The Role of Peptide Therapy in Complex Chronic Illness

Dr. Gordon (00:01:45):
Okay, and, you know, peptides, some of them are hormones. I mean, they’re messenger molecules, and they’re made by breaking down larger proteins.
You know, probably the most well, one of the more interesting ones is something called proopiomelanocortin. And this is a long protein that’s made, people thought initially was made in the pituitary gland, but it’s actually made, like many of these, turns out they’re made all over the body. And it’s broken down into ACTH, which is what tells your adrenals what to do, and into MSH and actually, and melatonin. And then it’s broken down into MSH, which is a peptide that we use a piece of, and we’ll talk about that later. But, but just wanna get the idea of it that these are chemicals your body is making as it’s going through the healing process. Okay. And they’re very non-toxic because they’re basically exactly what your body makes.

Dr. Parpia (00:03:32):
Okay. So I’m gonna talk about peptide therapy. It utilizes chemical messenger sequences in the systems of your body that you already have available. So we can get all kinds of results from the peptide. So they regulate tissue specific function. They promote restoration, they regulate a new and healthier homeostasis. Now, each peptide has its own unique set of functions. They can act as hormones, they can act as neurotransmitters. They can influence our brain chemistry, immune modulation, our physiology. They can even influence our behavior. They play a major role in how our body responds to diet, exercise, infections, or general cellular stress and recovery. So we see them have this significant role in the healing of immune dysregulation, fatigue, cognition, inflammation, sleep disorders, insulin sensitivity, metabolic health issues. They enhance longevity. They can increase endurance and increase lean muscle mass. So, each of these issues that I just listed, most of our patients have them all, right? So we’re not talking about using peptides just for longevity. Of course that does happen. But in our practice, it’s for bringing about a new homeostasis, a new normal in our patients. Starting with their immune system.

Dr. Gordon (00:05:07):
Yeah, these are pretty amazing molecules. And they’re safe and they’re effective. The problem has been in sourcing them, because most of them are not FDA approved. People have to understand that to get FDA approval for something to treat a medical condition these days is upwards of a hundred million dollars to get through the FDA. And so, no one, no one’s gonna do that for things that are natural and that can’t be patented. So, it’s a little bit of the wild west out there. And the important thing is so the molecules are very safe when they’re, now they’re, these are originally, when they first started using them, they were derived from animal tissues. But now they’re all synthesized, which makes them very safe. The issue is that in the process of synthesizing them solvents are used. And these have to be totally removed if you’re gonna take them, especially since many of these are injected.

That’s where it’s really important to make sure you’re getting them from reputable people and from pharmacists who process them and make sure they’re pure. You know, there was a recent article in the New York Times about, it was called at the Heart of the Vast Doping Network [1]. You know, and you have to understand the issue about doping is that I said these peptides had been used mostly by athletes and people who are looking to optimize their health. And you know this article from The Times showed that it was a report from Switzerland that about 80% of the ones that the Swiss government evaluated turned out to be adulterated. So it really is important to get the right stuff.

[1] https://www.nytimes.com/2018/03/26/sports/doping-thomas-mann-peptides.html

Dr. Parpia (00:07:04):
Right? So we don’t suggest purchase them on the internet because…

Dr. Gordon (00:07:08):
…we don’t know

Dr. Parpia (00:07:09):
<Laugh> We just don’t know. So you definitely wanna get them from a pharmacy, peptide pharmacies or from producers who know exactly what they’re doing, doing it the right way. Now the exciting part for us is that we’ve been sharing with other experts in how to use this for complex chronic illness. Like you were saying, most people have used them in the past, and in the present, for performance and longevity, and for biohacking tools for athletes, actually. Now that’s great, but what we’ve found is very different now as we use them with our patients with complex chronic illness. Now, we want to take a minute and tell you about who our typical patients are. And that’s gonna segue into why we use the peptides and how we use them for this patient population. So most of our patients have many chronic infections.

They’re low level, they’re low grade, they’ve been going on for a long time. They’ve been undiagnosed for a long time. They also have problems of environmental toxicity. They have high levels of environmental toxins, or they might have genetic issues with detoxification and in their inflammation pathways as well. So they’ve got this high body burden of environmental toxins, and they have a high burden of chronic, low level infections. The infections are typically things like tick borne diseases or it might have people who have post-infectious illnesses like Long Haul, or they have issues with mold, chronic viral issues like chronic Epstein barr virus, parasites. Most of our patients have a combination, actually, of all of these infections. And then the common toxins they have are heavy metals, mercury, lead in the blood, mycotoxins, microplastics. We test for all of these things, actually.

So now this combination of infections and toxins causes inflammation and immune dysregulation. Actually, it starts by causing immune dysregulation. That immune dysregulation then causes inflammation in the system. So we’re using peptides for inflammation and immune modulation prior to killing our infections and prior to reducing the toxins. Now, once we start with those peptides for immune modulation, it becomes faster and easier to kill infections in detox. So you wanna think about what happens whenever we kill an infection, even when we detox. We get a flare of cytokines that just comes with the territory of detox and with killing the infection. So we wanna prepare the patients for that load of inflammatory cytokines that’s gonna come through as we’re killing these low grade infections, as we’re detoxing. And these peptides modulate the immune system. Once we get that going, everything else is easier and it’s faster. So patients who could have taken maybe two years are now taking 6 to 12 months. That’s amazing. We can get our patients back their lives faster. And that’s what gets me so excited about the peptides. Now, of course, one more thing. They’re coming to the clinic, they’re doing other therapies, they’re augmenting everything else we do. It’s not a standalone treatment, for some people though, it can be.

