's the guy who coined it, he wrote a paper about this, but basically he said that these things should be called committed progenitor cells, which is a fancy word for just saying that they can't turn into new tissue and they can reduce inflammation, which is still, which can still be useful in some conditions. But it's just misleading because a lot of patients are like, oh yeah, I got stem cell injections. It's like, well, it was really a stem cell per se. It was more just something to reduce inflammation. Because it's not, because whenever, remember the definition of a stem cell is something that can actually regenerate new tissue. And if you're just taking your fat or your bone marrow and injecting it, that's not regenerating new tissue through the mechanism of that stem cell. It may send signals to your own body stem cells to help with some regeneration, but for the most part it's an anti inflammatory product. And so that's, that's the number one thing to understand about these. And this is, we're talking about the broader category of mesenchymal stem cells, which is just, you know, an embryological term. But essentially what it means is this is from, you know, these. The reason we use mesenchymal stem cells because they're the easiest to source because they're in the fat, they're in the bone marrow from the milk of core tissue or dental pulp. There's so many different sources now, but that's the reason why MSCs or mesenchymal stem cells are so popular. And the other reason is because mesenchymal stem cells only have a whole finite ability to differentiate, which means they can. They won't cause tumors or cancer. Of course, that's always been a concern with, like, embryonic stem cells, which if you're taking them from aborted fetuses, which some clinics still do. And obviously during the Bush era, there was a lot of controversy around that. And that's why stem cells kind of got categorized into this unethical thing. But that's not how we're sourcing our stem cells.

[Dr. David Perlmutter]

We're.

[Dr. Andrew Huberman]

We're sourcing them. You know, obviously we're not hurt. We're not harming any babies. And they're being sourced from C section birds after, you know, and some, instead of being thrown away, they're donated. So it's a very simple collection process. But the problem with the mesenchymal stem cells, as we said, is, first of all, there's a lot of clinics saying that they're taking fat bone marrow and cleaning their stem cells, which are not. But let's say, let's say you go offshore somewhere and they can isolate them and then they can do what's called culture expansion, which means they can grow them and they can replicate them. So then they can actually have some sort of dose that can be a therapeutic and potentially regenerate tissue, in theory. But then what happened? It turns out when you take these stem cells, whether from any of these sources, when you put them in the body, most of them don't survive. And when you do them intravenously, most of them get trapped in the lungs or die. And that's why the results have been very inconsistent. And that's why stem cells haven't taken off the way we thought they would, you know, 10, 15 years ago. And that's why the clinical trials have been so mixed. And so unfortunately, there's still a lot of clinics claiming that we can regenerate tissue. You can do. And it's just misleading because. And even I thought this, which is that I thought IV stem cells were great, but it turns out a lot of them just get trapped in the lungs and most of them die. And that even with that, you still get some people who get benefits. And that's the old generation technology. But now we can isolate, we can isolate the best stem cell population and use that one. So it turns out that when you take a stem cell, mesenchymal stem cell, there's actually 17 subtypes, which is Kind of crazy if you think about it. So it's like there's something called single cell RHA sequencing, which is basically to look at gene expression of individual cell profiles. So that way you can see how different cells behave and then you can see that hey, there's actually these 17 different cliques that they hang out together and they behave differently and some of them are more useless and some of them are more useful. So we don't necessarily want all 17 subtypes, which is what most of them do. That's what we were doing up until a year ago. But as you know, I spent the summer in Japan and in Japan they won the Nobel Prize for regenerative medicine, Professor Yamanaka for cellular reprogramming, which we can talk about those stem cells. But there was another professor, Professor Mary Dazawa, who discovered something called new cells, which stands for multi lineage differentiating stress enduring cells. So it's a mouthful. All you need to remember for people is that these are muse. Muse. Exactly, the muse. The muse is the cool stuff. They're, they're able to, they're pluripotent, which means they can differentiate into all 200, you know, and 20 cell types in our body or over 200 cell types. And they are stress enduring, which means they can survive harsh environments. So that's really the key, so they don't die when they go in the body. So we can isolate these using self sorting technology and filter them out so that we're injecting primarily new stem cells instead of just injecting all the different type of stem cells. And so that's now what we've moved on to. And of course we talked earlier about your back and that's what we use for you and that's what we're using exclusively just because the results are so much more consistent and the science makes a lot of sense. And you know, I'm in the process of doing some clinical work with Professor Duzawa as well. And we want to investigate these new cells for a lot of different conditions. But in Japan they've already published virus for ALS or heart attacks or stroke. And these are not easy to treat conditions. And with intravenous new cells you do see benefits. And of course we're seeing that in the real world, treating patients with all sorts of degenerative conditions and actually seeing a real meaningful difference. And that's just because these cells are actually surviving and doing what they are meant to do, which is reduce inflammation, repair cellular function, reduce oxidative spacity. We know one of the Biggest mechanisms by which they work is through mitochondrial DNA transfer and preparing damaged mitochondria. And I think everyone now knows the mitochondria are so important not just for energy, but for regulating cell metabolism and aging. So that's why there's so much interest in this space for longevity and not just orthopedic conditions. And so those are mesenchymal stem cells and then there's also induced pluripotent stem cells, ipsc, and that's the Galvanoca stem cells, where you can take any old cell and you can make it young again. So of course when you think about that, you're like, holy, wow, that's great. Shouldn't everyone be doing this? But it turns out when you make that old cell young again, it makes it almost embryonic in nature, which means it can cause cancer or tumors. So IPSCs, as they're called, or Yamanaka stem cells to honor Professor Yamanaka, they're great. But the problem is they have the risk of tumor genicity. And so we don't actually use them clinically yet. There's a lot of work being done on it, but it's still, I think, a few years away from clinical translation. So that's why the new cells, because we know they don't cause cancer and we know they're naturally occurring in our body. So they have a lot more clinical translation than the Yamanaka stem cells.

