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The mindbodygreen Podcast
636: The ultimate guide to peptides | Elizabeth Yurth, M.D.
00:46:16
Elizabeth Yurth, M.D., a double board-certified physician in Physical Medicine & Rehabilitation and Anti-Aging/Regenerative Medicine, joins us on the podcast to discuss why peptides are much more than an Instagram trend, what forms of peptides might be most beneficial, and how to be mindful of safety and quality if you’re trying to incorporate them into your own protocol.
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- [00:00]
Jason Wakab
Welcome to the mindbodygreen podcast. I'm Jason Wakab, founder and co CEO of mindbodygreen, and your host. Today's guest is Dr. Elizabeth Yurth, a pioneer in regenerative and functional medicine who has been at the forefront of peptide therapy long before it became an Instagram sensation. Dr. Yerth specializes in helping patients optimize their health through strategic peptide use, hormone replacement, and a deep understanding of the body's natural biochemical pathways. It's in today's show we explore what peptides actually are and how they're different from hormones and therapies and why quality sourcing matters more than most people realize. We also discuss why peptides are not magic pills and should not be used in isolation. How to think about peptides for women in midlife alongside HRT and the promising role of peptides in cognitive health and reducing neuroinflammation. Let's get to it. So how do you define peptides?
- [01:02]
Dr. Elizabeth Yurth
So basically think about peptides as small protein chains. So if you look at a protein, it's really greater than 50amino acids. So amino proteins are just amino acid chains like glycine, arginine, lysine. Right. They're just strings of amino acids linked together by bonds. Protein makes it greater than 50amino acids. And then a peptide is anywhere from 2 to 48 per amino acids. Right. So there's very large peptides and there's very small ones that are two or three amino acids. So, you know, ghk, copper, things like that are just like three amino acids. So they basically are. Think of them as just signaling molecules in your body. So where proteins do do one thing, hormones do one thing, peptides very have very specific signaling messages that they, they tell your body. That's why they're kind of unique, is because they have very specific messages. So you can't really do as much harm with them as you might with other things.
- [01:52]
Jason Wakab
Then how do you think of broad categories of the different types of peptides and use cases?
- [01:56]
Dr. Elizabeth Yurth
So if you think about the categories of peptides, the different types of peptides, people forget that we actually make peptides. So a lot of our peptides are what we call endogenous. They're made by our system. Right. And in that way they're a little bit natural, just like hormones. So people are doing hormone replacement. Should we be thinking about replacing the peptides we lose? So these endogenous peptides that our body makes all the time, and we haven't even identified all of them, and we can take those endogenous peptides and we can synthesize them. They're basically the identical structure to what our body makes. So your body makes peptides that are working on recovery and your body's making peptides that work on immune system and their body's making peptides that increase joint muscle function, increase growth. So there's all these different categories our body makes and this is what we call exogenous peptides, which are ones that are synthesized that our body doesn't make. But people have recognized in laboratory settings, things like that, that they have significant benefits. Right. So not all the peptides we use are going to be ones that our body natur makes, but the ones that I like the best really are. They really are things that our body naturally is doing anyway. So just like you're replacing the hormones that drop as you age, should you also be replacing the peptides that drop as we age? In my mind, I think so.
- [03:08]
Jason Wakab
So which ones you, which your, you just what are your favorites?
- [03:11]
Dr. Elizabeth Yurth
So you think about the peptides that are kind of high. When we're young and, and growing and developing and really, you know, through our 20s, we have very ample amounts of peptides and, and kind of the top of that list probably is the growth hormone peptides. Right. So what we call growth hormone secretags. Now, growth hormone secretags are not necessarily naturally made by our body, but they're trying to duplicate what our body does to release growth hormone. So as you age, your growth hormone levels drop naturally. All of us do. Some people are going to stay higher than others. If you exercise and eat well, you're going to have higher growth hormone levels. But they, we all drop just like your testosterone drops, just like your estrogen drops. So kind of top of the list. If you're looking at things that are going to keep your body functioning well as you age, you're going to be looking at the growth hormone secretag. Now how are those different from growth hormone? Because you hear all these people taking growth hormone, right. And growth hormone is wonderful. The problem with growth hormone is it kind of hits these very, what we call supraphysiologic higher levels than your body would ever make. Right. And it does that because you kind of need that to signal, but that that isn't so good for your body. Our bodies are not designed to have these sustained high levels of things all the time. So if you look at things like growth hormones designed to kind of go up and down throughout the day and some days more than others. So basically using what we call growth hormone secretags, which are natural peptides that are both increase your pituitary making more growth hormone and then stepping on the gas, increasing your ability to release more. By doing that, you get much more physiologic cycling. The body's going to respond appropriately at the right times as opposed to just keeping it high all the time. So use things like CJC or Tessamorelin. Those are what are called growth hormone releasing hormones. They tell your pituitary to make more hormone. Now we use, we can use things like ipamorelin, which is a growth hormone releasing peptide. And that's like stepping on the gas. So think of these as fill up the tank, step on the gas. But if the, you know, the body's designed again for the pituitary to kind of still do what it wants to do. So now I'm not keeping these high levels all the time. I'm giving my body have nice physiologic levels. So that's kind of top of the list.
- [05:11]
Jason Wakab
What's the use case for that one is, is that someone maybe you know, in their north of 35, 40, not active, not feeling the energy like walk us through the typical use case that you see in your office. Who benefits in general?
