Boost Your Longevity With Peptides

Suzanne J. Ferree, MD, FAARM, ABAARM

Thank you, Jen. It was great to meet you.

Jen Pfleghaar, DO, ABOIM

Let’s dig in a little bit. Why did you get into peptides? You are well-known in the peptide community. We were talking about this a little bit before you took back your maiden name, and your name was Suzanne Turner. People might have heard of you on the podcast before, and then they’re like, now I recognize you. Tell us how you got into peptides.

Suzanne J. Ferree, MD, FAARM, ABAARM

I had injured my hip, so I was a competitive runner for a while and was injured. It’s a condition called Trendelenburg, where the glute just turns off. A lot of runners will end up with a high-hamstring injury because of this. That is difficult to repair because it requires a multidisciplinary team to resolve it. I was desperately trying to find a way to correct this problem. went to an off-shoot breakout session at the A4M meeting where they talked about a mechanic growth factor, and they were presenting a research study that had been done on the benefits of making a growth factor supplemental or exogenous in humans. I said, What is this magical world of things that we have that I haven’t heard of before? And started looking for ways to learn more about what was available. Of course, I went to Google Scholar and began to research. Then, A4M did their peptide courses, and being one of the first in the peptide course, I was invited to start speaking for them. That was a tremendous blessing. I love teaching, and it’s part of my genetic makeup; it was fun to be part of that.

Jen Pfleghaar, DO, ABOIM

That’s so great. It’s a little bit silly because we’re not taught these things in medical school. I even have some patients who are physicians, and I talk to them about peptides, and they’re like, Wait, what? It’s just because they work so well. I guess what we can say with that. It’s so great that you turn a corner and that that works much where conventional medicine is not working for doctors. They’re like, why can’t I fix this with conventional medicine? Then we start to look into other things that are not taught in medical school.

Suzanne J. Ferree, MD, FAARM, ABAARM

There’s always a patient who is sick. Then, the first thing I found out about was that,  just in thinking about thinking outside the box, there were bioidentical hormones, of course. That’s our toe in the water for a lot of people. You get a good number of those unwell patients better by treating them with hormones. Then you still have a cadre of patients that aren’t getting better with conventional things. You start saying, “What else do I need to do to get them better?” Peptides were a beautiful add-on to the things that we were already doing to try to help patients get better. Of course, realizing that people are where they are on their journey and they’re going to get better at their pace, and maybe it’s while they’re working with you, maybe it’s while they’re with another provider. But having another tool in your arsenal can be super helpful in getting people better. 

Jen Pfleghaar, DO, ABOIM

That’s a great point. Sometimes it can move the needle, and I’ll see that, and I’ll even talk with patients about that. Be like, let’s just work on the basics. Let’s work on the foundation and gut health. But we have another thing—another tool—in our toolbox. Sometimes it can be intimidating because peptides are a little bit expensive. Most of them are injections. Sometimes that can scare people off. But you have to let them know that other things can move the needle if they’re stuck or not getting better as fast as we want.

Suzanne J. Ferree, MD, FAARM, ABAARM

It’s what I love about the FDA coming down on some of these things recently: it’s making us more innovative, and so we’re being innovative with oral options. We’re being innovative with smaller peptides like bio,

Jen Pfleghaar, DO, ABOIM

Bioregulators.

Suzanne J. Ferree, MD, FAARM, ABAARM

Bioregulators Yes. By regulating peptides so that we can do them orally and then we’re able to affect a lot of change, that’s just different than what we’ve been doing so far. I love this as much as it’s been disappointing and discouraging. It’s also been exciting because it means we get to be innovators in this space again, as opposed to being stagnant and saying, Let’s do something. This is great because as we continue, we get to continue to grow and learn as well.

Jen Pfleghaar, DO, ABOIM

That’s good for brain health. Just mean pathways, and I was talking with the compounding pharmacist I use, and she’s like, don’t stress about this. We will figure this out. That made me feel a lot better. We were all panicking last fall, but it’s all good. Let’s talk about these peptides and what the best peptides are for longevity.

