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Chapter 1: What are peptides and how are they categorized?
People are now stacking their GLP-1 as their insulin sensitivity tool, their growth hormone or their GHRH, and their androgen modulation therapies as this trinity stack. Trinity stack. To get very fit, very healthy quickly. So a lot of these transformations you see in CEOs and celebrities and stuff is using a combination of those three things.
You know, your TRT plus terzeptide or erythritide, whatever it may be. And then... using a growth hormone modulation, if you can afford growth hormone or testamoylin, ipramoylin. And you're seeing people lose a lot of fat, gain a lot of muscle in short amounts of time. Is that healthy? We'll find out. But that is like the celebrity protocol.
Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Abud Bakri, an internal medicine physician who is also extremely knowledgeable on the science and use of peptides.
When I say peptides, I mean both FDA approved peptides, such as the GLP agonists, you probably know these,
as things like Ozempic, Monjaro, and Retrotrutide, as well as peptides such as Body Protection Compound 157, or BPC-157, which, as you'll learn today, has a very long history of being used in humans for gut health and tissue repair, and many interesting studies in animals supporting its potential use in humans, but a minimum of formal studies in humans, meaning one.
We discuss BPC-157, what it does and how, as well as things like growth hormone secretagogues, like tesamorelin, MK-677, and others. And we talk about things like GHK copper, which nowadays many people are using to promote collagen synthesis and repair for aesthetic reasons, like improving skin, hair, and so on.
We also talk about peptides that have been studied for the purpose of DNA repair and longevity, like epithalin and pinelin, which also have been touted to improve REM sleep and for improving cognitive function. You'll also learn what is known and what is not known about these peptides, both in terms of function and safety.
During today's episode, you will come to appreciate that Dr. Bakri has truly encyclopedic knowledge about these peptides. He is also formally trained as a physician. And as a consequence, you will learn how to think about peptides based on whether or not they have known receptors or not, that turns out to be very important, and what their real safety profiles are, as well as what
particular concerns you ought to have if you are considering using peptides of any kind. As a formerly trained board certified physician, he comes at this topic through the lens of a physician, but also somebody who is very interested in the current status and future of peptide medicine. Today's discussion, thanks to Dr. Bakri, is a true masterclass on peptides.
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Chapter 2: What is BPC-157 and what do we know about it?
Sometimes it heals people, but... So nowadays... Is BPC-157 legal in the United States? Like if I wanted to go online and buy BPC-157, I can do it, right? Legally. For research purposes only? I thought now under the new regulations recently passed that you can get it from a compounding pharmacy or... Technically not just yet.
Okay. And it depends on medical boards. To break it down, BPC-157 never got FDA approved, right? So it gets into these compounding pharmacy lists. There's a category one, two, and three. Category one means the FDA thinks like, hey, this is not an approved drug, but we're okay with you compounding this and you're okay to push that forward. Category two, it's like, do not compound.
In late 2024, BPC-157 and 20 other peptides got moved to this category two list. Since about 2017 to 2024- People have been prescribing BPC in these alternative medicine anti-aging practices. It gets removed from that list. Of course, you know, compounded pharmacies re-label it as PDA, pedodecapeptide arginate. But it's the same thing. It's the same, exactly. Really? Yes.
One of them will be an acetate, one of them will be an arginate, but the PDA is BPC-157. Because there are many, many people selling compounded pentadecapeptide. Pentadecapeptide, arginate, PDA. Did I mispronounce it? Yeah, pentadecapeptide arginate. Arginate, okay. I think the acetate one is the one that's on the category two list.
Now, just in April of this year, it got removed from the category two list. And it's not yet on the category one list, which would allow physicians to prescribe it. through compounding pharmacies. Now- But they can prescribe the PDA version. People are prescribing PDA. Yes. Now state medical boards view that very differently. Like I got a letter from one of the licensed in many states.
One of these states reached out to me. It's like, you cannot prescribe, not me directly, like to the general public of people in that state. It's like, you cannot prescribe non-FDA approved peptides, no matter what. Mm-hmm. So there's controversy there. Even if the FDA says, okay, we're okay with you prescribing it, is your medical board in that state going to be okay with it?
