Transcript of Episode 573: Dr. Jonathan Schoeff: Peptides and the Marketing Behind Modern Longevity - Part 1

Hi guys, it's Tony Robbins. You're listening to Habits and Hustle. Crush it.

Welcome to Habits and Hustle, where I sit down with the world's biggest thinkers, entrepreneurs, top experts to uncover the habits and strategies that actually move the needle in your health and happiness, and of course, success. Today I'm sitting down with Dr. Jonathan Sheff. He's a surgeon and longevity expert who is actually still practicing medicine with which already makes him different from a lot of the experts you see online. He's not here to sell you some magic stack potion or scare you into a protocol, or even pretend that every trend on Instagram is backed by real science. He has spent more than two decades in medicine working as a surgeon and helping people understand what actually drives long-term health. And in this episode, we get into the wild world of online health experts, the peptide hype, GLP-1s, muscle skincare myths, and why so much of what gets packaged as longevity is really just great marketing with a lab coat filter. This conversation will make you question who you are taking advice from, what evidence actually means, and why the boring basics like building muscle, improving metabolic health, and staying consistent are still the things that move the needle.

So guys, buckle up. This is gonna be a great episode if you're into anything health, wellness, fitness, and of course just overall just great conversation. Enjoy. All right, you guys, welcome to another episode of Habits and Hustle, and, uh, we have a very special guest today. I should also say that I know I've said this 10 times before we even started to roll, but This is Saturday, so this guy has to be really great for me to actually be doing a podcast on Saturday. His name is Dr. Jonathan Sheff, and he's a surgeon and a longevity expert, but a real expert, not just one who plays one on social media, which we're gonna get into in a second. And he could not do the podcast during the week 'cause he's actually a working doctor.

Yeah, the darn jobs get in the way. Yes. Get in the way of all the fun.

Exactly. Like, 'cause I, I say all the time, you know, when I do this podcast and I have doctors who come on and I'm like, oh, are you practicing still? And majority of them are like, no, I don't practice anymore. So I'm like, so basically they've all just kind of shifted or morphed into media doctors, which I never really— interesting. Have you not seen that at all?

No, I have. And I think it's being new to social media. I was completely naive to that, right? There are all these narratives that exist around the pseudo-doctors, the docfluencers, all these things that, yeah, for the best, I had no concept of. But when I first got on social media, you know, you get blasted with these "you are this" type statements.

Yeah, yeah.

And I'm like, no, I'm actually not. I just, I'm just a guy from Ohio, you know. Oh yeah, people will I mean, that's the interesting thing about social media is they want to just box you in as quick as possible. You're one of those guys. You're a keto guy. You're a carnivore guy. You're a, uh, you know, you're a fasting guy. You're a muscle guy. You're a protein guy. And in reality, I look at that and I go, no, I'm just a doctor, right? And then we talked about that. Now, unfortunately, the word doctor, I think, is, is totally abused, and it's done in a I mean, let's face it, it's done in a manipulative way.

Well, 100%. Like I said to you earlier, you know, these doctors, they're— a lot of them are chiropractors, and then they're giving a lot of advice on a lot of things that maybe they weren't trained for. So I'm a bit like— to me, you know, that's what I kind of am. I try to be a little discerning. So because I think there is so much noise on Instagram, which is why, like, when I saw you, and like I follow you and I reached out to you is because I saw that you were legitimately a real doctor, you know, who actually practices and has patients and does the thing. And like, you just— by the way, you have a big following for someone who's barely even on social media. But that was just recently, I would imagine.

Yeah, we, we started this whole— I called it the great social media project. So back in May of last year, yeah, I had no logins or anything. And the, the reality for me, what I do in the longevity space is I, you know, have clients come in every day and they would ask these questions and a lot of them were just totally off the wall. Some were legitimate, but they say, I follow so-and-so and this is what so-and-so said. What should I do about that? And after a while I go, you know, it probably behooves me to get into this whole social media thing. So it started with really wanting to connect with my clients in the local areas.

Is it patients? Why are you saying clients?

Oh, that's a great question. My— so I look at what I do in the longevity space is very different than what I do as a surgeon. As a surgeon, it's doctor-patient. Someone is ill or someone has a disease process that I'm going to fix. It just happens to be with my hands. The reason I call my clients, my patients, I guess, in my longevity practice, clients, is because I play a very different role. I look at myself as a consultant. As a healthcare strategist, not in the traditional doctor-patient sense. Because one, I think the world we're living in now is so disenfranchised with the, the traditional medical model. You put any names you want on it, but at the end of the day, there is this public perception about doctors, and apparently doctors are paid by Big Pharma, doctors want to get rich. I didn't— I missed that course when I was in training. Training when I was doing 120 hours a week doing surgery. So But there again, it goes back to what I said in social media. They just— everybody wants to kind of lump you into a category, right? And that's because that's what social media drives.

That's what favors the algorithm. It's binary, it's controversy, it's black and white, right? The clickbait. I didn't know what that meant.

Right.

Okay. So for me, what I do in the longevity space is very different. I'm taking a physician education, the framework that I have built through 22 years of practice and using it to redirect the course or redefine the trajectory of another human being. To me, that's very different than what's perceived as conventional doctor-patient.

I get you.

So, so to me, if you went and hired a, you know, whatever, an interior design consultant, right, you would be their client.

Yeah.

So it is fundamentally— and I'm all about reframing, because if you get the framework wrong, the entire relationship, the entire experience is going to go sideways, in my opinion. And so as soon as, you know, as soon as people, I think, get sucked into that, they, they have preconceived notions. And, and I think the medical establishment has not helped itself. I mean, right, you know, the, the days— I say this The days of the doctor always being right, doctor telling you what to do. I think the American public and really the world is disenfranchised with that model. People want to be heard. People want to be seen. And then unfortunately, at least in the US, a physician can't keep the lights on. This is real. Okay. Yeah, we can play all the games, but like a primary care physician, if they're not seeing X number of people a day, they literally can't pay the bills. No one's getting rich, right? Okay.

Yeah.

And No one that I know personally who became a physician spent decades of their life while everyone was having a good time, was doing it to manipulate people or to control people, or all these kind of suggestions that the doctors don't care and stuff. Why else would you waste two decades of your life becoming an expert in human health and wellness? The problem is, this is not excusing it, but the system itself is rigged. It is. I mean, who controls healthcare today? It's commercial insurance. I mean, true story, okay? I do surgery anywhere from 3 to 5 days a week, and it is not uncommon at all for us to have to call— it's called a peer review process— to ask another person on a phone who works for the insurance company— they're employed by the insurance— if it's okay for us to do what in our professional judgment is best for the patient. That's the world we're living in. So the idea, all the, and I don't want to get too far down this rabbit hole, but the idea that the physicians have it out for the patient, I mean, that's insane to me.

Right.

Because I'm losing hours of sleep.

Right.

With a genuine intent to try to help my fellow man.

Okay, so wait, so you said something that was interesting. You said that you have to call the insurance company to see if they'll cover basically whatever, the necessary thing.

Oh, it's even better, by the way. I'll give you the whole scoop if you want.

Yeah, I want— so basically, my question— yeah, I want you to, because so if they say no, it's not covered, yeah, do you as a doctor not do it because they— because you're not getting paid?

Well, it's not about me.

Not you, but they're— well, yeah, no, no, no, because if you do the procedure, it's not covered.

I'm not getting paid. But, but bear in mind who else isn't getting paid, the way bigger fish than me. You see, there's a breakdown of how— yeah, let's do this real quick. Hopefully we have time. But there's a breakdown of about how compensation happens. And I'll speak from a surgeon's perspective.

Okay. Yeah, go ahead.

Primary care or in-office is different, but we deal in what are called procedural codes. Okay. Every surgery we do is defined by some numbers on a piece of paper. So the insurance companies are the ones that have to approve, or if you've ever had surgery, they'll call it a prior authorization. Okay.

Yes.