Suzanne J. Ferree, MD, FAARM, ABAARM

There are a couple of things that we do, probably starting with the growth hormone secretagogues where we’re going to land. This is the foundational basis of everything that we do. I’m going to treat patients starting from their gut. So that’s where we’re going to go. I don’t mean to say that peptides are a panacea. I’m getting that they need to get sleep. They need to manage stress. They need to be eating properly, and getting adequate protein intake. They need to be managing their relationships positively. There are so many baseline things that need to be happening for people to be successful in their health. They need to be bought in. We want to make sure that patients are engaged in what we’re doing. But once we get all of that going, there are also our patients who don’t and who need a little adjustment on top. I’m going to start those patients with some growth hormone secretagogues. I’ll typically draw their blood ahead of time. I want to do an IGF1. I want to see an IGF-binding protein-3 because I want to make sure they have adequate binders in case they get too much production. So as long as those are adequate, then I’m going to go ahead, and there I’m getting, excessive or not. In the IGF1, I’m going to go ahead and prescribe them. I prefer using Tesamorelin. as one of my favorites, it’s FDA-approved which helps me to be able to use it more comfortably. I’m going to have a conversation with all of these patients where I say, Look, these are, except for Tesamorelin, and these are not FDA approved.

Many of them have few human studies. Again, except for the Tesamorelin. So, there are no guarantees of outcome. These are conversations I have with every patient as they come through the door. Then we talk about what these things are doing at a cellular level, based on the research that I’ve done. I know how growth hormones and IGF1 are working in the patient’s cells. I know what we’re trying to accomplish. We’re improving the way that the cells work in general in the whole body. We’re going to start with the growth hormone secretagogues. If we’re using something like Sermorelin, we’ll be doing that a couple of times a day using the Tesamorelin, and we can get away with it once a day, which improves compliance for most patients. I’ll start with that. Of course, there are a couple of new ones that are on the way too, and that are being researched right now. So those are what’s exciting. As I mentioned before, that’s where I’m going to go right now: to Sermorelin or Tesamorelin because they also don’t have to be so tight about fasting when they’re using Tesamorelin. We do monitor about every three months their, IGF1 levels. All I’m looking for is that they’re not going high. If they do go excessively high, which for me is anything over 270 or something like that, and that’s not excessively high. It’s just that I don’t want to even have the thought or I don’t even want to worry about that.

If they head in that direction for about three months, I’m going to drop their dose back down again. Also, before we start anything, I’m going to ask them if they have any personal history of cancer. If they have active cancer right now, I’m going to ask that they manage that first, and then we can go back to using them. There are things we can do, but that’s another podcast for another time. but that’s where we’ll start for longevity. We know that these are improving the way that cells can use and create energy for themselves, that we’re changing the efficiency of the cell in general—the heart, the liver, the kidneys, the muscle. An exercising person taking in a nutritious diet, sleeping regularly, and taking growth hormone secretagogues should have a very positive body composition benefit as well as improve the way that the cells can create and use energy. That would be our first step in improving longevity. The second thing I would do is figure out a way to improve their thymus gland function, because we know, especially with the big pandemic we just had, that patients are having, that their thymus glands are replaced with fat as we age. They’re less able to produce the thymic peptides that we naturally need, the ones that have been available for a long time, thymosin alpha-1 and thymosin beta4. Those are naturally occurring peptides that we have created in a lab. These are produced in fewer amounts by the thymus gland as we age because of that increasing thymic fat fraction.

We know one of the things that growth hormone secretagogues do is increase the production of those peptides from the thymus gland because we have less thymic fat, and that is very exciting. We’re killing two birds with one stone by using the growth hormone secretagogues. But we’re working on that immunosenescence by using some thymus glands; the peptide health genomics are great ones. That’s a thymosin oral; that’s a thymus beta-4 fragment. Others make peptide fragments that we can certainly use. And then, if there are sources that we can find, some places will still be making those other thymic peptides that we can use. There’s an organization that we belong to called the Global Provider Alliance that allows us to get access to Thymus and Alpha-1 for our patients who have no other options and need this medication for wellness. If you don’t know about the Global Provider Alliance, feel free to reach out. To me, it’s a great group where you can get access to it for your patients. 

Jen Pfleghaar, DO, ABOIM

That’s amazing. Thymus and Alpha-1 got a lot of sick patients, clear, during the pandemic and helped a lot. So that is off, like from compound pharmacies, they can’t produce them in the US anymore because it’s now a patented medication. It’s a little frustrating when we have these tools. They were taken away. Then you have these conversations with patients, and you’re like, we could try something similar, that’s oral, but it’s not going to work as well. Let’s go back to the growth hormone a little bit. Why would they want to take the growth hormone secretagogues? Does growth hormone decrease as we age? Why is this different from the growth hormone that says that some bodybuilders have taken? Because some people think that it might have a bad rap to it.

