BPC-157, NAD, and the Truth the Wellness Industry Isn't Telling | Dr. Rachele Pojednic

Introduction to Peptides

0:00Hi, everyone. Welcome to Proof of Practice. Our guest today is Rachel Pajednik. She has a PhD in exercise and nutrition, and we are really excited to talk to her because, well, not only is she smart, we're going to be talking all about peptides, a little bit about NAD, and in a time where peptide talk is everywhere. I think a lot of us are trying to figure out what could we use? Do we really have to stack it? All these kinds of things. And the hope is that

0:31we're always taking this scientific information and giving you a practice for everyday real life. Rachel, welcome to the show. I'm just curious, peptides. I think for people who've been on the fringe, it's probably a solid eight years that at least BP-157 has made its way into someone's vernacular or you have an injury or something like that. But are you surprised at kind of how

Mainstream Peptide Use

0:54mainstream people are not only talking about peptides, but just how they're sort of everywhere now? I don't think so. I think in the world that I live in, which is longevity, and as you have described, the longevity space has been, you know, sort of doing the peptide thing for quite some time, or at least experimenting on themselves in this space. And so it's not so unusual given the context that I live in, but I think that the general population is kind of being taken by surprise

1:25by how in their face they all of a sudden are. And part of it is because of, I think, two things. Number one is GLP-1s are so popular right now. And a lot of people don't realize that a GLP-1 is a peptide. And so that has started to jumpstart the conversation, if you will. And the other is that they're quite controversial right now. And I think that has also gotten a lot of headlines around them. So peptides eight years ago used to be able to be compounded, and we can talk about what

1:59that means. And then in 2023, they were removed from the compounding list, which immediately put a spotlight on them. And so now, as we're talking about potentially bringing them back into the wellness space to be compounded, it's just a big buzz. And so everybody wants to know, what are they? What do they do? What's the research? And so that's where I'm spending a lot of my time these days.

Defining Peptides and Compounding

2:25So can you clear it up front? What is a peptide? And what is compounding? Yes, we can start with the simple stuff. So a peptide is essentially just a small protein. So when you look at a protein, it is made up of amino acids. There are 20 of them that you can mix and match and make these long strings. And they get folded and used in your body or created in your body for a variety of different purposes. A peptide is going to be a small version of that,

2:55that's somewhere between 2 and 40 or 2 and 50 amino acids long, depending on who you're talking to. And they don't get folded. Typically, they're just long strings. Your body makes them very naturally. And they're also being made synthetically to either mimic what's going on in your body or to create a new molecule altogether that can have some kind of physiologic action. That's where compounding comes into play, is that most of the peptides that are being used in the wellness space

Compounding Pharmacies

3:24are created by compounding pharmacies. And a compounding pharmacy is kind of a less than mainstream pharmacy. They're governed by state boards of pharmacies. So they're not quite as regulated as some of the larger pharmacies that you might go to to pick up your prescription. So like a CVS or a Walgreens or something like that. These are more independent. And oftentimes, a compounding pharmacy will be used if you, for example, get a prescription and you need it tailored to you. So let's say you have a prescription and you're allergic to a particular ingredient in the

3:58mainstream product. Then you can go to a compounding pharmacy and say, please create this new tab for me that doesn't have this problematic ingredient. And so that's why compounding pharmacies essentially exist. They also are able to create drugs in the time of shortage of drugs that might be used in the mainstream. So a really good example of this is the GLP ones. So they came online and everybody wanted them and the pharmacies couldn't keep up. And so they were allowed to be compounded in the compounding

4:33pharmacies under a restriction law because you wouldn't want somebody that has a prescription to not be able to get access to it. And so these compounding pharmacies are able to make them. And so this has opened the door wide up to controversy around who gets to create peptides, who doesn't, which ones do you get to create, which ones do you not. And so this is where we kind of enter the space where GLP ones,

5:00you know, the toothpaste is out of the tube at this point and everybody's making them. And now people are trying to get control over who gets to make and then distribute these wellness peptides.

Common Peptides

5:11Interesting. Before we jump into GLP ones, because I think we could talk about that. I think it's so cool that you live in both spaces, meaning you are looking at the data, you're creating research, but you're also in practice. And just that's part of why you're here. And so thank you for being here. But can you go and just talk through some of the most common peptides that are being talked about right now? Because I think everyone lumps them together. So we talked about GLP one. Gabby talked about BP 157. What are the other ones that are most common lumped into our peptides?

5:45Yeah, I think there are a few that people are really talking about lately. So the BP-C is body protection compound. It's actually made in your stomach. So that's one that naturally occurs. So that one is people are talking about using for wound healing and for recovery. There are a whole host of what we call growth hormone secretagogues. These are the LNs, if you will. So ipamorelin, tesamorelin, sermorelin. And these ones actually stimulate your pituitary gland to make more growth

6:19hormone. They're being used in the longevity space because growth hormone starts to stop being produced at such rapid levels as you age. And so we're trying to boost that back up. The interesting thing about these particular class of peptides is they will only essentially boost, if you will, as high as your body can make. So it's not like taking growth hormone. It's just increasing your ability, so they say, to actually make the peptide yourself. There are other derivatives that are often

6:50being told that women should take. So oxytocin, Kispeptin. These are kind of the ones that are the the ones that are released in your body when you hug somebody, when you are in love with somebody. So these are being released for sexual health and, you know, sort of women's libido. There are others that are being stacked for general recoveries. So there's a stack called Wolverine that's really

7:25popular right now. It's BPC-157 with something called TB-500. Oh, I have that. I'm a Wolverine. Yeah, Wolverine. I don't know what it does, though, so I'm excited to hear it.