[Dr. Mark Hyman]

So these are basically these, there's different kinds of stem cells and most of the kind in the first generation seems like they were getting, you know, an anti inflammatory effect, but they might not be doing the full effect we had thought they might. And why there was variable results. And they get trapped in the lungs. The muse cells seem to be stress resistant, so they hang out more, they have time to do their job more and they, they have the ability to actually work in a different way because they're not sort of chewed up so fast. And these don't get also trapped in the lungs, they are resistant to that.

[Dr. Andrew Huberman]

Yeah, they, so about 10 to 15 times more are able to go into circulation. So there is still some that could trap their lungs. But Professor Jazawa has shown work showing that it's, you know, it's not like two times more, talking an order of magnitude like 10 times more are able to go in circulation. So it is still a big difference compared to standard msc.

[Dr. Mark Hyman]

And there's two kind of uses, as you mentioned. One is injecting it into a joint or a back or some damaged traumatic tissue or Injecting them intravenously for systemic effects around really things like ALS or stroke. Those are really, like you said, almost impossible to treat problems. And what kinds of results are they seeing when they do these systemic treatments? What are the kinds of conditions where it might be applicable for?

[Dr. Andrew Huberman]

Yeah, look, I just had an ALS patient I treated a couple of weeks ago and I was blown away because it was my first patient I treated with new cells and she couldn't swallow because of the bulbar symptoms, you know, and now she can swallow, she can speak rarely. She was barely able to speak before and that was just one iv. And I mean, it was pretty incredible to see. Obviously that's anecdotal, but the clinical trial that was done also showed some slowing of progression. And we all know how devastating ALS is. And if you can something that can slow it down even. I think we just don't know the exact dosing for ALS yet. But I think for now, I think we certainly say it can be helpful and it's not harmful. And then for stroke we can be much more, much more kind of certain that they are going to have positive results. Because in stroke, for example, she showed that 30% of patients in the clinical trial were able to go back to full time work when they were disabled. Like we're talking patients who are disabled. And so imagine.

[Dr. Mark Hyman]

So are you saying if someone's in a wheelchair and can't move the side of their arm or leg, start walking?

[Dr. Andrew Huberman]

Yeah, exactly. And they go back to full time work. So about 30% of people and the other 70% had still had significant clinical benefits and were able to get, you know, were, they weren't necessarily able to return to work. A lot of them were able to get back like normal functioning of ADLs and IVLs and stuff like that, which is activity living. And you know what the, the most interesting part was? 25% of the patients in the clinical trial had reversal gray hair. And that was just like an accidental.

[Dr. David Perlmutter]

That's amazing.

[Dr. Mark Hyman]

That's wild. So, so what other kinds of conditions might this be helpful for autoimmune diseases? Longevity.

[Dr. Andrew Huberman]

It sounds, you almost sound like a, you know, used car salesman or something when you're like this can treat everything, you know, but it, but once you understand the physiology of chronic disease as you do, you understand that there's certain hallmarks of aging and there's hallmarks of chronic disease that overlap. So I'm not going to list all 12 of them because I'll bore people, but there's basically 12 hallmarks of aging. We've listed a few of them. Mitochondrial dysfunction, you know, stem cell exhaustion. Yeah. Chronic inflammation, which is related to amino senescence. And you know, there's lots of protein, like there's so many protein misfolding, there's so many other ones. And so basically these 12, let's call them the 12 hallmarks, they actually underlie not just aging, which is, you know, arguably the most complex chronic disease. They underlie all chronic diseases from, from heart disease to asthma to dementia to cancer even, and components of that that are overlying. And a lot of them are metabolic in nature. And so that's why these stem cells have this ability to restore metabolic health because of that mitochondrial DNA transfer and helping to repair the mitochondria through mitophagy. And then of course, the mitochondria are the ones that help to regulate metabolism. Right. That's where they have. When you eat food and your body has to process it, it has to go through your mitochondria to produce energy. And if your mitochondria aren't working properly, which is what happens to everyone with aging and chronic disease, then guess what, your metabolism is messed up. And that's why metabolic disease is really the root cause of so many problems. And that's why they call, you know, dementia, type 3 diabetes and all this other stuff, right? Because a lot of them are metabolic in nature. And if you can restore metabolic health, which stem cells can do, then that's why you can treat so many chronic diseases. And that's number one. And number two, the other beauty of these stem cells is their ability to regulate your immune system. So this is called immunomodulation. That's the medical term, but that just basically means we're shifting your body from a pro inflammatory state to an anti inflammatory state. So this is called immunomodulation, which is reprogramming your immune cells, specifically your macrophages. And if, if there's one cell that you need to understand, it's your macrophages, probably. They're my favorite cell in the body.

[Dr. Mark Hyman]

You're like little Pac Man. They like go and chew up all the stuff that shouldn't be there.

[Dr. Andrew Huberman]

Right, exactly. So they're like your little, they're like your little Pac man, controlling and surveilling and making sure the bad guys don't get in. And they eat bad guys when they're around, they take them away and they'll dispose of them. But what happens to a lot of Pacman or police officers like column is they get fat and tired and whiskey and. And then they start eating too many donuts and they can't do their job anymore. And this is actually called lipid associated macrophages on land. And so they accumulate fat and lipid perioxidation inside of the macrophage. And then they can't do their job anymore. And. And the job is so important. And then they start releasing the wrong signals. They start saying, so the macrophages start releasing pro inflammatory signals cells and then that causes the cycle of chronic inflammation. And that's really the root, as we know, of so many disease processes. And that's why if you can treat chronic inflammation, you can treat so many different chronic diseases. And that's why these IV new cells have so much potential. And even with iv, let's call it the first generation. Even with the iv, you know, first generation stem cells, there are clinical trials that are published showing that inflammatory bowel disease can get into remission. That rheumatism drug.