Suzanne J. Ferree, MD, FAARM, ABAARM

Growth hormone is not what I’m talking about. For you to produce growth hormone, you have to have a growth hormone secretagogues. So it’s a growth hormone-releasing hormone. What we’re talking about is using Sermorelin/CJC-1295 and Tesamorelin are growth hormone-releasing hormones, they are analogs of our natural, and most of them are within 90% of the same. They are just modified slightly to protect them from being destroyed by the enzymes. DPP-4 is one of them that breaks down the growth hormone-releasing hormone in the body. So these are modified to protect them from DPP-4. One of the reasons you wouldn’t want to use growth hormone specifically is that there are around 100 variations of growth hormone in the body. When you’re taking a synthetic growth hormone, you’re only taking one variation of that, so you’re missing the other 99 that are very important in the way your body functions. We have a patient right now who has Sheehan syndrome, which is the condition of death of the pituitary gland due to a decrease in blood supply during pregnancy and the loss of blood that occurs with pregnancy.

So she’d been on growth hormone for years because of this. We were able to get her off growth hormone and get her pituitary to make growth hormone again by using the growth hormone secretagogues. It has been so exciting to work with her. She’s been fully bought in on all the things that we’re doing, and it’s been fun to watch her be successful and to come to a place of greater health because of this great thing that we have, these things that we have available. The problem with using growth hormone is that most of you’ll see that most bodybuilders use it. They’re using it in doses that are super physiologic or higher than what you would naturally make on your own. You can get growth hormone by secreting growth hormone itself. but it’s not exactly what your body makes. All I’m trying to do is increase your body’s ability to make its growth hormone. You mentioned it a minute ago. Do you decrease your growth hormone production as you age? There are research studies out there showing that as we age and as we decrease our growth hormone, our risk of death from all causes goes up. There’s evidence that doing some supplementation can be beneficial for all kinds of people. Again, most of the research is done on animals. So although there are research studies in humans demonstrating that a low growth hormone level increases the risk of death from all causes, research is still being done on these other peptides. So it’s exciting to be part of this, leading the way in helping this move the needle. As you suggested, it is a little frustrating that we have this setback where we have less access because of the FDA. Keep in mind that the FDA has not taken these off the market because of adverse side effects. There are other reasons that I could speculate on, but I will leave that to others to figure out.

Jen Pfleghaar, DO, ABOIM

What’s great about it is that peptides work with your body. They’re chains of amino acids. It’s not like you’re getting a drug that’s changing the processes in your body. That’s why I like peptides because they’re more natural. That’s why you see functional and integrative practitioners; doctors are obsessed with them because we’re staying with them and working with your true body. That’s why we see so much healing with them. Honestly. They’re great.

Suzanne J. Ferree, MD, FAARM, ABAARM

Growth hormones can cause high cortisol, which can cause high blood sugar. It can cause that small intestinal over that small intestinal, hypertrophy.  It can be that there can be lots of problems with them. But if I’m giving you a growth hormone to repeat on, all I’m doing is, when it’s time for you to release growth hormone, you will release the maximum amount that your body can make of it, as opposed to a smaller, lower dose that you would produce without.

Jen Pfleghaar, DO, ABOIM

Let’s talk about perimenopause. This is such a long time for women. I always have this discussion with my patients. I’m like, It’s a long journey. It could be a decade that we’re in perimenopause, and women are struggling with this. How can peptides help?

Suzanne J. Ferree, MD, FAARM, ABAARM

One of the things I’ve read up on recently is how many women have gotten pregnant later in life. So, that is possible. The farther along we go, the better we’re able to do. Being able to have things like growth hormone secretagogues, things like Gonadorelin, which is a gonad-releasing hormone, and FSH LH encouraging hormone, in the same way, that the growth hormone secretagogues are, can help keep and allow people to be able to reproduce into later life and to stabilize that hormonal imbalance period that you go through so that you’re not chasing it all the time. One of the things that we as doctors do is give you a dose that’s going to keep your dose here. But your body’s going to produce hormones in and out of that. Your total level is going to go up and down. It’s very frustrating for patients, frustrating for private providers, or sad for providers because I want you to have this very helpful thing, but not all the time. 