7:38There's another one called GHK Copper that's supposed to be really good for your skin. Okay, so now that I've all said that, here is the big problem, is that there is almost

Lack of Human Data

7:49no human data on any of these peptides. So in a couple of them, the growth hormone secretagogues, they were being used in kids back in the day because they had a stunting disorder. Or BPC-157 has been studied in animals and rats pretty regularly, but there's really only one human study that looks at this. The others, you know, in some cases are used clinically, in others, you know, by a compounding pharmacy, in others, they're sort of, you know, decidedly

8:24shunned among clinical populations. And so this is where we find ourselves in this world right now is that as of this recording, these peptides are about to be released back into the wild, and we don't have good human data. So we don't know dose. We don't know effectiveness. We don't know one of the things with peptides is that people like to cycle on and cycle off them. What is the right protocol for that? The only people that know seem to be on Reddit, and they're doing their own research. But we don't have good clinical data. So to your point,

9:01Abby, this is where I come in, is the work that I do in industry, in the job that I have, is to straddle what's going on in the wellness space, what's being released into the wild, if you will, and then use my very classical training to do the randomized control trials, to do the real world data collection, to understand if they're going to be out there, can we at least have a baseline set of data to show safety, to show dosage, to show whether or not people should or shouldn't be using them? Does it affect men versus women differently?

9:35This is the challenge that we find ourselves in, and Abby, you'll appreciate this too, is as researchers, it takes a long time to do this study. And we've got hundreds of peptides potentially coming out into the market, seven to 12 over the next year or so, and then who knows what else coming after that. And if they're released directly into the market, and we don't have the research to back them, we've got to capture that data somewhere. And so that's the way that I'm trying to get creative to understand how to do this.

Research Challenges

10:06So just as a follow up, I think there's a lot of downsides for these being released. But one thing from a positive side is also now it gives the opportunity to gather research if some of those things are available and the FDA claims go away. So what would be your next steps? Like knowing what's just happening right now, what are the ones that based on the animal data, based on, you know, the clinical and the Reddit insight, which are the ones that you would put to the top that says, these are the ones that have the most potential, and I'm going after them as a researcher and as

10:38someone, a proof of practice? Great question. I'm going to come back to something that you just said before I answer. And that is that it has been very hard to study these peptides. Interestingly, if you go and try to buy peptides right now, and they haven't been released yet, if you go and try to buy them on, Google it, and you will find a whole bunch of places that will sell it, they will sell you a little vial. And on the bottom, it says for research purposes, not for human use. And I think

11:09what people get really confused about this for research purpose label means is that we as researchers can use this and give it to people in the lab. That is the farthest thing from the truth. What this actually is essentially is legal cover for these companies to say when you hit the button that you want to purchase it, a little box comes up and you click the box that says, yes, I'm a researcher. This is exactly what it says. Yes, I'm a researcher. No, I will not give this to humans. And so if you click

11:41that box, I clicked it. I'm researching myself. If you click that box, then you give cover to the company that you are purchasing from. Now, before I come back to which peptides I think are really

Gray Market Peptides

11:54interesting, the next layer in this right now is if you can't buy it from regulated and overseen compounding pharmacies, you are buying it from what is now being termed the gray market. Essentially, you are buying from factories, mostly in China, some in India. That's not inherently bad in and of itself, but they're not vetted, right? And so you could be getting in that little vial the actual peptide itself because it comes in what's called the lyophilized powder. You have to put bacteriostatic

12:28water and reconstitute it so that you can inject it for the most part. And you don't know what's in that bottle. Or the concentration. The concentration. Is there other toxins in that bottle? Are there heavy metals in that bottle? And so that's the big problem here is that, yes, you check that box to say, yeah, sure, I'll use it for research purposes. But you actually don't really know what you're getting because you don't know where it's coming from. And so right now, all of the compounding pharmacies are scrambling to find what's called API. So this is the actual ingredient itself that has been tested

13:03so they can bring it to the labs in the United States, make those compounded peptides, and then go through GMP or good manufacturing practices in order to make sure that when you purchase it, it is safe and it has been tested. But right now, as of this recording, that does not exist in the United States. So when you buy it, you have no idea where it's coming. So it's really easy to buy a lot of these things. It's really easy. Yeah. Google. Mine comes from Mill Valley, so it must be fancy. But I have no

13:34idea. So I'll tell you a really funny story. I did a little bit of recon on this because I wanted to understand the process as I'm thinking about how I can study these peptides better. And so I went on Reddit and I asked, where's the best place to get a particular peptide called retatratide, which is a GLP-1 variation that is not approved by the FDA in the United States. And I just wanted to see how hard it was to get. I found a company. Reddit was like, oh, this is the company that you