So it's state by state. State by state loss.
What about with telehealth? So somebody's on the East Coast in a state that allows them to write a script for... let's just call it BPC because it's effectively what it is, or this other thing where they kind of wriggle through the regulation. Can they send that to California or to Wisconsin or someplace else if the patient is there?
The telehealth laws go into effect where the patient is. So if, let's say in California, it's not allowed to have BPC according to the state board of pharmacy, whoever bans that, Even if you're a New York doctor that's licensed in California, that would be against the California Medical Board, and they would ask you, if they found out, to stand in front of them.
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Chapter 3: What are the potential risks and concerns regarding BPC-157?
The problem is no one's doing the work to figure that out.
You painted this picture where not you, perhaps, but let's just say another physician has the awareness that BPC-157 might be useful to a patient of theirs that's dealing with a, they had like an ACL tear. They're not recovering very quickly. Doctor says, listen, you're doing everything correctly. There's this new category of stuff. We don't have a lot of data on it.
I'm not aware that there are any severe risks, but they could be there. So if you're willing to embrace those unknowns, you could take X number of micrograms or milligrams per day for two weeks and see how you feel. Patient says, okay, I'm willing to do that. The physician says, okay, you want to make sure that it's real and you want to make sure that it's clean. There's no contaminants.
If that physician says, you know, I can write you a script for it and this compounding pharmacy will send it to you. And they're making money on it. A lot of people, well, the moment they hear that, they think, oh, well, they're totally incentivized to do this because they're going to get a cut. But if we go back to the original pharma model, It is a little bit of a different situation, right?
Because let's say Lilly charges $1,500 for a pen of some sort of GLP. The physician who prescribes that, are they getting a cut of that $1,500? They don't. They don't.
But there are kickbacks and pharmaceutical incentives and pharma dinners. Those are real. It's flights to Hawaii for a conference. Really? So there are real incentives. even though they're not getting paid directly. Yeah, there's always incentives in any kind of business, especially a business as big as pharmaceutical.
Well, physicians are already getting paid. So I'm not saying that, but these are peripheral incentives.
Well, the farmers also lobby a lot of the medical schools and the funding.
So there's a relationship there, but it's not cold, hard cash. As direct as the compound. Right. But in a compounding pharmacy, now this physician, hypothetical physician could say, hey, you know what? You can get it from this compounding pharmacy and it's going to be 500 bucks.
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Chapter 4: What insights does Dr. Bakri share about the pineal gland and its calcification?
Again, that's functionhealth.com slash Huberman. What about epitalin, which turns out comes from the pineal? Yeah. I'd love your thoughts on this. I've heard, and I thought it was complete nonsense when I first heard it, that the pineal becomes calcified as people age.
The reason I thought it was nonsense is I used to co-teach neuroanatomy when I was at UCSD before moving my lab to Stanford with a guy named Harvey Carton. You guys can look him up. Unfortunately, he passed away. He was in his late 80s. And he had this incredible career as, I think, one of the greatest neuroanatomists of the last decade. hundred years.
And that's a good category to be in because we have like Cajal who's like discovered everything basically. And then the rest of neuroscientists are just kind of tinkering around with what he predicted. And then a few other neuroanatomists like Ted Jones is there, but he's like the neuroanatomist of my generation.
And I asked him about this calcification thing because he had looked at the brains of so many different species, including humans. He was also an MD by the way. And he goes, yeah, I don't know whether or not this calcification thing is real. And he kind of brushed it aside. And I thought, well, Harvey doesn't take it seriously, so I'm not going to take it seriously.
But even though he was absolutely right about many, many things, I think he might have missed that one. Because when I go to the literature now, it's a little bit tough, because the cadavers that you looked at in medical school, not all of them are processed on the same timeline. Thankfully, it's not a controlled science. These are people that generously donate their bodies to science.
Does our pineal calcify? Even if it does, does that somehow inhibit its ability to communicate with our other tissues?
It's a big kind of debatable thing in the pineal research. If you look at the pineal gland Wikipedia, it's very underdeveloped, let's say, because it's kind of woo-woo. Like when you think of pineal gland, you think of someone who's going to sell you- No neuroscientist chooses to work on the pineal gland.
