in this week's podcast we're going to be talking about probably the hottest Topic in health and medicine today and that is OIC and The glp1 Agonist basically the prescription medications that are being used by millions of people for weight loss I'm going to be joined by Dr Tina Moore she's a good friend of mine and we're going to talk all about OIC and its sister medications and we're going to talk about micro doing it and some pretty surprising findings of what these peptides can do for you okay so let me introduce my guest this week her name is Dr Tina Moore she's an expert in holistic regenerative medicine and resilient metabolic health she's licensed as a naturopathic physician and a chiropractor drawing on Knowledge from both traditional and alternative fields of science and medicine to provide a comprehensive perspective to individuals striving to enhance their health and well-being her work is not just about treating symptoms it's about understanding and healing root causes to build a robust foundation for long-term well-being she's also the host of the Dr Tina podcast which is one of the top health and wellness podcast in the country and I have been a guest on it in the past so I'm really excited to bring this podcast to you because I get so many people ask me about OIC about wovi about Manjaro and these Associated medications how are they used for weight loss do I recommend you use them for weight loss and we're going to get into the nitty-gritty about these medications you're going to understand everything you need to know about them and my micro doing which is a whole other way of looking at them and how they can affect your health not just with weight or with your blood sugar but your brain your heart and your other organs so this is going to be really interesting I'm so looking forward to bringing you this podcast today so let's get started well thank you so much for joining me today Tina yes thank you for having me I'm so excited to be here so this is a topic that is everybody's talking about the glp1 agones whether you're talking about OIC or it's you know kind of I guess it's not it's twin I guess wovi that's the same thing or manaro zound all these types of medications that are so hot because people are using them for weight loss today we're going to be talking about that but we'll also be talking about some novel interesting uses that you are doing with it but I'd like to first start out by getting a little bit of your story so you are one of the country's foremost naturopathic doctors who is focused on longevity on regenerative medicine metabolic Health how did you decide to go into this Direction with your career so far as the OIC goes no so far as before the OIC stuff yeah we'll go into that next but yeah your career before the last you know couple years where OIC has been such a huge part of it you know you've been in practice for many many years you've been doing this for a long time a long time well I was fortunate enough to find a mentor way back in the day when I got out of undergrad in the early 90s I was interviewing for jobs I was living at home with my parents and I interviewed for a position with a naturopathic doctor in my little Suburban town where my parents liveed lived and it turns out he was like a complete rock star in our field and his name was Dr Rick Marinelli and he was young and he was fit and he was doing really cool regenerative medicine kelation all kinds of cool therapies and I just thought this guy was a magician you know he was an acupuncturist a lot of Physical Medicine just really a highlevel Jedi practitioner and I had the honor of following him around for 20 years so I adopted a lot of his practice ways and I learned a ton from him realizing in these latter years what I learned from him still really in many ways isn't entirely catching on you know with the more mainstream doctors and I didn't realize how much he had taught me along the way and then I took a turn and went through chiropractic training as well as naturopathic college and so I got both degrees and so I have a big Physical Medicine background in my practice was predominantly regenerative medicine so helping people using natural substances to get their joints back and you know keeping active people active so that they could not be nagged by shoulder and knee and spinal pain and a lot of that had to do with different regenerative substances that we had available many of them coming from the patient's own body like PRP stem cells and then Laton peptides Etc and so it's been just a long journey and at the core of all of that always for what Dr Marinelli taught me and what I taught my patients was metabolic Health you just can't regenerate if you are metabolically unsound and your insulin's all over the place and your blood sugars are everywhere so as you know it doesn't help the skin well it doesn't help the joints either so that's where it all kind of came full circle for me and then throughout the last few years I've really been beating the drum on metabolic health during the pandemic and lockdowns just trying to help Empower people to take their health into their own hands and really optimize their metabolic health so that they wouldn't be so susceptible to illness and that's kind of where you know it brought me into stumbling into this OIC story it was really just a lot of the clickbait headlines and even the functional medicine Community getting behind this narrative it just really started sounding propagandized to me and so that's where I dug in so before we get into The glp1 Agonist can you just I guess Define for my audience what you mean by metabolic health or being metabolically healthy sure so at its simplest form the foods we take in should be metabolized in a certain way in our body to optimally be used for fuel and for substrate to build the things we need to build so the fats and the carbohydrates that come into our body and the proteins should be assimilated in a healthful way to helping us regenerate our tissues at the end of the day and unfortunately way back when my mentor was talking to me about metabolic Health with patients and he was doing screenings with lab work and looking at waist circumference and other things and this is decades ago and it was a bit of a mess like I could see humans really going in a direction that wasn't great and so when I went into practice in the early 2000s I was screening everybody for metabolic dysfunction and the term Syndrome X was popular when my mentor was teaching me and then it turned into this sort of metabolic syndrome that they call it and I was screening everybody for that I was actually catching a lot of slack from my profession because they were like oh Tina thinks everybody has metabolic dysfunction and I'm like I'm literally finding glimmers of it on everyone's Labs like almost everybody that walked in my office had some glimmer of either the beginnings or they were in the throws of it and what people don't realize is this pre-diabetic state is should be its own classification right I call it phase one diabetes because it's this preliminary phase of 10 to 15 to 20 years before people are diagnosed with type two but a lot of damage is happening during that period and that can be dialed back through lifestyle pretty readily and it's low- grade insulin resistance it's where the cell's not uptaking glucose the way it should root cause of that often is being under muscled Ultra refined carbohydrates as the predominant source of calories in a person's diet not getting enough movement not doing all the things that you know you and I both talk about and it's leading the American public into a real mess and now it's a worldwide phenomenon and interestingly 2018 data showed that roughly 93 94% of us adults had busted cardiometabolic health so those who were making fun of me back in the early 2000s I'm