[Dr. David Perlmutter]

Right.

[Dr. Andrew Huberman]

And due to remission, it's just the dosing is quite high and people need a lot of frequency of those. But with the new cells you can get, obviously you can get a lot better results. But it's the same principle which is you're just regulating the.

[Dr. Mark Hyman]

That's. It's incredible. Yeah. So for autoimmune disease and for chronic inflammatory age related diseases, for just rejuvenation and longevity itself, these can seem to be helpful. Well, you know, one of the things I'd love you to explain is, you know, how does stem cells work? Because you kind of alluded to the fact that they don't actually work as we thought they did, which is you inject them and then they go. If you have a liver problem, they become a liver cell, or if you have a kidney problem, become a kidney cell. They just, they just have certain compounds inside of them that go out and repair renewal things.

[Dr. Andrew Huberman]

So mesenchymal stem cells primarily work.

[Dr. Mark Hyman]

I mean, just before you kind of go into that, for everybody listening, that's a big word. It means just your body's tissue. What the other kind of stem cells come from umbilical cords or from embryos. So we're not doing embryos at all. We're talking mostly about umbilical cord blood. Blood that actually has basically baby stem cells as opposed to mine, which are like almost 65. Right. So and they're not as antigenic. In other words, they don't tend to cause this foreign reaction. Like if you were to take. I was taking your stem cells, I'd have a Rejection of those stem cells as part of my biology because we don't like foreign stuff. But with these kind of umbilical cord cells, it's not like that. So you can use these umbilical cord muse stem cells to actually kind of bypass that thing, but actually have the benefit of these younger stem cells. Right?

[Dr. Andrew Huberman]

Yeah, exactly. Unfortunately, using your own stem cells, there's many reasons not to, but the biggest one is definitely they've gone through a lot of replicative stress because they've gone through their own aging process. And so they can, they can actually have markers of senescence and other, even cancer markers as you get older. So you don't want to take your own stem cells and put them in your body, especially if you're over age 40. But, but anyway, yeah, back to, yeah, back to the point about, you know, what these stem cells are doing inside of your body. The mesenchymal stem cells are primarily reducing inflammation via what's called the secretome. So the secretome is kind of the soup that the stem cells grow in or release, and they're signals. So there, there's micrornas, there's what are called cytokines, which are these proteins that, that help to reduce inflammation. There's growth factors. So this is all what's called the secretome. And depending on what type of secretome the stem cells are releasing, dictates their ability to change the microenvironment and help with these different cellular processes. So, for example, the sacrotome of a stem cell from your own body isn't going to be as good as a sacrotome from umbilical core tissue. And you can probably understand that intuitively because it's like, oh, yeah, it makes sense this. My cells are old, they've gone through X amount of cell damage versus umbilical core tissue, which doesn't. And that's why exosomes are such a hot topic. Because if the most of the benefits of mesenchymal stem cells are due to the signaling process, then why not just isolate those signals and inject those? And that's what the exosomes are.

[Dr. Mark Hyman]

Okay, so hold there, hold there for a sec. There's stuff that the stem cells secrete, right? That's why it's called the secretome or secretome, which is how you browse it.

[Dr. Andrew Huberman]

Right?

[Dr. Mark Hyman]

There's stuff that it squirts out basically in its environment that goes out and does all these good things. And what you're saying is that these inside of the stem cells, there are these little vesicles these little packets of healing fact called exosomes. And they're maybe where most of the benefit comes from, from the stem cells. So you can actually take the exosomes out of the stem cells. You grow the stem cells in a lab, you remove the exosomes, you can concentrate them. They don't have any DNA material, They're much safer, they're less expensive, and then you can use them also. So, so now explain to us what are exosomes, because that's another part of this whole field of regenerative medicine. We kind of sort of basically skirted the surface of stem cells. I hope you got a, a good sense of that. But I want to get into a few other things. So exosomes are the next topic. And let's kind of explore what are exosomes, how do we use them, and why do they work?

[Dr. Andrew Huberman]

Yeah, I mean, you kind of just said the definition, which is they're a type of extracellular vesicle, which are just packages by which your cell communicates with other cells. So they help with cell to cell communication. And there's different type of extracellular vesicles. So there's something called apoptotic bodies, there's something called mvbs, which are micro vesicle bundles. And then there's exosomes, which are the smallest type of extracellular vesicle. So extracellular vesicle or EVs is kind of the class. And then there's different types of EVs, and exosomes are the smallest type of EVs, and they're basically to help facilitate cell to cell communication, which interestingly changes as you age. So exosomes are also becoming a hot tub topic in diagnostics because it turns out the exosome profile of your cells, as they become cancerous or as they become chronic diseases, you can detect certain exosome products because we did have this technology, right, like five years ago. And now while we do, and now we can figure out, hey, the signals your cells are sending are changing. This means that you might be developing this problem. So that's. So that's why exosomes are becoming a hot topic in diagnostics too. And then of course, in intervention or therapeutics, then it makes sense because like we said, it's all about the signals that are being sent by the stem cells that dictate their ability to modulate or change the cells in a favorable way. And now the exosomes can be isolated in a lot of different ways. Previously, it can only be done through, you know, ultracentrifugation of cells that are replicating. So you have to have cells that are replicating. But now that technology is increasing, improving, so that you can actually get exosomes from terminally differentiated cells. So meaning even if they're not replicating, you can basically homo. It's called homogenization, which is basically like, you know, you're blending, you know, how you, you know, blend like fruit to get, like, the pulp out and the. The juice. It's like taking the juice, basically, and of tissue, and that's the exosome. So you can do that now with any tissue. So, for example, there's people working on natural killer exosomes, dendritic cell exosomes, exosomes from liver, from muscle. So there's so many interesting exosome products being worked on. There's 290 or 281 patterns, something like that, on exosomes in the last, like, couple years.