14:10want to go through. I kid you not. I went to this company. I went to their website, clicked on the link, and they sent me an email that said you had to send your email and sent me an email with a WhatsApp connector. A signal, a signal app. Yeah. This one happened to be WhatsApp. And I had to connect with them only through WhatsApp. And in order to pay for the peptide, I had to send them an ACH wire. And then this was my favorite part. I should send you a picture so that you can put it in the show

14:40notes. It showed up in my mailbox in an envelope that was like 123 Yellow Brick Road or something like that. And when I opened it up, I had no idea what it was when it first came. I was like, what is this? What did I order? And I opened it up and it was a little blue box that said some kind of like hair care product on it. And it was like, you can apply this to your hair when wet or dry. Just make sure that you like comb it all the way through. And I was like, what the heck did I buy? I'm thinking like, did my husband buy hair care products? And then I opened it up and there were 12 vials of

15:12what they say was retatratide, which you cannot get in the United States. So I took it one step further and I sent it to a lab to actually get it tested. And that product had retatratide in it, not at the right dose. And right now I'm waiting for the second test to come back to see if it had any of the toxins or the endotoxins. Oh my God, that is so scary. So that's the process that you have to go through to get these peptides. And so this is why it's actually a good and a bad story to bring it back into the United States because you can put some legitimacy behind the supply. And then I can

15:45start to study it because for research use does not mean researchers can use it. It's legal cover. So back to your question. One follow up quick in so people that are taking them, can you just speak quickly to the potential downsides? The risks obviously depends on the peptide, but maybe just like what we should consider by buying off the internet, not just what's in it, but what are the potential risks? Yeah, I think there's a couple of things. So the first would essentially be, is there toxins that are in this vial? That's my biggest issue with this is that you don't know

16:23what's in there and you also don't know the dose, right? So I think that's the big issue. I'm not so concerned about the safety necessarily of the peptides themselves. Gabby, as you said, they've been on the market for years. If people were going to start dropping like flies, it would have happened, right? There would be some noise there and I haven't really seen that. That being said, I do think that there's potential for pretty significant adverse experiences, right? So not taking the right dose, taking it for too long. And the one class that kind

16:54of is giving me pause right now is this class of growth hormone peptides. If you give yourself a boost of growth hormone, you can't target where it goes, right? So you could be thinking it's making it in my muscles. Yeah, right.

17:12Don't think it works. But if you have a pre-tumorous lesion in your body or you've got something growing in there that you don't want to make bigger and you give yourself a surge of growth hormone, we don't know the answer to what might happen. And we also don't know the answer to what might happen if you take these peptides for a really long time. And so those are the big questions that I have, particularly with this class of peptides, is what are we making grow? And

17:42what happens if you do these for the very long time? We just don't have the data to show that yet. So it sounds like the growth hormones would not be top of your list to study first. Which ones would be there?

Peptide Research Priorities

17:53Yeah. So BPC-157 is right at the top of my list. And this is just because muscle is my tissue. This is my jam. I'm an exercise physiologist and I study how supplements help with muscle. And so this one for me is top of mind. I have a lot of people that use it that say it's really helpful for them. And that's really interesting to me. It's actually pretty fascinating, Gabby. You'll appreciate this. There's a whole group of researchers that study athletes, right? And

18:24Louise Burke gave this talk a couple of years ago where she was talking about we can't let the data drive what the athletes do all the time. Sometimes we have to look at what the athletes are doing and understand why it's working. And there's a lot of people right now that are saying that BPC-157 is really helpful for their recovery, coming off of a surgery. I have a lot of orthopedic surgeons that are really interested in understanding this. So that one's, it's really top of my list right now. Also, I think the safety protocols are probably pretty good.

18:55So this is like a layman's question. But like when I think about the GLP-1s, Ozempic, all the ones that they're giving, you know, those, everybody's like, oh yeah, those are fine. But we don't know downstream of like, oh, your bone health, all these other things. And obviously people know that they've got to manage protein intake because now their appetite's diminished. And so it's like, okay, but for every pound, right? It's like you lose, it's two pounds of muscle and kind of all this stuff. I always think it's so fascinating that somehow they've managed to

19:26figure out that that's all safe. Right. But some, but then we have these others that they're like, well, we're not sure yet. I always found, I always find that that's sort of interesting, what we freely will give to patients. But we, they don't really know. That's going to be my question. Is, is that actually really researched or is it just, that's where all the money is? So there's more availability. I genuinely don't know. Is there a lot of research on GLP-1? So yes, there's a significant amount of research on GLP-1.