They should, but it's not a very sexy- It sounds like someone's going to sell you crystals or something.
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Chapter 5: How does the thymus gland influence immune function as we age?
It's not very sexy, yeah. But I think it's a key aspect of aging and longevity. So that's what gives us our interest in it. The pineal gland, it seems from Cavendish's work that the decrease in pineal gland function with aging is more of a physiologic than a anatomic problem.
So I will see some calcification on MRIs when we have a patient come in for like a stroke or a TBI, we'll look at their MRI. I'm like, hey, that looks like a little bit of calcification there. Maybe my neurology colleagues will disagree, but that seems to happen. But the question is, what is actually leading to the deterioration of melatonin synthesis? Because it decreases quite dramatically.
Chapter 6: What role do peptides like thymosin alpha-1 play in immune health?
And some people even think that might start puberty. Like if you have a pineal cyst, you can have precocious puberty like at eight or nine years old.
The rhythmicity in melatonin. Yes. Because a young baby, very young baby, their melatonin secretion is not very rhythmic, but they're in REM like a lot. A lot of their sleep is REM. It's a beautiful thing, right? With time, it becomes more rhythmic.
And of course, in today's day and age, with all the artificial lighting and the lack of sunlight exposure, things that you and I care a lot about, people are making themselves somewhat arrhythmic or... phase shifted. But epithelin is somehow restoring pinealocytes, is somehow enhancing function of the pineal and other tissues.
Yep. So in Kevin's work, he's found that it will increase the expression of the different clock genes. So in like, you know, lymphocytes that he'll measure in peripheral tissues, he'll notice that the clock genes actually change. So in a more rhythmic pattern, he'll notice that morning cortisol is higher. Great.
Which by the way, folks, I've said this in the cortisol episode, you want your morning cortisol super, super high. You want your evening and nighttime cortisol low. If you're a resident in medical school, just listen to what your superiors say. They don't give a shit about your cortisol levels. You got to do the hard work and then later you get to go to bed.
It's a little weird that the medical profession tortures their own by disrupting one of the primary anchors of health. Yep.
And cognitive function.
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Chapter 7: How are GLP-1 medications transforming weight management and metabolic health?
I mean, I've had 28-hour shifts, and that's what got me interested in security. You're young. You're good. But yeah, the idea was restoring a moreā a circadian appropriate hormonal profile through, you know, ACTH, cortisol. Take and when? Anytime.
Because the idea with these bioregulators, unlike, you know, a GLP-1 drug that you take today and have the effect for the next week, the idea from the Cavendish model is that you take these and then you accrue benefits when you're off of them. Like you notice with pinelion, you took pinelion for a day or two or three days a month, and you had effects until you took the next dose.
So the idea is, can you accrue benefits from these compounds as they upregulate or downregulate certain genetic pathways in a more favorable state, and then keep those effects later on. So in the Cavendish seminal work was his 15 year longevity study. He got people in nursing homes, two groups, one of them got epithelon in the form of epithelamine, which is the whole pineal gland extract.
And then a thymus peptide called thymulin, not thymulin. There's two different peptides. A lot of people can confuse them. Every peptide website confuses them. But He injected them for 15 years, like a 10- or 20-day course per year, just beginning of the year, middle of the year, and that's it.
And they had a significant lower mortality when it came to cardiovascular disease, infectious risk, and for cancers. So Russian study, caveat. But that would be the most interesting longevity study I've seen done, if accurate, if true, because he was able to take nursing home patients, give them peptides for, you know,
very small amount of the year, and yet they accrued benefits the rest of the year.
Impressive. One of the things that really got me excited about epithalon, is it thalon or talon?
The Russians say epithalon. It's the way they say it, but it's spelled with a T-H. Okay. So I'll say epithalon, whoever wants. You know, we're making the rules today. So epithalon is also A-A-D-G.
That's the amino acid sequence for amino acids. I'll say epithalon because it's easiest for me and forgive me if anyone takes offense. I took interest because in my former life, running a lab focused on, among other things, visual pathway repair to reverse blindness or impending blindness. There's some interesting papers, and there I can really gauge the data.
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