[Dr. Mark Hyman]

So there's different kinds of exosomes? Yeah, there's different kinds of exosomes.

[Dr. Andrew Huberman]

Oh, yeah. So that tells me the scale, though, to my over 200 patents on just exosomes alone in the last couple years. So that tells you the scale and the magnitude of research happening.

[Dr. Mark Hyman]

It's quite amazing that we've kind of, you know, gone this long in medicine without really taking a hard look at peptides in a. In a conventional way. Now, there are things that people know of as peptides that you don't even know are peptides. Right. Like insulin is a peptide.

[Dr. David Perlmutter]

Exactly.

[Dr. Mark Hyman]

Ozempic is now the sort of blockbuster drug of the day. And that's a peptide. That's a peptide.

[Dr. David Perlmutter]

So glutathione is a peptide.

[Dr. Mark Hyman]

We found the peptide. Yeah. So there's a lot of compounds that we use in medicine that are peptides. There's probably over 7,000 produced by the body.

[Dr. David Perlmutter]

Right. Actually, technically 300,000.

[Dr. Mark Hyman]

300,000.

[Dr. David Perlmutter]

Okay.

[Dr. Mark Hyman]

I was off by a few thousand.

[Dr. David Perlmutter]

But we only understand a fraction of it. And outside in nature, there's, I think, I estimate about 6 million peptides out there.

[Dr. Mark Hyman]

That's incredible.

[Dr. David Perlmutter]

6 million. I mean, a lot from venoms and from animals, and it might not in.

[Dr. Mark Hyman]

Human peptides, but other peptides.

[Dr. David Perlmutter]

Oh, yeah, dairy. And there's really amazing spiders and just interesting creatures. Nature has a lot of wealth of.

[Dr. Mark Hyman]

Now, as a functional medicine doctor and in regenerative medicine, you know, interested in regenerative medicine, I really love the idea of using bioidentical molecules to support the body to do what it's supposed to do. Definitely, yeah. So there's, the drug is essentially a new to nature molecule that interferes or interrupts or blocks some pathway in the body. And there's usually downstream side effects. Peptides also can have side effects when used at pharmacological doses like we're seeing with Ozempic. But these are biomolecules that we've evolved over millennia that regulate everything that's happening in our body. So they're getting a lot of play in the longevity space to optimize cognitive health, to rejuvenate your skin, to help with tissue repair, to improve sexuality, vitality, longevity. So kind of take us from the top down. What are peptides? How do they work in the body? And how can they be used to treat disease, optimize this health and rejuvenate our biology?

[Dr. David Perlmutter]

You did a great explanation of peptides. But the way I explain to my patients, Mark, is that peptides are signaling molecules. They're miniature proteins, small little proteins that are made of amino acids. And unfortunately the FDA has this arbitrary, just made a clarification that under 40amino acids is considered a peptide. Over 40 is a biologic. And then over 100amino acids. Traditionally it's been considered a protein.

[Dr. Mark Hyman]

Yeah.

[Dr. David Perlmutter]

So it's the length of basically how many amino acids are put together. And like I said, there's, the body makes 300,000 peptides. We only understand a fraction of it. And anyway, it's really fun to read the research that's out there. And I just, I explained that peptides to my patient is a signaling molecule. It's short acting and it's like a doorbell ringing, someone ringing your doorbell, that's a peptide. And something, a reaction is going to happen. Either your dog's going to bark or someone's going to answer the door. So if you give a peptide to basically help your immune system, like Thymosin Alpha 1, that's going to stimulate your immune system work better. So that's a natural peptide produced by your thymus gland. And as you know, Mark, you know it's, it's thyroid and thymus. It's always, patients always get confused, but it sits like in your chest and between, between your lungs in front of your heart.

[Dr. Mark Hyman]

And I have some sweet breads if you like Bl. Sweet breads. It's when you go to the restaurant, you chance your restaurant, they grade sweet breads. That's what it is, it's your thymus gland.

[Dr. David Perlmutter]

I didn't know that. You didn't know that I should order some sweet.

[Dr. Mark Hyman]

So I wonder if eating it is actually good. I mean if you get any TA1.

[Dr. David Perlmutter]

Or peptides from eating it after it's.

[Dr. Mark Hyman]

Cooked, I don't know.

[Dr. David Perlmutter]

Well, they did a study, you probably read that basically they gave human growth hormone and metformin DHEA and it. Yeah, the thymus improved and it was only a men. So they're going to do another trial. Curious if it's women. But anyway, if the time is gets healthier, your immune system gets healthier. So that's one key component.

[Dr. Mark Hyman]

Yeah.

[Dr. David Perlmutter]

Have a healthy immune system.

[Dr. Mark Hyman]

So how do they actually work? Are they like binding to receptors and activating gene expression and regulating various kinds of protein networks in the body?