19:57But not at that dose. That's the thing. Got it. Because you can, I, I, I interviewed Tina Moore, who's been using them with, for 10 years, because if you do it at a truly a microdose, not what they're saying is a microdose, it's like the, for inflammation, for your heart, for all kinds of things they've known for a long time, these things are very supportive and regenerative, but we're talking at a very small dose. So I think it's interesting how we made the jump to, you know, 10 times or more the amount. And I, I think it's going to be really

20:29interesting in the next five to 10 years to see what happens to this large group of people. Now, I get that if you're really obese, overweight, that this is a jumpstart. I get all the benefits of that. But there's people who are like, I have an extra five, 10 pounds I'm trying to lose. Because by the way, that's a huge part of the population that's doing it. And what that's going to do in the long run. But it's interesting from a research perspective, and I would be curious if it's the same and more of like an industry research space as a research, academic researcher, we cannot study microdoses

21:02because they are not FDA approved. And so we can only study what you can prescribe based on a certain indication. And so I hear what you're saying, but then to get data on that is much harder. And to get those answers are is not possible. Now, that's where you learn from what's happening in the field and bring it to the lab. I don't know if you have lived by different rules, if you can 100% I live by different rules. So this is the part that's really interesting about my job is if it's in the wellness market, if it is being sold, if it is being purchased, essentially, it falls under my

21:36purview to be able to study. Now, I have to get a little creative about the way that I study it. I also can't give it to people in a randomized control trial prospective kind of study. I would never get that through an IRB or an ethics board. But I can essentially study the participants that are coming into my 260 locations throughout the country in order to understand is this teeny tiny dose, which we are probably going to be rolling out as are so many people in the market right now,

22:09And so what I can do essentially is start with safety, I can look at, you know, real baseline data, is this helpful, and then start to think about the longer term implications of longevity, if you will, right? Are these tiny doses helpful in our environment of the world that we live in for inflammation for preventing the decline, the early declines of the diseases of our time. And so I get to study it in a really different way than Abby gets to study it. But we have really good data we

22:44published about six or eight months ago on our GLP one product that I did just simply to understand if the compounded version would mimic the tested version from Eli Lilly and Nova Nordisk. Turns out it did. It was great. Exact same weight loss, exact same safety profiles. And the cool thing about my system is I have a team of 40 nurse practitioners that meets with all of our participants weekly, they have to come and meet with their nurse practitioner in order to be monitored to get

23:17their next dose. So every week we were having conversations with our clients, we do have conversations with our clients. Are you eating enough protein? Are you resistance training? And in our paper, we showed that yes, they were losing weight, and they did lose a small amount of skeletal muscle or lean tissue that happens when you lose weight, no matter how you do it. But I believe because of this touch point where it was week after week, they were actually able to better improve their body composition because they had some education behind the scenes. I love the clinical model where we have a really controlled product that

23:54is being prescribed and overseen by a clinician. But I'll tell you more often than not, we were getting clients that were coming to us that were former patients that were frustrated because they saw their doctor two times a year and their dose was being changed and they didn't understand why they were having side effects and they didn't know what to do about it. And so I think there's a real beauty in how we can all work together to figure out what works for real people in the real world and all learn from each other. I want a quick follow up on that just as from a different, when you're talking, I'm thinking who's paying for it? And I think that's something that gets a lot of pushback. Well, is pharma paying

24:29for it? That doesn't mean it's corrupt. In this case, who's paying for your research on these doses? And there's still ethics involved, but maybe can you speak to that of the separation of industry and the outcomes so that they, you know, can be used? Yeah, it's a great question. So just to be clear, in order to do these studies, I still have to go through an ethics board. I still have to go through an IRB. So we follow all the same rules. It's just I'm looking backwards where you might look forwards. And so I think that's really important to know. And the other piece here is this particular study was an unfunded study. So when you come to my system, you sign a waiver.

25:05It's very clear that I can look at your data, as you would in a traditional electronic health record, you can abstract data and pull it out. They give me permission, if they don't want to give me permission, they put an X on that part of their waiver, that I can look at their data retrospectively. So at the end of the day, the client is essentially paying for their own science. And so that's a model that I'm really excited about. And I'm thinking about this from the peptide perspective, too, is I'm actually on the founding board of a company that is going to roll out peptides.

25:41And the foundational principle of this company is going to be the science. So essentially, you come to us, you come to this company, because you want to study yourself, does it work for you, the goals that you have, and you get to track it over time. And then you say, hey, Dr. Rachel, you can use my data to aggregate with everybody else using BPC-157 and the glow stack and Wolverine and, you know, TB-500 to figure out what is the right dose. So it's almost like a citizen science

26:13model. So I think try and think right now about how to get creative around the science. Are you allowed to say the name of the company? Yeah, it's called Chiral Peptides. Chiral Sciences is the parent company. And so that will be coming to market hopefully in the next 45 days or so. And what do you say to the people, well, of course, you're the founding member, this is going to be corrupt science, meaning like, I know that's not the case, but maybe for the listeners of why that, why there's things in place, and that's not true. Yeah, I get pushed back on this all the time. And I'm more than happy to have this conversation of,

26:46you know, I do, I have a bias. I am an industry. My company is literally profiting off of these therapies. And the good thing about this, and I share this story pretty regularly, when I signed my contract with my current company, I actually sat down with the CEOs and I said, I will come and spin up this lab for you. We call it Restore Labs. But I wanted in my contract that I am not here to rubber stamp your shit. So it is literally in my contract that says, I'm going to do independent science. My science has nothing to do with their profits. And whatever

27:21my science says is able to be published, and that they will abide by within the models and the medical procedures that they are creating. So I've actually nixed probably six or seven different products within my system to say they either didn't work, and I'm not allowing this team to put this out just because it's popular. Or we saw some adverse experience, and I just don't think it's the right thing to put this out into the world, even if there is market share to be had. And I will say to my company's credit, every single time I have taken a stand on something or the data has shown

27:56something that wasn't supposed to be or, you know, wasn't beneficial, they have taken their word. We made more of that. Yeah. What are some of the adverse experiences or some of the side effects? So we don't have good data on peptides yet, but this might be a really good moment to pivot to NAD.