- [05:26]
Dr. Elizabeth Yurth
Let's say there's, you know, if you look at the importance of growth hormone, it's important for muscle building, it's important for bone healing, it's, it's important for your brain, it's important for your immune health. Even your immune health have these receptors or what we call IGF or insulin growth factor. Growth hormones released by the pituitary. It tells the liver to make IGF insulin like growth factor. And that IGF has receptors on all of your cells, including your immune cells. So five people who have immune dysfunction as they're aging. So all of our immune systems age. So you're getting sick more often, Things like that, Those are, that's gonna be a group. You're definitely going to want to use it. If you have people who are just having trouble putting on muscle, or women with osteoporosis who are, you know, in their 40s and 50s with osteoporosis, those are people you're definitely going to use it. Now would you venture, say everybody needs this over time? Well, if you follow IGF levels, most people drop. Not everybody. I have people coming in in their 60s who have nice high IGF levels, but not everybody. I think one of the places where it really helps is in sleep. So our body's designed to release a lot of growth hormone at night. When we're sleeping, right? That's when you recover. And so by taking it before you go to bed, it helps deep sleep and helps you recovery. So the next day you can get up and go. So people are having trouble sleeping who aren't recovering well, that's also a great group to put it on. I also, if you think people who come in and you'll hear this all the time, right? So somebody's on testosterone and they're like, I'm on all this testosterone. My testosterone is great and I'm still not building muscle. You have to look at IGF levels because if they're low, that's contributing. IGF is a pretty big factor still in building muscle and, and, and recovery and rebuilding after you exercise.
- [06:57]
Jason Wakab
So if we back up, peptides have exploded. A number of conversations I've had online or offline were, you know, someone says, you know, what peptide should I take? I'm going to take this or that, you know, and it usually starts with, you know, I'm not getting the results I used to get or I'm not feeling well. And I'm just going to go straight to this peptide. Let's talk peptides without any real conversation around, you know, maybe their lab work or their sleep, they're just going straight to the peptide. What's your view on the explosion of peptides? Obviously they're game changing, but there are also risks.
- [07:33]
Dr. Elizabeth Yurth
I think that we've, we've hit this whole new, you know, paradigm. I've been, I've been in this world for a long time. So I was one of the first people using peptides, teaching peptides. And back then it was, you know, it wasn't every, everybody on Instagram talking about peptides all over, right. It was kind of done in, usually with physicians offices who are, who were trained in regenerative functional medicine and prescribed through compounding pharmacies. Now you can get online and buy peptides anywhere, right? When you do that, there's a few problems. Number one, you don't really know the safety of these, these products. They're not, don't go through the distinct testing. But number two, you really do have to know how it's kind of an art to use peptides appropriately. Because you're absolutely right. If I just have, you know, I'm somebody who's, you know, my age, in your 60s, and you basically, you know, you're like, oh, you know, I'm not feeling well, I'm, I'm losing my edge. I'm gonna just take some bpc. Because everybody's heard about bpc, it's really not going to do.
- [08:25]
Jason Wakab
I'll pause there for a second. The amount of content I've seen about BPC100 on social media, it's just astounding.
- [08:34]
Dr. Elizabeth Yurth
And somewhat warranted because BPC is a really remarkable peptide. It's another one of those endogenous peptides our body makes it. So it's made by our gastric juices, so it's made in our gut and then it's secreted and it's not only very protective to the gut which is great, but it's secreted to be sort of protective everywhere and help recovery everywhere. So if you, if you kind of looked at the, one of the most powerful peptides to kind of just use for anything, BPC would kind of fall into that category. It also has these great neuroprotective properties. We work a lot with athletes and the problem is, you know, it's not. Peptides aren't water approved. But ideally you would have all your athletes on BPC because if they get hurt they're going to recover faster. It's also been shown to be very preventative to brain health. So I think it's valid that this, this peptides, it's so powerful and does so much for healing and recovery and prevention. I think it's valid that it's getting the attention it's getting. Right? The problem is what are you getting when you buy how much you do? What is the right way to dose it? You, those are all the nuances. And again in the face of just putting somebody on bpc. So you see all these, these, these profiles about bpc. You know, let's say you have an injury and you're, you know, and you're a, a 40 year old guy and you have this injury and it's naked and you're like I'm just going to get on some bpc. Well, maybe getting a little testosterone on board is going to be actually really vital to you recover from that injury because testosterone is really helpful for recovery as well. So I don't know that you can use these in isolation and get huge effects. So people are spending money and I think that the not doing them with the best benefit that they could get from. But BPC is cool because you really can't take too much of it. Honestly it's, you know, it's been safe, you know, at least in, in animal studies shown safe to be very high doses. It's an endogenous peptide meaning our body makes it so it is a cool peptide. But again, none of this stuff is going to be the magic pills. It looks like it's online unless you have the other things in place. Your micronutrients have to be in place, your hormones have to be in place. Other these are icing on the cake. And they're not the base. They're extremely helpful for us to recover and heal, but they're not going to do it alone.
- [10:32]
Jason Wakab
Well, I love what you said. They're not the base. Like the base is still nutrition, exercise, sleep, not the base. They're not magic. But they can be extraordinarily helpful.
- [10:43]
Dr. Elizabeth Yurth
They're not magic. Right. They look magical on Instagram, but they're not magic.
