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The Good Question Podcast
The Future of Regenerative Medicine Caleb Granger On Stem Cell Exosomes & Advanced Healing
00:30:20
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- [00:01]
A
You're listening to the Good Question podcast with Richard Jacobs. Our goal is to make each of our guests exclaim, hmm, that's a good question. I don't know the answer. Because when that happens, it means you, the listener, may be inspired to learn more beyond the interview and to ask great questions yourself that lead to new insights. In this podcast, we cover historical and current anthropology, comparative religion and history. Welcome. And let's get started.
- [00:36]
B
Hello. This is Richard Jacobs with the Good Question podcast. My guest today is Caleb Granger. He's the founder and president of Apex Medical. We're going to talk about what's called either extracellular vesicles or exosomes, and why 99% of stem cells that are taken out of people die within 24 hours, obviously rendering them useless. So I would guess that, you know, we'll get into it, but Apex has probably found ways to make sure that survivability is much longer and that these amazing tools can be put to good use. So welcome, Caleb.
- [01:05]
C
Thank you so much, Richard. Glad to be here.
- [01:07]
B
Yeah. Well, tell me a bit about Apex. What's the goal of the company and the focus?
- [01:11]
C
Sure. So Apex Regenerative is a regenerative medicine company. We do essentially go after that regenerative component with two pillars. One is increasing your cellular power. And so we do that through the only intracellular nad. NAD is the single molecule that powers all of your body's cells. So we have a oral supplement that has been shown in human studies to raise intracellular NAD, which is something that's unique among NAD supplementation, currently can raise your intracellular NAD 53% on average in five days, 300% or more in 60 days. And so we can reproduceably raise your total kind of cellular health. And then we also do produce placental and umbilical derived live tissue mesenchymal stem cell exosomes. Exosomes are the information carrying microparticles that stem cells actually all cells secrete. And so ex, the language of cellular information transfer. And we take the most potent healing generative cells that the body ever produces, get the exosomes from those cells, and deliver them in a therapeutic way in a variety of modalities to help essentially anybody that has a degenerative or inflammatory condition. What we're finding and what the peer reviewed studies are finding, massive amount of peer reviewed studies are finding that any degenerative or inflammatory condition can be essentially stopped and even reversed with stem cell ex up the cells and then use exosomes to show those cells where and how to Heal.
- [02:39]
B
So what are the most common conditions people come to for health?
- [02:43]
C
You know, it's fascinating the exosome literature and everything that's being done clinically on exosomes, it doesn't negate what we know and the literature on stem cells. In fact, it builds on that. They are stem cell exosomes. Therapeutic stem cell exosomes are what we use. And so what we now know after 20, 25 years of doing stem cells therapeutically, we now know that the way stem cells work when they're doing their healing is through paracine signaling and these exosomes that they secrete, that's how they work. So we kind of take out the middleman and leave the stem cells which are inflammatory, they are capable of carrying genetic, viral and bacterial load and just take their signals that have all the proteins, growth factors and regenerative signals and no cells. So we cut out the middleman, are able to deliver in a systemic way via IV sublingual spray or intranasal spray injection, intra articular or inter tendinous and you know, sublingual. I mentioned that topical sub q subcutaneous injections are incredible for aesthetic treatments and that sort of thing. Anywhere that we deliver exosomes into the body, they seek out any deficit from perfect and start repairing that deficit, you know, these cells. And so, you know, your question is who would use it? Well, anyone that has any degenerative or inflammatory condition. And so that's of course a wide swath. We see incredible application. We've now treated about 13,000 PAT in the last three years. We started with the first year we did about 500 patients all in the U.S. the next year about 2,500 patients. And this last year about 10,000. And we're on have a trend to do about twice that this year in 2026. The majority of those patients at the beginning were mainly orthopedic. So they were degenerative and inflammatory orthopedic indications. So you know, the typical arthritic bone on bone, knee or hip or ankle or toe joint or wrist or elbow or shoulder, all of those at the beginning we were treating those primarily with ac intra articular or intra tendinous injections. What we found was and that those did incredible, there's an immediate anti inflammatory response and then you are the entire body is filled with healing signals and so that creates this healing cascade. What we found now is, and what the studies show is that you get the best result when you are carrying out kind of systemic protocols. So instead of just doing one injection, if we do an injection, we also do an IV that same day. And studies have shown even from doing that at injection and IV the same day, that within three months and then definitely by six months in arthritic hips, bone on bone hips and knees, that there's a study that showed 1.2 millimeters, essentially on average new cartilage growth in osteoarthritic bone on bone knees and one little more than 1.3 millimeters new cartilage growth in bone on bone hips.