Dr. Gordon (00:10:32):
What I think one of the important things that people have to realize is that, and what kept us from using the peptides more years ago, was many times people were starting with some of the peptides from the thymus gland that can be immune stimulating. And since many of our patients have MCAS or Mast Cell Activation, and these are folks who in the past, they would start a therapy for treating Lyme or even in detox and they would have big reactions. They’d flare, their symptoms would get worse, and often made them very gun shy of any therapy. Because everywhere they turned, life wasn’t safe. You know, everybody’s good idea made them sicker. And it turned out that most of these people have Mast Cell Activation, which just means that the mast cells, which are your prime, your original immune cells, the T-cells and B-cells came later. But the mast cells were the first ones as organisms developed into multicellular beings and mast cells are everywhere. They actually help orchestrate immune response. So if your mast cells are overactive, anything that gets your body to begin to turn on to release cytokines, those chemicals that your immune system uses to communicate kind of can trigger mast cells. Now, when they’re working well, they know not to overreact, but if you’ve been sick a long time, they get very, very antsy and they start causing inflammation. And we have found that if we start using two of the peptides in particular, in fact actually, one of them called amlexanox is small like a peptide. It’s a small molecule, technically it’s not exactly a peptide because it’s got another chemical in it other than just an amino acid.

But it’s, again, it’s a very small molecule and so we consider it a peptide. But amlexanox is a medicine originally developed in Japan for aphthous ulcers and is now licensed there for treating asthma and allergies. It’s not licensed in America for that, but we can get it from compounding pharmacies. It tends to mellow the immune response, those mast cells, in a very gentle way without the side effects of many of the antihistamines, which lead people tired and kind of drugged, like, okay. And also a medicine, another peptide called KPV. And if you remember the beginning, I talked about that really big long one, the proopiomelanocortin, which breaks down into melatonin. And then from that, there’s something, well, actually, the thing that produces melatonin, something called MSH. And a little piece of that is called KPV, just three amino acids. But it has a lot to do with quieting the immune response and getting it to be more balanced. And also it helps healing.

Dr. Parpia (00:13:36):
Okay? And I’m gonna talk a little bit about BPC-157. This is peptide therapy’s golden child. This is the peptide that, if anybody’s using peptide therapies or they’re just beginning, they usually turn to this one first. It brings down inflammation in the gut. Now, it was studied, it’s been studied for decades, actually. It was first found in human gastric juices, and it helps to heal ulcers. Now we also know now, through all the studies it’s been through that it protects and it protects an inflamed GI epithelium, meaning leaky gut or inflammation in the gut as well. Now, it protects the liver from toxin toxic insults like alcohol or too many pharmaceuticals. It’s a free radical scavenger. It has neuroprotective properties. This is one of the ones that I do like to use earlier on in the process.

Now, some people will get, will be sensitive to BPC-157. It can keep people awake longer at night. So I tell people, don’t take it after 2:00 PM. Now, our patients are super sensitive, like Dr. Gordon was saying, they have mast cell activation syndrome. Their mast cells are on a hair trigger. Anything is gonna set their immune system off for our patients generally. So for some people, even BPC-157 can be difficult at first. So that’s why we like to start with amlexanox and KPV, make sure that they’re gonna be able to handle the next thing that’s coming. You might notice we’re not even at killing the infections yet. We had some people ask about LL-37 when to use that. Certainly not yet because we’re still working on immune modulation. This can take a month, sometimes three months in certain people.

Now, the next one I’m gonna talk about is TB4 frag. This calms down the immune system. It stimulates the production of T-cells. It’s essential for the protection, repair, and regeneration of tissues, for inflammatory cytokines, and it also impacts multiple pathways for neurologic recovery. It reduces inflammation and it increases angiogenesis, which is the creation of new small blood vessels. Neurogenesis, not too many things do that. But there have been trials on rats, not in people yet, but on the rats it does show that it brings about neurogenesis. So that’s very interesting. And then it stimulates the expression of a variety of molecular mediators, of neuromuscular plasticity. So now, once someone has been on these for a month, two or three months. Typically not more than three months, we’re talking about our patient population who’s really sick, right? And really sensitive. Usually three months is the most. We can now come into peptides for infection treatment. So once we’ve onboarded these peptides for allowing the immune system to put its defenses down, we’re stopping the loop of inflammation the patient is stuck in. And that’s really important. It then becomes faster and easier to kill the infections and to detox. And we’re more able to deal with the cytokines cascade that comes about with killing of infections.