like well here we are so it's really pickle and unfortunately doctors aren't taking it seriously I think they're starting to see it but you get this aqualia fatty liver which has been normalized you get lipid changes so cholesterol triglycerides start to change and they're like oh here's a Statin not addressing the root cause and at the core of this is the fact that people's bodies are not utilizing food optimally as fuel the way that it should be the hottest topic really in health is OIC and everybody thinks I mean OIC is kind of like the kleenex you know it's the brand name of gp1 Agonist so let's proceed in talking about that really is the subject of the podcast today because you have become one of the foremost experts throughout the country on this peptide it's not technically a drug it's a peptide let's start by asking you to explain what a glp1 Agonist is and how it functions to help people lose weight and I know we're going to talk about some other functions of it today as well but let's start by just kind of the weight part of it because that's what everybody's talking about right now sure so a glp1 Agonist is a naturally occurring substance in our body produced endogenously it's produced in the L cells of our gut and it's also produced in our brain and we have receptors throughout our entire body for it but what it's most notably known for is the fact that it can induce regulation of insulin secretion it reduces glucagon which ultimately is going to lead to improved blood sugar handling in the body and more optimal metabolic function in the body for the individual using it which is ultimately going to lead to weight loss in of of itself because we're getting insulin in check the other part is that it has a impact on the brain to regulate and it works with other signaling peptide hormones which this is a signaling peptide hormone it works with the others like gin and leptin to have an impact on appetite and so it's perceived you know decreased appetite the person doesn't want to eat as much and then it has an impact on the gut directly by slowing gastric motility and which allows for someone to feel Fuller longer so that's the endogenous natural version and and then it works in the brain there's several mechanisms happening in the brain that we don't entirely understand but it's working on reward Pathways up there and all throughout the body so I think the general public they look at OIC they look at wovi they look at monjaro and they look at these as Pharmaceutical medications in reality that's not quite the case can you explain the difference between a true pharmaceutical medication and what OIC technically these glp1 agonists are I'm not a pharmacist but I do understand pharmacology decently well and I have a license to prescribe and so and I used to teach pharmacology actually kind of the 101 version to the chiropractors in the chiropractor college and what I understand mostly with pharmaceutical medications is that these are synthetic substances that oftentimes mimic natural substances to be honest with you and they have a binding to the cell they have an impact on the cell and they change Pathways and the most simplistic terms they have a direct impact on changing Pathways and sometimes these are blocking Pathways that are necessary sometimes these are inhibiting bacteria from replicating it might be working on the cell wall it might be working in the nucleus peptides on the other hand are they've been known in the biohacking community and in the regenerative medicine space for a long time and they are strings of amino acids that are peptide bound to each other and that creates a peptide and a string of peptides is what makes up a protein so peptides insert themselves where they need to go similar fashion they'll bind they'll go into the cell they'll do their thing but they insert themselves where they need to go in more of a regenerative healing and oftentimes anti-inflammatory fashion and what happened here is I believe the pharmaceutical industry basically co-opted the this peptide which is The gp1 Agonist or peptide they've been around for a long time 20 years they've been in use with lots of safety data there's just different generations of them they're just getting fancier as they grow up with tepati being the fanciest on the market right now they have the route of being an injection and so that warrants them being a prescription item and that's where we are in this and so somac tide for instance Is bioidentical to the gop1 that is secreted by our body with one caveat the gp1 secreted in our body naturally endogenously has a really short halflife and so it's just in and out really quickly and sometimes it doesn't linger long enough to be really effective for the body individual but the seacu tide has a tweak on it so that it has a longer halflife but otherwise it's pretty close to the original form and so it's different there I don't know if that explains it well but peptides are a different Beast I think it does because I think a lot of people don't realize that you know people think I think oh you know if I have this OIC if I have semaglutide basically injected then it's it's like if I'm injecting an antibiotic or if it's like I'm taking a Statin drug it's just another drug that I'm taking and I think a lot of people don't realize that this no this is a peptide This Is A protein that is naturally occurring in your body you know this isn't some synthetic medication that you take that's going to alter your body's processes in an unnatural way this is basically just replenishing A protein that is present already in your body but now it has been altered so it can as you said have a longer halflife essentially meaning that it can last longer in your body and create its facts so that's The glp1 Agonist and so those are the ones that people talk about OIC which is the one that's FDA approved for type 2 diabetes patients and then wovi which is the one that's FDA approved for weight loss the same medication or the same peptide essentially just two names for the same thing and then people are also getting it compounded the generic name is semaglutide what is the difference then between the gp1 agonists like the ones I just mentioned and eptide which is a kind of a different category I know it's a little different it's got a little more to it but how do they function differently and how would somebody decide which one would be best for them well before I get into that I want to say one thing I do think that when you take something like a peptide and you crank the dose way up which I know we'll get to dosing conversation in a minute but when you crank it way up you start getting into pharmacologic changes versus physiologic changes so that's where I think a difference lies that we we could talk about but that's how I look at hormones that's how I look at everything it's like where's the physiologic need and then when we're cranking something so that we really do start pushing Pathways at very high doses I think that's when we can get into trouble so I think it could be used either way okay so sucti is just a glp1 Agonist meaning it binds this receptor the gp1 receptor and it behaves as gp1 would tepati is a dual Agonist it's a GP Agonist and a glp1 Agonist P so glp1 basically causes insulin to Surge and secrete as needed more appropriately and it reduces glucagon secretion Gip actually promotes glucagon secretion which seems like an oxymoron and I've Dove deep into this and I've listened to so many webinars with the scientists who've developed these peptides and who are studying them and who've done all the studies on mice and it almost seems like Gip we could agonize it or antagonize it and we still get similar impacts and so tepati just happens to be a gp1 Agonist and when you start tweaking with the Gip you get a more profound impact on blood sugar handling