- [05:29]
B
Well, with how many treatments?
- [05:31]
C
With one treatment. So one systemic treatment. Right. So it's the injection plus iv. What we do typically now as our standard protocol is we'll do that. If you need an injection, we'll do an injection. That's usually if you have pain 7, 8 or 9 out of 10, constantly. If you have less than that, if it's, it's, you know, significant pain, but it can spike up to 70 or 9, and normally it's 3, 4 or 5 out of 10. We see incredible results with just a systemic protocol. So typically a 60 or 90 day protocol where we can do a bolus of exosomes via an IV or multiple IVs and then a daily sublingual that keeps kind of a steady state amount of healing signals going through your body. We can provide about 10 billion exosomes per day through your sublingual glands. And that combination has incredible healing and symptom reversal properties and can actually regrow the internal components of the joint. And we've used it in up to 103 year old that wasn't for joint stuff, that was for kind of degenerative and inflammatory brain based conditions and that sort of thing. But what we're finding is that, you know, kind of the, the way to look at AG aging, for instance, and all the degeneration that we associate with aging is that aging is the moment when your growth degeneration outstrips your internal regenerative capacity. Right. So there's a point where your gross regenerative capacity is higher than the degeneration that your body faces, either self inflicted environmental, genetic. Right. When you're a kid and you fall and break your arm, well, your regenerative capacity is such that even though you've inflicted this level of degeneration, traumatic degeneration, you will heal that bone and it will heal back stronger and you know, with greater tensile strength. Right. And there's so many other examples of that when you're a kid. That's because your regenerative capacity is higher than the Gross degeneration your body faces. At some point those two become offset and your regenerative capacity can no longer keep up with degeneration. When that happens, you're now aging, right? And that accelerates over time. We can reproducibly, consistently with our protocols, raise your body's gross regenerative capacity until it once again outstrips your degeneration. And so that is the definition of anti aging. We do that with protocols, you know, 60 and 90 day protocols that really magnify your regenerative capacity. And when we do that, we see incredible regenerative results with orthopedic applications, but not just that, brain based degenerative conditions.
- [08:11]
B
What happens if I have a, let's say I have a knee problem? You would do injections or would you do, I guess an IV to help my knee once that's, that's fixed? I would think there'd be a spillover or even with the initial injection and, or infusion, there'd be a spillover and it would go to the rest of my body. I guess the exosomes just look for the next damaged tissue and then they fix that and fix the next and fix the next. Is there any point or need in controlling the cascade as it goes through the body? Can it be much?
- [08:39]
C
It really can't. So there's been studies that have been done where for instance, they tried to give a toxic amount to in an athymic rat model. Athymic rat is kind of established by the FDA is these are the closest they're used for pharmacological applications, they're used for device applications. They're kind of the closest genetically to humans. Is this a thonic rat in an athenic rat model that was a healing model, it was showing concentrations, right? They did a 500 million, 1 billion and 2 billion exosomes concentration in a bone break model on athymic rats and then watched how the rats healed. What it found was essentially as you doubled the concentration, you essentially doubled the healing, the speed and fullness of the healing. In that same study, they gave what they thought would be six times a toxic dose of exosomes to these rats based on their, you know, blood volume and that sort of thing. So it'd be like, you know, you and I drinking a gallon of, of exosomes. It essentially made these rats super rats. You know, there was no toxic amount. It makes sense because the source material from whence we get these exosomes is the placental and umbilical material. There's a long established History of safe use of placental material in surgery, in brain surgery, in oncological brain surgery, where we take that. My background is neurosurgery, orthopedic surgery and spine surgery for the last 26 years. And then in the last three years have started apex regenerative and so focused on the regenerative side. In neurosurgery, spine surgery, orthopedic surgery. For 25 years, we've used dehydrated placental material, dehydrated placental lining as what's called a dural repair. The dura is kind of a thin wetsuit material that covers the wetsuit, like material that covers the brain and spinal cord. You get like an intradural injection, right. That's going into the spinal cord. This is used. It's been FDA cleared. So meaning it's been safe and efficacious. It works and it's safe in humans. The placental material as a dural repair, right. To be laid over the brain. If you do brain surgery, they say lay this stuff over the brain, it's safe and, and works to heal that covering. In those applications, we know the only thing better than two pieces of placental material is four pieces of placental material. Right. They're angiogenic blood vessel forming, they're anti inflammatory, they're antibacterial. There are studies that have shown that they're cancer fighting. The placental material itself is cancer cell starving and new cancer cell blocking. They use it in oncological settings in the brain. They use it in breast, you know, where they take out a tumor and then line the margin with placental material because they know that it's cancer cell blocking.