Dr. Gordon (00:17:08):
Now, you know, one of the interesting things about peptides is they’re part of the healing cycle, okay? Is because a lot of the chemicals that we release when we first get infected, and especially some of these proteins then get broken down into smaller particles, which are these peptides that have then allowed healing. Now, one one, a big part of this process is from a larger molecule called Thymulin. And it turns out it’s not just in the thymus gland, it’s produced in lots of places in the body. But what’s happened is we’ve broken these down into smaller pieces. You have the TB4 frag, which Dr. Parpia was just speaking about, and then we have thymosin alpha 1. And it’s interesting that these all come from one bigger molecule, just pieces of them.

And they actually, even though they start in the same big thing, each piece does very different things. So I just wanna emphasize for people, because out there on the internet, you’ll see something called TB 500, which is TB4, but it’s the full TB4 molecule. And I emphasize again, this field, there are many different names that sound similar, are sometimes the same thing and sometimes a little bit different. So it can be confusing. So the TB 500, or the TB4, they’re the same. Is something again, helps healing, okay? And does quiet down the immune system, but it also has a stimulating effect. And that’s why we use the TB4 frag, which is a smaller part. That’s the part to quiet things down. But the other interesting molecule that comes from this Thymulin, this big piece, we call it TA1, Thymulin Alpha 1.

Now this one really reconstitutes your immune system, especially your T-cells, okay? And so it is great for if you’re healthy and you get a cold or a virus infection. This really will help you beat it. In fact, people have looked into this for treating covid. It’s used all over the world, not in America, but in the rest of the world for treating hepatitis, hepatitis B especially, and also has been used in cancer because it activates your T-cells. But we have to wait until we’ve modulated the immune system, as Dr. Parpia was talking about, before we add it in. And along with this is another small molecule called LL-37. Now, LL-37 comes from a family called cathelicidin. These guys are small molecules that help us fight viruses, okay? And again, at the right time, they’re excellent. You give it to a patient who has MCAS or just an overexcited immune system and you can cause a bit of a herx or an allergic, not quite an allergic reaction, but a reaction where their immune system makes them not feel well. So again, it’s knowing when to add these things in.

Dr. Parpia (00:20:35):
I wanna talk a little bit about our immune system. So for our patients, we have this combination of many infections, many different environmental toxins, structural integrity issues, hormonal issues, neurotransmitter issues. All of this contributes to immune dysregulation. And when we’re talking about immune dysregulation, we’re talking about, on one hand there’s a hyperactive immune system that’s mast cell activation syndrome that Dr. Gordon was talking about earlier. We’re talking about autoimmune conditions. So this is where the immune system is hyperactive. On the other hand, the patients can’t mount an appropriate immune response to kill recurrent infections, these low grade intercurrent infections. So how can it be that we have a hyperactive immune system, we have a weak immune system at the same time? Well, it’s a confused immune system. And so we’re using the peptides at first to bring that confused immune system bring into alignment.

So once it’s in alignment, the hyperactivity comes more into alignment. We can now start to kill the infections. Because when the immune system is so confused, if we try to kill infections first, it just backfires. So we’re using peptides to calm down the immune system first. Then we’re using the peptides to bump up that other part of the immune system that isn’t able to take care of the infections. So then we’re ready for peptides, for neuro inflammation and mitochondrial repair. So now you might wonder, well, how long does this take to use LL-37 and TA1? By the way, we’re also using other infectious agents, right? Agents to treat infections. We’re using antiviral herbs or medications, we might be using antimicrobial herbs, sometimes antibiotics, all depends on what the patient needs. So the answer about how long for that, I don’t know. It’s different for each person. When it comes to killing off the infections, it can take several months. Some people a year, some people years. This is really an individual thing. But once we’ve finished dealing with those chronic infections, we then wanna address neuroinflammation and mitochondria. So treating mitochondria and neuroinflammation is more towards the end of treatment. So, do you wanna talk a little bit about the cell danger response in mitochondria?

Dr. Gordon (00:23:19):
Well, just briefly, cause we’ve talked about this many times. It’s just that the mitochondria, you know, many people think when they’re chronically ill and they’re fatigued all the time and have brain fog that their mitochondria are broken. And you almost never, it’s more often that the mitochondria, when they sense inflammation or toxicity, they kind of turn down their energy production. And the little ATP they make, they now use as a signaling molecule rather than something to supply your body with energy. And that’s doing that. When that’s going on, you’re not gonna have as much energy for functioning. You’re gonna feel tired. So we have to signal to the body when it’s stuck in that place that it’s safe, because the mitochondria is really sensing danger. And once it begins to, this should be a very short-lived process. And when the immune system is working correctly, the signals all go and the mitochondria, you know, start getting the nutrients that they expect and they go back to normal. But many times when we can’t get rid of the infection and it stays at a low level, some of the, some of the cells, your body are continuing to feel that life isn’t safe. And so the mitochondria are stayed at a low energy state. Now, the cool part about peptides is that these are the signals your body use to tell your mitochondria that it is safe. You can come out and play again and start functioning normally. So that’s just one of the really exciting aspects of peptide therapy.