- [10:46]
Jason Wakab
So can you talk a little bit about quality sourcing? What's the right conversation someone should have with their practitioner if they're seriously considering a peptide and think they could benefit?
- [10:58]
Dr. Elizabeth Yurth
This is tough because I pissed off a lot of people because even a lot of doctors use research peptides. Right? So, so peptides either come from compounding pharmacies which are, are. The pharmacy is regulated by the fda. So even though these are not FDA approved drugs, the pharmacy is regulated by the fda. They get inspections, they, they have to follow certain standards and they have to go through a much more rigorous testing process for anything that they're handing out. So if me as a physician, if I prescribe something, I rely on the pharmacy that this is going to be sterile. It's not going to have things in it that shouldn't be in it. It's going to have in it what it should have in it. Right. And, and that's my kind of protection in a sense. Right. I'm getting stuff that I know the pharmacy has to stand behind. So if something's wrong with that peptide, the pharmacy is really the problem. And so you work with legitimate pharmacies that are well tested, that we know well. So we work seven or eight different pharmacies across the US to get the different peptides you want. Now what's the difference? Because, you know, people who talk about the research peptides are going to say, well, it's the same compounds. They're getting the same compounds from the same place. And to some degree that's true. The difference is that when you look at a research grade peptide, they don't have to. The, the facility does not have to be tested. It's not, there's nobody coming in. So they can give you a certificate now of analysis. Right. So they give you what's called a coa. Everybody's like I have the same coa. This has what is in it. It doesn't have any contaminants. They you give p. Are not held to the same standards as a compounding pharmacy. So that coa, you could still have certain amounts of contaminants in it. You can still have certain amounts of things like arsenic in it. So the coa, you know, as long as it's below a threshold, they'll give you a COA that says it's fine. But there it's a different standard COA than what the company pharmacies use. The other problem, and this is what's happening kind of all over in the physician world, is that these research facilities are making a peptide and they're sort of putting it onto the doctor. So they, they, instead of saying this is a. So if you buy a research peptide, like you buy it from anywhere, Peptide sciences, anywhere you want to go, it will say, this is not for human use. This is for research use only. Right. And that's to protect the person making it that's used at your own risk. We told you it's not for human use. It's for research only. And if you want to inject it yourself, blah, blah, blah, we don't, you know, we're not watching. But that's what everybody does, right? So the facilities are protecting themselves by saying this is for research use only. If you want to do anything you want with it, go ahead. And everybody, well knows that everybody is not using them for research. They're just injecting them them because it's a better, cheaper way to. Not a better, but a cheaper way to get them. And then now what's kind of happening in that world is they're actually changing that, Taking off the not for human use and putting for physician use only. Right. So the way they've done that now is they've taken all the liability and put it onto the physician. So if I give my, my patient something says for physician use only, and I don't have the pharmacy standing behind it, then something bad happens. It's, you know, it's, it's my fault. So I think, you know, as a physician, I have to get compounds that are regulated, controlled. And I can tell you that we've seen some bad things happen with research peptides, and we've had our, some of our pharmacists who are compounding pharmacies look at some of the research peptides and they, they do have contaminants in them. They, they, they do have less amounts. So again, that COA doesn't mean a Whole lot. It just means they are within the research grade standards, not within what we consider useful for humans.
- [14:18]
Jason Wakab
So suffice to say, if one's considering peptides, make sure it's from a compounding pharmacy.
- [14:23]
Dr. Elizabeth Yurth
That's certainly my bias, but you know, you will find physicians everywhere and online everywhere and that are going to disagree with that. But being in this world a long time, I mean it was just a case. I don't know if you, you heard about the case at Radfest where there was a doctor there who was just injecting a peptide into people. It was in the exhibit hall, right? And you could just get a peptide injection. So he was there injecting these peptides into people. And a whole about 30 people had a very adverse reaction, two actually very serious. They had to be hospitalized. They, you know, so very serious reaction, right, to this peptide that he was injecting into people. So these are, you know, and this is a well known doctor, well established, got it from one of these legitimate research peptide sites. But it wasn't, there was something obvious off, you know, off for it. And you know, again, you're not screening these people and you're just sort of randomly injecting peptides. We can't be doing that. We can't be using these so nonchalantly. You know, when I was a, I was just an American Academy of Anti Aging Medicine and literally There was probably 30 booths with people with, you know, research peptides, with people with oral peptides, which for the most part we only have a few oral peptides that work. Most have to be injected to be working. So this, this industry is, you know, is, is getting a little out of control and that, that for those of us who are kind of doing this for a long time and doing it what we feel correctly, it's worrisome.
- [15:42]
Jason Wakab
I find it astounding that we kind of just jumped the shark with regards to like I'm thinking I'm in like I'm at a trade show or an event and I'm just gonna sign up for an injection.
- [15:51]
Dr. Elizabeth Yurth
People do, I mean look at all the people who go to these conferences and they get an IV run by, you know, I mean these conferences are full of that. I, I mean, yeah, it's, it's, it's a little frightening but you know, people go, this is the greatest injection since baked bread. I'm gonna do it. And you're like, it's free that, you know, people, people especially a radfest like that.
- [16:10]
Jason Wakab
And I'm not familiar with radfest and I don't know if that's on my short list of events now after what I just heard.