- [11:15]
B
I was going to ask you, right. If someone has cancer that's, you know, in metastasis, sure. This doesn't push that along. Will it slow it or stop it or has there been any Harvard thought.
- [11:26]
C
Yeah, there's actually been. So there has never been a study showing that therapeutic mesenchymal stem cell exosomes initiate cancer, accelerate cancer or bring back cancer that was in remission. So that that hasn't been shown in the last year. In 2025, there's about 20 peer reviewed published studies showing exosomes, therapeutic mesenchymal stem cell exosomes as a index treatment for cancer. So cervical cancer, breast cancer, glioblastoma, they used exosomes to try and shrink the cancer and it was shown to be effective. Again, given what we know about how they're used in oncological setting, how the placental Material itself is used, right? And that's just the placental material that not a cell free, super clean, just healing properties thing like exosomes is even that just the material, the tissue has cancer fighting properties. So one of the things that happens, Richard, is that people, for instance, if you Google exosomes, one of the AI prompts from Google's AI says the dark side of exosomes. You go to that, the dark side of exosomes, it says, talks about cancer cell exosomes. Well, the reason that comes up is because every cell secretes exosomes. That's how cells talk to each other, that's how they pass on information is through exosomes. So cancer cells have cancer cell exosomes. So the dark side is that cancer cells had exosomes. That's not what we're using. We're using zero day old placental and umbilical live tissue derived mesenchymal stem cell exosomes. The exosome only carries whatever their source cell produces, right? And so the cells that we use, mesenchymal stem cells from placental material have spent the last needed to create an entire perfect human being from two cells. Right? That's been their task for the last nine months. The day they finish doing that, we get them a list of the exosomes and all the generative power to generate perfectly everything in the body. Hair, lungs, brain, muscle, heart, you know, everything. They bear that generative potential in their exosomes. And so we then get hundreds of billions of them and deliver them to the body, whether it's acutely in the joint or systemically. We get an incredible. People get an incredible benefit. We see an incredible benefit with anything degenerative or inflammatory when they're taken systemically. And so, you know, you think about what all that can be, all the dementias, right? Alzheimer's, vascular dementia, post stroke, recovery, traumatic brain injury. We've got about 30 NFL and NBA guys that are doing these protocols, these daily protocols. And a lot of the NFL guys are either, you know, towards the end of their career and a lot of them have these CTE symptoms which are tbi, you know, traumatic brain injury type symptoms and get incredible resolution of those symptoms with this because it takes away inflammation and starts regenerating where there's calcified tissue or tissue that's, that's not having proper vascular flow, it's blood vessel forming, it's angiogenic, it's nerve regenerating, it's tissue regenerating of all kinds. And so when you can flood the entire body with increased regenerative capability. Your body now just heals these things that it had no capability of healing because its regenerative capacity was not high enough to overcome the degeneration.
- [14:43]
B
Yeah. That's amazing.
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C
It really is.
- [14:45]
B
So is this now like people can you have clinics where people can visit, just get a shot and go, or is it an inpatient type thing?
- [14:52]
C
Yeah. So we're the manufacturer. We work with providers throughout the US we're based out of Austin, so we have a, of course, very close, you know, relationships with providers here in the Austin area.
- [15:03]
B
You're in Austin? Oh, son, I am coming over.