Dr. Parpia (00:24:57):
And so we wanna use the mitochondrial treatments towards the end because we don’t wanna rev up the mitochondria when they’re in a stuck pattern. It’s just gonna create more stuckness in some aspects of the cell danger response where inflammation is key and where mitochondria are creating inflammation. So that’s why we wanna rev them up at the right time, which is once those insults are gone, the primary insults, the infections, the toxins. So we’re gonna talk a little bit about neuro treatments. So I like to use RG3. It’s not a peptide, but it calms down microglial inflammation and it brings down the inflammation that begins to spill out the inflammatory chemicals from the brain just automatically. And then there’s selank, it elevates BDNF, BDNF is like fertilizer for the brain cells, so it’s protective to the brain cells. It also helps with some detox of the cytokines that can be stuck in the brain. So it’s cerebral protective, and it helps with some of those toxins that are latched onto the receptor sites.

Dr. Gordon (00:26:10):
Okay, and then we have cerebrolysin. Now cerebrolysin is a really interesting one. Originally it was derived from pigs brains and it was used as, it was purified, and used actually as an IV therapy for a long time in Europe and in America, unfortunately it is no longer used that way. But it has been synthesized and it is available as orals and you can still get it from Europe as an injectable. It’s really an amazing peptide. I mean, I’ve seen it in the old days when we used it injected, just really brain fog and early dementia, sometimes even pretty advanced dementia, had improved in certain people. You know, and it also works really well along with glutathione and BPC, and as we’ll see later, it’s sometimes in a little stack of a few of them.

Another one that we like to use is dihexa. Now, dihexa is interesting because it comes as an oral form and also a topical, and it’s used a lot in Parkinson’s. It definitely also improves cognitive function and mood. And we use it a lot in Parkinson’s, because sometimes I mean, it’s just good for them and people who have trouble swallowing, it’s nice to have the topical approach. Now, some people and, we also have found it helpful in helping cognitive function is combining the selank and the semax along with the cerebrolysin. Now selank is more detox and helps anxiety and mood a lot. The semax is more for, it does help decrease inflammation in the brain and it really helps cognitive function.

So you know, inflammation causes problems with thinking and so they all kind of work together. And the combination of selank, semax and cerebrolysin, there’s actually some literature in people showing that it does help in Parkinson’s. And it makes sense because Parkinson’s is, we know that all illnesses have a huge environmental component, but Parkinson’s is one that even, what I call the conventional world, acknowledges that there are definitely environmental triggers that have a lot to do with Parkinson’s onset. And so helping detox the brain really is helpful.

Dr. Parpia (00:29:01):
Right, now, another thing I wanna talk about is getting our glucose under control. What we’re noticing lately is that a lot of patients are coming in with high fasting blood sugar or high hemoglobin A1C. And these patients have perfectly normal BMI, they’re not overweight, they’re eating pristine, actually, their diet’s pristine, and yet they still have issues with blood sugar. Or we’re seeing people who have pristine diets and they’re overweight. It’s not fat, it’s inflammation. And so what’s causing this blood sugar dysregulation is inflammation at the heart of it. That’s what’s causing hyperinsulinemia. And so we’ve got some peptides that can help with that. Now, a combination of semaglutide and BPC-157 can really help to modulate the insulin response. Semaglutide works by helping the pancreas to release the right amount of insulin at the right time.

It blocks the liver from releasing a sugar too quickly, and it slows down how fast food leaves your stomach. So this can help with weight loss as well, as a lot of you probably already know. But also with blood sugar. And then MOTS-c. So this is a potent metabolic regulator. It enhances autophagy, mitochondrial function, and improves insulin sensitivity as well. It’s been referred to as exercise in a bottle because it can mimic some of the effects of exercise by activating the fat burning pathways and it upregulates the mitochondrial genome.

Dr. Gordon (00:30:52):
Yeah and just a note about the semaglutide, is that, still not sure it’s a great idea to be using it long term. It’s become a big thing. Everybody wants to be on Wegovy or Ozempic and that is semaglutide. But for short term use, I think it really is excellent. It’s just that if we don’t fix the underlying inflammation, the weight gain comes right back. That’s the part that people in the conventional diabetes and blood sugar world, I don’t think they’ve quite gotten. It’s inflammation, which is probably driving a hyperenemia that is driving the weight gain, right? And the fat storage.

Dr. Parpia (00:31:36):
I think that using with BPC-157 and KPV would really help address that

Dr. Gordon (00:31:42):
Exactly

Dr. Parpia (00:31:42):
Instead of just using it on its own.

Dr. Gordon (00:31:44):
Right. And again, the detox and dealing with the underlying infections. I mean, remember if you just use a substance, you are just using a bandaid, okay? And that’s the problem with conventional medicine, is just the bandaids. These are all meant to be used as part of a process of healing, of getting the body back to health and back to functioning normally. These are not designed to be used forever. You know, you’re not supposed to be living on these, this is not another blood pressure medicine or blood sugar medicine where, “here take this and come back”. And for the rest of your life. These are used as part of a process to help your body get back to normal. Okay, so peptides for sleep, this is always a big one because sleep is a huge issue.