and on metabolic health and metabolic healing and so it's just a little bit of a different Beast and who needs what it kind of depends on what you're going for and what your short-term and long-term goals are with these peptides and then also tepati seems to have a more comfortable side effect profile although I don't dose patients up into side effects but it does seem to be handled better by some people and in other people they say oh it gives me a little bit too much indigestion I don't like that and so kind of different beast and I've even noticed a different impact on overall I'm using it more of an anti-inflammatory fashion and more for like autoimmune conditions and I'm noticing a little bit difference depending on the patient on which one's better and cost can be a difference too being a naturopathic physician I know I'm assuming some of your colleagues may have questioned that okay here you are recommending an injection know you think okay I'm a naturopath I'm into natural medicine Are there natural ways that people can bypass these injections and you know eat certain foods or anything that can help to get a similar effect so I think that adjunctively there are ways to support natural glp1 secretion however that said these are secreted prod l in the gut and most people's guts are a mess as you well know and so when you've got an inflamed gut or a leaky gut which most Americans seem to be dealing with some version of either IBS there's inflammatory bowel disease which would be more like the Crohn's and ulcerative colitis I mean even my daughter she's 24 and she's like Mom all my friends guts are so messed up it's a that's the true epidemic right and so asking a cell that's maybe petered out or perhaps it's atrophying due to age that's another factor that nobody's really talking about that I think about it's like as we get older our gut lining atrophies so trying to get the L cells to go is the goal obviously we want to do both it's not one or the other so a food Bolis going through the gastrointestinal tract will just mechanically stimulate it so just eating enough in a sitting instead of sort of grazing all day long on small little tidbits like getting a meal and a meal in instead of you know six little tiny snacks I think that can be helpful glucose itself actually stimulates the L cells bitters will stimulate the L cells so bitter herbs like berberine now these are all helpful but there's not a natur OIC like it's not the same thing stimulating the L cell to go is a whole different Beast than actually having an Agonist sit on a receptor throughout your body and do its thing so it's not the same thing but we certainly don't want to throw the baby out with the bath water their sodium butyrate I think has good data behind it on helping to trigger the L cells to actually do their thing there's different you acromania probiotic has a roundabout way of getting the L cell to Via sodium butyrate getting the L cell to go so it's not one or the other in my mind it's adjunctive and depending on patient needs if a patient is using a gp1 Agonist and they have gastrointestinal issues I might choose some of those substances that I'm very familiar with in naturopathic medicine like berberine sodium butyrate some of the other herbs fenu Greek to get the gut happy so it kind of depends but some of my colleagues were suspect but I've always been using Pharmaceuticals I have a license to prescribe and I'm not afraid to use it and I'll just say this the way that I was trained by my mentor and this doesn't jive with everyone but I think most people can appreciate this sometimes we need some pharmaceutical intervention and some help and often times the lifestyle is down here and so you know my hand that's in the air for the people listening to this on audio it's like people come in on a lot of pharmaceuticals and their lifestyle is kind of in the dumps my job is to get their lifestyle improved and it's like a teeter totter which will bring down the need for the pharmaceutical so we can get it to the lowest dose necessary to get where we need to go but I'm not afraid to use it even when it comes to maybe a Statin drug or an anti-depressant I'm not afraid to use those either but I ideally want it at the lowest dose possible so we're getting the impact and the Improvement but not the side effect and in the meantime the patients working on lifestyle to really optimize all the things and that's I think a really beautiful way to combine holistic medicine functional medicine along with allopathic medicine and that's the way I've always done it that's the way I continue to do it I do that with hormones I do it with all kinds of pharmaceuticals and patients usually appreciate that and I think I mean it makes less sense you know what you're talking about is a nuanced approach to health and not being extreme you know of all pharmacology or all lifestyle and understanding that everybody comes in it from a different place and and it's trying to dial that in for where they're at to try to get them where they want to be we don't all start in the same place and and it makes complete sense and I applaud you for your approach to it so where you have really made a lot of headlines and you've been on a lot of podcasts a lot of people are talking about you is because you have brought up the topic of micro doing of these medications so just for those people who don't maybe know how these medications work there is the prescribed the the recommended dosing of these medications just for example with the semag glut so if you have a Doctor Who's going to put you on wovi which once again is the semaglutide is a generic name wovi is the brand name for the FD approved for weight loss glp1 Agonist if you're an adult or children 12 years of age or older you want to start with 0.25 milligrams once a week for 4 weeks and then they may increase your dose every month or so maxing out at about 2.4 milligrams and so this is kind of the normal dosing but what you have talked about that has gotten a lot of Physicians a lot of healthcare prns really interested is the idea a of micro doing these medications not following these FDA approved protocols because you know you could be really injecting a lot of this peptide into people but looking at micro doing it in much smaller amounts how did you come about doing this you know what are some of the benefits of the whole idea of micro doing these versus giving the FDA recommended amounts that that most doctors are doing nowadays well I looked at it and I started researching it about just over a year ago I started researching glp1 Agonist in general and their impacts throughout the body and I found out that they're neuro regenerative they're cardioprotective they are protective to the pancreas they help regenerate the you know cells of the pancreas that secrete insulin which oftentimes gets burned out in a lot of individuals they are protective and healing and regenerative to muscle tissue to joints to Bones you know it just really I was blown away and I was like well then what the heck is going on so insulin is a signaling peptide hormone for example and if you crank somebody out on high doses of insulin you will kill them and I thought well I think this is just common sense I think they're just dosing people too high like I think I think this dosage schedule is crazy like oftentimes those doses are being almost doubled every four weeks and that's what the studies did the studies took people up to 2.4 milligrams and then looked at the side effects and the serious side effects and the minor side effects and by the way the side effects are not nearly as gnarly as the media has been leading us to believe so that's an interesting conversation but the way that I've always done medicine was exactly what I just described earlier that teeter totter and I was like I use hor hormones in the