- [15:05]
C
Oh, awesome. Yeah. So in Austin, for instance, we can do, you know, we've got multiple nurses, we can do kind of concierge, white glove service at your home or office for our IVs. That's the primary foundational thing is our placental derived IVs. That's the most potent and most healing version that's available. And we have the most potent healing version commercially available in the U.S. we, we do those IVs. We can do a direct to you sublingual or intranasal. The sublingual is just a daily spray, five sprays under the tongue that gets 10 billion exosomes into your bloodstream through your sublingual glands. Intranasal is for any skull based or brain based condition. Incredible. Even for like depression and ADHD and autism, certainly for Alzheimer's and Parkinson's, we see incredible results. And there's incredible peer reviewed published studies that are in the literature. That's another thing that I want to mention is this is something that's relatively new. You, let's call it in the last seven or eight years, that we now know that unlike what was previously thought for the last 20 years, that stem cells don't get into your body, stay alive, engraft in the body, duplicate, and eventually differentiate into various tissues. That was the thought of what stem cells did for the last 15 years. For the last seven or eight years, in fact. The father of stem cells, a guy named Dr. Arnold Kaplan, who coined the phrase mesenchymal stem cells, discovered that and coined the phrase. He published a study in 2018 saying, from what we now know about how mesenchyma mesenchymal stem cells work, they should be called medicinal signaling cells. MSC should stand for non mesenchymal stem cells, but medicinal signaling cells, because they're essentially exosome carrier. We now know that if you get a stem cell injection or infusion, Those stem cells 99% of them are flushed or killed by your body, your body sees them as a foreign invader, even if they're your own cells and they're flushed and killed within 24 hours, all of them for sure, within 72 hours. The benefit you 72 hour infusion of stem cells is only in the fact that they are carrying and secreting exosomes. We now know that's how they work is by secreting these exosomes. So, you know, that is totally established and it's relatively new information. From 1965 to 2019, there's approximately zero studies on stem cell exosomes as a therapy. From 2020 to today, there's close to 43,000 peer reviewed published studies on stem cell exosomes as a therapy. It is a. There, you think about any other surgical intervention drug, you know, insulin, aspirin, you know, anything. There is nothing that has that level of peer reviewed published studies in such a short period of time that has that many at all and certainly that has that many within five years of kind of being discovered. So, and all of it is basically the pinnacle of it all peaks off of and is built off of the tens of thousands of studies on stem cells as a therapy. Because what we now know is with anything good that the stem cells did, they did by secreting exosomes.
- [18:08]
B
I didn't culture enough of them and I would think they're incredibly fragile because they're so small. Like if you have to centrifuge them, they would tear to pieces. Like, I know it's probably proprietary, but how, how have people figured out how to keep them from, you know, keep them usable?
- [18:22]
C
Yeah, it's, it's really this ultra centrifuge centrifugation. Right. That you're, that you're starting to describe. That's really what it is. They are actually robust and so it's not. Cells are not robust. Cells really have to be treated with k, kind of the more specialized the cell, the, you know, the more you have to treat them with kid gloves. Throughout the entire process, including the delivery there, you know, cells you have to be worried about. You can actually crush cells by putting them through a cannula that's too small. That's not the case with exosomes. Exosomes are 1/1,000th the size of a cell. They are, because of that, they're able to, unlike cells, cross the blood brain barrier and so can perfuse into the brain and take away inflammation in the brain, regenerate tissue in the brain. When you do nasal application There are studies that show within one hour, 90% of the exosomes are in the midbrain and hippocampus, taking away inflammation and regenerating brain tissue. In Alzheimer's models, they show that they target the exosomes, target and dissolve beta amyloid plaque and regenerate the brain tissue that the plaque ate away.
- [19:29]
B
And so that's amazing.
- [19:30]
C
It's amazing.
- [19:31]
B
Quick question here. They sound like they're similar order of size of viruses. Has anyone attempted to inject them or inhale them when, let's say they have the flu, does it work? I don't know. I don't know that an application that's been tested yet.
