Dr. Craig Koniver: Peptide & Hormone Therapies for Health, Performance & Longevity
In this episode of the Huberman Lab podcast, Andrew discusses the potential uses of peptides - small amino acid chains that can influence the body's mental, physical, and cognitive functions. Guest Craig Koniver shares insights on peptides like semaglutide and BPC-157 for weight loss, joint pain, and healing, as well as growth hormone secretagogues for muscle growth and fat loss.
The conversation also touches on compound therapies like NAD infusions, methylene blue, and glycine, exploring their effects on energy levels, cognitive performance, and sleep quality. While acknowledging the FDA's restrictions and concerns around certain peptides, Huberman and Koniver emphasize the importance of obtaining these compounds from reputable sources.
This is a preview of the Shortform summary of the Oct 7, 2024 episode of the Huberman Lab
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1-Page Summary
Peptides and Their Uses
Peptides are small chains of amino acids that can influence mental, physical, and cognitive functions in the body. As Andrew Huberman mentions, they sit between basic lifestyle factors and more advanced hormone therapies, providing benefits without necessarily shutting down natural hormone production.
Specific Peptides Discussed
GLP-1 Agonist Peptides for Weight Loss
Craig Koniver discusses using compounded semaglutide and tirzepatide, originally diabetes drugs, to facilitate weight loss. Through microdosing and gradual increases, he aims to mitigate side effects like muscle loss while enabling steady fat loss.
BPC-157: Anti-Inflammatory and Healing Peptide
BPC-157 is a highly anti-inflammatory peptide used by Koniver's patients for issues like joint pain and gut problems. Notably, Koniver says it may upregulate [restricted term] receptors, enhancing the effects of [restricted term] secretagogue peptides.
[restricted term] Secretagogues
Ipamorelin, tesamorelin, and hexarelin can boost natural [restricted term] release, promoting repair, healing, muscle growth, and fat loss when injected. Koniver notes they have different "flavors," with some more focused on energy/endurance and others on fat loss.
FDA Regulation of Peptides
The FDA has banned or restricted several peptides like BPC-157, CJC-1295, and thymosin alpha-1. While safety concerns exist, Huberman and Koniver suggest pharmaceutical companies' financial interests may play a role. They emphasize obtaining peptides from reputable, regulated compounding pharmacies.
Other Compounds Discussed
NAD Infusions
Huberman and Koniver discuss the transformative effects of NAD infusions on energy levels, noting NAD's role in mitochondrial function and inflammation reduction, though exact mechanisms are unknown.
Methylene Blue
An old pharmaceutical gaining new interest, methylene blue can enhance oxygen delivery and mitochondrial efficiency, potentially improving cognitive function.
Glycine
The amino acid glycine can help calm the nervous system and aid liver detoxification. Combined with peptides like pinealon, Koniver says it may improve sleep quality and recovery.
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Additional Materials
Counterarguments
- The efficacy and safety of peptides for various uses are not universally accepted and require more robust clinical trials to substantiate the claims made.
- The idea that peptides can provide benefits without shutting down natural hormone production may not be true for all peptides or in all cases, as hormonal pathways are complex and can be affected in unforeseen ways.
- The use of GLP-1 agonist peptides for weight loss is an off-label use, and while it may be effective for some, it may not be suitable or safe for everyone, and long-term effects are not well understood.
- The claim that BPC-157 can upregulate [restricted term] receptors and enhance [restricted term] effects is not widely recognized in the medical community and lacks substantial evidence from large-scale, peer-reviewed studies.
- [restricted term] secretagogues may not be appropriate for all individuals, and their use can come with risks, including potential effects on insulin sensitivity and glucose metabolism.
- The FDA's regulation of peptides is intended to protect public health, and while financial interests of pharmaceutical companies may play a role, the primary concern is typically the safety and efficacy of these compounds.
- The transformative effects of NAD infusions are not conclusively proven, and the exact mechanisms and long-term benefits require further research.
- The benefits of methylene blue for cognitive function are not conclusively proven, and there may be risks associated with its use that are not fully understood.
- While glycine has some recognized benefits, the claims regarding its ability to improve sleep quality and recovery, especially when combined with other peptides, may not be supported by strong scientific evidence.
Actionables
- You can enhance your understanding of peptides by starting a peptide journal to track your experiences with different supplements. Begin by researching and selecting a peptide supplement that aligns with your goals, such as improving sleep or reducing inflammation. Document your baseline health status, dosage, and any changes you observe in your physical and cognitive functions. This will help you personalize your approach to peptide supplementation and monitor its effects over time.
- Explore the potential of NAD and methylene blue by incorporating foods rich in precursors and natural enhancers into your diet. For NAD, focus on foods like dairy milk, fish, mushrooms, and green vegetables, which contain nicotinamide riboside. To potentially benefit from methylene blue's cognitive effects, consider safely increasing foods that promote oxygen delivery, such as beets and leafy greens, while engaging in regular brain-stimulating activities like puzzles or learning a new language.