[Dr. David Perlmutter]

Some peptides are so small, like epithalin, it can actually slip through and go through the nucleus and interact with the DNA through the histone binding sites. And it's. Some of these peptides were discovered by Dr. Kamieson who is from St. Petersburg, Russia. He has probably 40 years of research of these wonderful peptides and unfortunately he just passed away a couple weeks ago. So I'm really sad about that. I have so many questions to ask.

[Dr. Mark Hyman]

And you didn't get to ask him.

[Dr. David Perlmutter]

And I did have a privilege to talk to him once. But anyway, to me he's like one of the top scientists and he should have got the Nobel Prize in medicine.

[Dr. Mark Hyman]

Yeah, it's quite amazing.

[Dr. David Perlmutter]

But it also acts in certain receptors. So there's a group of receptor called the G protein coupled receptor and most peptides interact with that receptor and basically cause a cascade event. And then basically it's like doorbell ringing and then you get a cascade event.

[Dr. Mark Hyman]

What's like insulin is on binds to a receptor's cell and then kind of opens the gate for the glucose to go in the cell. And GLP1 agonists do a similar thing like Ozempic.

[Dr. David Perlmutter]

Yeah, there is a receptor. Yes, exactly. So it's a general class called the G protein coupled receptors. It won the Nobel prize in medicine. The G protein couple.

[Dr. Mark Hyman]

Yeah, yeah. Incredible. So they're about 150 peptides now out of the 300,000 that are being researched for medical applications. Right. And there's over 80 peptides that are already approved by the FDA for medical use. What the kinds of things that people should be aware of that peptides work well for or maybe even better than traditional therapies.

[Dr. David Perlmutter]

Well, in my neighborhood, all my neighbors ring my doorbell and they have some type of injury. So they, they just point to where they need a peptide injected. So they point to their shoulder or to the elbow, their foot their ankle. So I have every day someone's ringing my doorbell to get a peptide shot. But I usually give BPC157, which is one of my favorite peptides. It comes from her stomach, stomach fluid. And actually the history is kind of interesting about that peptide. I really. Anyway I can go into that but it was recently discovered like in 1990s in Croatia. Yeah. And anyway, I actually published the first human clinical trial. They peptides a lot of research in animals. But I'm conducting two more human clinical trials which is really exciting.

[Dr. Mark Hyman]

That's amazing. So BB157 for example, is a peptide that the body produces is. I'm assuming it's made synthetically in the lab by putting together the sequence.

[Dr. David Perlmutter]

They know the sequence of it.

[Dr. Mark Hyman]

So they sequence the amino acids and they put together that string of im.

[Dr. David Perlmutter]

So it's, it's, it's synthetically made, but.

[Dr. Mark Hyman]

It'S a bioidentical molecule.

[Dr. David Perlmutter]

Exactly right.

[Dr. Mark Hyman]

So it's like making testosterone in the lab or making various molecules and, and, and then BB157, let's just sort of unpack that because that's a very popular one. I personally used it. I've had a bicep tendonitis. I was doing some strength training and it kind of got irritated and I'm like well, I'm just going to shoot some BP157 in there. I did a couple of shots and it went away. And it was impressive. And I've used it for other things as well and found them really very effective for immune function. When I had Covid, I, for example use TA1 as a peptide. I use it in my patients. BB157, let's sort of just unpack that for a minute. How does that work in the body when you inject it, for example systemically and you're subcutaneous fat in your abdomen or if you have an issue in a particular muscle, tendon tear. When you have a tendon tear, you inject it into that. What's actually happening is it.

[Dr. David Perlmutter]

Well, for tendon tear, muscle tear or even like I inject patients joints and they have a tear. What is interesting is that the one classic study that was done is they had these rats and they cut the Achilles.

[Dr. Mark Hyman]

That sounds fun.

[Dr. David Perlmutter]

So poor rats. And basically one group basically got PPC injection in their stomach and the other group just got placebo. And the group that got injected into their stomach in a month later they were walking again. And you don't see that in nature when you have an Achilles repair Doesn't heal by itself.

[Dr. Mark Hyman]

It's sewing together.

[Dr. David Perlmutter]

Exactly. This was the first thing that was shown and that was like, wow. Wow. So for my son, he had basically, he was in high school, it was a cross country team. He had like six pack. He was just like born to run. He. He's developed basically ITB injury Eliot band. And he couldn't even your IT band, we call it.

[Dr. Mark Hyman]

Right?

[Dr. David Perlmutter]

Yeah. So he just could not even get in and out of the car. And I told him he was in ninth grade. I said, son, I can inject BPC into your, you know, into your leg. And he said, you aren't effing doing that. So I had to show him some slides and I show him the rat. I had to show him hard data. Yeah. And he goes, okay, you can eject. And then literally, you know, he was, I don't know, 15 at that time. He quickly recovered and like a week later he was running again.

[Dr. Mark Hyman]

That's amazing.

[Dr. David Perlmutter]

It's amazing. And so it actually helps. There's multiple theories on how it could help, but number one, it reduces inflammation. It recruits your immune system to basically heal. But the one part is there's a receptor called Fat C receptor that activates your growth hormone receptor. So it's a pathway to help growth hormone receptors to be activated so that whatever growth hormone you have, you can actually heal faster.

[Dr. Mark Hyman]

So growth hormone is really involved in healing and repair.

[Dr. David Perlmutter]

Exactly. It's an anabolic hormone, but you need the receptors. And that's what BPC157 does. And there was a study that once they stopped it, three days later, they still had high expression of growth receptors. So if you use growth hormone peptides with basically BPC and TB4, you will heal much faster. So I have people, I have so many patients who had all these massive.

[Dr. Mark Hyman]

I think Tessamorelin, some Morellin peptides. You mean for adding.