lowest dose is necessary I do not always follow the algorithm of how you're supposed to dose the estrogen or the testosterone I dose until symptom alleviation and since my practice completely revolved around pain and muscular skeletal complaints it was really easy to gauge when symptoms were being improved because most people were having pain as their Cardinal symptom and so when I would get that pain down that was the dose that was pretty easy right like I didn't have to go by you know we're looking for like let's take a menopausal woman we're looking for improved cognition when we're using estrogen and progesterone we're looking for hot flash alleviation whatever it is I mean hot flashes are kind of last on the list with testosterone erectile dysfunction is kind of last on the list you're looking for these other symptoms that are pretty common and so I would dose until I would get results and then I would back off we monitor with labs and that's a really safe and effective way I think to do hormones and so I looked at it from that perspective I was like wait a minute maybe they just need some physiologic doses of gp1 because of the reasons I described maybe their gut lining is just burned out maybe they came out of the womb with some issues I don't know we don't know we haven't looked that hard at what actually being born from a mother who is metabolically dysfunctional and the baby is swimming in a bath of insulin for nine months in utero we're not looking at their glp1 levels but I started thinking I wonder if people either have a functional deficiency that came on through a life of whatever I mean like you said how did they come to the situation how did they present what was their life like before that or is there may be even some potential this is a hypothesis I've been taking a lot of heat online for this but I have a hypothesis that I think some some people might be a little bit glp1 deficient for various reasons and or we're not all secreting the same is a better way to say it right and so we do have data showing that those who are dealing with fatty liver Andor type two diabetes have a low level of gp1 and those with obesity have a low level so erroneously say deficiency and maybe it's not exactly the same thing but by definition but these folks are presenting with really low levels of glp1 did their lifestyle get them there did the Obesity get them there did the high insulin levels yes all of the above it's kind of like a chicken and egg but I got to thinking huh I wonder if we use these in small doses for individuals who maybe don't have metabolic dysfunction or maybe they have low-grade metabolic dysfunction but they've got a cardinal list of other Cardinal symptoms so that maybe they've got cardiovascular disease and we could use them protectively and preventatively because my business is preventative medicine I'm not waiting for them to have a heart attack before I apply a therapeutic right maybe we could use it for brain fog for neurod degeneration which was what it was originally studied for maybe we could use it in really tiny doses what would happen so I started playing with it with myself and with my patients and got a whole bunch of my colleagues actually sort of playing with it on their own in their clinics on themselves and got all the feedback and it's just been really interesting that when people are particularly metabolically sound like someone like you or I like we're doing all the things we strength train we exercise regularly our sleep is pretty dialed in we eat really well we're doing all the things I found that a small Touch of glp1 Agonist can can have really remarkable benefits and for me personally this was really a personal journey I was dealing with some pretty severe brain fog that came on you know per menopause covid gave me I had postco brain fog which a lot of people do and then I have serotic arthritis which induces a tremendous amount of inflammation in the brain and causes a ton of brain fog and it was impacting me physically it was impacting my spine it was impacting my skin it was impacting my brain and I was just really in a pickle and everything that I know to do with regenerative medicine I have access to all kinds of cool stuff that you probably know about you know exomes things like that nothing was cutting it and I could not get out of this loop I was in and I put on about 15 20 pounds from stress it was just happening and I was like oh my gosh this middle-aged thing that I used to see walk into my clinic where women who were always fit and healthy and lean would walk in and say I doc I just gained 15 pounds out of nowhere it's all in my midsection what the heck happened I haven't changed anything and I'd be like oh it's happening and I watched it happen to all my family members and it started Ed happening to me and with it came a tremendous amount of pain I do think some people's fat tissue adapost tissue is more inflammatory than other peoples I come from a family where you gain weight and you hurt and I thought you know what I'll give it a try I mean what can it hurt a small tiny dose let's see what happens and I'm talking a fraction of the starting dose and that dose is different for everybody so I couldn't give you a clear answer and like everyone wants to know what's the dose it depends on the patient in front of you but a small dose for me might be different than a small dose for my patient or my family member or who ever else and it just has been really remarkable and so I started applying it for different conditions and I shouldn't say conditions just different presentations different symptom pictures people were having you know and remarkable like just really remarkable impacts for people really the answer when people say what's the dose I say it depends and we keep it just this side of symptoms so we don't dose into symptoms and it's the highest dose necessary to get the individual the results they need it sometimes I have to bring on other peptides hormones other things this is not a One-Shot Wonder it's not a monotherapy magic Cur all we use it as a tool as part of a comprehensive tool box but it's been really remarkable and so I started talking about it and it all just kind of blew up and then here I am so you start yourself on micro doing a gp1 Agonist what specific changes did you see in your body and your how you functioned and how long did it take for you to see those changes I immediately felt my anxiety leave my body which I didn't even realize was there until it was gone and I was like ah that's nice really yeah it was very quick and many people have reported that they don't even notice that they notice it until I asked them I'm like how's your anxiety well I didn't have anxiety well do you feel calmer on it actually I do do you feel more clarity actually I do so a lot of cognitive benefits I'm seeing mood boost I'm using it personally to have that anti-depressant impact if you will it's not a FDA approved anti-depressant so people out there don't misunderstand me but for me it has worked in a fashion I've taken anti-depressants and it's worked in a really really wonderful fashion to boost my mood help my cognition predominantly that's been the best part and then on top of it all my autoimmune symptoms just leave the building when I'm using it and so my psoriasis cleared up completely and other people have reported that as well my pain is way down and a lot of other people have reported that as well a lot of people reporting like oh all my joint pain is gone I didn't even realize I had it just kind of like this low grd Naggy pain we learn to live with pain because our brain down wires our perception of it you know so we can endure it but that just kind of leaves for a lot of people not completely not always and there might be flares in between but significant Improvement and then for me my Mobility