And again, this is one area where I think it really is a little more hit or miss. In the other peptides we find, it’s always hard to say, like 80 or 90, never 100%, but very, very good. With the peptides for sleep, it really depends on what’s moving in your body. Now, interestingly, one of the ones that we’re trying for sleep is something called CJC or CJC 1296. This is a growth hormone releasing peptide. And growth hormone is something that at tiny, tiny doses we used 20 years ago for people with chronic fatigue. But tiny doses, not the doses that athletes use to get big and strong or Hollywood people would use to stay young. But tiny doses are very, very effective. Now, the reason we’ve gone to these peptides is because the FDA looked at scans at the use of growth hormone for quote unquote off-label uses. So it’s only approved for low growth hormone states that have been proven.

So CJC is a growth hormone releasing…it gets your body to release the peptide, but it hangs around. The nice part about it, it’s bound very tightly to albumin. So it stays around a while, but it still allows a pulsatile release, a growth hormone, which is kinda nice because growth hormone is meant to released in pulses, not to stay consistently high. What we’ve found is that it really helps sleep. Initially sleep is the first thing it improves but it also will improve muscle mass. And after a few weeks it seems to have some really nice effects on cognitive function as well. So we like it a lot and it does decrease the stress and inflammation in the body. So blood sugars often improve. And then we have…

Dr. Parpia (00:34:51):
We have delta sleep inducing peptide. This is a neuromodulator and sleep regulator, so it increases GABA and glutamine in the brain, which allows for relaxation and then sleep. It helps with pain modulation. It is typically found in the brain. And so when it’s given, it does pass the blood-brain barrier to help with these things. It’s given for the treatment of pain, alcohol or opiate withdrawal as well. Eric, do you wanna talk about epithalon?

Dr. Gordon (00:35:24):
Okay. So epithalon is sort of like the grandfather of the peptides, it was developed by Dr. Khavinson. Dr. Khavinson is a Russian scientist who’s been exploring peptides, initially from animal tissues, but now made in the test tube for the last 40 years. And he’s written a lot about it, and he’s a very good resource if you wanna read about peptides. Now, interestingly, the peptides he uses are different from something that we’ve been talking about, but they are also very interesting and another subject. But epithalon is one that I think is worth really going over because there’s probably the best data on this one for its effect on longevity and not just longevity, but health. And again, once the inflammation is down a bit, I think we can start with this one.

And it’s used anywhere from twice a year to three times a year, depending on how you dose it. It increases the sensitivity of the hypothalamus, which is the source of a lot of your basic hormones. And it gets the levels of the sex hormones and melatonin back to a little more normal. It seems to make people a little less reactive to emotional stress. It’s a very powerful antioxidant. But the most important thing is that there’s clear, at least animal data and some human data that it increases longevity significantly, at least on animal models. And just the fact that it’s only used a few times a year, I think is a real plus for it. But more importantly, it helps sleep and helps the depth of sleep and really getting into stage four sleep. So I think it’s a really exciting one.

Dr. Parpia (00:37:19):
Right? And then we wanted to briefly address sexual health for our patients because our patients have been chronically ill for quite some time now, and they don’t have that intimacy with their partner anymore because it’s just, it’s for so many reasons. So it’s nice to be able to help people enjoy that part of their life again. So peptides PT-141 and kisspeptin are very, very helpful. Same with oxytocin. Kisspeptin will help build testosterone levels in younger men. We don’t like to give testosterone to men who are younger than 60, because then it inhibits them from being able to produce their own. So Kisspeptin comes in here, you can give them a little bit, it’ll stimulate their leydig cells to produce their own testosterone. A little bit of kisspeptin and PT-141 is going to stimulate libido in women and also in men.

Dr. Gordon (00:38:21):
PT-141 is a very interesting molecule. Again, we talked about that big molecule in the beginning, the proopiomelanocortin. Well, then you have the MSH, Melanocyte-stimulating hormone, which is a part of that. We tried using a piece of it called melanotan, and they discovered melanotan II, it’s called. And they were using that because it caused people to tan and it was good for people who had very sun sensitive skin. But they started using this and discovered that men started getting erections, I mean, notably. And they took a piece of that, a smaller piece of that protein, and they came up with PT-141. Now, this seems to work on the dopamine centers in the brain, and so it helps men with erections, totally independent, well, maybe not totally, but mostly independent of blood circulation. Viagra and Cialis and medicines like that work just on vasodilitation. And this seems to work more on central function in the brain.

What’s interesting is that PT-141 is actually approved as a medication in America. And it’s called Bremelanotide, or Vyleesi, is the brand name. This is for women. In order for anorgasmic women, for women who have trouble reaching orgasm, it works, but not great. But if you mix it with oxytocin and kisspeptin, you’ll get a much better effect. And it really augments the ability for women to actually enjoy sexual intimacy.

Dr. Parpia (00:40:11):
And sometimes we use bioidentical hormone therapy too.

Dr. Parpia (00:40:18):
So I think we need to end

Darcie (00:40:20):
So much information.

Dr. Gordon (00:40:22):
A quick overview, and remember there’s more out there. You know, there’s a lot to read on the internet. You just have to take things with a little grain of salt because, like I say, everything works sometimes and you just have to be careful not to push your immune system, because these all have profound effects on the immune system at the same time.

Darcie (00:40:46):
All right. A couple of questions that have come up since you shared so much information. We will be transcribing this and sharing it so everyone will get the transcription as well as the replay. And the next question is concerning which peptides, which companies. And so specifically someone had asked about Kent Holtorf, Integrative Peptides. So can you speak to specific brands for a moment?