- [19:47]
C
Oh my gosh. One of the most tested applications is for the treatment of long Covid. And so that's a fascinating thing. That was in the early 2000s, of course, that this started. And so now there's multiple years of data. The symptom list for long Covid, it's identical to the symptom list for a vaccine injury, which is fascinating. Vaccine injury isn't studied. Long Covid is. But you know, depending on kind of where you land on that, know that it is applicable to both of those things. The, the symptom list for long Covid is a 60 disease list. 6, 0. It's essentially the 60 most popular inflammatory and degenerative conditions that Americans face. Type 1 and type 2 diabetes, Alzheimer's, Parkinson's, depression, neuropathy. You know, like it's a massive list. And that is the long Covid. Covid list. This, the, the original study that was done was with 600 people given six IVs where they were hospitalized for Covid. 300 got saline IVs, 300 got exosome IVs, and two years later, 88% of the no exosome group had one or more of those diseases. 20% of the exosome group had one or More of those diseases at two years later. Right. So massive statistically significant healing and prophylactic effect against the top 60 diseases plague Americans. We integrate that into our protocols because basically that's 600 billion, 100 billion per IV. We know that is going to help. We know that is going to make you significantly, statistically, significantly healthier. And we also know from our, our protocols and, and what was originally a type 2 diabetic cohort, patient cohort is that from one IV and six days of sublingual, which is essentially week one of our 60 or 90 day protocols from, from one week of our protocol, all that we see a 500 to 1000% reduction in total body inflammation as measured through ESR. So you imagine that, you know, inflammation is just so pervasive, right? Everybody has a low level, low grade level, at least of total body inflammation. Inflammation is the body's signal to send healing. Well, if the entire body is inflamed, clearly your healing capacity is totally overwhelmed. And so as a result, a thing that actually needs healing can't get healing because your body is trying to heal everything, right? When we can reproducibly lower your total body inflammation 500 to 1000%. You mentioned it at the beginning of the show that you would, we would do something for an orthopedic injury, right? Say a right knee that was degenerated, get symptom cessation of that right knee. But also the left knee would feel better. Also the swelling, arthritic swelling in the second knuckle on both hands would totally go away. Their psoriasis would go away. You know, three years of psoriasis, their eczema would go away, their sinuses would clear up, their eyesight would improve. Is all the things that again, ultimately when you raise your regenerative capacity and it can now go back to outstripping the amount of degeneration your body faces, that's anti aging. And so that's what we end up getting. And of course it varies by patient, but we can reproducibly, with our protocols, just bring your body's regenerative capacity up significantly. And when we do that, you really see an incredible result that shows itself in all the biological markers as well. You know, A1C and AST, ALT, right? All the things that get higher as you age and are in worse shape. We can have, you know, single and double digit percentage reductions in, in 60 and 90 days.
- [23:27]
B
That's amazing.
- [23:28]
C
You know, every day I say we're, we're close to 13,000 patients and and so, you know, I personally hear about those right. From a lot of our providers and man, just a, you know, got, got a note from somebody recently from, who is on doing our protocol and was doing it for her cystic acne, right? And 30 years of cystic acne, Accutane and a bunch of different medications and it's totally cured, right? She was saying, I can't believe that I would go from 30 years of unrelenting cystic acne to now people complimenting me on my skin. She's like, it's just.
- [24:02]
B
That's cool.
- [24:02]
C
Yeah, it's totally cool. It gives me goosebumps. You know, because you just imagine the,
- [24:06]
B
the life change or two like 300 years old.
- [24:11]
C
Exactly, exactly.
- [24:12]
B
I guess I would assume you done this on yourself.
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C
Oh my gosh, big time.
- [24:16]
B
How has it helped you?
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C
Well, I'll tell you. Two years ago when I started doing this in a significant way, for instance and I'm an active guy, was a college athlete, have been athletic and try to stay athletic and eat healthy and all that good stuff. Two years ago my HSCRP which is the most discriminating measure of total body inflammation. It's also a great measure, prognostic measure of potential for heart disease. Potential for or basically organ failure when that is high, when your CRP is high, that's bad news. Two years ago my HSCRP was 2.3. That's kind of mid range low for a 48 year old. I'm 50 now, about to be 51. That's mid range. 2.3 is about mid range. I was doing once every two months IV and about halfway through that year I started doing daily sublingual doing that regimen by in one year it went from 2.3 to 1.2. That was a low CRP. One point last.
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B
Wow.