- Create a nightly routine that includes glycine-rich foods and relaxation techniques to improve sleep quality and recovery. An hour before bedtime, consume a small snack that includes ingredients like bone broth or spinach, which are natural sources of glycine. Pair this with a relaxation practice such as progressive muscle relaxation or deep breathing exercises to calm the nervous system and promote restorative sleep.
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Overview of peptides and their uses for mental health, physical health, and performance
Peptides, which are small chains of amino acids, play numerous roles in the human body, influencing mental, physical, and cognitive functions.
Peptides are small chains of amino acids that can have diverse effects in the body
A peptide is essentially a small protein, and our bodies contain thousands of different peptides, each with a unique function. There are about 300,000 different peptides that the body makes, and therapeutically, approximately 150 are utilized. They are simply chains of amino acids that can target and augment specific biological pathways related to various aspects of health and performance.
Peptides sit between basic lifestyle factors and more advanced hormone therapies
Andrew Huberman notes that his overall well-being—encompassing physical health, mental health, and performance—improves when he takes AG1, a nutrient mix including adaptogens. These adaptogens are often found in insufficient quantities in food alone, suggesting the importance of such compounds for foundational nutritional needs.
Peptides and related compounds offer a middle ground between solely focusing on diet and exerc ...
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Overview of peptides and their uses for mental health, physical health, and performance
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Clarifications
- AG1 is a nutrient mix that includes adaptogens. Adaptogens are natural substances that help the body adapt to stress and maintain balance. They are known for their potential to support overall well-being by enhancing the body's resilience to various stressors. AG1, by containing adaptogens, can potentially contribute to improving physical health, mental health, and performance by supporting the body's ability to cope with stress and maintain equilibrium.
- Peptides are short chains of amino acids, while hormones are signaling molecules that regulate various physiological functions in the body. Peptides typically act as messengers in the body, influencing specific biological pathways, whereas hormones have broader regulatory roles. Peptides are often involved in more localized and specific actions, while hormones can have widespread effects throughout ...
Counterarguments
- The claim that there are about 300,000 different peptides in the body may be an overestimation or simplification, as the exact number can vary and is subject to ongoing research.
- While peptides may not shut down the body's natural hormone production, their long-term effects are not fully understood, and they could potentially have other unintended consequences.
- The therapeutic use of approximately 150 peptides suggests a growing field, but it also indicates that the majority of naturally occurring peptides do not yet have a clear therapeutic application.
- The effectiveness of AG1 and adaptogens for overall well-being is not universally accepted, as the evidence for adaptogens is mixed and may not be as strong as suggested.
- The idea that adaptogens are often found in insufficient quantities in food could be challenged by advocating for a balanced diet that may provide adequate levels of these compounds without supplementation.
- The notion that peptides are a middle ground between lifestyle factors and hormone therapies oversimplifies the complex landscape of medical interventions and may not account for ot ...
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Specific peptides discussed, including GLP-1 agonists, BPC-157, and growth hormone secretagogues
Craig Koniver, Andrew Huberman, and Dr. Conover delve into the therapeutic potential of various peptides such as GLP-1 agonists, BPC-157, and [restricted term] secretagogues, highlighting their unique attributes and applications.
GLP-1 agonist peptides like semaglutide and tirzepatide have become popular for weight loss
Semaglutide and tirzepatide, as GLP-1 agonist peptides, were originally approved for glucose control in type 2 diabetes but became popular for weight loss due to observed side effects. These drugs are now FDA approved specifically for weight management and have been compounded to make them more affordable. With microdosing and gradual increases, practitioners like Koniver aim to reduce side effects like muscle loss, emphasizing the importance of protein intake and resistance training.
Microdosing and gradual increases in GLP-1 agonist peptides can help prevent side effects like muscle loss
Craig Koniver discusses compounded semaglutide and tirzepatide, aiming to help patients lose weight at a healthy rate while mitigating side effects such as nausea through microdosing. By allowing less than two pounds loss per week, he ensures muscle mass retention along with weight loss.
BPC-157 is a highly anti-inflammatory peptide that can accelerate wound healing and recovery
BPC-157, known for its strong anti-inflammatory properties, is used widely by Koniver's patients for conditions ranging from joint pain to gastrointestinal issues. It has shown improved results with injection over oral administration due to its systemic effects. Koniver reveals that BPC-157 can be administered directly into tendons, unlike steroids, and upregulates [restricted term] receptors, enhancing the efficacy of [restricted term] secretagogues.