[Dr. David Perlmutter]

Yeah, yeah. CJC 1295, teslamorelin. Yes. They can all help heal faster too. Amazing.

[Dr. Mark Hyman]

So it works by helping, for example, growth hormone. There may be mechanisms actually we don't really understand yet. Exactly. What you said in the rat was interesting is they just injected into the abdominal fat.

[Dr. David Perlmutter]

Right. It's a signaling molecule. So it basically tells the body to.

[Dr. Mark Hyman]

But it didn't have to inject into the Achilles tube.

[Dr. David Perlmutter]

They did not inject even near the.

[Dr. Mark Hyman]

Does it work better if you inject it near the site?

[Dr. David Perlmutter]

Yes, it always does work better. But that study was like truly like mind blowing. In the belly of the rat and the killy field.

[Dr. Mark Hyman]

That's quite amazing. And in some ways peptides are used to treat injury or illness. Like for example, BP157 or insulin. Ozempic you could say would be something that would be a semiglutide peptide that would be used to treat obesity or diabetes or to help with various things that it helps with. But many of the peptides are not really treating disease so much as bioregulators that regulate our bodily functions to optimize them.

[Dr. David Perlmutter]

Right, right. And my favorite one in regards to bioregulators is epithelium. Yeah, epithal. And that was discovered by Dr. Tavern. And so for example, four amino acid peptide.

[Dr. Mark Hyman]

Four amino acids. Seems like what would it do?

[Dr. David Perlmutter]

Comes naturally from our pineal gland.

[Dr. Mark Hyman]

Yeah.

[Dr. David Perlmutter]

And as we get older, like our thymus gland, it will calcify and will shrivel up and you lose melatonin and you lose epithelium from the pineal gland. And when you lose epithelin, what happens is your cells that are supposed to self replicate get stuck in G2. So there's self replication. So if you want a new skin cell, your body basically can get rid of the old skin cell and then you generate new skin cells. Inside our body, we can generate new heart cells, new myocytes, new liver cells, new pancreas, but our ability gets less. Exactly. Because we're losing epithelin. And epithelin basically turns on cell cycle. It's the peptide to make you younger. And I have patients who have prediabetes or type 2 diabetes. Some of them have reduction of their medication or even get off their insulin. I have patients who basically their macular degeneration is improving, their vision is getting better, so it's actually making you younger. But you can't self replicate forever because then you have discovered immortality, which I haven't discovered yet. But anyway, far from it. I don't think I'll ever do it, but I'll ever find it. But anyway, I have patience. I Hurry up. Dr. Lee. But epithelium is just amazing. Just, I just love it.

[Dr. Mark Hyman]

I mean, is this something you take every day?

[Dr. David Perlmutter]

Is it something you take wants you to cycle it. And so I have made my patients, which is sad because the FDA has this on the chopping blocks there too in terms of banning peptides. But you can get epithalin spray, which.

[Dr. Mark Hyman]

Is actually nasal spray.

[Dr. David Perlmutter]

No, under the tongue.

[Dr. Mark Hyman]

Under the tongue. Normally you have to inject.

[Dr. David Perlmutter]

The problem is there's so many on the Internet. But if you can get from Russia, the original one, cavesin.

[Dr. Peter Attia]

Sure.

[Dr. Mark Hyman]

There's Not a lot of commerce going.

[Dr. David Perlmutter]

Back and forth with Russia, China.

[Dr. Mark Hyman]

Through China, yeah. The black market for peptides.

[Dr. David Perlmutter]

Well, this one's a spray and this one I trust Dr. Kaveson.

[Dr. Mark Hyman]

Yeah, so you know, these are.

[Dr. David Perlmutter]

I don't trust the other ones. It's cavison, Brian.

[Dr. Mark Hyman]

So you mentioned, for example, sort of epithelium as a bioregulator that controls our self suffocation. Self suffocation healing repair. And so they're not like treating a disease.

[Dr. David Perlmutter]

Exactly. So you get it.

[Dr. Mark Hyman]

So what happens is insulin can treat type 1 diabetes. And that's great. But not all peptides are doing that. In fact, most of them are not. They're actually simply just enhancing function. Like.

[Dr. David Perlmutter]

Yeah, like.

[Dr. Mark Hyman]

Yeah, like PT141, for example.

[Dr. David Perlmutter]

Is it both, Both at the same peptide, same time? Yeah, that's for better libido. Better sex drug.

[Dr. Mark Hyman]

It's actually for women.

[Dr. David Perlmutter]

Yes. Has been FDA approved for that. And.

[Dr. Mark Hyman]

And it also works for men.

[Dr. David Perlmutter]

Yes, I have a lot of men and women on it.

[Dr. Mark Hyman]

So it increases desire.

[Dr. David Perlmutter]

So does oxytocin. Oxytocin is actually FDA approved.

[Dr. Mark Hyman]

Is it peptide?

[Dr. David Perlmutter]

It's a peptide. It's FDA approved.

[Dr. Mark Hyman]

Yeah. So oxytocin is the love molecule when you. After sex or when you, you know.

[Dr. David Perlmutter]

But there's a lot, there's a lot of other benefits and my nurse practitioner, Becky Murray is going to do a webinar. I host a monthly webinar. Not as popular as yours. I. You probably have thousands. I have only 30 people following. But anyway, one day I'll be as popular as you, Mark.

[Dr. Mark Hyman]

Well, let's see.

[Dr. David Perlmutter]

There's no way. I mean, you're like New York Times bestseller.

[Dr. Mark Hyman]

That's all right.

[Dr. David Perlmutter]

Well, let's. Bought my books.