NAD and Longevity

28:15We love NAD. Okay. Wait, before we leave the peptide, the other application I hear a lot of is people who have thyroid issues. You'll see people in the thyroid space really dancing with peptides, microdosing peptides as a way to support people with thyroid, you know, Hashimoto's and other things. So I think there's a lot of people like you were stating earlier that have been working with these in so many different ways. Yeah. And I think that kind of ties with something that Abby said just a second ago too, is who is

28:45accessing these therapies? Most people think that people that are coming to longevity clinics are kind of like the affluent people that just have enough money. They want the frosting on the cake. They want these therapies to live to be a hundred. I will say that's probably about a third of our clientele, the wearied well, the affluent wearied well, if you will. I would say about two-thirds of our clients are what I call disaffected patients. So these are people that have not

29:15found the answers to their problems in the traditional healthcare space. They're frustrated by not being able to access their clinicians. They can come to our studios that has two nurse practitioners overseen by a, you know, medical doctor. There's nurses running around all over the place and they can get the questions answered that they have sitting there for two hours while they get an IV drip in real time. And that in and of itself is really therapeutic for people, I think. It takes two hours to get an IV drip. Well, if you get it, well, if you get, if you get an

29:48NAD, some people can take a long, some people don't squick. That's so boring. Well, the good thing is you can get stuff done. Yeah, you can get stuff done. There's a community as you're kind of like dripping around with everybody else. And you have two hours with a nurse and a nurse practitioner to ask questions. It really is. Yeah. Yeah. So let's jump to NAD because this is something that's been around for a while. There's a few companies that have really kind of led the way with research and science. I think initially you could see it with the oral capsules. And now,

30:24obviously, we're seeing a lot of the IVs. Where does it show up for you in your understanding so far of NAD? So this is really exciting. I actually just got back from Denmark about a week ago in a conference. It was about 75 or so people, 40-ish of the best NAD researchers on the planet. We were talking about this earlier. I think NAD is kind of getting this wellness longevity wrap

30:54out in the world. There is exceptional science, particularly in what we call preclinical work. So that's cells and animals. And it's starting to transition into human clinical trials, particularly for people with rare genetic diseases, for people with Alzheimer's and Parkinson's, really interesting peripheral vascular disease patients. And so we were all in a room for three days. They literally locked us into a room because we were seeing a bunch of data that had not been

31:26published yet. We weren't allowed to use phones or any devices to record. And I was blown away by the level of science that is happening in this space that's really unique from all of the other stuff that's in the wellness market. So peptides, I mean, it's like in its negative infancy compared to what's going on in the NAD space. That being said, the way that it's being translated into the wellness space, I think, is the real problem here. And so I think of myself oftentimes as like a Trojan

31:57horse. Like, can I go into these rooms of these amazing researchers and then bring back the science and communicate it in a way that we can translate into products or translate into talk tracks that go along with which product you should, which product you shouldn't use. Which brings me to the NAD products that are on the market. So you were right, Gabby, that the products started with orals, particularly the precursors to NAD. Now this is really important when we talk about NAD. NAD is a molecule that your body makes. It is responsible for creating energy ATP. It's also responsible for DNA

32:32repair and it's a signaling molecule for other things that happen inside your cell. This is really important. I'm going to say it two more times. NAD lives inside your cell. One more time for the people in the back. NAD lives inside your cell. There is no door to get from the outside of your cell to the inside of your cell. So what you need to do is take the building blocks of NAD, which can get into the cell. They will get into your cell and your body knows what to do with them. It can make

33:04NAD once it is, let me say it again, inside the cell. Now here's the problem with how it got translated into the wellness industry. We are infusing people with straight NAD. So when we put NAD in very, very, very high concentrations, 500 milligrams, 1,000 milligrams, straight into people's blood, their body absolutely freaks out. I've had people vomit from it. Vomit, instant diarrhea, chest pain, headaches. Sounds incredible. Yeah, wonderful. The reason that we believe that this

33:38is happening is because NAD lives inside the cell. Wait, where does it live? Yeah, exactly. So when you have it in massive concentrations in your blood, your body essentially thinks you're in multi-system organ failure, right? You've got this massive amount of NAD in a place where it shouldn't be. So you have this super intense inflammatory and immune response trying to figure out where things are going wrong. Now, I will say I don't think it's dangerous, right? I don't think there's something about the NAD being in your blood that's going to be problematic long term, but it gives you

34:09this really sick feeling. My research in my lab, as well as a couple of other researchers that I partner with, have shown that giving that NAD infusion actually results in either zero or just a teeny tiny amount of NAD increase inside the cell. And the reason is because it gets broken down by your liver and your kidneys, or it gets broken down into these precursor molecules, in which case just skip the middleman here and take the one that's going to work. Which is? Which is? Excellent question. Which