improved I was going through kind of a gluing together because of the psoriatic arthritis my spine was starting to fuse and I've got near full Mobility now and I'm much more active than I was before without getting all these little Naggy injuries that I was getting because I was so locked up so that's just for me mainly where it's been my menes is regulated out better I was starting to get some par menopausal shifts in my menstrual cycle it's gotten much more stabilized I can't think of of anything else that's most notable how about weight oh so I had like I said I'd put on you know 15 20 pounds this is what I noticed for everybody on the low dose it just takes the fluff off so I still have a little bit of a belly I still am built the way that I've always been built unless I'm really really trying to get my body composition in check I tend to carry a little bit of a belly I am right back to where I was 2019 before all the stress started before that weight came on and that is exactly what I've noticed for everybody doing it in very low doses to the point where some people are frustrated they're like I want to lose more weight I'm like well you either have to bring some other adjunctive therapies on board or and or you have to really dial in your lifestyle like are you lifting three days a week are you walking 30 minutes a day are you sleeping are you doing all the things necessary for optimize metabolic health and weight loss and they'll say well no okay well then cranking the glp1 dose is not the answer do the other things first right but if they want to crank the dose and go into symptoms they can and they'll lose weight but that's not what I'm going for so I have not cranked anybody into symptoms and if we do we back right down we don't want symptoms we don't want nausea or feeling you know sick at night or any V definitely no vomiting we don't want any of that so the fluff kind of came off and everybody's just at their fighting weight as I call it everybody just dropped back down to kind of where they were and if we want to dial that in there's other peptides and there's other resources for that so from your experience you know and I think we have to always mention you know in this situation you know we're not talking about peer-reviewed studies we're talking about we're talking about your clinical experience with the people that you have it on so all the things that she's saying here are you know you take it for education but not you know she's not your doctor here no I'm not and I'm not telling anyone how to do it I'm just telling them how I how I've done it so what you're seeing is that you feel that a lot of these symptoms side effects that people are worried about pancreatitis nausea vomiting those types of things are really pretty dose dependent and that where we're going wrong with the dosing of these glp1 Agonist is that we're just giving too much and if we were to dial those doses down into the micro does you may be able to get a fairly similar effect but at the same time avoid a lot of these side effects that people are worried about yes and I will say this I am realizing because I've got a decent sized platform and so a lot of getting a lot of feedback from people all over the world and for some people a micro do quote unquote is actually the starting do the standard starting dose you know some people do not respond if they're severely diabetic or have a lot of weight to lose they're going to probably need much higher doses this strategy is reserved for those who are already metabolically sound I want to be very clear about that because people have heard me podcast decide to mess with their own dosages don't do that people do not follow your doctor's instructions I'm not telling anybody what to do in fact I highly discourage that because you can get into trouble with these but they'll they've lowered their dose and they're like well it's not working I'm like well not working for what like if your goal was weight loss I was real clear this is not a weight loss strategy so want to really drive that home for people because they're hearing whatever they want to hear on these podcasts they get excited and hopeful and then they hear me say things and then they make up things and that's not what we're getting at so what was your question originally so it was basically just about the side effects if you dial it down and possibly you could prevent a lot of these side effects you know one of the things that people are worried about with these is the side effects obviously so let's talk about those so the pancreatitis I think is a real risk the number one cause of pancreatitis is throwing a gall stone and or fatty pancreas and so I think we're taking when we're looking at the side effects in the general population taking the higher doses of these those people are already sitting on the edge of a lot they are already predisposed significantly more predisposed than their lean counterparts to have all of the things that you're hearing about so in the case of pancreatitis they're already sitting on the edge of pancreatitis because they've probably got some billiary issues in their gallbladder and it's real easy when you go super low calorie super fast which I don't suggest people do that's a dosage problem they will potentially throw a stone because their gallbladder sledges up and that stone gets thrown into the pancreas and now you got pancreatitis which is a real issue like that's a really bad thing you do not want so I do think that's a real concern and anybody with a history of biliary disease or gallstone should be very very careful even if they're lean or even if they're a tiny dose like they should be very careful the gastroparesis the group most susceptible to gastroparesis is type 2 diabetics it's because of the hyperglycemic impact on the Vegas nerve it's being destroyed slowly but surely already and then they're cranked up on these high doses and they go into their stomach basically seizing up on them but that's been shown in the data to reverse itself once the g1's out of the system in a few weeks so it's not permanent I haven't seen any cases where that's been permanent I'm not saying they don't exist but that's not a real big potential to have a permanent gastroparesis but a type two diabetic is most at risk for that some of the other concerns the muscle loss any severely low calorie diet is going to induce the same percentage of lean mass loss and they're clumping muscle into the lean mass measurement and so that's a bigger conversation but these actually are muscle regenerative they actually help peruse the muscle with better capillary fill and they help potentially bring in more amino acids to for muscle protein synthesis so that's almost like an anabolic impact on the muscle it's not digory to the muscle that's not how these act so that's not the peptide that's the severely low calorie diet that's inducing the lean mass loss and if these individuals aren't being counseled to or not being compliant with which is often the factor with strength training and prioritizing protein in their diet especially if their appetite's being crushed they've only got so much room and so much appetite if they're just eating you know a bag of potato chips or whatever you know eating less of the potentially garbage food they were already eating you know I'm not trying to vilify anyone but people are admittedly you know junk food addicts and they're like well I'll just eat less of the same thing that's not going to cut and you will lose lean mass and that's a mess down the line those people I think are going to be worse off than when they started they're going to end up ghost of themselves with no muscle and that's a metabolic disaster some of the other ones the thyroid cancer there's a blackbox warning for thyroid cancer that was on rats and those studies were interesting