- [16:14]
Dr. Elizabeth Yurth
The rad fest is, is the radical something against age, aging and disease. And, and so basically it, they are the really push the envelope to say we can live forever. Right. And then, and I like to go to it because there's some very cool futuristic stuff that's presented that, you know, in the field, like, you know, cry, you know, freezing ourselves so we can wake up 30 years from now or whatever. So there's a lot of interesting fut stuff there. But it does push the limits on things. Now that I won't say it's always a bad thing. Right. I've my whole career pushed the limits on things. That's how we advance a little bit. But you have to be careful with how you're doing it.
- [16:49]
Jason Wakab
Oh, of course. It looks like maybe Walt Disney was onto something with freezing himself. Right. So if we zero in on women in midlife, per menopause, HRT is definitely. We went from HRT is dangerous, no one do it to it's. It's on the table. And that's very beneficial for a lot of women. How do you view peptides and midlife and potentially HRT is working synergistically or not together, I think we're going to.
- [17:20]
Dr. Elizabeth Yurth
See them go a little bit the same way. Right. Hopefully in a controlled fashion. Right. Right now you can't go buy estrogen, testosterone just over the counter, you know, like you can peptides where you can do that. So hopefully if we get a little more control of it, I think they have, you know, I think they are the next step where if you, you know, if you look at my, my paradigm, the way I practice medicine is let's replace the things that we are losing. Let's replace the things that we can, that we are losing as we age. So bottom line, all of us will lose hormones. I don't care how well you eat, I don't care how much you exercise, I don't care how many supplements you take, your testosterone levels, your estrogen levels, your progesterone levels are going to drop. You can't help it. Okay, so do we just sit around and go, well, that's, that's it? No, because we're living a long time. We want to live a long time healthier. So you're going to replace those? Well, what if I tell you that, you know, your BPC levels drop considerably as well or what we call the thymic peptides, Thymos and Alpha 1 and Thymus and Beta 4 are huge. When we're young, those are our immune modulating peptides. Those are the peptides that keep our immune system healthy. So when you're young and you have this giant thymus gland that's producing all these thymic peptides, you can fight off disease much more easily than you can when you're old. Why, you know, still one of the number one causes of death in older people is viral infections is because you don't really have the immune capacity. So if I can give you back Thymus and Alpha 1, Thymus and Beta 4, can I give you back that immune capacity so you heal better? And if it's available, should we not be doing that because that's, you know, it's declined as we age, should we not be replacing it? So I, I, I, I'm kind of of a bias that these should be following suit as we should be getting a lot more awareness of them, legitimate use of them, people who understand them and treat appropriately. So, you know, I do a lot of educating physicians around peptides. I think that's the key is we have to get more physicians educated. The physicians are learning the same way their clients are, which is sort of online teachings about it. Right. And so we need to get physicians much more, you know, understanding the science, the biochemical pathways behind this, how to use it in the right way, appropriately. But I do think they should follow suit a little bit because I do think healthy aging is going to rely on, on replacing those things that we've lost, hormones and peptides.
- [19:28]
Jason Wakab
Well, it's a good point because I think there are a lot of people who are doing all the right things. You know, they, they, they eat a pretty clean diet, they're getting their cardio, they're doing strength training, they're keeping lean muscle mass. But to your point, like it's kind of very hard whether you're a, a woman or a man to maintain the same hormone profile you had in your 20s and 30s.
- [19:51]
Dr. Elizabeth Yurth
At some point, it may be earlier, maybe later. At some point your testosterone is going to decline. At some point your estrogen is going to decline.
- [19:57]
Jason Wakab
And that's health to some degree. That, that's, you know, we got introduced via our mutual friend Frank Lippman, and he says his views completely like if you're, if you're, if, if you really want to increase your health span, hormone health is, act, is so critical.
- [20:13]
Dr. Elizabeth Yurth
Absolutely critical. Right. We, we know what happens when estrogen levels drop. You know, you get cardiovascular disease, you get brain disease, you get, you know, loss of bone, muscle. So it's impossible. And you know, and tell people, you know, I have these people who come in, they're like, well, I don't want hormones, I don't want testosterone, but I'm going to the gym, I'm working out, I'm doing all this stuff and nothing's happening. Well, you can't, I mean, you can't build muscle if you don't have testosterone. So, you know, and again, people, this decline happens at different rates in different ages. We're seeing it earlier and earlier now. Or CP seen hormones decline in people's 20s. So we're seeing it earlier and earlier. But you know, and honestly, the earlier you could actually intervene, the long, the better off we are going to be.
- [20:54]
Jason Wakab
So let's talk about cognitive health. I think with cardiovascular health, like, sure, declining estrogen is. Estrogen is, is cardio protective. And so when that declines, whether it's a male or a female, that's potentially problematic if we think about cognitive health. How do you view peptides and interventions for someone who's concerned about cognitive decline as they age?