34:46is, we are discovering two molecules that you've probably heard a lot about if you're in the longevity space. And this is NR, or nicotinamide riboside, or NMN, nicotinamide mononucleotide. Both of these have a door that can get from the outside the cell into the cell. They're also present in food, so your body doesn't recognize them as an invader. So you can take the orals, or as we are discovering, and we just released this first manuscript, it was a safety manuscript, you can infuse NR. You don't get that sick feeling, and you do increase those NAD concentrations inside the cell. The interesting thing about this

35:21is it's kind of being touted right now in the longevity world as an NAD booster, which it probably is. But one thing that we're also recognizing is it can bypass the GI tract, which might actually be helpful for people that have absorption issues, or Crohn's disease, or IBS. And so that bypassing of the GI tract might actually be a really great way to get this therapy. Again, because it's being studied in Alzheimer's, Parkinson's, these kinds of diseases. Now here's the last thing that I'll say

35:53about NAD specifically in these therapies, and why I'm kind of interested and excited about them. We know that it is very true NAD concentrations decline with age in your blood, as well as in specific tissue areas, also your brain. And so what we're noticing, this is my work, as well as some really beautiful work being done by a couple of groups in Europe, is that these declines start happening a lot earlier than we anticipate. So probably around the age of 30-ish, which is also where muscle starts

36:25to decline, which is also where gut tissue starts to go sideways. And so what we're seeing is that giving these precursors potentially earlier in life, rather than waiting for a diagnosis to be picked up at age 55, 65, 75, might be a good way to start to prevent these diseases that we don't otherwise have a cure for right now. Now, is this drug potency? No, it's a B vitamin derivative. But potentially, it could have some therapeutic effect for the long term, which I just think is really

36:58interesting to study. And I'm kind of uniquely positioned to be able to do this.

NAD Supplements and Food

37:03And that's super interesting. Do you take it orally yourself? I take an oral, yeah. You do 1,000? I do, yes. So if we look at the data in humans, what we see is that the effective dose tends to be somewhere between 600 and 1,000 milligrams, depending on the study, and depending on the molecule. So NMN studies have been studied slightly lower concentrations, and NR studies have been studied slightly higher. There were a couple of experiments that were done in humans up to about 3,000 milligrams, and they didn't notice any boosting effect above that 1,000 milligrams. So save your money,

37:37save the pills. And that 1,000 seems to be that kind of maximum beneficial dose. So follow up, just to ask the question then, if I wanted to, it's a supplement. Supplement. If I wanted to match that to food intake, so B vitamin derivatives, have you looked at, or can you equate that to a certain food I would need to eat? Yeah, it's a great question. There are many foods that have niacin. So this is the B vitamin, B3, that is the precursor to the nicotinamide molecules.

38:08Meaning that it has to be broken down once I eat it? Sorry, you take these together, or the food is a replacement for NAD? The food that would have enough to be a supplement. Got it. Okay. So I think the amount of food that you would need to eat to get the same dose as the supplement would be basically like this entire table's worth of food. What kind of food? Like seaweed? No, so most of it is going to be animal-derived, so that's really where you're going to get. So if you're a vegan or a vegetarian, you're probably going to be fairly low.

38:39There is some in things like brewer's yeast, so you'd have to drink a lot of beer for that. Or just take the brewer's yeast. Or just take the brewer's yeast. But, you know, it's actually challenging to get as much as you could from the supplement. And again, that therapeutic dose, not the baseline dose for health, but that therapeutic dose does seem to be between 600 and 1,000 milligrams. So it would be challenging to get that. That being said, there are other molecules that you can take to increase NAD that can become NAD.

39:11So tryptophan is an amino acid that can also be used to make NAD. The one in Turkey. And his one in Turkey. I just know that from friends. And then you get tired and take a nap. Yes. Although the data on getting tired after tryptophan is not really there. It's probably the story. The potatoes and the cheese cake and their family. Oh, my God, the football's over. Yes. Because the postprandial sugar crash is really what's going on there. So there are other places that you can get it besides the B vitamin derivatives. But you would have to eat a pretty significant amount of food to get that particular therapeutic dose.

39:45And has there been any research, I'm just thinking about your clinic, of what's baseline intake? Of, like, how low are we actually, which is why there's a potential? Yeah. So the data across the board for micronutrient intake, so this is all of our vitamins and all of our minerals, is actually fairly dire. Not because it's not available in the food system. It's there. We're just not eating the right foods. So if you look at what we're eating as a population, there's been a couple of studies that show, you know, at best, about 50% of our food comes from highly processed food products.

40:22Yes, everywhere. And so those don't tend to be high in the vitamins and minerals that we need. I think we could probably get enough from all of our different foods if we were eating a very high quality diet. But I don't know, actually, if it's enough to stop the decline later on in life. I don't think that answer has been teased out in the data yet. You might not know this, too. And actually, maybe it's a question to everybody. But do you think some of it is because our food is worse than it used to be?

40:56I think it's tough to tease out. There are some data, if I work and I put my nutrition hat on for a second, I did a lot of work with a big farming organization probably about a decade or so ago. And from what I could glean from them is essentially they said, yes, in some cases, as we're mass producing some of our meats and produce, that the nutrients decline. But from my read of their data and the scientists that are in that space is it seems to be more cyclical than necessarily kind of like what we're doing to food and production right now.