The beauty of a prior authorization, the fine print, uh-huh, is literally, this is what the fine print says, prior authorization is not a guarantee of payment. Think about that. Think if your profession operated in that capacity. So I can do a surgery. This is true. It's been pre-approved by the insurance. They said, yeah, we'll pay for it, but actually we're not gonna pay for it. So they'll come back and say, well, there wasn't a psych eval done, and so therefore we're not paying you. But bear in mind, this is a much bigger picture because everybody looks at the physician and goes, oh my gosh, it's, it's all their fees and all this stuff. We're about 1% of healthcare cost. Okay. You still have a hospital. You still have multiple other physicians, care providers, then the actual equipment, then the actual— in surgery, you know, the actual devices or implants that we're using, all that. Are line— all of those are line items. Okay.

Yeah.

And so if an insurance company comes back and says, no, we actually— we authorized it, we said in writing, good to go, but we changed our mind. Like, how cool would that be if that was your business?

Well, it's not— I mean, for the person, obviously that's sarcastic, of course, but I'm saying like, so what do people do in that situation?

Yeah, so there's, there's a number of things.

Well, the healthcare system is so crazy right now. No, nobody understands it. You can have Not 9, but they think they do.

But that's the problem.

But yeah, but no, but it's— and it's always— it's so complicated. So nothing is ever really covered. I'm paying all this money for, for my copays and for my monthly to get the PPOs and all these other things. And then I'm always— but, but I'm still paying.

Yep. Yeah. And guess who's flying on the private jet?

Tell me.

The insurance company CEO. I don't see too many of my doctor colleagues flying on private jets.

No.

Look at the administrative, the administrative cost burden, the acceleration of the administrative pool relative to physicians over time, right? The population's increasing. We could, we can agree on that, I hope, right? And yet the physician, the absolute physician numbers in the United States is a much slower uptrend. But where the explosion occurred earlier in the 2000s was in the administrative roles. So administration doesn't just mean a hospital CEO. Okay. Imagine this as a physician. If I own my own practice, in order to keep— to give quality patient care in a timely manner, I now have to employ some number of people that are the pre-auth experts, the actual people going back and forth with the insurance people.

Yeah.

And then the insurance says we're going to approve it. And then after you do all the work, They come back and say, actually, we're not going to pay you. So now those people now have to submit appeals and you go round and round the process. So again, the administrative burden— if people want to know where their dollars are going, they are going to the administrative burden of healthcare that has become so outrageous. The problem was 2, 3 decades ago, as physicians, we— I think we failed. Obviously, this is long before my time, but I think some physicians were, were reckless. There weren't the guardrails to ensure that, hey, I'm being compensated fairly for my time. And there was a time probably 40, 50 years ago where you kind of charge what you want and you get paid. So it created an, an opening in healthcare cost where costs were thought to be excessive and being driven by physician choices. Oh, look at that. All these administrators come in to help control the cost. But what we forgot was the administrators themselves are a cost.

Yeah, exactly.

So they have not come close to managing cost containment to even justify their own salaries. But the people making millions are the insurance CEOs. They're the hospital CEOs. Those are the people that are profiting off of the efforts. And in reality, the care providers, that's Physicians, it's nurse practitioners, that's nurses, that's techs, everybody collectively, we don't account for even upwards of about 10% of the total healthcare costs. So where else is it going? And so the person that suffers, so going back to your original question, what happens? You need a surgery, okay? Your leg's on fire. You come in, you see, you get seen, this is a surgery you need. Now, in most cases, that's going to be fine, but say for whatever reason, it gets denied, the insurance company says nope. You as a patient have a couple options. First, you appeal that denial.

You.

So you go to bat for yourself. So now you're fighting the same entity that you're paying probably thousands of dollars in premiums to, right?

Yeah.

You're begging and pleading, saying, I'm living this, I'm in pain, like, I can't do this. So patients are one major piece of the, the appeal process just to get surgery done on them to help them. Okay. The alternative that does exist and now as we've seen these high deductible plans and stuff, the alternative is the patient pays out of pocket. So that's really— and to be honest with you, that's what happens in Canada. It's just those people come to America to get their surgery.

Yeah, I'm Canadian. Well, yes.

So you probably know how you—

well, you had to wait. Months and months and months to get anything.

Over 2 years for a knee replacement.

Over 2 years.

Right now.

Yeah.

In Canada. And the Canadians are probably going to flip their lid.

No, no, no.

When we say that, but—

No, no, no. I mean, it's—

Because it's not necessary. I mean, you can hobble around.

You can't even find a doctor, never mind. This is one of the other problems. Even in— Forget about Canada. I mean, it's actually in the US. No one can find a regular doctor. Nobody can— like, I'm in a certain class, you know, socioeconomic place in LA and all these things. Ask me how many of my friends have a doctor. They have concierge— you can only find a concierge doctor, right? So unless you pay a high premium to see somebody, you're not seeing anybody.

Potentially.

Yeah, not, not potentially. It is literally what's happening.

Yeah.

So even to get the bare minimum you have to be paying a premium.

Well, consider— look at it this way though, because the same criticism could be leveled.

Are you a concierge doctor? Okay, but I don't understand you. Okay, and I'll tell you why. Okay, so you're a surgeon, so you go into surgery every day, Monday through Friday, blah blah blah, but then you also have a longevity practice. Like, so, like, I don't even know, like, so are you a concierge doctor? Like, why both? So, and also, by the way, before you do that, I need to concentrate because this is like, you're very much— you've got a lot of information, we're doing these shots. Okay, this is, um, a performance shot. It has a lot of amazing nootropics like Lion's Mane. Well, this one's— well, this one is the original, but you also— I gave you a caffeine-free option. Okay, you want caffeine? Okay, so we shake these up. This is basically a performance shot that will help you— will help me focus, because God knows I'm going to need it with you.

If the host falls asleep, the, the viewers are really in for a treat. I'll just keep talking.

Yeah, I Okay, wait, we do this. We, we do a cheers. Don't— okay, okay, here we are. Boom. I've had so many of these already today. I love them. It's good, right?

Yeah, it's good. I was waiting for you to drink it.

It's very chivalrous of you.

Oh no, it was not that, not that chivalrous. It was if you kind of like—

oh, oh, I've had a million. Oh, but believe me, I've had a million of these. No, but you know how like this is Oh, you're watching to see how I'm actually— yeah.

The fun fact about the wellness industry is the more absurd it is and the more disgusting it is, the pricier it is, right? Like AG1. Zero health benefits. Zero. Nothing. And it's disgusting.

Disgusting.

And people are like so proud. They're like, oh yeah, just throw it back. One of my clients was in yesterday and he was telling me about this green concoction that a chef makes for him and stuff. I was like, how? He's like, it's just terrible. Why are you drinking it?

Yeah.

Well, you know, I think it's really good. It has probiotics. It has— like, take some fiber. Yeah, that works just as well.

People don't like the— people want magic, magic formulas and magic potions. The fact that AG1 has become like a billion-dollar brand, and it's because they have great marketing, they went to the right influencers, the right podcasts, the right this, the right that. Paid great, great performance marketing, and now they're, they're like crushing it. And everybody's under the impression that they're like doing something great for their body.

Yeah, because it tastes disgusting.

Because it tastes disgusting.

It tastes disgusting and it's pricey. So it must be—

it must be great.

Must be really good.

And Joe Rogan does it, so it must be good, right? That's literally where our brains are psychologically. So, and also, like, if you don't know what you don't know and it's— it looks— it's green, so then it's psychologically— you think it's healthy for you.

It's pretty. So it must come from a plant.

Exactly. It must come from a plant. So everyone's just like, you know, drinking the Kool-Aid or drinking the AG1.

Drinking the AG1. It's funny you say that. If I could take a brief detour.

Yes.

Because I've not been on social media long, like I had in my mind what an influencer was. But now when I see it play out, especially in medical circles or medical applications, Influencer is very much an influencer. I say that and you're like, yeah, I know, that's why they're called him. Yeah. No, no, you're talking about changing the mindset, like a Joe Rogan, of millions of people. Joe Rogan, when he's talked about methylene blue on his— which is an absolutely outrageous phenomenon by itself— the number of phone calls I got in my practice. Do you have, do you have methylene blue? Do you carry? Will you, will you get me methylene blue? This was before I was involved in social media, and I, so I didn't even understand the connection. Why, why is every— so I used methylene blue in my surgical training to like localize lymph nodes. Okay. So that's how I knew of methylene blue. It's, it's something that we inject into an IV and it consolidates into a lymph node. Like, why would you want methylene blue? I mean, there's, it's a surgical dye, right? The, all that, the whole methylene blue story is trumped up.