- [21:16]
Dr. Elizabeth Yurth
Again, hormones are gonna still be paramount for cardiovascular or for brain health because estrogen is so critical to the brain. So in men, testosterone has some benef brain too. But men that rely on testosterone converting to estrogen and that's really the most brain beneficial. So one of the reasons women get dementia more than men is simply because of the decline in estrogen and women live longer. But the, there are a lot of peptides that are super useful here as well. Right. So if you have somebody who has declining cognitive function and you've got their hormones good. And I always would encourage everybody, you have to make sure your micronutrients is good as well, are good as well. Because if you're lacking and B12 and folate and B6 and magnesium, those again, those become a base. So I do recommend everybody has like an intracellular nutrient panel that they know what the nutrients are that they're lacking. But then how can we use peptides? Because peptides can be really sort of helpful for the brain. And if you look at cognitive decline, there's a, the, the primary reason for it is neuroinflammation. So every disease across the board, be it Alzheimer's, be it Parkinson's, be it depression or anxiety, those are all neuroinflammatory diseases. The brain is inflamed. So if you are, you know, if you have. It's why we're seeing a lot of brain Dysfunction, you know, post Covid is we're seeing a lot of people in a chronic inflammatory state, chronic viral states. The brain starts to get chronically inflamed and that creates ongoing cognitive loss. So how do we get rid of the inflammation in the brain? Hepatitis. Do that in a little bit like progesterone helps for that for both men and women. But peptides are really hugely beneficial here. And there's a couple of peptides that we really like for that one is called Cenk, it's a Russian peptide. So it came from Cavinson's lab. So it's kind of considered what's called a bioregulated peptide. It's, it's nice because it's a nasal spray so you can get it right to the brain. The nose has a direct access to the brain, so now we can get a direct access to the brain. So you do a little nasal spray and it's potently anti inflammatory to the neurons. So you can have people do that a couple times a day and start reducing some of the inflammation in the brain. And then you can use what's called clank, which is this kind of sister peptide which actually sort of now keeps the brain a little bit more awake. So, so now we've settled the inflammation down and now we want to make people more alert, more focused. So like even in, in, you know, people like you and I, where we want to be more alert, more focused but not anxious, doing a little C length, doing a CMax can keep us in this nice level state where we get sort of focused and intense on things, but we're not feeling hyper or irritable. So they're really a night. Those are really a nice combination of peptides. Probably our favorite peptide peptide to go to, which is harder to get anymore here we actually have to fly to Austria to get it anymore. It's called cerebralysin. Super lysin is usually done as an iv. It's been utilized for many, many years in Europe and Asia for dementia, for traumatic brain injuries, for stroke with tremendous results. It's not approved here and they're not really trying to get it approved here because it's really conglomerate of about a hundred different neural peptides and it has to be done IV or it's best done iv. You have to give a pre volume, but basically it really stimulates the brain to make new neurons. So it has all these little peptides that your brain is making or natural peptides that your brain is making so you can make new neurons. So what we have People do is come and do like cerebral lysin infusions and then go do something new and different. Learn how to play guitar. That starts to form new, new connections in your brain. So Cerebral License CMax are some of the really great go to peptides for. For brain health.
- [24:37]
Jason Wakab
It's fascinating. And you mentioned Covid and neuroinflammation. So I have currently. So I have to do the test again. My P Tau numbers are elevated. I only have one copy of the APOE 4. I'm like metabolically so fit. And then my SARS cov. Covid results were off the charts. It was like 7,500. And so. And then Frank had me do the amyloid beta 40 like the other tests for neurod and I'm all good. I just have this like neuroinflammation. So we're doing all these things that.
- [25:13]
Dr. Elizabeth Yurth
Right. So it's not really Alzheimer's. It's a neuroinflammatory disease.
- [25:17]
Jason Wakab
Right, from the COVID and I got Covid in the summer.
- [25:20]
Dr. Elizabeth Yurth
Exactly. Yeah. I mean, I know you had Robin Rose on your show and you know, and we're finding, you know, this is scary.
- [25:27]
Jason Wakab
Well, it's a huge problem. It's very scary because, like, I'm good. Like, I'm not even. Like, I wouldn't, you know, there's nothing wrong with me.
- [25:37]
Dr. Elizabeth Yurth
No, it's huge. I mean, I know she talked about some of the data they're finding and with, you know, we're. We're seeing MRI scans of people, asymptomatic people, young people were already seeing, you know, decline of brain function. We're seeing atrophy of the brain. We're seeing white matter lesions. I have a lot of people like you where, you know, they get back this PTOW from their neurologist or their doctor. They was like, oh my God, you have Alzheimer's. I'm like, no. You know, you measure some other things. Like gin 3 is also a really good marker to look at. So Galectin 3, if Glexin 3 is not high and you've got this PTOW that's high, you know, this is really just distinct neuroinflammation. That's why you have to really go hard. Because right now, you know, we have some methods maybe to get rid of spike protein. I'm sure Robin talked about them a little bit, but it's not. Not. It's not. This is not going to be an easy task. And so many of us are affected by this. Right. Even if you don't know it. You are probably affected by it to some degree.
- [26:24]
Jason Wakab
And it's interesting because Covid's. Let's just. Let's just assume, because my Covid numbers were so high, that Covid is driving the ptol. If everything checks out and then it's essentially like, okay, there's some therapeutic interventions. That's a function of time. But then the problem here, if you, like, zoom out, well, Covid is just kind of here to stay. And how. Who else besides me? It's like, okay, maybe I clear this thing and then I get reinfected again and then I clear this thing. And so. And I don't want to freak people out, but I think it's really interesting.