41:33So if you think, for example, I live in California. We've had pretty significant droughts over the past several years. That's going to affect the soil. And that's probably going to have more of an effect kind of like year to year and batch to batch than any kind of like aggravated decline over time. But that's not really my area of expertise. So, yeah, tough to say. I would say the quality data, excuse me, the quality of food is a real matter. It matters. Yeah. So are there, as we round the corner, are there for you, would you take a peptide?

42:08Do you take a peptide? I don't. Oh, but you have access to all the good stuff. Well, I get the illegal hair products. I don't have access to the good stuff because it's not allowed to be compounded yet. So I actually don't. Nobody does have access to this. I have had several knee surgeries, and I'm very curious about BPC-157 to see if it can help. My knee talks to me all the time, and my surgeon has assured me that I will need a new knee at some point. And so I'm hoping there is something better than, you know, the sort of like knee inserts that we have now, maybe some new cartilage growth or something, maybe a peptide that grows cartilage.

42:45But yeah, that would be an interesting one for me, for sure. Because people, listen, they're going to be experimenting. We've got groups on GLP-1s, and then people who are going to be looking at BPC-157. You see how I've used it often enough that I've gotten so lazy that I just call it BP. Sorry, BPC. Are there ones that you go, these ones I feel really optimistic about, this group of peptides, as far as for, I'm just talking about overall wellness, not necessarily, okay, I want to have perfect skin, so I'm going to do the copper, which, by the way, burns, apparently.

43:19It does burn, it does burn. Yeah, so I have friends that have ordered it. I've actually never done the copper, and they're frustrated because it's like, I didn't burn. I'm like, well, maybe you didn't get the wrong thing. Because apparently, you put it at the end. I did copper, too. BPC. Yeah, what they did. You don't reject them, though, right? Instagram? No. Yeah. Oh, no needles. Oh, yeah, no, that's the only way to do anything, just with a needle. I've always felt like it's way more effective. What do you use? This is a, like, elite-level athlete mentality. Yeah, hang on, she's going to tell us. I know. If it doesn't hurt, it's not good. I'm not on a...

43:50Have you tried any? Oh, yeah, BPC-157 for, like, you know, this and that. Yeah. I already have an artificial knee, so I can talk to you about that. But just some of the heroes, and maybe the better conversation is go to somebody who's doing your blood work, looking at you, and if they're ordering it for you, don't go rogue online and just order stuff because you don't know what you're getting. And I think the stacking part, I think maybe people, I think not more is more, necessarily. So this is really important.

44:21And I think, I'm going to come back to your first question about which are the heroes. This stacking issue is also something that's really problematic to me right now. So there's a beautiful study that was done a couple of years ago now. They used C. elegans, which are little worms. And what they did was they took the top 12 supplements that had good human data for longevity outcomes. You can look at the hallmarks of aging, and they kind of, like, touched on one of those hallmarks of aging. And what they did was a beautiful study that could only be done in worms because you need

44:53a bajillion of them to do this study. Is basically they stacked these supplements in one, two, three, or four supplement stacks. And they gave them to all, they pair-wise connected them, and they gave a whole bunch of different ones to all different C. elegans. And what they found was really fascinating. At the end of the study, what they were expecting to see is essentially that one plus one equals two or better, right? So at least they worked synergistically, and hopefully they worked to enhance each other

45:23because they were tackling pathways that could potentially be helpful. What they found, and I want to say about 70% of the combinations, is that one plus one actually equaled negative one. And the reason for that is because these supplements, not peptides, but supplements were antagonistic to one another. And so, for example, a really classic one is if you take zinc and copper at the same time, they are going to not get absorbed well because the transporter shuts down when one

45:56goes high. And so you can take the two together, and you're probably absorbing way less, if not any, from the supplement that you've taken. And so in this case of all these C. elegans, they actually found that not only were they not absorbing and using them, but they were detrimental to the health of these C. E. elegans. And so, again, it's not a human study, but you can imagine the biological plausibility there is that if you're taking 7,000 supplements, the likelihood that a couple of them are working against each other is probably pretty good. And so thinking about these peptides, what are the pathways that they're targeting?

46:29Are they synergistic? Are they not? So that's something that we're thinking about at Chiral, too, is how do we put these different stacks together so that we have good data to show, yes, these work well together, or nope, these are not good. We have to take this apart because we're not seeing the outcomes that we expect.

Foundational Health Behaviors

46:46That's important. So what are the heroes? I mean, I keep coming back to BPC-157. I just think it's low-hanging fruit. And I think everybody's in pain. And if it can help and it's not going to wreck your liver, like that seems like a good option to me. You know, something like acetaminophen or ibuprofen, which over time can be really problematic for your liver. I actually, I'm going to be a little controversial here. I think the GLP-1s could potentially be the longevity drug of the future in tiny doses. These molecules are made in your body.

47:19So I know that they're being used in massive doses right now for good reason. But I just think that there's something there to think about in the world that we live in and the diseases of our time. If we can prevent those slow declines over time, I just think that there's something to be looked at there. And again, whether they're synthetically made or made in your body naturally, they do have a pretty potent physiologic effect.