You’re going to get that when you’re using bioidentical hormones alone. Sometimes you think of a growth hormone—you know, something like Gonadorelin, even this peptine which is even harder to find right now—but this peptine where you are allowing patients to have the production of their hormones. That’s our goal. How do I allow you to produce your hormones? We can use things like HCG, which is also difficult to access. It is FDA-approved, but it’s only for infertility at this point. We can certainly use oral things like Enclomiphene. Those are also available, which can also help with improving the release of hormones from the brain. I do think the peptides work the best. That’s where I would go if I could treat it. These are cycling and you’re not going to use them constantly. I hope that we can get patients to work with a provider who is trained in using these, as opposed to just going on the black market and getting them. We know that a lot of the adverse effects that we see are from patients using that.

Jen Pfleghaar, DO, ABOIM

That’s a great point to make because compound pharmacies, they sterile, they test the batches to make sure they are what they say they are. If you’re purchasing peptides online and mixing them yourself at home, it could get a little bit scary. You don’t always know what you’re getting, especially if you’re getting them overseas, from China, or something like that.

Suzanne J. Ferree, MD, FAARM, ABAARM

We did have, a drug rep who came in this past week and was trying to tell us about how compounded medications are not FDA-approved. I wanted to be very clear that the source of the peptide that the compounding pharmacy gets has to come from an FDA-approved facility. The FDA goes to China, or wherever the compounding pharmacy is used and has the facility. You, the compounder, can’t use a source that is not FDA-approved. While it is specifically made for you as the patient, rather than being made unmasked for a group of patients or a population, it is from an FDA-approved source.

Jen Pfleghaar, DO, ABOIM

That makes a lot of sense. That’s the raw material because the compounding pharmacy has the raw material and then makes it a specialty for you. That’s because compounding pharmacies have different levels too. There. Some are not approved to make peptides. They may just make bioidentical hormones. I find that confusing for my patients. Sometimes they’re like, Wait, why can’t we use the local compounding pharmacy? I’m like, well, they don’t make peptides. We have to go; you have to get it shipped, so that’s another thing to bring up. But you can get them on the Internet. It’s just that you don’t always know the quality, and you’re injecting a lot of these into your body. For me, that’s just a little scary.

Suzanne J. Ferree, MD, FAARM, ABAARM

Especially because the method of creation of the peptides requires them to be attached to a resin for them to be made. If that resin is retained in the injectable solution and you inject it, it is liver-toxic. Keep in mind that the way they create these peptides requires them to be made with a toxin. The toxin in the right pharmacy is then removed from the solution, and they are tested for that to be removed from the solution. Not all of the labs that are in the world use that process or are as stringent with that process as the compounding pharmacies are required to be. When I say things like, there’s a new growth hormone secretagogues that are coming out soon, that’s because it’s still in testing and they will not release it until it has been proven to be clear of that resin and other toxins that could be there.

Jen Pfleghaar, DO, ABOIM

We don’t want liver-toxic things going on. There’s enough toxic exposure in the world. Are there any other peptides for perimenopause that you would like to use?

Suzanne J. Ferree, MD, FAARM, ABAARM

I like B-FIT  it works well not only for sleep, which is what’s in the thought process around it, but it can also improve the release of LH. So it’s not going to help with things like male infertility if your sperm count is a problem, but it may help with the release of estrogen and progesterone from the ovaries if that’s part of the problem. Working with those patients, we will use growth hormone secretagogues as well. Some of the pharmacists and two of the providers will directly inject growth hormone into the ovaries. That’s above my pay grade at this point. But there are a few providers that are doing that for fertility reasons. We have great success using growth hormones to release hormones. Now, keep in mind that none of these are safe in pregnancy or have been studied to be safe in pregnancy. I’m going to make patients if they’re going to come to me for their infertility, they’re going to have to come and use some alternate form of birth control. My preference would be something like a copper IUD with no hormones. Do some protection against pregnancy during the time we’re treating them and then wait a few months before they try again, purely because I want to make sure that their bodies are clear of it before they attempt conception. We just don’t have enough research to show they’re probably safe. I just don’t have any research to show that. I don’t want to put their baby at risk.

Jen Pfleghaar, DO, ABOIM

That’s cool. Because in Northwest Ohio, there are just fertility centers. There are a lot of them; it’s just that they push a lot of IVF. I wish they were doing stuff like injecting ovaries with growth hormone. That’s cool. It’s great to know there are other options out there for those who are struggling with infertility, or, like you said, even just maybe waiting until later in life to have children.

Suzanne J. Ferree, MD, FAARM, ABAARM

It’s exciting.