Someone will get pissed for me saying that.

Well, no, I want to, I need to know this.

Yeah.

Okay, so this is— oh my God, I love that you're here. Okay, so methylene blue, that's the— it's the hottest thing in like in biohacking. Still, it's still—

I feel like it's— wow, wow, it's gotten replaced by some other.

Well, but the thing is, people are still thinking it's great. So tell me what— okay, so is it a total farce? Is it a total risk?

Like, tell me, it really isn't the evidence. So you, you have to look at it this way, and so We're definitely getting into the, the data. Like, I was talking to you about the buzzwords.

Yeah.

So the data that is like the Ten Commandments handed down by God.

Yeah.

That's not how it works. Methylene blue. So there's a lot of mechanistic data out there, and it's really important to understand what mechanistic data is because it's scary when you know what it is. And as a doctor, my— the most disturbing thing I see in the, the docfluencer circles.

Yeah.

Are the people that seem to have like gone totally off the rails with just rational thought. Like the rules didn't change. A physician is a scientist. They're just, they just specialize in human health, anatomy, biology. Okay. Science is science. Science is predicated on a thought process, a systematic way to ask a question and find an answer. And that process starts typically in a lab setting. Because when you get to an organism level, humans are the highest level organism. I— you can make, make up stuff, but from, from an intellectual standpoint, from a complexity biology standpoint. And so trying to test something in a human is very difficult. And after World War II, it's also illegal. Right?

Right.

So when you look at what happens, how do we begin to test? So I observe, say, something in nature. I go, that's really interesting. I wonder what would happen if I introduced a substance into a cell. So you go, you take a Petri dish, plastic dish, you put some cells, single cells, the smallest building block, and you introduce the substance. If we, if we get to the peptide conversation today, we'll get, we'll get well into that. Yeah. So, but mechanistic data is observing some effect on a single cell. You are trillions of cells. A mouse is trillions of cells. Okay. One single cell, that's typically called like cultured cell lines. Okay. And so seeing an effect on a single cell in a Petri dish raises questions. I mean, you can go, oh, well, that's an interesting mechanism or pathway or biologic activity that occurs, but that's all you can say. That has nothing whatsoever to do with the human body. So what methylene blue does for mitochondria in a single cell line, we don't have any evidence that it has an impact at the organism level. Does that— yeah, does that track for you?

Basically, for the person who doesn't understand all these things, you know, like for example me, would you say that it's all hype, there's no real evidence on it, and it's basically a load of non— like a load of crap?

I wouldn't say that.

So what—

because I think you have to literally parcel out—

why were people taking it?

Because, I mean, besides that—

besides—

no, no, but there is no besides. Think— I mean, there is no besides. It's literally because Joe Rogan said that, and he has such a powerful reach and influence.

What does he say? What does he say the reason is?

Energizing. I mean, again, like I said, in a, in a controlled lab setting, okay, what what it can do, what methylene can do in a single cell as it relates to mitochondrial performance. Realize if we, in the longevity space, mitochondria and muscle should be synonymous. Those two parameters drive metabolic health and metabolic disease. The opposite of health is the leading cause of death in the United States today. We could unpack it, but cardiovascular disease is not the leading cause of death. That is an effect of the leading cause of death. What, what blows my mind is we're still 2026, we're still listing off, you know, the statistics, the data around cardiovascular disease, cancer, stroke, dementia.

Okay.

This whole slew of leading causes of death. But I would submit to you very plainly that you don't want to ask, you know, the, that list. You wanna ask what's causing that list. And there's one thing very plainly, which is the progression of metabolic dysfunction, insulin resistance, synonymous metabolic inflexibility. And then ultimately think of it as a, as a timeline over time, the progression to type 2 diabetes, because what we can say, okay, this is nerdy. Okay. But what we can say plainly, diabetics, type 2 diabetics, that's an easy population to study. Right. They have a diagnosis. They're in a disease that they have a disease qualifier, easy to find in a database. What's the— so the question we have to ask is what's the impact of type 2 diabetes on all-cause mortality? Death from anything, 300% to 400% higher than the average population. That's a problem.

Wow.

I am not aware of any other single agent relative to all-cause mortality because we talk about Grip strength. We'll get into all these like numbers. So all-cause mortality, if you say, well, what is longevity? Well, it's preventing or reducing risk of all-cause mortality. That's the ultimately longevity agent. Okay. Is that fair?

Yeah. Fair.

So in a diabetic, 300 to 400% higher likelihood to die, period. All-cause mortality. But look at the impact of type 2 diabetes on the risk of cardiovascular death. 2.5 to 3 times higher than the average population, almost on par with familial hypercholesterolemia. We all know, you know, cholesterol's bad.

Yeah.

We can get into that, that conversation. Yeah. Statins for everybody. And I think there's a rational use to it all, but nevertheless, we're so hung up on cardiovascular death, leading cause of death in the United States today, which by the way, it's, it's just barely above cancer. But one single agent exponentially increases the risk of death from heart attack, stroke, early onset dementia, cancer. And that's diabetes. To me, that's the smoking gun.

So does that— yes. So does that mean sugar should be eliminated from your diet? Not if you want to.

And not directly. No, no.

And then does that mean then— okay, I'm just— if it's all about insulin resistance, So is there a reason why everyone then should be on a GLP-1?

The argument I think is being made towards that, the short answer is no, not everybody should be on a GLP-1. GLP-1s are tools. Okay. They're not right. They're not weight loss drugs. That, that, that to me, Eli Lilly and Novo Nordisk should be pitching a fit because they're not weight loss drugs. They're well beyond that. And we see that in the data, right? The impact on reducing the risk of cardiovascular disease, all these things. But as a purist, as a nerd at heart, you have to look at what we call mechanisms of action. And GLP-1s do one thing and one thing only. They improve insulin sensitivity. Okay. Now, how they achieve that can be through reduction in food noise, very powerful slowing of stomach emptying. Okay. What we call delayed gastric emptying. But those agents also work preferentially on the pancreas, so they're improving insulin sensitivity. So this goes to my point. People want to say, oh my gosh, Ozempic reduces the risk of heart attack. Yeah, the data said 20% reduction in major adverse cardiac events, but it doesn't reduce the risk of heart disease. It reverses insulin resistance.

Right.

But insulin resistance is the driver between heart disease, stroke. So you can logically say, yeah. This is what I would expect to see.

So you just said to me that cancer, dementia, cardiovascular, you know, heart health, all these things, the root cause of all these things is insulin resistance. So then if you're saying that, then if you're reverse engineering this whole thing, you would say that how do we get not— how do we not be insulin resistant?

Correct. That is true.

Is then we should be like, we should— okay. Taking the tool of a GLP-1, right? How else can we become not insulin resistant if we don't want to take that?

Move to Europe? I don't know. Yeah, right.

Okay, no, I'll do that.

So yeah, insulin resistance, understanding insulin resistance, the how, the why, the, the mechanistic nature of it, I think is really important because this is where all these groups come from— the carnivores, the, the ketos, that all these things. There is no one way.

But wait, then let me— I'm just going to keep on interjecting here because I've got questions. So wouldn't that make the most logical sense if we don't want to be insulin resistant and there is a tool like a GLP-1 or 2 or 3 with all these, you know, new ones coming up? Isn't that like— doesn't that make the most sense? Why shouldn't we all be on a GLP-1 then if that will if that will basically create a situation where we're not going to potentially get cancer or heart problems, you know, heart attacks or whatever else.

Well, I mean, I think the fundamental argument is that GLP-1s are drugs. We— let's clear this up. Okay. GLP-1 in situ produced by the human body is a peptide, short-chain amino acid. Okay.

Okay.

Ozempic is a drug.

Yeah, they're all drugs.

What makes it different? Its origins are as a peptide. But what does Big Pharma, the infamous Big Pharma— which, by the way, I'm going to give a quick PSA to the world here because you have a great following— if a doctor uses the terms Big Pharma in the same sentence, you should walk out.