Dr. Parpia (00:41:22):
We trust Kent Holtorf. Absolutely, we trust him.

Darcie (00:41:26):
And so everyone knows, that’s Integrative Peptides is Kent Holtorf’s.

Dr. Gordon (00:41:30):
Yeah, we’ve known Kent a long time. And his stuff is good. What’s on the bottle is on the bottle. It does work. You know, most of the injectable peptides we get from compounding pharmacies, the one we use. So you have to usually work through a physician to get them. Those are the safest sources.

Dr. Parpia (00:41:57):
Yeah. So we use a combination of Integrative Peptides, Dr. Holtrof’s and the compounding pharmacy.

Darcie (00:42:04):
And then that leads to the next question. Does taking peptides orally, are they as effective as injections?

Dr. Gordon (00:42:12):
It depends on the peptides and the process. But many of them are, because these are small molecules and the enzymes in the system are designed to break down large proteins into small peptides. And so these guys get in pretty intact.

Darcie (00:42:34):
Great. Alice had a question here. My doctor said peptides are a no-no for people like me with a cancer diagnosis, since they promote cell growth. Can you comment on this?

Dr. Parpia (00:42:46):
There are certain peptides that help with cancer, that’ll be a longer conversation. I think it needs to be done carefully. It needs to be done with a doctor who knows what they’re doing with cancer and peptides.

Dr. Gordon (00:43:01):
Yeah, but that’s just one of those gross generalizations. It’s just like when you go for surgery and the anesthesiologist tells you to stop all your supplements. And it’s not because they know that all the supplements are bad. They just know that there are one or two or three that they’ve read about that can cause problems. And therefore they just, because they know they’re not experts in supplements, they just have you stop all of them. And that response is the same thing. There are many peptides that are safe to use in cancer therapy. In fact, many people use them in cancer therapy because they actually augment the immune response. But that’s a very fair thing to do, if you don’t know what you’re doing, you don’t want to throw them at it.

In fact, one of the questions I saw was about, someone said, Dr. Jill Crista was saying not to use peptides because they’re gonna increase TH17, and exactly the point, you have to first modulate. I mean, because not all of them will do that. TA1, you know, thymosin alpha 1 and something like TB 500 can do that in the wrong setting. It happens because your breaks aren’t working. So first we gotta get your brakes working with the other peptides to modulate your immune response. Then we can use them.

Dr. Parpia (00:44:26):
And that’s why we’ve developed this methodology for patients with complex chronic illness. I’ve seen it happen. I’ve had new patients come to me, they’ve been on TA1, it backfired. They felt terrible. So that’s not the one to start with. Not for our patients. Now, for someone who just has a cold and they don’t have any chronic illness, go ahead. Usually, right?

Dr. Gordon (00:44:49):
So yeah, that’s just the point is that many of the most effective peptides are gonna cause a flare if your immune system isn’t well modulated. So that’s the whole point of the stacking of them, starting with the ones that quiet and then watching the immune responses and then knowing when to add the ones that are gonna help actually kill things like LL-37, which is great. Viruses, probably even helps candida, there’s real good evidence it helps candida, but at the right time.

Darcie (00:45:23):
I was asked specifically about peptides for chronic fatigue syndrome.

Dr. Parpia (00:45:33):
So we need to understand why the patient has chronic fatigue syndrome, right? Is it because there’s a high viral load? Is it viruses and parasites? Is it environmental toxins? Are the hormones way dysregulated? It goes on and on and on. And each person’s reason for having a diagnosis like that is gonna be different. And so we really need to get down to that. Why are you having chronic fatigue syndrome? And then we would bring in the peptides, not just peptides, but any medication, any herb to address it very specifically to the person. So, I also saw someone ask for a Lyme protocol. We don’t really do protocol medicine because everybody is different. What we discussed today would kind of seem like a protocol in a way, it is, but it also is a dance with each patient. Sometimes chronic fatigue syndrome, I’ve gotta understand why I know they’ve got inflammation. We can do all kinds of tests to figure that out. I would wanna work on bringing inflammation down in their body and then the next stages are whatever that patient needs.

Dr. Gordon (00:46:49):
Yes, and I just wanna reemphasize that. Chronic fatigue is, as I said, I’ve been working with chronic fatigue for over 30 years now, and for most people, it’s just a label. It’s not a real diagnosis because you have to look for your triggers, but then the peptides really help. I mean, there is a place, like I said, we used growth hormone for people with chronic fatigue, you know, 20 years ago, Dr. Paul Cheney, who the people in the chronic fatigue world sometimes remember he was like one of the leaders in chronic fatigue from the eighties. He was very big on very, very tiny doses of growth hormone at the right times. So that is the problem.

I always feel bad when we do these webinars. We come up with all these great ideas, but then you need a doctor to work with. We’re giving you the ideas to ask the questions and do the exploration. But the order of treatment matters if you’re in this place of chronic illness, because chronic illness is there for a hundred different little things. It’s not like acute illness. You got sick because you got hit by something hitting you in your head or you know, you got a bad bug and you were tired and weak and you got a cold or pneumonia comes – better in three weeks, six weeks, you know, a month. Yeah. That’s an acute illness that had one cause you know, even then probably more, but we can think of it that way.