in that this is a type of cancer that's very rare in humans and very common in rats because they have a different receptor in their thyroid that will bind and so they were developing spontaneous meary thyroid cancer and so was the control group and they were given very very high doses of glp1 so in humans we don't see this as often and the data that's coming out right now is really just saying like we've looked at it we've looked at it we've looked at it we've looked at all these studies we've looked at all of these chart notes and it just doesn't line up we're not seeing an increased risk for thyroid cancer in humans so that's still ongoing of course but if you have a history of any type of thyroid cancer particularly medary thyroid cancer or it's in your family history of course you're probably not a candidate for these so be careful there and the kidney issue they're actually it's regenerative to the kidneys they had to stop the flow trial at the end of 2023 because they wanted to ethically be able to give the control group The peptide because it was so impactful on chronic kidney failure so we hear these like click baity random one-off stories where somebody takes a super high dose and vomits thems into some kidney damage and so then it's oh it causes kidney damage it's just not true my mom sent me an article yesterday it's just lies and lies and really propagandized level so people are going around saying 80% of people are having severe nausea that is not true the studies consistently are showing about a 20 to 25% and that's at the high doses having transient nausea not even severe so it's just not lining up with what we're being pumped and I'm not really sure why this pushed to say how much do you think this is becoming in some ways a war between big Pharma noo Nordisk who basically creates WG goian and OIC and big food where yeah I mean if people are eating less then they're making less money yes I mean do you think that has I mean you know I know you you're a little bit of a conspiracy theorist do you think that that's really going on and I know I'm sure you have no guessing I'm assuming you don't have any solid proof you think there really is a war that they're literally fighting each other where you've got one big Pharma where they're making unbelievable amount of money they're saying that that oepic is going to be like the most money-making drug in the history of humankind verses big food where they're thinking oh my gosh like people are actually losing weight they're eating less food they're losing you know the desire to eat all these ultr processed foods do you think that really is going on I do because big food has come out and said like the CEO of cheese it said we will watch this carefully and now big food has come out and essentially said that they're going to create a line of products that are in alignment with glp1 use so you know kind of like the Weight Watchers and the Atkins have their own food line it's going to be like that like they're getting in line with glp1 friendly highly processed packaged Foods so yes I think there's a lot of industries that have something to lose the what about the diet diis clinics that are popping up on every corner in America and the suburbs I don't know if it's happening in your part of the country but there's a lot of dialysis clinics and mini malls around here because type two diabetes is very profitable for a lot of Industries and they were potentially concerned I know for a fact because I read I think it was in forbs the joint replacement companies are concerned it's a very profitable industry when you're dealing with a life of obesity in an individual so I wonder also the big Pharma companies who don't have a glp1 patent yet are they I mean I don't know I'm just specul ating I know big food is concerned McDonald's has said something it also here's the other part because it works on the dopamine reward Pathways and the serotonin Pathways it impacts on alcohol cessation smoking sensation drug use it's actually making people want to do those less and so many people are reporting and I've even got a patient on it who they just don't want to drink when they're on it and it's being studied for alcohol abuse syndrome so there's a whole industry there there's a couple Industries there that might have something to lose if people don't want to drink and they don't want to smoke and they don't want to eat crappy food you know a lot of businesses are going to have major Financial issues yeah it's I mean it's interesting to think about or speculate so one of the things that honestly really irked me is that I know plastic surgeons were advertising some of glutide injections essentially they get it from compound pharmacies and this brings me back to several years ago when weight loss balloons were a big thing that they were marketing to plastic surgeons I think because we tend to want to do invasive procedures that make us easy money and that we ideally don't want to have to do a follow-up with patients so I know plastic surgeons who are advertising semaglutide injection some of them were early on when it was very short in Supply and so they were getting it compounded and it irks me because you know I go to our meetings like plastic surgeons don't know anything about lifestyle and preventative health like we're not trained in any of that at all as much as we think because we're an MD we know we don't know and the only reason why I know is because I've spent thousands of hours studying it on my own and so it bothers me because I do see my colleagues who are advertising this I think it's a pure and blatant money grab they're not doing it necessarily for the benefit of the patient now there are some who may be doing this out of weight loss centers obesity clinics like okay you know that's great you know I think that the big thing is if you're going to do this you need to follow these patients up you need to help them with lifestyle modification because ideally you don't want to have them on these large doses of these peptides and having to have them pay all this money every month for the rest of their lives I saw one plastic surgeon on social media answering a question of like how long do I need to be on this and he said you should just be on it for the rest of your life well I mean then that makes this doctor a lot of money every month for the rest of his career so the question that I have for you is that what would a plastic surgeon be missing if they are treating somebody with these medications as far as educating patients regarding lifestyle I know that we touched on it a little bit ago you know with strength training but can you explain kind of what specific things that patients maybe if if somebody's listening today and they've got a Doctor Who's injecting them with semaglutide every week but they don't say anything to them about lifestyle what are some of the things that they should consider so that they can number one Thrive number two get the result they're looking for and number three hopefully be able to reduce the amount that they have injected in them as they you know do better and better what are some of these lifestyle things that that they need to know about well I'll quickly just say around the dosing I think the alpath community is starting to catch on that we just simply don't need to take people up to that 2.4 milligrams like we don't have to go there you know and so there was a group out of Italy that just presented a paper talking about how they're having great success with personalized dosing which is similar to what I'm trying to talk about but they're using much higher levels getting people to the dose where they're getting impact and I know a lot of smart doctors using it this way right they're using very small doses and they're getting people the results they need maybe not the micro tiny doses that I'm