Really?

We don't talk about Big Pharma. There is a pharmaceutical industry. We don't work— we're not poisoned, we're not agents of Big Pharma. It's just total crazy train where people go. But The important thing to understand is, are you getting paid by Big Pharma? You weren't supposed to bring that.

I know, sorry.

I, I only get paid a million dollars a year. Oh, here's another PSA for everybody, just get it out in, in the open. Openpayments.gov. If you want to know if a doctor is being paid by anybody, Big Pharma or otherwise, you go to openpayments.gov and type in the doctor's name. It's a public database. So all the trickery of like, oh, you're getting paid— no, listen, I can't be paid literally a penny, not a penny that is not reported. Now I'm already going to go here, but— and yet a fitness influencer can make millions, show you his new car off the peptides he's hustling you for, and there's no conflict of interest there? No, they just, they just want you to be healthy. They're just, they just care so much. So a doctor, for a doctor to take money, okay, which by the way, folks, that was decades ago, decades ago, where yes, indeed, there was a time where pharmaceutical companies in my world of spine surgery. Yeah, there's, there's a lot of money being exchanged decades ago, back in the '90s. Okay. The laws that had been passed to scrutinize It is illegal for me to take money and not report it.

Well, so it's— it's not— do surgeons or physicians do it? I'm sure they do. I'm sure it happens. That's the reality of life. However, it is actually against the law.

So because it's against the law now— oh my God, there's so many things here. So because it's against the law, is that why so many doctors are hustling these compound peptides because they can make money off of it. And because they have the Dr. in front of their name, people will believe them more and therefore people will subscribe and buy from their affiliate code and do all the things and they can make millions of dollars. You don't have to— it's not just the fitness influencers, my dear friend. It are doctors who are doing the same shit because they want to make money.

I agree. And I feel chiropractors. Yeah. So I would say very plainly, And I see this all the time. I commented on— someone gave me the distinction of being the number one peptide troll on Instagram the other day. And I was like, I don't know if I've ever been number one in my life, but this is great.

Like, how is that possible?

Because I don't know how the algorithm works, but the crap shows up on my feed.

Yeah.

If I see something that's fraudulent, I'm going to comment. So when you tell somebody that this is what BPC will do for you.

Yeah.

Implication is that there is scientific evidence of it actually taking place in the human body, and there is not. So saying, we go back to that cell conversation, saying something like methylene blue does something in a single cell devoid of an organism is actually totally irrelevant. So when people tell me, when I hear a doctor say it's really exciting, I look at that guy and go, you are, you're lying through your teeth. You and I both know. It's not at all exciting. Reading mechanistic data is not exciting because, do you know the natural history of mechanistic data resulting in outcomes-based human evidence? Less than 10%. Less than 10% makes it to the point because this is the standard in the pharmaceutical industry. You see something, it's interesting, you put it in a cell, oh, something interesting happens. Now we're going to put it in an animal. Oh, something interesting happens. Now we're going to put it in a human. Oops, it causes cancer. Or oops, it doesn't actually do anything at all.

So, okay, this is—

does that, does that resonate? It does, because that's the absurdity of the world we're living in. You're telling me you're excited? And so it's one thing for the general public, with all due respect, to be excited, because I, I, I get it. You're reading something and you're like, oh, this sounds really cool. Or someone told me Oh my gosh, it regenerates tissue. That's really cool. I don't disagree. But as a physician, as a scientist, it's fraudulent to then tell another human, right? Because you're an authority on human health. I'm using that authority, just what you alluded to. I'm not one to point fingers at intentions or motivations. That's beyond what I can do. But the surface observation is that a doctor who is a trusted resource in human health care, is making claims about a bioactive substance in humans, knowing full well that it does not exist.

Okay.

This is not even a leap of faith. It's just crazy train.

Yeah, this is blowing my mind because BPC-157 is all over the place and all over it, and everybody I know is taking it. Everybody.

Millions have been miraculously healed. Did you know that?

Yeah. Well, is it placebo? Is it like psychosomatic? Are people thinking they're being healed by it? Are they getting healed by, by something else? Like, and they think it's PPC? Is it?

It's hard to say. I mean, I can't, I can't say definitively. So here's my—

You don't take it?

I don't. When I had my neck surgery, I did.

But why? You just finished saying that it's not necessary. There's no evidence around it.

Correct. But, but there is anecdotal evidence which has value, which has merit.. And there is preclinical evidence. So here's the difference.

Okay.

Okay. I'm not anti-peptide, I'm pro-evidence. Really key distinction. Okay. I've read all the data. If I'm talking to a client and they come to me and they say, doc, you know, I twisted my knee and my buddy's been on BPC, it saved his life, and da da da, should I be on that? I say plainly, listen, here's the, here's the situation with BPC. Here's what we know to be true. There is mechanistic data, single-cell data that suggests that BPC has healing properties. Okay. We've observed that in many, many, many studies. And we also have lab rats that have demonstrated some element of connective tissue healing. Okay. At least 30 separate articles or papers written about it. What we don't have is any zero, any human evidence. Okay, so here's where the gap exists. Like, at a very basic level, who the hell knows this? I'm not even going to get into the gray market stuff, but who the hell knows if I inject BPC into my thigh? Who knows how long it survives? First step one for a pharmaceutical company to build a drug is something called pharmacokinetics. You actually evaluate it in the— does it make it into the bloodstream?

Does it survive in the bloodstream? Does it actually deliver to the intended treatment site? Those are all things leading up to the ultimate question, which is, does it alter outcomes in a human organism? So you see how far removed we are from hard facts. So I can't look you and say, Jennifer, you need to take BPC to heal your knee.

But wait. Okay. Okay. But you don't say you need to. But would you put me on it just because it might work? I decided I wanted to go on it. Why did you go on it for your neck? If you had all the information, you know, all the research you've done, why did you do it?

Because it might help.

Because of the might. Did it help?

Hard to say because I don't ever use BPC as a, as a standalone treatment.

Okay.

Because we have—

or stem cells or—

well, so no, in that space we have, we, we have decades, maybe centuries of data surrounding growth hormone and its reparative or restorative effects. That's clear, that's very linear, and that's in humans. Big, big difference. Okay. So I will pretty much uniformly recommend a growth hormone secretagogue, which has been well studied in humans in addition to the BPC. I mean, truth be told, I personally, as a practicing physician, I don't trust BPC enough to use it as a standalone in my practice. I mean, over 1,000 clients over time, my data's split down the middle, 50/50. Okay. 50% have a— you get the thing too, subjective response. That's a story, which is very valuable. Placebo effect, possibly. Don't discount the placebo effect. I don't as a physician, right? There are plenty of people that you don't have a diagnosis for. They have symptoms that for them are significant, severe, debilitating. And if I have something that they take and doesn't harm them and they get better subjectively, that's not the worst thing in the world. That's just reality.

So then, okay, so does that make sense? Yeah, that makes sense to me. That makes sense.

So it's not, so there, there's a balance and people, again, everybody wants to box specifically box me in. I try to maintain a high level of transparency around what we do and don't know regarding peptides. What I can't do, I can't say, Jennifer, this BPC, so it increases new blood vessel formation through upregulation of VEGF, vascular endothelial growth factor. And that translates to improved tissue healing and repair. If you heard me say that, how would you interpret that? That it works in you? Yeah, but you're a human.

Yes.

So I do have that data.

Last time I checked. Yeah.

Well, I mean, you can always— it's what you identify as.

Yeah.

But the level of data that we have to make those statements I just made are in lab rats, right? So if I don't qualify that, do you see the difference?

Yes.

If I don't qualify, say, Jennifer, this is what we saw in lab rats. Now I need to tell you plainly that the translation of data, positive data seen in animal models to human outcomes, it translates very poorly.