- [26:55]
Dr. Elizabeth Yurth
So what do we do? Right. I think, I mean, it's a little bit like a lot of the things our role. We're subjected to all these horrible things like microplastics. What are you gonna do about microplastics? I don't know. I mean, you know, you could take somebody as pristine as possible and they still have microplastics. You get things like, you know, glyphosate levels in us. 90% of my patients have high glyphosates. I'm not gonna actually be able to have them not exposed to glyphosates. Europe is a little better than us, but so the problem is we're gonna have to actually become more resilient somehow, right? Because we're probably not gonna have great ways to get rid of all these things. So we have to become a little bit more resilient. So maybe this is where you have to use ongoing things like maybe cerebralysin. Like you should be doing cerebral lysin monthly, right? Where you're actually doing something that's gonna actually counteract the fact that maybe you are gonna have this chronic low level inflammation. If we can keep it at bay, then it shouldn't develop into something horrible, right? There's even so now in people who have this high G antibody or high galectin 3, which is another marker of neuroinflammation, but more serious disease, a lot of times sometimes forming. So we have actually have a new. A new drug that we're experimenting with called TB006 that's an antibody to galectin 3. So, so people can actually get this antibody so they can actually remove the Glein 3. We have a lot of cool stuff. I think it may be, unfortunately, this is where we're gonna have to kind of keep doing some of this stuff, right? You Know, maybe you need to. Beyond Sealank and CMax, all the Sealank, at least all the time. Right. You know, until we've, until we can figure out how to, how to actually deal with this spike protein. Because I don't. I don't know that this is an easy answer. And we have the people who, you know, all. What the vaccine has done as well. Right?
- [28:27]
Jason Wakab
Yeah. And then it's, well, what, what, what's, you know, which one happened first, the infection or the vaccine or. We just, we just, there's just so much. As Frank said, we're in a new world. We just like. And this is why I love Frank. He's like, I don't know. We're all learning.
- [28:40]
Dr. Elizabeth Yurth
We make the best decisions we can at the time, like with, you know, what people do with the vaccine and things. But I do think that's where, you know, looking at some of these, you know, so. So certainly if you have neuroinflammation, keeping your hormones optimal, keeping your nutrients optimal. Do you say that people and assume everybody does, or almost everybody does. I mean, I measure P taus in all my patients and I will tell you it's at least half of them are high. I mean, it is not a minute problem.
- [29:02]
Jason Wakab
And that's why I call attention to this, to the COVID because I think a lot of people, if it is in fact a Covid spurgeon spike protein, there's a lot we can do here. And I think P Tau is on the map. And I think there are a lot of people freaking out and, you know, maybe they obviously have a sense of urgency to fix it, clear it, but at the same time, it's maybe not as bad as they think. And I just think it's interesting and something to be aware of. So what do most people come see you for? Like, they walk in, they want a peptide. What are they usually trying to solve for?
- [29:34]
Dr. Elizabeth Yurth
Most of the time patients come to, you know, if somebody's. So people know me because I do a lot of peptides. So a lot of times they come, but usually they're coming with a complaint. Right. It's not coming in saying, oh, I want BPC so much. You know, my background's orthopedics, so I get a lot of musculoskeletal injuries because that's, that's my world. And people still know me from the orthopedic realm. So we get a lot of patients who I treat my orthopedic practice and now come here more for regenerative, therapies and peptides. So, so we get a lot through the orthopedic realm and then what we tell them lots of times is, you know, yeah, we, you can use some BPC and some Thymus and Beta 4 and other things that we have. But in all honesty, we sort of feel like everybody needs to be in this kind of full program where everything else is optimized as well. If you're gonna heal, recover. Now not everybody goes for that. Some people just want a little BPC and Thymus and Beta 4 to heal up a knee. But I can tell people that over the long term they're a lot better off. Kind of going down the spectrum and then we have the people who come to us who are just these high level athletes who have heard about these things that are gonna make them faster, better, smarter. So we get a lot of those people, the sort of performance people. So they're coming just because they really wanna stay optimized. But most of those people aren't just coming for peptides. Most of those people kind of at our state where they, I just want to be top of my game and stay top of my game. And they want everything we have to offer regarding that. And then we have the really, really sick people who have tried everything, right? And they're like, nothing has helped me. I'm going to come and see if these guys have more stories. And again, I know peptides really well. There's a lot of peptides out there. There's a lot of things that we could use, but you do have to know how to use them and target them.
- [31:00]
Jason Wakab
There are so many. And you've named a couple. It's, it sounds like in terms of the ones that should probably rise to the top of a consideration list, I heard BPC 157, Thymosin Alpha 1 and 4. What else? Maybe there was, I think there was another one. But like what else should be.