BPC-157 may also upregulate [restricted term] receptors, allowing it to work synergistically with [restricted term] secretagogues
Koniver notes synergetic effects of BPC-157 when combined with [restricted term] secretagogues, as it makes [restricted term] receptor binding more efficient. Hence, while BPC-157 alone is beneficial for healing ligaments and tendons, its combination with [restricted term]-releasing peptides enhances its healing properties.
[restricted term] secretagogue peptides like ipamorelin, tesamorelin, and hexarelin can boost natural [restricted term] release
Koniver and Huberman explore the benefits of [restricted term] secretagogue peptides, which stimulate the body's natural ...
Here’s what you’ll find in our full summary
Specific peptides discussed, including GLP-1 agonists, BPC-157, and growth hormone secretagogues
Additional Materials
Counterarguments
- GLP-1 agonist peptides for weight loss may not be suitable for everyone, and long-term effects are not fully understood.
- Microdosing strategies, while potentially reducing side effects, may not be as effective for all individuals and could lead to slower progress than some patients desire.
- The use of BPC-157, while promising, is not fully supported by large-scale clinical trials, and its long-term safety profile is not well-established.
- The claim that BPC-157 upregulates [restricted term] receptors and its synergistic effects with [restricted term] secretagogues may not be universally observed and requires more scientific validation.
- [restricted term] secretagogue peptides may carry risks of side effects and long-term health implications that are not fu ...
Actionables
- You can track your body's response to peptide supplementation by keeping a detailed health journal. Start by noting your baseline weight, energy levels, and any pre-existing conditions. As you begin taking peptides, record daily entries on your dosage, any physical changes, side effects, and overall well-being. This will help you notice patterns and adjust dosages as needed, ensuring you're using peptides like GLP-1 agonists and [restricted term] secretagogues effectively for your personal goals.
- Consider integrating a balanced workout routine that combines strength training and cardio to complement peptide use. Since some peptides may influence muscle growth and fat loss, creating a workout plan that targets these areas can enhance the effects. For instance, on days you focus on endurance, align your peptide regimen that supports energy and endurance to maximize the benefits of your training.
- Engage wit ...
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The regulatory landscape around peptides, including FDA bans and restrictions
The Food and Drug Administration (FDA) has taken action against several peptides, prompting discussions on the complexities of regulation, safety, and the pharmaceutical industry's interests.
The FDA has recently banned or restricted the use of several peptides, including BPC-157, CJC-1295, and thymosin alpha-1
In October of 2023, the FDA listed many peptides, such as BPC-157, on a category two list, effectively removing them from the legitimate compounding market. Additionally, peptides such as CJC-1295 and thymosin alpha-1 have faced similar bans or restrictions. Thymosin alpha-1 was widely regarded as effective for immune modulation and used in treating autoimmune diseases and long COVID, but now it has been "nuked" by the FDA. Although CJC-1295 was once banned, it and thymosin alpha-1 are again allowed for prescription.
Despite the FDA's action on certain peptides, alternatives such as Hexarelin remain available. Hexarelin does not stimulate appetite and is sometimes used in the morning to help with waking up. However, rumors suggest that the ability to compound GLP-1 peptides might be removed, leading to potentially higher costs if not covered by insurance.
This has led to the development of alternative peptides like pentadecapeptide that may have similar effects
After the restriction of BPC-157 by the FDA, alternatives such as pentadecapeptide are gaining attention as potential substitutes because they may offer similar benefits and are still available for compounding.
The banning of peptides by the FDA appears to be a complex issue, with potential factors including both safety concerns and financial interests of pharmaceutical companies
Andrew Huberman and Craig Koniver discuss the role of safety concerns and financial interests in the banning of peptides like MK677, Thymosin alpha-1, and BPC-157 by the FDA. They question whether the FDA's actions are completely in the interest of public safety or if pharmaceutical companies' desires to profit from these compounds play a part.
Physicians who work with peptides emphasize the importance of obtaining them from reputable ...
Here’s what you’ll find in our full summary
The regulatory landscape around peptides, including FDA bans and restrictions
Additional Materials
Counterarguments
- The FDA's actions may be primarily motivated by safety concerns due to insufficient evidence of efficacy and potential side effects, rather than financial interests of pharmaceutical companies.
- The FDA's restrictions on peptides could be seen as a measure to ensure that only well-studied and proven treatments are available to the public, which is in line with their mandate to protect public health.
- The availability of alternatives like Hexarelin and pentadecapeptide may indicate that the FDA is not opposed to peptides in general but is specifically concerned about the safety profile of certain compounds.
- The FDA's regulatory actions could encourage further research and development to ensure that peptides meet safety and efficacy standards, which could ultimately benefit consumers.
- The suggestion that pharmaceutical companies' financial interests are a factor in FDA bans may overlook the complexity of the drug approval process, which includes rigorous testing and review.