Let me take a quick break to tell you about something that has genuinely changed how I perform throughout the day. For years, I just assumed that my mental sharpness had a ceiling, that by mid-afternoon I was running on fumes, slower to think, harder to focus, and even a little more irritable than I wanted to be. And I never really thought that a supplement was gonna change that, but I was wrong. Since I started taking Magic Mind every morning, I think more clearly, I focus longer, and I'm much more productive in the afternoon than I used to be. And that actually surprised me. Magic Mind is this daily 2-ounce shot that gives you a sharper mind and sustained energy. It's built with clinically backed ingredients like lion's mane, ashwagandha, turmeric, matcha, developed over 10 years of research. This formula is nanoencapsulated, meaning that your body absorbs the active ingredients 5 times more effectively than pills and powders. And every batch is third-party tested for purity and potency. So if you order today, you get 50% off your first order at magicmind.com. You can try it risk-free for 100 days and get a full refund if you're not satisfied, no questions asked.

So that guarantee tells you everything that you need to know of how confident they are. You can also find Magic Mind in stores near you through their store locator on Magic Mind. And I was a little skeptical too, but now I notice when I don't take it. And that's the only proof I need. So don't forget to check out magicmind.com to find out the stores near you and get 50% off your first order at, of course, magicmind.com. What about another one? TB500?

TB500 is even worse. Way worse. In Wolverine.

And yeah, the Wolverine stack.

Wouldn't you like to be Wolverine?

I like—

I like that. You kind of look like Wolverine.

What are you doing? I don't have I don't know.

You don't have to.

Okay, but you look really fit. What do you— you're on— you're definitely on something.

Oh, have to be. I'm on hard work and consistency.

That's what I want too.

That's what I use. Hard work, everybody. Oh man, that's a whole nother—

we're gonna get annoyed.

So, so, but let's do— let's do TB500 because this is really important.

The TB500. And I also want you to talk about the Wolverine.

Wolverine, right, right, right. So what I love is that people are literally going back and forth on social media about combining two peptides in a single delivery model like the Wolverine. So TB-500, BPC-157. And they're talking about, well, can they survive together? Can they basically cohabitate? And also, who gives a rip if they don't even work, period?

Right?

Like, you're talking about layers. See, this is what happens. This is the, the, the influence, right, is we're bypassing these huge steps in the process.

Yeah.

And we're talking about should they be paired together? I'm more concerned. Do they do anything? Okay.

Yeah.

And obviously, you know, as a physician, first do no harm. So the safety piece always has to come first. That's why we in phase 1 and phase 2 clinical trials, those are about safety. Phase 3 is about efficacy. Okay. So you spend years making sure it's safe in a human being. We haven't done any of that for a peptide. Well, but your body produces it. Well, yeah, it produces GLP-1 too, so we don't need safety data. And then let's go down the vaccine route. I'm not going there. So here's really important. We got to stress about TB500 that this borders on criminal because TB500 by definition is a fragment. It's a short chain fragment of something called thymosin beta 4, TB4. Okay. The thymosin family, thymosin alpha, thymosin beta. These are peptides that were extracted from the thymus. Which is, which is a gland that secretes various bioactive substances in a human. And TA1, thymosin alpha 1, thymosin beta 4 have been studied in humans, not to the extent of, say, like a drug, but they actually have indications and FDA approval for use, which means they've been studied enough to say they're safe and they actually work.

Okay. So Thymosin beta-4, we have great, great studies on.

Well, never even heard of it, by the way.

Oh, exactly. But you've heard of TB500?

Yeah.

So the game is, okay, so we have this larger molecule that's proven to be— have biologic effect, positive biologic effect in humans. So we've got to credit it there. If we just chop off what seems to be the most active part of that molecule, Now we're back in the petri dish. Okay. And look what it does in a petri dish. Oh, wow. It's active. It renders similar effects. Therefore. Okay, now we're here and we're going to make a big leap here. You ready? Therefore, TB500 and TB4 are the same thing. Does that make sense to you? Like, would you sign off on that yourself?

No.

Because that's what's being presented. People talk about TB500, but what they're referencing are studies They're referencing scientific evidence in humans of TB4, thymosin beta-4. So it's a complete clown show. And one of the kings of this whole narrative is this chiropractor. I don't have any issue with well-qualified chiropractors. Name Trevor Bachmeier. I mean, this guy is just totally unhinged. He literally lost his license as a chiropractor and resurfaced, as you know, we were talking about. Yeah. A lot of criminals, felons like to resurface as longevity experts.

That's, you know why? Because there's no regulation.

Correct. I know. So they imagine they can do so, right? So I take a lot of heat, understandably so. I mean, I get it. I don't have any qualms with that. If you can't defend or provide rationale, supporting evidence, data to what you do clinically, yeah, I would call that— I mean, some would call it malpractice. Yeah. Okay. So, but yeah, that's the beauty of the wellness experts and enthusiasts and longevity experts. Experts, right? You can literally be picking your nose one day and the next day you're an expert just because you said so.

Just because you said—

oh, and then, and then mix in a little bit of ChatGPT. Oh, you got your certificate now, right? And so that's— but that's the tragedy is, uh, you know, I— people, what's a longevity expert? I get that all the time. I'll give you my definition.

Tell me, what do you think a lot— what, okay, what is your definition of a longevity expert?

So a longevity expert First, it's a foundational educational background. So could you be a PhD in human something and become a longevity expert? Yes. I mean, you know, David Sinclair is an example, right? He's PhD, lab, lab at Harvard, very well known for his resveratrol work. Right.

Which was a total fraud, by the way.

Total fraud. Correct. So exactly. But But, well, we don't want to talk really big-time fraud. We can talk about the human biologist.

I, I don't care.

Um, apparently now when you get a bachelor's degree in biology, you are a biologist. Typically in academic circles, we reserve a title like biologist for a higher-level degree, like a master's at least. Minimum master's. Minimum. Exactly, exactly right. Like I myself, it's on my wall. I have a Bachelor of Science in human biology. I'm not a biologist, nor would I ever reference myself as a biologist. But, but again, the rules also—

it's like me, I have a bachelor's in psychology. I'm not a psychologist.

Oh, I didn't know that.

Clinical psychologist.

Cool. Yeah.

You didn't know that?

No, I didn't know that. So yeah, so the, the goalposts are kind of constantly moving.

Yes.

I, I digress, but But really, long and short of it with TB500 is we're talking about all these mechanisms and actions in the human body that are totally irrelevant. People are referencing, literally quoting research from a parent molecule.

Okay, so the Wolverine stack, what is it? Why are people taking it? And that's obviously also a total scam.

So I want to be careful here because I really try to adhere to science evidence. I mean, I'm a physician. This is where to me the, the docfluencer role, which can be powerful, can be— there are some really cool people out there that I learn a ton from.

Who do you like?

And then, oh, I knew you said Marie Claire. Dr. Marie Claire, obviously from a women's health perspective. I, I see the, the women's health movement that's evolved from social media is like probably the greatest thing to come out of social media, at least right now. Yeah, in medicine. But, um, oh, I could list off— there's, there's one woman, I'd have to look it up, but one woman I follow, she's an obesity medicine specialist, and, um, she gets it. The cool thing about social media is that it does force you to communicate much better because you're trying to deliver a nuanced message in 30, 45 seconds, that's really hard to do, right? It's a challenge. And, and then what I love about social media is that I see it as an element of accountability, because despite all the quacks that are out there, there are some really smart people. So I don't get to say I'm a physician and then just spout off on something. I, at least I don't believe that's— that's—

you have— it's like, it's like basically like a— you— it's like a It's like the Wild West. You're going to have people who are good, you're going to have people who are bad, but you have to be super discerning. That's the whole thing, right? You have to know there's so much noise, and it's over-information now. It's too much information, which is why people are confused, which is now getting back to the Wolverine stock. Tell me what you think.

So BPC-TB, TB500, like I said, that, that is the biggest hoax that we have. There is absolutely no human evidence, and all the rationale or thought around why this is a synergistic synergistic combination, okay, is completely irrational. It's unsupported.

Okay.

Now, if you were going to make something— and so why not TB4, thymosin beta 4? Very expensive, difficult to make. So no one's— so the hustlers are like, hey, I'm going to just make it just a little— I'm just going to sneak this in here. And so I literally see these, these online peptide companies and stuff that will say TB4, when they're talking about TB500. Doesn't work that way. Like, biology doesn't work that way. So at some point in time, we've got to call a spade a spade. That's fraudulent, right? You're literally describing a molecule that's been studied, chopping a little chunk off of it and calling it the same, which— that's just grossly inaccurate. If a pharmaceutical company did that, Wall Street would It'll be massive fallout, massive class action, right? So, so we have a certain standard that we hold pharmaceutical companies to, but we'll let the wellness guys just make these leaps of faith and, you know, so cool.