- [31:18]
Dr. Elizabeth Yurth
So the growth homocytes. But I'm gonna put, if I put it sort of one of the top of my list, it's gonna be the GLP1 agonist. So you know your Ozempic, right? Ozempic has gotten a lot of press for its weight loss. But Ozempic, the GLP ones we were using long before they ever got this whole weight loss thing we're using for immune health and healing. Because if you, you know, GLP1s have gotten a very bad rap because if you put somebody out of GLP1 for weight loss, they stop eating, they stop drinking, they lose muscle mass they lose bone mass, they lose their hair. But if you keep somebody on, on a high protein diet, have them hydrate, that doesn't happen. GLPs do not cause you to lose muscle at all. In fact, when they were first developed many years ago, they actually used them because they actually helped, helped put muscle onto their diabetic patients, these little frail diabetics. So GLP1s have gotten a bad rap. Used appropriately, they are a very good drug. But from a longevity perspective, they're kind of attacking almost everything that we need to attack. There's GLP1 receptors on immune cells so we can bump up immune function. We know that joints are helped by GLP1 agonists. We, you know, they just published that they did, they failed the trials for the, for the cognitive decline. But if you read the study, it didn't really fail. All of their markers got better. They just probably weren't on them long enough to basically see the, the substantial change. So they basically saw, yeah, baselines didn't change in terms of their, their, some of their cognitive testing, but their C reactive proteins went down. Their immune markers all got better, everything got better. So likely over time, it's just going to take more time. The study would have had to go out for five years. So basically, you know, they're still hugely beneficial for cognitive, for cognitive protection. So I, I like them kind of. We have, you have certainly a large number of patients, but use a low dose of a GLP1. You don't need a lot. So you use a dose that you find that somebody is not losing weight and they're, they're not nauseous and they feel fine. And that's, that's the dose you target in to do all these protective effects. And I have a lot of osteoarthritis patients. There's great studies now. The GLP1s and osteoarthritis, they, there's great information on it for helping immune function, for helping you people fight viruses. So the GLP wants kind of float to the top of the list. We do make glp, right? That is again, it's an innate peptide to our bodies and it has huge power including lowering inflammatory markers like N what something called NLRP3. So we know that lowers, so we know that we can actually, you know, once you lower inflammation, you improve immune function, you're dealing with a whole lot of the aspects of aging. So the GLP ones are going to kind of float to that top of the list, right? And then, and then it's going to Be your, your, your reparative peptides, your thymic peptides, Thymus alpha 1, which is known as Zidax. Zidaxin. It's approved, like Asia, they use it all the time. I had a patient with cancer who moved to Asia so she could get Zedactone because it's an approved drug there. It's not approved here. It's hard to get. But Thymosin Alpha 1 is a really big key to keeping your immune system healthy. So if you have autoimmune disease, if you have cancer, if you have, you know, viruses all the time, and Thymosin Alpha 1 is a key peptide. So those are gonna kind of. And then thymosine beta 4 being more of a reparative thymic peptide. Those are gonna kind of flow to top and then. And then BPC for helping repair, and then kind of. And then the growth hormone, secretive Al. And the other thing I'm going to add in is the other thing that fades as we age. Again, no matter what you do is mitochondrial function. Especially for you, like if you have Covid spike protein, you almost certainly have mitochondrial dysfunction. It's probably one of the causes of some of the neuroinflammation in the brain is the brain loses the capacity for energy. So how do we actually fix that? You know, how are we actually with the mitochondrial dysfunction that occurs? We actually use mitochondrial peptides, right? There's kind of two that are most widely used, and I love one of them. It's called the SS31 peptide. What happens as we age is our mitochondria design. The inner membrane has this kind of shape like this, right? It's like a flower inside. And what happens is all these protons get collected in that little groove, and when they get enough of a force, they actually drive ATP production. It's called a proton motive force. If my mitochondria now look like this, the peptides never accumulate. I can't make ATP. So basically, if we reshape that mitochondrial membrane again, all of us, this has happened to whether you've been age worse with COVID worse with infections, worse with stress, worse if you don't sleep. But the mitochondria will always start to lose its structure. So you have to put SS31 on board at least a few times a year, maybe three, four times a year to restructure those, those, those mitochondria. So, so Exos31 goes kind of to, you know, you've got to repair mitochondria. So now we're addressing, you know, what Are we addressing. We're addressing my immune health. We're addressing my, my brain health. You know, we're, we're addressing my cardiovascular health and we're addressing my loss of energy and all the other things that occur as we age. So by kind of that little handful, you can do a whole lot and you can sort of cycle them through time.
- [36:06]
Jason Wakab
Interesting. So who should not be using peptides?
- [36:10]
Dr. Elizabeth Yurth
You know, so that's a tough question because used inappropriately. Right. There's a lot of people who should not be using them. And there are peptides you need to be a little bit more aware of, right. That potentially could they drive cancer? If you have cancer, could they drive cancer? Now if you look at the data, it's probably unlikely that these drive cancer, but some of them potentially could. Thymosin beta 4. Thymus and beta 4 causes revascularization. It allows stem cells to come activate. Now, now, because it's, it truly is actually does it in the same way your body does. Probably doesn't cause cancer. But we get a little bit concerned if somebody has an active cancer of putting them on something that's increasing cell growth, increasing, you know, increasing blood flow to the area. Right. So Thymosin Beta 4 is one of those ones that if you have cancer probably should be staying away from. Right. If you. There are people who just don't tolerate certain peptides. They seem to have reactions to them. Who knows why they're endogenous to our body. Sometimes it's the carrier molecule, but sometimes it seems to be the peptide itself. So, you know, so there are some people who know you try them and you just can't get anywhere with them. But I would say cancer using the growth homo secretagogues and Thymus and Beta 4, that sort of peptides that are causing growth and, and recovery are probably ones you need to be a little more careful of in cancer faces. Now we will do it because it used appropriately. It can be helpful. But you don't want to do that by yourself. You want to do with somebody who's really, who's really understands peptides and understands how to use them in these cases.
- [37:32]
Jason Wakab
To me that's the, that's the catch all for peptides, period. Like, you should probably never do them by yourself. Like, like make sure you're working with an informed physician.