47:50And I think that they should be studied in these smaller doses to understand how they can help people independent of weight loss. And I say this all the time. Everyone's like, all this stuff we have to do right now to be healthy. And I'm like, yeah, because we don't live in the way that is in harmony with our biology. So in all these conversations, it's just acknowledging that, hey, we live in a busy, stressful world, blue light, EMFs, the soil, whatever the million things are. And so these are the nice little things that we can do to kind of compensate for the fact

48:22that we do live differently and against, in a way, our biology. And so it's not about like, oh, now we need to do all these things to be healthy. It's like, these are just measures to kind of go against some of the things that we're not getting anymore. And I will push back on that a little bit too, in a good way. I was actually talking to Laird downstairs. And he said that you were talking about this this morning and are in agreement, is that the foundational stuff is so important still. Of course. And so if we think about the peptides, the NADs, they are tiny levers at the end of the

48:56day. If we don't have those big levers that we're pulling, exercise, sunlight, sleep, stress reduction, if we don't get those under control, it does not matter how many pills that you take. It doesn't matter how many little injections you do. It is not going to make a difference. We talk about effect size all the time in research. And this is essentially how much of, how much are you actually moving the needle? If you're eating 80% highly processed food and you're not exercising and you're doom

49:31scrolling until one in the morning, I don't care how much BPC you're injecting in your knee, like it ain't going to do anything, right? And so we have to get those foundational behaviors in first. And I think that's why people often will turn to these supplements and peptides and therapies because they're kind of fun and easy. Yeah. The foundational stuff is hard and it takes a lot of time. But if you don't do the foundational stuff first, none of these longevity hacks are going to do anything for you.

50:01We tend to beat that horse all the time because I think it's the reminder. Yeah. So I think it's unique where you're at in your space. So kind of bridging the practice and the proof per se. What would you tell the, your younger self or even people like, how do we get into this space in a way? Like, what would you wish you would have known based on where you're at? I so appreciate that question. I often feel like I am at the tip of the spear doing this and I get a lot of pushback from both sides, right? I'm a nice to have in industry unless they're getting letters from the FTC and I can help

50:36them figure out how to switch their marketing around. Um, but I'm also a bit of a pariah right now in the academic space because there's kind of this old adage. If you leave academia for industry and they mean big food or pharma, they certainly don't mean the wellness industry. It's kind of like you can never come back. And so I feel really lucky right now. I've got my, you know, appointment at Stanford. I've got my industry job and I can really leverage those two places to bring this forward. I think one thing that's really important as scientists is that we start to get really

51:11good at communicating our science. You're getting so good at it. I love the work that you're up to. And for, you know, having conversations like this where platforming the science, where it's at where it's not, it's so important. And then what that can do is start to pave the way for these jobs to open up for our young students, for people that want to get into this space because they're psyched about the data that's available here and the therapies that are being used that maybe we can't study

51:42in really traditional ways in the lab. And so I think it's up to people like me to be really loud in this space and say, it's okay to partner together. It's okay to have these conversations between these two houses. And we have to because we all have to move in the same direction at the end of the day. I also like what you said about partner, even if you disagree, but just having people from multiple facets, having a conversation and coming together. And you were talking about this too.

52:12You can have differences of opinion, but we at least need to get more truth and more of the conversation going because as a non-academic, non- is really confusing. And you're, you're in industry, right? Like you're in the belly of it all. And I can't, I feel like I've gotten an MBA over the past year, right? Like the, the, the, the new acronyms that I know about like KPIs and OKRs and like all these things. Oh, that's my jam. I have a QBR on that. I know. Please give me a QBR.

52:42Um, is that a peptide? Um, I, I have, I, I think that there's this narrative in our world, which is the wellness industry is a bunch of hacks and charlatans and there is, you know, snake oil salesman and nothing else. And I hate that narrative because there's a lot of good happening on that side of the house. I mean, your work in the fitness industry, like how many lives are being saved just because they love going to the gym and lifting weights to loud music, right?

53:13Like there's power to that. And community. Yeah. Well, and funding. That's what's going to fund the research in an accelerated way. And, and your, your business model allows for that to be carried out to the general population. I was listening to a previous episode and somebody said, you know, Oh, I, I learned about this, you know, this creatine study. And I think he said that was my study. And like, what a dagger to the heart to be like, there's this like prominent study that's out there about creatine that we're all talking about and taking as women.

53:45And like the researcher is sitting right here that did the work. And like, you all didn't know about that, right? Like I want to be like Abby Smith Ryan, like, let's like get her like in front of everybody. And I think that's the important part and the partnership that we have to have with industry. They have the microphone, they have the funding, we have the knowledge. So how can we all work together so that people really get a good understanding of what they're doing and what they're putting in their bodies and we can move the needle forward.

54:16If we don't do that, people are just going to live in this vacuum of confusion because that's what we've created by keeping these two worlds so separate. Great. Well, thank you, Dr. Rachel. I really appreciate it. And the reminder that you still can't avoid the work part. So just remember, don't just take it because it's a trend. Make sure you get real help. And I think, you know, the notion of slow and low is always an interesting approach, but you're not going to avoid eating food, getting outside, moving your body and getting

54:49to bed. So thank you for all your work so much. Thank you. Thank you for having me. Thanks, everyone. Hmm.

55:15Thanks. Thanks. Thanks. Bye. Bye. You're welcome. Come on. Bye. Bye.