Does that— exactly. So does that mean then TB4 is really effective?

Yes. For what it— for what it's—

so why are more like— so if people who don't have access to it, if they have money, can't they get access right now?

No, I would say not really outside of again, FDA-approved uses. So right now, you know what happened with the compounding pharmacies?

Yeah.

Which is a whole nother— everybody wants the conspiracy. Everybody wants to know, right? Because money trail, right? How about we look at the money trail right now where fitness influencers, people who literally have no comprehension of basic science, are making millions? They are profiting millions by taking off their shirt and saying, My stack did this. Okay. The stacks thing makes my head want to pop off because conveniently, 9 times out of 10, their stacks include 1 to 2 substances with well-known, well-documented effects, and then a slew of other things that are doing all activating this pathway and moving the needle here. When you're on Retatrutide, Okay. And you're seeing radical body composition, you know, change real time. Well, we know that's what redotrutide does. We have literally tens of thousands of human subjects that we've already proven that it works. So now why do you need to add in MOTS-C, 1-aminofib, this whole slew of your stack, and then try to justify it with these bizarre mechanistic pathways? Again, understanding this, that a mechanistic pathway that exists in a single cell does not mean it exists in a human. Moreover, it does not mean at all in any way, shape, or form that it's synergistic with another pathway.

The idea in the— these guys that say peptide sciences, the, the theory that breaks down from the word go is that, well, if I activate this pathway and I activate this pathway, that they're synergistic. That's pure hypothesis, not even supported hypothesis.

Okay, but redish root Thai hot thing right now.

Totally.

And, uh, it—

I thought it's gonna change the world, right?

But I thought it was the only— well, I heard last time I checked it was only in rats. That's not human, uh, it's not proven.

No, no, no, no, no, no. On the contrary. No, it— I don't know the exact timeline for FDA approval, but the Phase 3 clinical trial— so, no, retatrutide's at the end of the, uh, it's coming up to the finish line. It's gone through phase 1, 2, and 3 clinical trials. It is the most well-studied. And this is a whole nother story that the world has never seen, where an actual drug, a pharmaceutical drug called retatrutide, is maybe being produced in substandard areas, the gray market.

Yeah. And they're all compounded, the ones that I've—

Yeah. And I believe truthfully, I believe some of it's retatrutide and some of it's not. Okay. I mean, but redotrutide itself, that molecule, that synthesized molecule, that drug has the most compelling, overwhelmingly compelling science to support its use in humans. We're already— we're probably— I don't know. I'm going to guess within a year or two it's going to be FDA approved. It's going to be widespread use through pharmaceutical channels.

So if someone's buying it compounded right now, But they're still getting great results. Is it— what do you say?

What do I say?

Do you believe in that one?

Do I believe in retatrutide? Like, like the effects? Oh, it's, it's, it literally is a life-saving drug. The idea, by the way, that, that big pharma wants to keep everybody sick. People keep themselves sick. Okay. When you gorge yourself on soda and donuts and you sit on a couch and play video games, you're keeping yourself sick. I hate to be the bearer of bad news.

Yeah.

Big Pharma has introduced more therapeutics even in the last decade that are targeted therapeutics to actually reverse disease conditions. But Big Pharma is just out there to make money. Sure they are. They're publicly traded.

Yeah. Like, who's—

that's not a secret. But so are the wellness influencers hustling peptides. They're there to make money. You see any of them handing stuff away for free?

No, they're not like, just use my code and get free shipping.

Yeah, yeah, yeah, yeah, yeah. Just so, so no, Red Truthide, the GLP class. Okay. And again, this is where it's tricky because at a very technical level, the GLP class is born out of or built off of a peptide framework. Okay. Calling GLPs peptides, I think, is, is a pretty loose— it's a mechanism to alter the narrative because what people are doing is they're taking these wholly unstudied in humans, BPC, TB500, GHK copper, uh, epitalon. I mean, the list goes on and on, on wholly unstudied in humans. Okay. And then they throw in a GLP, which is studied into the ground decades, decades. The first GLP was brought to market in 2005, decades of data. Proven effective. And then they're like, well, we see— look how well peptides work. Let's parcel this out. We have FDA-approved drugs based on a peptide framework, right? Then we have the influencer hustle peptides with zero human evidence. Not the same camps. Okay, but you don't get to lump them together.

You don't get to. But why people are compounding trizeptide. Yeah. And Ozempic, and it's a fraction of the price.

It's really not, by the way. If you look at— here's my belief about— you want to do the GLP conversation? I mean, we don't have to get too far into it. I mean, GLPs are—

before we get to GLP, I want one more. I have one more question about peptides. MOTC, I want to know about. And I also want to know about GHQ, GHK, copper.

Right. So Matsi's again, I think mechanistically, why do people take it? So it's, it's a mitochondrial optimizer. I said earlier, right? It's very clear the relationship. So your, your densest repository of mitochondria, so energy production, okay, for skeletal muscle. So think of mitochondrial health as synonymous with muscle health, synonymous with metabolic health. That is the trifecta. No other single parameter that you could trend— and this, we can get into longevity metrics— has a more direct positive influence on metabolic health than muscle. And I'll unpack that for you, right? But more muscle, technically I would say more functional muscle, so strength over size, is the single greatest predictor of long-term health and survivability. Okay. But realize that's bolstered through its effects on human metabolism. By the way, VO2 max has nothing to do with insulin resistance. Sorry, sorry to break it to you folks. So we're saying the leading cause of death in the United States today is insulin resistance in the form of type 2 diabetes. The single most potent agent we have to directly reverse insulin resistance. Okay. We can get into the weeds of remission versus reversal diabetes. Is muscle, period. Everything else flows from that.

Is—

does that track?

Does that make sense?

So when it comes to—

you keep on asking me that.

So no, no, no. Well, well, because, because this is the thing that I wrestle with, is you can be knowledgeable and you're not an effective communicator, and you might as well not be knowledgeable, right?

You're very—

if it doesn't land—

landing— it's landing—

if it doesn't land or resonate, and And honestly, my platform, my position is very simple. I actually went into medicine. I became a doctor to help people. Crazy. I know it's crazy. Yeah, I didn't do it to get rich. I didn't do it, whatever other— to work for Big Pharma or anything. Right.

You're from Ohio. I mean, you're just like a simple—

truly, this simple country surgeon. Like, that's my origin. It is not anything fancy or elaborate. And I really believed becoming a doctor, I could help people. And so when you look at what's going on in the United States today, which is a broad landscape of insanity, but when you look at the health crisis in the United States today, the obesity epidemic, we need to get back to the root cause, the actual root cause. If I can change— it's Occam's razor, simplest explanation. To, to equate to the larger good. If, if I can change one parameter and it exponentially reduces your risk of death, I would go after that.

Yeah.

I wouldn't actually spend a lot of time chasing a bunch of other stuff. And we can, we can talk about how that relates in, in actual clinical practice. But the truth of the matter is, if you are building healthy lean muscle as a priority, you are indeed extending your lifespan, healthspan. If I look at someone who is insulin resistant, we get a fasting insulin on you, and we then proceed to do nothing. Don't change your diet, don't change anything about what you do day to day, and we strategically build more muscle. Your fasting insulin will come down. It has to by definition. Now, where does a GLP-1 fit in? It's a tool. So I can talk to you about how those tools relate, but ultimately I see a GLP-1 as, as a mechanism to enhance muscle.

But don't get there yet. I want to know about MOTS. Masi, you said the mitochondrial one.

Mitochondrial, you're right. Masi.

And then GHK, don't forget about the copper one.

Well, GHK is easy. I'll just put it to you this way. There's no evidence for systemic use.

Okay. Because I keep on seeing girls and—

Topical is a workhorse.

No, they're getting injections and they're like, I'm like, why does your skin look so good? And they're like, oh, I take copper. So will I look 10 years younger?