Chronic illness happens for lots of reasons. So when you try to use what helped your next door neighbor, it can help sometimes, but they might have a totally different set of causes. The end result is you have post exertional malaise and a stack of other symptoms, but you got there for your own, it’s your story. It’s not everybody else’s. That’s why we feel bad that we don’t have, “oh, do this” because that works only in the first few months of illness. After that, it’s figuring out what’s inside you. Right? Not what the world threw at you, but how your body is processing it. And that’s about you.

Dr. Parpia (00:49:15):
It’s about our genes and how your genes expressed, what biochemical components were then created as a result of those genes expressing. Your biochemical components expression will be different than the other persons who’s got the same diagnosis. And it’s not the same genes that are expressing in people who have the same diagnosis. So it’s a very, very personalized process. We had a question from our good friend, Dr. JP Saleeby about Peptide Science. You know, because it is internet-based, I have never referred my patients to them, but maybe they are good. I’ve had patients from Europe who couldn’t get the peptides from here and they could order them from Peptide Science and they never had a problem.

Dr. Gordon (00:50:05):
So Yeah, I mean, that’s the issue. But we just yeah, we don’t know. And the ability to be sure of the purity is always difficult. But there are people out there who’ve been using peptides for a long time from people on the internet and have done well. I just can’t promise you that they’re gonna be what they say. So I kind of hesitate to name names.

Darcie (00:50:36):
There are questions about, and this is probably very similar to the chronic fatigue answer, concerning peptides for long haul.

Dr. Gordon (00:50:48):
Yeah, same story with long haul. It will work if you have the right issue. But again, long haul, do you have it because you have micro clots? Do you have it because you’ve got reactivated viruses, especially EBV? Do you have it because you have autoantibodies? Do you have it because the spike protein is stuck in some of your, in some parts of your tissue? I mean, that’s where it’s hard to say, oh, try this one. You know, because again, and it depends how activated your immune system is. So I think, if you’re gonna talk to your doctor, a safe place to start is with amlexanox and KPV, because those usually are a safe entry, people don’t usually react badly to them. They begin to quiet down the immune response no matter what chronic illness you have. But after that, it’s the dance and figuring out what your triggers are.

Dr. Parpia (00:51:53):
Yeah. And Annika was asking, I just see your question pop up to, to speak of any side effects to watch for. So if we use TA1 and LL-37 first in a person who’s already highly inflamed, it’s not gonna go over well. So you wanna start with the ones to calm down the immune system first. The side effects are using the wrong one at the wrong time could be the right medicine at the wrong time or at the wrong dosage. So you wanna make sure that they’re being used by a doctor who’s experienced and trained in the use of peptides.

Dr. Gordon (00:52:46):
But for side effects, the most common ones for the injectables are redness in the area and occasional nausea, and the nausea is usually transient. You know the thymus based ones and the ones we discussed the KPVs, the amlexanox , the TA1, TB4, TB4-frag. I just wanna emphasize TB4-frag, for the sensitive people, because the plain TB4 can flare people with mast cells. But those are usually pretty benign. You’re not gonna have much. But once you start using something like the semaglutide, well that can cause severe constipation in some people even at tiny doses. So the good news is that none of them are life-threatening side effects.

Nobody’s gonna get sick for a week. I shouldn’t say I never wanna promise that. Almost nobody that I can imagine is gonna have anything more than a transient redness at the site of injection or nausea. And if you flare your immune system for most people it’s very transient. Again, if you’re very, very sensitive, it’s like chronic fatigue people, you know, there’s some people they overdo a little bit and they’re tired the next day and some people they’re gonna be out for a week or even longer. So it depends on you. But in general, these are very safe because your body is making these all the time. It’s not like you ever stop making these things. It’s a question of, do you make enough for your body for your body’s needs at the moment? Because sometimes I said the signaling isn’t working well anymore. But these are incredibly safe. That’s why we like them so much. They have less side effects than most of the herbs, that’s for sure.

Dr. Parpia (00:54:50):
Of the first supplement, it’s amlexanox, it’s a peptide. That’s the one that we like to use for MCAS to start with. That and KPV.

Dr. Gordon (00:54:59):
Yeah, I was like to, just for people who are sticklers for details, it’s like a peptide. It’s a very small molecule, but peptides technically are just amino acids and this one has another chemical moiety or chemical substance mixed in with it, but it’s still a very small molecule. And that’s the idea. These small molecules tend to be much safer because they don’t have the amount of possible ill effects in the system are much less the smaller the molecule up to a point. I mean cyanide’s a small molecule, will kill you, but <laugh> in general, the smaller the size, the less bad things will happen.

Darcie (00:55:39):
There’s also some questions about like sort of on average, how long does it take for a peptide to start working for chronically ill patients?

Dr. Parpia (00:55:48):
Very quickly, quicker than I expected at first. So, some people it could take a month, some people could take a week for super, super sensitive people. I’m talking, people who are even sensitive to water, they have to take a toothpick dip. That’s just a certain percentage of our population. Most people within a week you’ll notice, some people within a day.