[Dr. Mark Hyman]

I bought your book. Actually, you know what, I went on Kindle and it was free because I think it's part of the Kindle Unlimited.

[Dr. David Perlmutter]

Oh, really? Yeah, I'm gonna take it off Amazon.

[Dr. Mark Hyman]

I was gonna buy it. I was like, wow, Kindle Unlimited.

[Dr. David Perlmutter]

I got no, maybe 10 cents a year from Amazon. So let's kind of dive in a.

[Dr. Mark Hyman]

Little deeper around, around some of the use cases. And where are you finding, you know, the, the top value for peptides in clinical practice and for patients? What are the ones you like to use?

[Dr. David Perlmutter]

What are they used for? Okay. Number one that I just truly love is if you want skin, GHK, copper. Dr. Pickard discovered GHK, and it's a natural byproduct. So when you have collagen and basically breaks down Part of it is ghk. So GHK can turn on your fibroblast to make work. Basically collagen and hyaluronic acid. And your skin look better. Yeah.

[Dr. Mark Hyman]

And you don't have to inject it in your face. You can just put in your abdomen.

[Dr. David Perlmutter]

Well, we have GHK copper. Topical. Topical, yeah. So I'm not that smart, not that good looking. I'm not. Not a great athlete. But I have good skin, even though I don't. I live in Florida and I don't even use any sunscreen, but I use.

[Dr. Mark Hyman]

Tons of GHK copper on your face.

[Dr. David Perlmutter]

Oh, yeah. Topple. I love it. Yeah. And I tell all my things like hell.

[Dr. Mark Hyman]

When you inject it.

[Dr. David Perlmutter]

Well, no, no, I'm talking about topical, but you can inject. And for my father, who has. Who passed away recently with very aggressive cancer, T cell lymphoma, small bowel. He had a great life. And he. He basically was told, you really have, like, 30 days to live. Chemo, radiation, won't work. And I said, all right, dad, you're like, basically in a walker. Let me give you some peptides. And so, I mean, for cancer, I mean, there's several different peptides that have a lot of clinical studies. So Thymus Alpha 1 could help to.

[Dr. Mark Hyman]

Help your immune system fight cancer.

[Dr. David Perlmutter]

Oh, yeah, yeah, yeah. As an adjuvant.

[Dr. Mark Hyman]

We're not saying it's a cure. What you're saying is.

[Dr. David Perlmutter]

Oh, yeah, yeah. All the studies, even stage four, most of them, shows basically improvement of basically longevity, their reduction of mortality. So Thymus Alpha 1 has been used. You can use basically met enkephalin, which I was using. GHK copper turns off. Also cancer genes. Epithelium can also do that. So I told my dad, you're going to get some peptides. And I already drew it up. And my dad, he goes, I don't want him. He's like a stoic. He goes, I don't want to live. And he goes, I said, it's too late, dad. Mom is going to inject you anyway, so you can say whatever you want. And we got eight great months with that.

[Dr. Mark Hyman]

That's amazing.

[Dr. David Perlmutter]

So he went from, like, literally from a walker to walking two miles a day, regained his weight, and that's incredible. Yeah. Altered peptides and better nutrition, too.

[Dr. Mark Hyman]

Yeah, amazing. So, you know, so kind of going down again into the sort of the rabbit hole of like, what are the best use cases? What are the top peptides in your. In your toolkit. Right. For example, I know, like, My best supplements are magnesium, vitamin D, fish oil. Like those are my go to right probiotic. What, what, what are the. In your.

[Dr. David Perlmutter]

I would say number one is I love BPC157. You can take it orally. People with reflux, it tightens the LES junction. I have some people get off their reflux medicine.

[Dr. Mark Hyman]

That's the bottom of your esophagus where, where the kind of reflux happens come back up from the stomach.

[Dr. David Perlmutter]

And there's not many things that tighten LES junctions.

[Dr. Mark Hyman]

Yeah, that's the lower esophageal sphincter. Yeah, like a sphincter at the bottom of your esophagus. And that, that's loose.

[Dr. David Perlmutter]

Then you get, that comes up, you get reflux gird and all that.

[Dr. Mark Hyman]

That's impressive.

[Dr. David Perlmutter]

But BPC has, FYI just. I have people taking it and you know, I inject peptides in their elbow and a month later they re injure their elbow. But they go, since I've been taking that ppc, my shoulder, I can sleep much better. So it can improve your entire body. So I call the wolverine peptide.

[Dr. Mark Hyman]

So you'll get younger, so you can grow back.

[Dr. David Perlmutter]

Yeah, so you can say wolverine peptide. That's right. Some people maybe 157.

[Dr. Mark Hyman]

That's the top of your list. So we talked a bit about that. And it's great for injuries, for trauma, for tissue repair. And I think it's, I think it's, it's one of the ones that I tend to rely on because I think it, it really personally it's helped me and I think it helps a lot of patients. What, what other. And there. What other peptides?

[Dr. David Perlmutter]

I love thymus and alpha one because as we get older, our thymus gland shrivels up and we're trying to basically help the thymus gland, I mean, your immune system get healthier. And as you know, Mark, you know, you gotta have a healthy immune system because once it goes down, it goes to two ways. It goes to cancer. Right. To infections.

[Dr. Mark Hyman]

So yeah, we get immunosenescence, which means the aging of our immune system. Which is why when you're older, you get more infections, you can't fight them as well. You die of pneumonia, you don't respond as well to vaccines, and you get, you know, looking at Covid, the people who are elderly had the higher risk of death. And so I think you're, you're talking about a very important phenomena that we don't really have a good treatment for with traditional medicine.