No, you will if you put topical. So I love GHK copper. As a topical application for any, any invasive procedure of the skin. You violate the epidermis. So that could be like a skin pin, RF microneedling, even a, even a laser. Okay.

So GHQ, GHK topical works.

Excellent human evidence.

Yeah, actually injection.

Well, the injection has zero. It's never been studied.

So why is everyone taking it?

Because you told me that you took it and your skin looks amazing. You left out the part that you just did a full-field ablative laser and you— right. And you high-dose omegas and you do IV vitamin C. You want to talk about, by the way, making skin glow and heal. You do high-dose vitamin C infusions. Okay. But that's the part they leave out. Why? Because they can't sell that stuff. That's not— but I can hustle you for some GHK. I can put it on my podcast and get a lot of likes. There is zero— there's no debating it. And for some reason, someone will come up maybe from this podcast and be like, no, see, here's the studies. Yeah, it's called topical. If I put it in a cream form, it's actually well studied, most well studied actually in aging women, 70-year-old women. It's a very effective tool.

Where do I get it?

Compounding.

What's the best?

I compound it.

Can you compound some for me? Sure. Yeah, just the— just a topical.

I make Lots of concoctions.

Really?

Oh, yeah.

Do you use it?

So my— I mean, the workhorse is tretinoin. You—

everyone talks about tretinoin.

Okay.

Okay. What is that?

Tretinoin is the oldest vitamin A. Vitamin A. But this is really important. Yeah. So for the listeners. Okay.

And for me, I'm listening.

I know, I know. You have retinoids. You've heard. Yeah. Everyone's like, oh, you need retinoid. No, you need retinoic acid. They're different. Retinoids are retinol-like compounds. So you see those, you can get— now there's some that are OTC, over-the-counter. You get at Walgreens. Okay. Retinoic acid, the pill form, Accutane.

Uh-huh.

You've heard of that, right? So the topical form, tretinoin, is pure retinoic acid. And so retinoic acid is the most potent, is the single most critical anti-aging skin health modality. Every single person should have a high-quality tretinoin. It can't be— I can't make the same claims for the stuff on the counter at Target.

Where do I get it?

From a doctor's office.

And they have to prescribe it. Yeah. And how often do you use it?

So I, I try to have every one of my clients build up to nightly application. Tretinoin acid. Retinoic acid, tretinoin, at the concentrations that I would recommend. So for you, I'd recommend 0.1%.

Okay.

If you just started at 0.1%, it will fry your face. Now, I would submit that probably 6 to 8 weeks of, you know, some redness and flakiness, some real irritation, you'll get past that initial phase and it's a glow up for life. But the way I do it in my clinical practice, because no one's jumping around to do it, is I start at 0.025% and then I progressively work up. So we start extremely light, have a great vehicle. This is— don't worry, I don't get kickbacks. We love SkinBetter. SkinBetter, by far and away, I think is the most powerful, potent skincare line, medical-grade skincare. And so that starts at 0.025% retinoic acid.

So I can— can I buy that?

Yeah, from a physician's office.

So you can, you can prescribe it for me. Yeah. Yeah.

And I think it's— that is, it's a really nice delivery vehicle. So it keeps your skin hydrated. It is.

It's—

you could do the experiment like on your forearm. I give you 0.1%. I mean, it, it's pretty irritating. It's pretty harsh. It's only 6 to 8 weeks. And so, like, if a lot of dermatology colleagues of mine are like, oh, it's only 6 to 8 weeks, I'm like, come on, really? You're out. Your whole face is flaking off, bright red, you're itchy. Not too many people sign up. But if you sequentially, if you go 0.025, 0.05, 0.1 and you work up to it, I usually with clients it's like 6 to 8 months. I'm in no hurry because ultimately when you get to that 0.1 concentration, that's, that's the sweet spot. But I love that with topical, with topical estrogen.

Oh, that works so well.

Yeah. So I make my own little concoctions. It's a very potent— it's a powerful hormone for skin health and skin turnover.

So can't it like seep into your bloodstream?

The estrogen? No, no, no.

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Go to prolonlife.com/JenniferCohen and use Jennifer Cohen to claim your discount and bonus. That's prolonlife.com/JenniferCohen and use code Jennifer Cohen. Okay, so what if I just use the topical estrogen? Does that work without the tretinoin? The—

no, tretinoin is the workhorse. Tretinoin. Literally every single person that wants to age well proactively should be on tretinoin. And I would argue, like, all the people like, oh, it's, it's the GHK and all that stuff, and then they refer you to the link to buy. They're probably doing something else. I'm sorry. I'm sorry. That's just the truth of it. Now people are going to flip out and be like, well, you're lying. I get this all the time. Well, how do you account for the millions of people that have been cured of X, Y, and Z with BPC? I say, that's great. If it works for you, that's great. I've used it in my clinical practice. I track every patient. That's part of being an expert. It requires documentation, data analysis, all of it, and interpretation, right? That's how you're an expert. In my practice, and really, if you pin people down, BPC is a 50/50. And last time I checked, flipping a coin is not— if I said we're gonna do surgery on you and we'll flip a coin to see if it's going to work, Would you sign up for it realistically? I had, I had someone tell me, I said 50/50 and they're like, so you're saying it works great?

No, I'm saying it's placebo effect. There's a 50/50 chance.

You know, this reminds me of, have you ever seen Dumb and Dumber when they're like, would you, would you go out with me? Yeah.

But one in a million. So you're saying, exactly. So you're saying. That's what it is.

And so you're saying there's a chance.

Exactly. And that's the, that is the essence.

Yeah.

Of, of the peptide hustle. So you're saying there's a chance?

So you're saying there's a chance?

A $50+ billion industry— that was 2024— $50+ billion spent on peptides for the hopes of something. So you're saying there's a chance?

Yeah.

Is a chance worth $50 billion? I don't think it is. But the tragedy is people would rather take that chance than just do the basic stuff. Tretinoin, I mean, $20. I mean, it's dirt cheap. GHK, it's a nice theory, but again, GHK, copper, tretinoin, estradiol cream. Now that, that we're talking and you'll see meaningful results.

So wait, get back to the tretinoin. So then would you put the 0.025% on every night?

Yes, for sure.

Okay. Like, what would be the routine? Would I wash my face, then put serums? How about the serum?

Yes. So usually so, so the application of the Tret product, whether it's pure Tret or it's, or it's in a carrier vehicle. And then that's when you put whatever serums, lotions, Tret first, beef tallow, butter.

So you think beef tallow?

No, I'm being sarcastic.

Okay, good.

It's just outrageous. I mean, you stick your bowl, your head in an ice bucket, and then you put butter on your face.

Yeah.

Like, who is coming up with this stuff? And it would be one thing if like we didn't have tried and true proven. But yeah, you want this, the not-so-secret secret. Every one of my clients, regardless of age— now, a younger woman, for example, I would keep on 0.025, 30s into their 40s unless they demonstrated more accelerated age-related, age-related change.

So for every day you'd put— you'd wash their face, put that on evening, evening, right?

Yeah.

Yeah. Okay. And then you could put your serums.

Yep.

And then—

or some moisturizer. I would always do a moisturizer on top of it.

So when— how often should we use the estrogen on our face?

It can be—

it can be periodized, but on a daily basis, like during the day or at night?

At night. Yeah, I would do it at night.

Not during the day.

During the day is when I would use whatever your standard regimen is, typically some type of, of moisture, some type of delivery vehicle. You know, a lot of these products have vitamin C, so on and so forth. I don't—

How about hyaluronic acid?

Complete clown show.

Really?

Topical hyaluronic acid.

Yeah.

Is only matched by injected, right? Skinvy. You've heard— have you heard of Skinvy? Allergan bought Skinvy. It was well over $1 billion. I don't— I don't want to misspeak. Skinvy is an injectable, just like your, you know, HA fillers that you're supposed to inject into the skin. To deliver hyaluronic acid. Being in Colorado, by the way, hyaluronic acid is a workhorse in my practice. Hyaluronic acid is hydration and volume. Think of it that way.

Yeah, right.