Dr. Gordon (00:56:20):
Yeah, I mean these things can be quick and also dosage. That’s one of the things that’s difficult is some of the peptides you know, some especially the oral peptides will, if you tolerate them, we’ll start you off with one, you know, one twice a day. But we quickly want you to ramp up for the first two weeks or three weeks to high doses. And that’s crazy, but it’s kind of worth it because it will get the effect going and then you can quickly taper down and use it intermittently and probably need less. But if you just stick at the dosage, that’s on the Integrative Peptides label like one, twice a day you might not notice something, but if you take two or three twice a day for a week or two, you’ll notice and then you can taper down on them, you know? But yeah, that’s the point. These are not things that you have to take for months to notice a benefit. I mean if you’re on it for a month and nothing’s happening, I’d really talk to your provider and wonder what your body needs. And probably best to try something else.

Darcie (00:57:30):
On the other end of the spectrum here, people are wondering how long you typically stay on peptides.

Dr. Parpia (00:57:38):
Months. But we weave in and out of them. You could be on it on them for three months, come off for a month, come back on, add in new stacks. So a long time, but weaving in and out.

Dr. Gordon (00:57:51):
Yeah. And, and again, depending on, see peptides are a big grouping. A lot of the ones that we use, we use for a few months to get going and then we go off and on. I said Dr. Khavinson’s peptides, which come from Europe and the oral ones that he has, he often recommends shorter periods of time, 10 days or even if it’s a month, one month on, two months off. Because these are communication molecules and in people who have a problem, they might need them regularly for a few months, but in many people you just need them for a month or high doses for a week or two and then you can stay off of them and put them back in and it’s a little bit of a dance, but if you’re healthy, you can follow a lot of the recommendations that are on internet sites. If you’re sick, that’s when I worry about playing doctor on yourself. If you’re healthy, the peptides are fairly safe. They’re on the level of supplements. They’re not gonna push your system past where it needs to go. Okay. Because they’re part of your body’s self-regulatory mechanism so you don’t really go too far. You know, it’s not like a drug where we can keep pushing something.

Dr. Parpia (00:59:11):
I think that we might have to do another webinar, just Q&A on peptides because there are so many questions.

Darcie (00:59:17):
About, yeah, we can pull all of these down Dr. Parpia and we can definitely do something. One last thing before we wrap up. There are quite a few questions about whether or not you all do professional consultations with providers on peptide therapy.

Dr. Parpia (00:59:37):
I have in the past, but sometimes it can be difficult because I don’t know your health fully in and out. I’m not watching you like a hawk. If you’re not that sick, if your health is in a state of ease in general, I could do that easily. If you’re highly complex, and I’ve tried to do it for patients who are highly complex, it can be difficult because the patient maybe thinks they’re gonna have one appointment with me, but then they end up writing more messages. They need more help, due to the complexity of their health. The treatments then need to be more complex. So if you want just a one off with me and it’s gonna be simple, easy-peasy. If your health is of a complex nature right now and you need help with peptides, you might need more than one consult, you might need five.

Darcie (01:00:43):
But in terms of also speaking with their their doctor directly

Dr. Parpia (01:00:49):
Oh yeah, yeah, I’ve done that. I’ve had appointments where I’ve spoken to the patient and the doctor, we’ve been on a zoom call together and then the patient has needed more or the other doctor has needed more and it gets tricky. So I mean if you’re willing to see me a few more times, it’s going to be helpful. If you’re sick, if you’ve got a lot going on, I think once isn’t enough.

Dr. Gordon (01:01:20):
Yeah. But if a doctor is really interested in learning about peptides, then it can be useful to give them a place to start. And the question is just timing. Because we don’t have a lot of time for that, but if you have an interested doctor, reach out. Because if we can help get somebody else started, that’s really great because this is something that I think just augments anything another physician is doing.

Dr. Parpia (01:01:51):
Just know, it might be more than one conversation with me.

Dr. Gordon (01:01:55):
But I’m hoping if that doctor can reach out, we can set up sometimes other ways of helping. So we can create something if there’s an interest, because we have done it a few times and you know, I said with an interested doctor who wants to learn. It’s a great thing. I think what Dr. Pape was talking about is that if the doctor’s just gonna be there and go, okay, I’m gonna be the one to write the prescription or get these for you, then it’s a longer process. But if you have an excited, interested doctor, reach out. Let’s see what we can do. Love to help.

Darcie (01:02:31):
We dropped the link to set up a discovery call into the chat. So anyone that is interested, that would be the next best step

Dr. Gordon (01:02:46):
What I wanna remind people is that you see we’re the talking heads here, but we’ve got some other really great physicians who’ve been also using peptides with us. Dr. Jamie Kunkle is an amazing doc and very creative as well. And we’ve got some others that we’re trying not to keep too busy yet because they’re working with me. But you’ll get to know them in time.

Darcie (01:03:15):
I think that’s it.

Dr. Gordon (01:03:20):
Thank you all, it’s fun, it’s stimulating. And I’m really looking forward to the questions because that’s when it gets interesting. Then we have to start, you know, it’s like seeing patients, we are constantly learning and the more the questions, the more we learn. So thank you all for your time and really excited to share. Thank you for being here.