[Dr. David Perlmutter]

So generally I tell my patients to use like 250 micrograms of thymus alpha 1. Like once or twice a week, just as.

[Dr. Mark Hyman]

Just not daily.

[Dr. David Perlmutter]

You can use daily if you're sick. Like, higher doses, like you. Yeah. My wife, one day, she goes, she. When she gets sick, it's like. It's a nightmare because I don't know when to drop the kids off. Do I give them lunch money? Do I. Where do I pick them up?

[Dr. Mark Hyman]

You don't have the playbook for.

[Dr. David Perlmutter]

I. I just. This is an Uber driver. So. Yeah, I don't. I mean. And so when my kids were younger, my wife goes, I took everything. The C, the D, the zinc, you know, silver. I'm coming down with something. And I said. She goes, you have something else? And I go, yeah, yeah, in the fridge I have the thymosin alpha 1. So I gave her. I remember this clear way before COVID I mean, 2016 or something like that. So I gave her about 1.1milligram of thymosin alpha 1. Next morning, she was perfect. It's like, thank God, because if she was sick, I wouldn't know how to handle the case.

[Dr. Mark Hyman]

We don't. We don't have the cure for the common cold. But. But if you take this. If you start to feel sick, you know, when you get that feeling, I think I'm getting sick. And you take it. It can be profoundly effective.

[Dr. David Perlmutter]

Oh, exactly. Exactly.

[Dr. Mark Hyman]

Yeah. What. What else besides T1 and BP157?

[Dr. David Perlmutter]

I love Epithelin. Then generally we do 5mg sub Q daily for, like, 10 days. If you skip a day or, like the weekend, you Frequently. Yeah, that's okay. Just. Just make sure you finish the vial. So one vial will have 550 milligrams of epithelium twice a year.

[Dr. Mark Hyman]

So you just do it twice a year?

[Dr. David Perlmutter]

Yeah, twice.

[Dr. Mark Hyman]

Like 10 days, twice a year. It's kind of a reset for your longevity.

[Dr. David Perlmutter]

And I have people. Like, for me, when I was doing it, it's amazing, my sleep. I was on melatonin every year, higher and higher, Higher doses. And do you know epithelin turns on three genes of your pineal gland to make melatonin? And my wife goes, how come you're not taking melatonin anymore? It's like, I don't need it. Sleep without it so it can reset your pineal gland and help you sleep better. So I love epithelium because as we get older, and you mentioned the.

[Dr. Mark Hyman]

The Russian version via the nasal spray.

[Dr. David Perlmutter]

But you can also take it, not nasal. It's under the Tongue, under the tongue.

[Dr. Mark Hyman]

But you can also do it through.

[Dr. David Perlmutter]

Injection, through a 503A compound form. It's prescription. Yeah.

[Dr. Mark Hyman]

Amazing.

[Dr. David Perlmutter]

And the problem is that most people, when they hear this, they're going to get addicted to Epithalam. Do not use it every day for the rest of your life because you're going to stop the magic. In terms of self replication, it will eventually, like the Hayflick theory, it's going to stop in terms of it's no longer going to work.

[Dr. Mark Hyman]

Just because a little bit's good doesn't mean a lot's better.

[Dr. David Perlmutter]

Exactly. So yeah, just be patient and don't, don't take it every day of the year because it's going to eventually stop working.

[Dr. Mark Hyman]

Now the other thing that sort of happens as we get older is we end up with hormonal changes. Lower testosterone, we have lower growth hormone, we tend to lose muscle, we sort of age as a result of changes in our hormonal environment. And what was interesting, a lot of these peptides can be involved in regulating hormone function and well, yes, there, there.

[Dr. David Perlmutter]

Are like regards to women that are done with, they're in post menopause or finish with menstrual cycle. Sometimes I tell them like, you may start your period coming back and if you get pregnant, please mention me because I want to be famous in choir because I can't be famous like you, so I have to go the other route. So anyway, yeah, it's amazing. They go, my period was gone five years ago and I was coming back, so I don't know how long it's going to keep on going. But they've in the animal studies using which peptide? Epithelium.

[Dr. Mark Hyman]

Epithelin.

[Dr. David Perlmutter]

Ovarian function gets better.

[Dr. Mark Hyman]

So it works not just on the pineal gland, but also other organs. Maybe the hypothalamus can help the heart.

[Dr. David Perlmutter]

Because it turns on gene expression, which is interesting. Research approaches that get kicked off and things work so epic. Talent is like to me, that's a good one. I love it.

[Dr. Mark Hyman]

If you love this pod, have you ever wished there was a trusted space where you could get real support on your health journey, where your questions get answered and you don't feel like you're doing it all alone? That's exactly what's happening inside my brand new membership community, the hymen Hive. And I couldn't be more excited about it. Thousands of members are already inside, sharing wins, asking meaningful questions and supporting one another like never before. The conversations are powerful, the camaraderie is real and the community is growing every day. Inside the Hive, you'll get monthly live sessions with me, office hours with our resident functional nutritionist, science backed protocols, monthly challenges, behind the scenes content, and so much more. All designed to help you create healthier habits that actually stick. Whether you're just getting started or fine tuning your routine, the Hive meets you where you are and gives you the tools and support to keep going. If you're ready to take control of your health with a community that truly gets it, join us at Dr. Hyman.com hive that's Dr. Hyman.com hive hive cast. Please share it with someone else you think would also enjoy it. You can find me on all social media channels at DrMark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Drmark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness center, my work at Cleveland Clinic, and Function Health where I am Chief Medical Officer. This podcast represents my opinions and my guests opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of impro improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.