So its basic function is to pull water into the extracellular space. So you get that nice plump hydration. And in Colorado, we're bone dry. So it's huge. There is actually a technology that works so well, it's actually proven in large-scale studies, 200-plus percent increase in hyaluronic acid production, 212 to be exact. But it's a technology.

What is it?

It's called Exeon. So it's a combination of radio frequency and ultrasound heat. Have you ever heard of Ultherapy?

Yeah, I have.

Think of it as kind of— at best, it's a cousin of that. It's— I wouldn't consider it a similar modality, but the data around hyaluronic acid production is rock solid. We use SkinVee in my practice. I, I'm free to say all this stuff, right? Like, yeah, people may throw fit. SkinVee is, is a disaster. I've never once seen a good result. Hyaluronic acid is a workhorse for skin health. Again, so we use it, uh, think of it as even like, um, we'll use this technology. It's, it's anywhere from a 5 to 8 minute treatment. My female clients will come in the morning of a social event because you get this immediate production of hyaluronic acid. So you get this nice kind of— it's a glow up, but it's a real glow up that, yeah, you actually glow. So you get a nice little pink, a little plump. They go to their event, rock stars. But that's, that's a technology.

Okay.

But so then just to be clear, yeah, topical hyaluronic acid, I am not aware as a physician of any study that demonstrates efficacy for topical hyaluronic acid because hyaluronic acid exists below the cell, outside of the cell. Okay. So to cross an airtight, watertight barrier called the epidermis, you think about that.

Okay.

Kind of silly.

So you're right, but it sounds good. So it does.

Yeah. Yeah. And I would stress very importantly, hyaluronic acid collagen, elastin, hyaluronic acid. Those are the 3 most critical elements of skin, skin health.

What is it called?

Collagen, collagen, elastin, right? So, so you've got your collagen is your support structure, elastin gives your skin that elasticity, and, and all these obviously decrease with age, and then hyaluronic acid. So those are the 3 components. So Every product on the market will make some reference to those. But bear in mind what is critical for collagen production. We know, we know what happens when you don't have it. It's a vitamin, right?

Vitamin C. So you said high doses of vitamin C. What does that mean?

8 to 10 grams of what? Vitamin C?

No, of how do you—

how do you intravenous? Intravenous.

So we should take— where do we do that?

Come to my office. It's— it only took me like an hour and a half to get here. So, yeah, I mean, it's not that far.

That's not that right. I could just take a flight.

Yeah. I mean, I think, I think a lot of that's become kind of one of my— so now we veer into a little bit about what we do in the non-invasive aesthetic space. But vitamin C, people forget that that is by far and away the most potent element of collagen synthesis, that having optimized levels— I, I use it. I mean, it's been described in cancer treatments as well, but using using pretty, pretty high dose is very powerful. People are going to argue this. People are going to throw fits that I'm saying this, but anytime we're doing an invasive procedure, like an RF microneedling energy-based procedure, we'll run a drip of high-dose vitamin C. Really? And then what, what I'll finish off the treatment with is what we talked about is plus or minus PRP, but we use PDGF, platelet-derived growth factor.

That, that's the best.

It's the only.

Yeah.

Okay, that's what the exosome people are going to crap their pants because, because we get such great results and we actually have no research to support it and we actually are printing money. No one likes to hear it, but I only— I really stress in my practice, I'm only going to use the things that have clear supporting evidence.

So yes, you still believe in our— you still believe in PRP as the best. Yes.

Yes.

Well, what's the difference? PRP was the other one you said.

I always— in truth, I'm giving away all the secrets here. I add PDGF, PRP, platelet-rich plasma. Yeah, platelets are Amazon trucks. Okay. They contain a whole slew of growth factors.

Yeah, yeah, yeah.

One of the highest concentration growth factors in a platelet is platelet-derived growth factor. So I just use— it's synthesized in a lab, what we call recombinant pure PDGF, and I mix that with PRP. That way there's, there's always this debate around PRP and biologics, PRP, PRF, in that as we age, is the quality of our platelets less? I don't know of any scientific evidence one way or the other, but, but I don't take chances. Imagine this. PDGF, recombinant PDGF is 10,000 times more potent than PRP.

Wow. And this is for— when do you use this? For what?

So I will use it. My general sense of it is any time we violate the epidermis for any type of procedure, I'm going to use it.

Do people use it?

Is it common topically? It's— I think it's gaining more traction. But, but again, there's What Instagram is, it's just a brilliant MLM marketing system, right? It's just a giant marketing scheme. You get— you're right. I mean, you get the right person. If Kim Kardashian says, oh, I use exosomes on my face, right? Guess what's gonna sell? Exosomes. Does that mean they do anything? No, not necessarily. So, but, but that's, that's the part about Instagram that's crazy. Crazy.

What about if I just go to— if I just get like— call my friend and, um, my friend Dr. Abe Malekin— shout out— he has a hydr— like drip hydration or Concierge MD, whatever. And I said, hey, can you come and give me a vitamin C drip? Would that be great for my skin?

I think so. I do it— bear in mind, I do it more strategically.

So give me an example. What should I do? Give me—

so like, if you're getting a treatment with an energy-based device, so that's like an ablative laser therapy, I'm not doing that. I don't see there being— there's not enough bang for your buck. Okay. So take advantage of— this is where you're always looking for synergies, right? I mean, efficiency is the name of the game in my practice, whether it's clinical, whether it's aesthetic. Shortest distance between two points, still a straight line.

Yeah.

Least amount of resources. So if I'm going to invest in an energy-based procedure, we're doing RF microneedling. We're giving you a shot of energy. We're violating the epidermis. I'm going to put everything into your system that's going to facilitate a maximum tissue response.

Okay. That's why you do input-output. Okay. So that's why you say vitamin C. That's why you're saying PRP.

PDGF. Yeah.

Yeah.

So you're on it. So we just put— slam it.

What do you do? All this stuff? Because you look like— you look good.

Yeah, I, I'm—

and you're a guy.

I'm a geek about it.

Yeah. Yeah, you do. I could tell you do a lot of stuff. Skin care? You look very put together.

No, I have a wonderful wife that tells me, like, she, she puts the things out in order and I just do it.

Like what?

We, um, again, this is all nothing for shout out to Skin Better. I do love their line, so I use the sequence. Yeah, yeah.

And what's the sequence?

The sequence is, um, I gotta think. So it's Ulta Advanced, so it's a It is a vehicle for a vitamin, basically a topical vitamin application, but it's also very hydrating.

And then you're not getting paid by saying this?

No, no, no. Yeah. Nope. You want to know if I'm not getting paid?

Yeah, you can go check.

Just go check.

Yeah.

No, it's the product line we use. And then I have to— I can give you the whole, the whole rundown, but we do that in sequence. Now, they do have a topical HA product that I've been using. So I'm always open to things. I don't want it to come out as like really dogmatic and black and white because it's not. I mean, medicine is nuanced for a reason. There's a reason it's the practice of medicine. Yeah, because there is—

you got to keep on practicing.

That's the human part of it. And that's why AI will not replace doctors, because one, AI is not compassionate above all else, but so on and so forth. Yeah, exactly. So, so do that, then to do a moisturizer and then, and then topical sunscreen, mineral-based sunscreen. So they have tinted. Trust me, 5 years ago, if you said, would you use a tinted sunscreen? I'd be like, what are you talking about? But that's my go-to. So why is tinted? Just kind of just like, I mean, I'm pretty pale and so it gives you a little color, but tinted or otherwise, but SPF 75. Sorry, Paul Saladino. Ionizing radiation is still ionizing radiation.

Yeah.

And, and the, the, the weathered look is out.

Yeah.

Like, especially for men in Colorado, for example, there's been a big— I see a big shift or trend now. More and more men are coming in like, okay, I got to do something. But the thing is, men and women just need to be starting much, much earlier.

Yeah.

Start— literally start on a retinoid in your 20s. That's a true story for me.

And that's the tretinoin.

That's tretinoin. Tretinoin's optimal. That's what I would recommend. If someone comes to me and says, what do I need to do for life? Very low dose. Again, age-related or decade-related. Yeah, but tretinoin, tretinoin's the base. That's your nighttime hydrating moisturizer. And then a quality sunscreen, mineral-based sunscreen. That's what you need.