talking about but they're using lowd dose then you titrate them off you slowly taper them off the drug and that is showing a paper was just presented that I don't know if it's been published yet and I think it was the European obesity or Congress of on Obesity they showed that for the nine weeks that they tapered them off they maintained weight loss and then they even lost further weight and maintained weight loss for 26 weeks beyond that that's as far as they followed them so they're starting to catch on that you don't just crank up the dose and then drop it and then it's gone that's not how you do it and I don't think anybody should do that with any hormone or any peptide especially if they've got the dose high so not getting the dose High I think is number one number two is doing all the things so really prioritizing your muscle mass which we should be doing anyway you know me you know I've been beating that drum for a long time I've been telling people to eat steak and deadlift for as long as I can remember even being online like that's what I came online with and it wasn't popular then because everyone's like go vegan and do yoga so really optimizing your muscle mass that is your insurance for your future self that's it like this is how we fully optimize our metabolic Health keeping a tight check on your metabolic Health right like that's a whole thing in and of itself but just keeping a check on your waistline and your waist circumference and making sure that it is less than half of your height so just taking your height measurement in inches or centimeters having that and that's your Red Flag Zone you want to be below that always making sure you're optimizing your sleep because that'll destroy your metabolic health so getting that in line that might take some hormonal therapy that might take some other things right that might mean that you have to prioritize exercise during the day so that you're worn out at night appropriately like children and puppies we adults are the same we need to have that exercise during the day making sure you're getting adequate light during the day and and really setting your circadian rhythm so you're getting morning sunlight you're getting midday light you're getting afternoon light or sort of that sunsett time your eyes are seeing it happen and hopefully you're outside in it that's going to do really wonderful things for your daytime and nighttime health and making sure that you have some Stress Management in place because elevated chronic elevated cortisol will destroy you it'll destroy your metabolism it'll destroy your insulin sensitivity it'll destroy your hormones literally turn your ligaments and tendons and Joints to goo over time and so it is C abolic and it is not great and so making sure that we have a check on how we go about managing our stress and that might mean some lifestyle changes that might mean some job changes or some marital changes I don't know but people do not appreciate what stress is doing to them we live in this country where it's like you're my age you know we went through the whole period where it's like don't sleep and handle as much stress as you can and you're a hero for it you know and I think this just was a really damaging message so those are some of the top things that I would say that all humans to human the best they can gp1 not they have to do those things and I don't think most doctors it's not just plastic surgeons most doctors don't have a clue how to deal with metabolic Health most naturopathic doctors and functional medicine doctors really don't have a clue if someone doesn't lift weights I'm like dude you're not even lifting just why do I keep getting letters why do my patients keep getting letters saying your lab results were normal you have a little fatty liver I'm like no there's no such thing as a safe little fatty liver like we're normalizing these degenerative conditions in humans and it's just this been this slow trajectory during the course of my career and there's just no safe level of metabolic dysfunction we got to get that dialed in so ideally if somebody is taking OIC or one of these medications for weight loss is the goal eventually to just have them on a very very low dose or would the goal be to eventually get them so metabolically healthy getting them to change that what they're doing in their lives that we can get them off of it I think it depends on the patient because what I'm finding is I only have one patient on it for we got to get some weight off this fellow his cognition is so greatly improved and his mood is so greatly improved and his humor's coming back and his lights are coming back on in his eyes and it's been gone for so long and he's had some traumatic brain injury and he's had some Strokes so for him I think that the Obesity was secondary to The Strokes and to the traumatic happens when you get you know massive hemorrhaging or massive trauma to the brain it will induce metabolic dysfunction pretty quickly in an individual so I think for him this might be a forever thing and so keeping the dose as low as we can and then my strategy even with hormones is to cycle so I'll take them off for a period of time I'll put them back on so that those receptors get naked again and they get revved back up we don't want receptor resistance to this and it's happening I was talking to a compounding pharmacist yesterday and he's like I've got patients that are at the highest dose and they're wanting a higher dose because it's quit working for them so we don't want that to happen and there might be other individuals who maybe a young woman say a woman who's in her 30s and she's had a few children and she's got that extra weight maybe once she loses that and she's really dialed in her lifestyle and her metabolic Health she may be able to just go off of it forever some of those people actually I do believe there is the disease of obesity I mean there are genetic factors involved here there's epigenetic factors and I don't pretend to understand at all I don't think anyone really can Oprah Winfrey said it so well she said there are people who are obese who do not have the disease of obesity and there are people who have the disease of obesity and I think for some of those people they might be on this lifelong but there's an elegant way to do it and then there's just a really disastrous way to do it so I think that the Nuance like you discussed and what I'm saying here this comprehensive treatment strategy which I talk about inside a course that I offer is the ticket to making sure that if someone is going to stay on it that they have Success With It long term and they can stay on the lowest dose possible or lowest dose necessary I for one will probably cycle this forever because it's been so impactful on my autoimmune conditions and those are not going away I can lifestyle them away but they tend to flare up pretty quickly when there's extreme stress maybe I get a severe viral infection something happens and you get knocked off gear and now your autoimmune disease is in full fire and you need something to put that fire out and it's not just go carnivore I mean I wish that worked but there's so many people that I have heard from that were like I did everything so and so Guru said and I did everything so and so extreme Guru said and I'm still in this mess and I'm like I hear you sister join the club you know it's not as simple as picking a tribe dietary tribe and then you know going full boore there I mean I know people that went carnivore that gained significance amount of weight and threw themselves into autoimmune disease so you know we got to treat the person in front of us it's Nuance once again couple of really quick questions before we finish and I do want to talk about your OIC uncovered where you've got so much more information for people who want to get a little more