- [37:41]
Dr. Elizabeth Yurth
Yeah, I think the problem is they're very nuanced. I think people don't get that. You do want to like use them in certain cycles. Using one you like, like people all taking this mod sc right. Modesty is a mitochondrial peptide, increases energy, it acts as an exercise medic. But if you actually have misshapen disrupted mitochondria, you might actually be doing more harm than good by doing it. So there's so many little nuances. Or if you have none of the baseline micronutrients for your mitochondria to work and you. And you try and spin up activity in the mitochondria, you're actually going to create problems. And so you are right. I mean, I think you should be doing it with. We always say it's, can you do it yourself? Yeah. Can you climb Mount Everest by yourself? Yeah. It's going to be really tough. And the likelihood of you dying is a lot higher than if you do it with a guy. So that's what we kind of all are. We call ourselves Sherpas. Right. We are helping people do this.
- [38:24]
Jason Wakab
I love that you mentioned cycles, because I think for some people and some peptides, the peptide is a bridge. It is not your new daily protocol. It is a bridge. There is an on ramp and an off ramp prep.
- [38:36]
Dr. Elizabeth Yurth
Right. You don't have to stay on these forever. You can do them. But. But if I look at, I'm replacing BPC or I'm placing my thymic peptides, so what I'll do is cycle people a few times a year of all these different peptides. Partly because people don't want to be doing six, seven injections a day. Right? So they're on seven peptides. It becomes ridiculous. But you can use. I can do a cycle of Thymosin, Alpha 1, Thymus and Beta 4. And then I can do a cycle of BPC and then maybe a mitochondrial recovery peptide. Right. There are peptides I think are just beneficial to take all the time time. Like the GLP1 agonist. Right. Those are probably beneficial for most of us just to be on at a low dose all the time.
- [39:12]
Jason Wakab
So I'm going to come back and close with lifestyle because we've touched on this one. And I have a feeling I know what your answer is. I think it's a good answer in terms of nutrition. Nutrition is foundational. What is your. Nutrition is complex. It is confusing. There's so much conflicting advice. But in your view, what is your go to nutritional hack where if you start here, you're gonna be pretty good.
- [39:36]
Dr. Elizabeth Yurth
I mean, you guys have all heard this, but, you know, it's protein forward, right? We need so much more protein than we think and that the, the guidelines say. And so, you know, you really need at least A gram to a gram and a half of protein per pound of lean body mass. It's a lot. And it's hard to do. I mean, those of you guys who are trying to eat that much, I weigh about 130 pounds. Even for me, getting 130 grams of protein is really not easy. You have to conscientiously be doing it right. You have to really be thinking about where I'm going to eat all the. Because people tell me they're eating enough protein and I have them, I have them. Food journal for me, I'm like, you got 60 grams, you got nowhere close to doing that. And now we're seeing people, you know, as, as, as the. Like. I have a lot of people who follow that. Omad one meal a day, right? Can you truly get all the protein you need in one meal a day? No. And it's a little bit promise. Like you look at something like me that's very thin. You know, with even intermittent fasting, you know, can be a problem sometimes with people losing muscle if you don't have a lot of reserve. So you have to be a little careful with this stuff that you're making sure that your macronutrient profile stays high and that you're, you're not, not kind of overstressing your body. There are people who do great with intermittent fasting who can go three days and has some huge benefits. And there's people who actually are going to create more stress in their body and more muscle loss by doing that. So, so you know, all. So. But if you had one rule, it would obviously be making sure that your protein intake is there. And I will also, I'm going to add that, you know, add water to that mix because people forget so much how hydration is so important to us. Like it is. So yeah. So neglect it. And, and so like when you look at the muscle loss people had on GLP1s even, even if they ate enough protein, a lot of them started to lose muscle. It was because they weren't drinking. You also lose your thirst when you're on GLP1. So you were not drinking water. And, and you'll. And then we. I like to use this product called Isol Water because it's an osmotic load to your water, adds some amino acids to your water and if you sip that during the day, it adds actually an osmotic load. So it pushes that water into your cell. Cell, which is where you actually want the water to be. So you can actually add this little, this little isol which is actually an osmotic push of bringing that water into your cells so you can hydrate the cells a little bit better, but you need a lot more water. Most of us are dehydrating. I see it all the time when I look at in body scans and things like that. You can see there's cellular dehydration.
- [41:47]
Jason Wakab
Wow. We covered a lot of ground today. Is there anything we didn't touch on that you want to cover before we wrap?
- [41:53]
Dr. Elizabeth Yurth
Yes. There's so much you may have to have me back to talk about. Two of my favorite topics, which are ketones and why. Why ketones are so incredibly exogenous. Ketones are so incredibly helpful to us for aging. I. I was on podcast and they said if you had one thing, just one thing you could do, it would probably be ketones. So we'll have to come back because it's a whole big conversation around ketones. And then my other passion as an orthopedic doctor is a medication we use called Pentasyn polysulfate, and it's going to come to market, guys, in a few years. It's going to be known as Xylosol, but it is really a remarkable treatment for osteoarthritis. We've never had anything like this to treat osteoarthritis, and we've been using it for about four years now in such dramatic, dramatic benefits. So, you know, so those are two things we'll have to talk about at a different time because they're very cool topics.
- [42:33]
Jason Wakab
Done. Agreed. Elizabeth, thank you so much.
- [42:36]
Dr. Elizabeth Yurth
You're welcome. Thank you. This year's tax changes better not get caught snoozing. Miss one deduction, lose thousands. Not amusing. Big tax changes can mean bigger refunds at Jackson Hewitt. And right now, get $100 just to try us. Don't worry, tax filers. If money is tight, get $100 from Jackson Hewitt so you'll sleep better at night. Limited time offer for new clients. Participating locations only. Details@jacksonhewitt.com.