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C
That next year which was last year that right. That was last December, not December 25th. December 24th January of 25 I started doing monthly IVs daily sublingual every day. And then in the last 3 months I did daily LNAD plus that's our LapMyZed NAD. That's the intercellular NAD. December of 25 my HSCRP at 50 years old was 0.1. 0.1 is the total unattainable is like of a 7 year old. It's like wild. That's, that's no other lifestyle change. That's the exact same level of stress. And you know, running a business, all the things that, that you have as, as a 50 year old founder and you can't get a lower total body inflammation. And so that's one incredible measure. There was the article in the Wall Street Journal titled inflammaging, right? This, this conflation of inflammation and aging. And you know, this was maybe three months ago in their weekend edition they talked about how science is essentially getting to, to understand that the condition that we call aging is essentially inflammation. That inflammation is not something from aging. Inflammation causes what we call aging. And so when you can reproducibly take inflammation completely away, you not only increase the regenerative capacity, you decrease the degeneration. And so it's not just one, you know, not Just raising one, your gross regenerative capacity, it's lowering the other significantly as well at the same time. And so when you do that, you know, I've got our, our social media on every social media is at Apex Regenerative all one word. And on my social media I've got a. A side by side of my face. You know, unfiltered my face before I started doing that and then my face and it's, you know, now it's maybe six or eight months old and it's crazy. I have done no other aesthetic, any, anything, you know, I can't stress enough. I'm doing, you know, Axe 5 and 1 body wash on the same loofah. I wash my body with. Right. That's my facial regimen. Typical, typical bath for sort of thing. And it looks like I have aged in reverse. That was not my intent. Right. My intent was performance and longevity. But the reality is it's a external representation of internal regeneration. This is what it looks like. You know, your skin has. Is the fastest turnover cells. Your skin cells are the fastest turnover. So as you're arming them with more regenerative potential, more regenerative capacity and they turn over fastest. Well, this is what happens. You can see a marked change in, you know, my, my skin condition and health. It's really wild. My, you know, the folds of my eyelids and, and kind of all the wrinkles around my face. And this is, you know, it is what happens when you increase your regenerative capacity.
- [27:55]
B
I was, it was a pretty stupid joke, but I was thinking, what if you're accused of spreading misinflammation? And that makes no sense.
- [28:04]
C
That is a super joke, but it's right up my alley. So.
- [28:06]
B
Yeah, well, right on, Caleb. So what if people are located in Austin, great for them. Are you able to do this nationwide? Are there like registered clinics or, you know, how can people find out more and get this help?
- [28:18]
C
Yeah, so our website is the apexmedical.com and then as I mentioned our. On all socials, so Instagram, Facebook and TikTok. We're at apex Regenerative. So reach out to all those, to any of those. And then we can work with providers. Providers, we do kind of. Our main hotspots are Southern California in the Texas market, South Florida, but we work all over the nation and so if you don't have a provider who does this currently, we can work with your provider or as I mentioned, a lot of people come in and will kick off their protocol with say a long weekend in Austin you're in Austin, you know, it's a fun town to visit. Doing that over like a Thursday to Monday, you know, time period. You can get in a couple of potential injections and IVs and then be on your way with the at home protocol as well. That's a good start. That many people do people come from outside the US to do that often? We do that every week. Have people come from Europe and South America and so, you know, those are two ways. In Los Angeles and Orange county we can come direct to you with IVs at your home or office. And then in any Texas metro area we can do the same thing.
- [29:26]
B
Okay, excellent. Okay. Thanks for, for coming on. I really appreciate it and that's fantastic that you know these things. I've been studying them for a few years and glad they have such widespread and positive uses. So, you know, I encourage listeners, they have any problem to check it out. And again, thanks for coming.
- [29:41]
C
Awesome. Thanks so much, Richard. Appreciate you.
- [29:43]
B
If you like this podcast, please click the link in the description to subscribe
- [29:47]
C
and review us on itunes.
- [29:51]
A
Thank you for listening to the Good Question podcast. Please email support thegoodquestionpodcast.com if you have any referrals to great guests for us to interview, visit thegoodquestionpodcast.com to hear more interviews. And please help us spread the word by rating and reviewing us on Apple podcasts, iTunes, Spotify, YouTube, or wherever you listen to this podcast.