information to dive deep into this stuff so they can hopefully get them self treated so first question you know I was listening to an interview with Dr Jason fun I'm sure you've heard of him he's fasting Doc and one of the things he said was when he was treating his patients with OIC for weight loss for type two diabetes is that they lost the enjoyment of eating food and that they could only tolerate that for so long and that's why a lot of people would end up going off of it when you're micro doing semag glut tied do you also find that you lose that enjoyment for food which is one of the great enjoyments in life you know I mean it's like what are the great enjoyments of life like obviously food sex what bro what are you talking about man yeah a glass wi once in a while you know good movie yes yes I did I did that to myself and so to me that has been a dosage issue so I have a I have a long history of being anorexic and I mean severe it was severe and what got me out of it was strength training like I actually joke that I cured my anorexia with strength training so I know that feeling of going so far like I know it well and when I was starting to get glimmers of that on the smac ti I because I guinea pig myself first before I ever started talking about this I was like no no no no I don't want to not want food right I don't want to ever go back to that and my mom was really scared for me she's like Tina do not go back into that I was like don't worry I'm not going to because I'm being very cognizant of it because I I can't be strong and be you know not eating so that has been really interesting and it is when I think the dose is too high and I do know people who use it low dose and they will report that with patients but they're doing like a cut phase on a patient they're trying to get like 20 PBS off a patient and this is a a metabolically optimized patient but they're going for like 20 pounds in 6 weeks kind of cut that's too drastic that's not what I'm talking about I'm not even like I said I'm I'm rarely using it for weight loss at these small doses you should have an appetite intact but you should have control over it that's what I'm finding there's a sweet spot there's a really sweet spot where enjoyment for food isn't gone but you're not having your sugar cravings and you're not wanting to drink maybe you have a desire to drink four glasses of wine a night maybe you just want one a few days a week or none you know I mean we're not trying to take everything away I've seen it to be a dosage issue interesting and then as far as compounded versus brand name any difference between them any recommendations for somebody you know do doctors make more money if they use a compounded version of it what are your thoughts there I don't think so so the compounded cost is very affordable for especially for Su acuti and so the way that I'm dosing people it's costing them anywhere between $ 30 to $50 a month at most for their suac glutide yeah because we're using standard compounded suac glutide we're just dosing it very low with the tepati that's a more expensive product but I'll pull that out when I'm looking for more of that metabolic impact or I want a little more oomph with the metabolic health because it does have a better impact on visceral fat and treating and dealing with the liver you know fatty liver Etc so the studies haven't been done on T epatite and cardiovascular health just yet like they have been with some acuti so we have different substances being studied for different issues if people are really sticklers about that but that can be a little more expensive it's it's three to four times the cost compounded but still quite affordable compared to the brand name version but if someone can get insurance coverage with the brand name version something I've learned with some folks is that they can tolerate the starting dose and in fact the starting dose barely touches what we're trying to get at because their metabolic health is so disrupt when they're going into it and so some folks have had great success starting with the prescription version and you know they have to qualify in those cases with for coverage they have to have a BMI of 27 or above and one comorbidity like cardiovascular disease something like that high blood pressure or they have to have a BMI I believe over 30 and it can be a real hassle to get insurance coverage but if they do then insurance will cover it for up to six months so some people are reporting back to me some people in my program are telling me you know what I could not get anybody in my town to compound it and my doctor wasn't willing to do it and so I started with a pen at the starting dose and it's been just fine and I'm getting a ton of benefits and this is with the help of a good doctor because they will know what they're doing they can help you keep the dose as low as possible while still getting the impact you're trying to achieve this has been so so helpful it's been so informative and I think so many people's lives are going to be changed by just learning what they have learned in this podcast today you've got a great course it's free I think isn't it all about OIC I have a free course and then I have a paid program that's a really deep dive it's for clinicians and the general public but the free one is very informative it's called OIC uncovered it's a four-part video series I'm actually adding a fifth part and it is all of the things we've talked about in deeper detail so a lot of people are getting benefit from that and just educating themselves and doctors are listening to it and it's been a hit so I encourage people it's on my website or you can go to Dr tina.com it's Ty y na OIC uncovered that's free and then I've got hours and hours of podcast episodes on my podcast about it so I've covered studies in there there's just a lot of Education there for free so if you're interested in what OIC semaglutide all of these glp1 agonists can do for you whether you're looking at it for weight loss or whether you're looking at it just for overall improving your metabolic Health your brain fog your cardiovascular health this is a place to go Dr Tina has become really one of the nation's go-to experts in this topic and I think what I really really love about what you're doing here is you are taking such a nuanced in detail approach it's not the kind of bang somebody over the head crazy do get 20 patients in a day injecting injecting injecting it's taking each individual patient as an individual unique person and looking at what their needs are where they are kind of on their health journey and then trying to personalize their care and their treatments toward each individual person and it sounds like really what I've learned over the last week really deep diving into this whole subject your information and others is that a lot of the about these glp1 agonists is not really necessary and that there is so much more to these peptides I think people realize and where you want to go to learn about this is Dr Tina she's got the Dr tina.com OIC uncovered we're going to put a link in the caption of this podcast and she's got a fantastic podcast herself the Dr Tina show thank you so much for joining me this was a lot a lot of fun really interesting and I think people are going to really get a lot out of this thank you so much this is so fun and thank you for all your great questions it was great to be able to explain it well thank you so much and everybody if you've been enjoying this podcast if you could leave a rating or review on iTunes Spotify wherever you get your podcast it definitely helps me spread the word and as always I'm Dr Anthony Yun known as mir's holistic classic surgeon this is the Dr Yun show as always remember to eat real food use Clean Skin Care and auto rejuvenate before you operate and we will see you next week everybody [Music] a