- The concerns about endotoxins in peptides from unregulated sources highlight the importance of the FDA's role ...
Actionables
- You can enhance your understanding of peptide regulations by creating a simple spreadsheet to track the status of various peptides, noting which are banned, restricted, or available by prescription. This will help you stay informed about legal changes and ensure you're discussing only permissible substances with healthcare providers. For example, you might have columns for the peptide name, current legal status, approved uses, and any notes on rumored or upcoming changes.
- Develop a habit of researching the background of compounding pharmacies before obtaining any peptides to ensure their credibility and safety standards. You could start by making a checklist of criteria such as certifications, reviews, and testing practices that a pharmacy must meet before you consider purchasing from them. This proactive approach can minimize the risk of encountering harmful endotoxins or substandard products.
- Consider setting up a monthly budget f ...
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Alternative compounds used to support health, such as NAD, methylene blue, and glycine
The podcast featuring Andrew Huberman and Dr. Craig Koniver delves into the world of health-supportive compounds like NAD, methylene blue, and glycine, discussing their transformative effects on patients and exploring their applications and mechanisms.
NAD infusions have had transformative effects on many patients' health and energy levels
Andrew Huberman and Craig Koniver discuss the impressive impact of NAD infusions on health, referring to the compound’s ability to enhance mitochondrial function and electrone flow, leading to substantial improvements in energy levels.
The exact mechanisms behind NAD's broad benefits are not fully understood, but may involve supporting mitochondrial function and reducing inflammation
Koniver explains how NAD is related to mitochondrial health and is used in the process of making ATP, emphasizing that efficient electron flow is crucial for energy production. The discussions around NAD include its original use in the 90s for substance abuse treatment and its significant effects on patients, surpassing any other agent they have used. However, they also admit the exact biochemical mechanisms behind NAD's broad benefits are not yet fully understood.
Huberman shares his own experience with an NAD infusion during his bout with COVID, resulting in a marked improvement in symptoms and wellbeing. Koniver has seen similar transformative effects on patients with various clinical conditions. They further discuss the use of NAD infusions in specific dosages and the administration methods that have evolved during the COVID-19 pandemic, recognizing the treatment's psychological impacts and communal aspects in a clinical setting.
Methylene blue can enhance oxygen delivery and mitochondrial efficiency, potentially improving cognitive function
Methylene blue emerges as a topic of interest due to its ability to bind to cytochrome C oxidase and enhance mitochondrial efficiency and oxygen delivery, which can subsequently improve cognitive function.
Methylene blue is an older pharmaceutical compound that is gaining renewed interest as a performance-enhancing supplement
The conversation touches on methylene blue's history as the first pharmaceutical prescribed in the United States and its recent resurgence as a supplement. They mention its applications, side effects, and benefits, as well as its potential antiviral properties and use as a cognitive stimulant. The compound's dosing and administration methods, including ora ...
Here’s what you’ll find in our full summary
Alternative compounds used to support health, such as NAD, methylene blue, and glycine
Additional Materials
Counterarguments
- NAD infusions, while promising, require more rigorous clinical trials to validate their efficacy and safety for widespread use.
- The exact mechanisms of NAD's benefits are not fully understood, and attributing broad health improvements to NAD without more evidence could be premature.
- The psychological impacts and communal aspects of NAD infusions could be influenced by placebo effects or the setting in which the treatment is administered, rather than the compound itself.
- Methylene blue's effectiveness and safety as a cognitive enhancer need more research, especially given its potential side effects at higher doses.
- The renewed interest in methylene blue as a supplement should be approached with caution, as self-medication can lead to misuse and unexpected interactions with other medications.
- The antiviral properties of methylene blue are not yet conclusively proven in humans and should not replace established antiviral treatments without further evidence.
- Glycine's calming effects and benefits for ...
Actionables
- You can track your energy levels and sleep patterns to see if dietary supplements might benefit you. Start a journal to record your daily energy levels, sleep quality, and any feelings of inflammation. After a few weeks, review your notes to identify patterns and consider if supplements that are known to support mitochondrial function, like over-the-counter NAD precursors or glycine, might help address your specific issues.
- Experiment with blue light exposure to potentially mimic some cognitive benefits of methylene blue. Use a blue light filter on your devices in the morning to expose yourself to blue wavelengths that could help wake up your brain. In the evening, switch to a warmer light setting to avoid disrupting your sleep cycle, as methylene blue is thought to influence mitochondrial efficiency which is closely linked to circadian rhythms.
- ...
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1-Page Summary- Overview of peptides and their uses for mental health, physical health, and performance
- Specific peptides discussed, including GLP-1 agonists, BPC-157, and growth hormone secretagogues
- The regulatory landscape around peptides, including FDA bans and restrictions
- Alternative compounds used to support health, such as NAD, methylene blue, and glycine
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