Jen Pfleghaar, DO, ABOIM

Now what peptides are good for women who like to lift, or you could tell your personal story. You’re this awesome powerlifter. Because I preach to my patients and women in my groups that we need to lift weights as women. It’s going to help with your insulin sensitivity. It’s going to make you look leaner and burn more fat. You’re not going to look like a man or be bulky. even with peptide use. What do you suggest for your women who like to lift?

Suzanne J. Ferree, MD, FAARM, ABAARM

I can’t tell you how many times I’ve had that very conversation with my patients who come to me in their 50s and they say, or 40s and they say, “Look, I’m just having trouble losing weight, and I don’t know what I’m going to do. I do cardio all day long, and I do two hours on this, two treadmills, and whatever. I’m still having trouble losing weight.” I say, I know that you’re going to fight me on this, but I want you to know that that resistance exercise is critical for us. And then, without fail, they all come back to me in the end and say, You were right. This is how I was able to lose weight. This is how I was able to get the body that I’m looking for. Because what they’re looking for is that lean look. The only way to get that lean look is to do resistance exercises. You do not have to lift heavy weights. That’s what I do because I don’t want the focus of my exercise to be how I look. I want the focus of my exercise to be strength.  I love that I’m a little bit of a challenge. So I love having that number to shoot for that goal of, now I can lift 100 pounds, I can lift 105 pounds, now I can lift 108 pounds. I’m seeing progress, and that makes me feel like I should stick to it because I can see progress. If I’m treating patients who are doing things like that, one of my favorites for this is the unsung hero, oxytocin. I love this, especially for women. I love oxytocin as an anabolic hormone. I say that with the gentlest heart that I can around the word anabolic because most people are afraid of anabolic steroids because they’ve been abused for so long. This is not something I would talk about abuse. What we’re trying to do is change your body composition so that most of what you’re dealing with is a leaner, fitter body, that is, a lower percent body fat, because we’re trying to get rid of that toxic fat around the organs when you have a high percent body fat.

I have a lot of patients who are this way and have 30 or 40% body fat, but they’re very thin. These patients are unhealthy even though they appear to be healthy. What we want to do instead is give them the ability to have that lean appearance and that lean look. What you’re looking for is the definition in the muscles—the definition of your legs. Even though we’re not talking about bulking, we’re talking about using a smaller amount of the way that you train, the years of training that mean whether or not you bulk up, and then also the things that you add to what you’re doing, the foods that you eat, etc. Keep in mind that if you’re going to be training heavier or harder using resistance, you need to eat more. This is one of the harder things for most of my patients to do. To convince them, I need you to increase your caloric intake. If you’re going to be doing resistance exercise training, you need to increase your calories. There was a great study done recently. I don’t know if you follow Bill Campbell, PhD, on Instagram. He’s awesome if you don’t. He showed us in this study that if women who are doing regular resistance training increase their protein and their total caloric intake by 300 calories per day, they will lose weight. We’re, but those are protein calories. If you increase your total calories and protein calories by 300 calories per day, patients will. Women who are exercising regularly will lose weight. So that’s been what we’ve been preaching at the practice for the last several months since that article came out. It’s very exciting to know that we have something to back it up, and it’s exciting to see it bear out in our patients as well, that they can increase that without gaining weight. They’re able to work on their bodies. They’re not being catabolic or breaking down all those muscles. It’s exciting to watch.

Jen Pfleghaar, DO, ABOIM

When I hit age 42 years ago, I’m like, I’m concentrating on heavy weights. I recovered from having my last baby. Just tons of focus on protein. I’ll have people say, You look great. Your body has changed, and the scale hasn’t much. But I’m more muscle. My goal for this year is to do an unassisted pull-up. I tend to have some junk in the trunk. It’s a little bit harder for me, but I do. I need to lose a little bit more body fat to hit that goal and gain upper-body strength. But it’s a fun goal. Protein is so important, and I love that study. I’ll have to grab it so I can tell my patients about that. Because my family thinks I’m a little silly. I was visiting my parents, and I was like, What’s the protein that we’re eating? Because we had a condo, we were eating it. My parents thought it was a joke by the end of the day because they knew that I needed my protein and that it was important to me now. You could do silly things like make chicken crust pizza. My kids will have pizza, and my husband and I’ll have a cauliflower crust, and I’ll have a chicken crust. Yes, ladies, I love that. Have the protein. Now, how does so much oxytocin work? I’m curious, how do you do that for your more powerlifters, and how frequently do you menstruate versus non-menstruating women too?

Suzanne J. Ferree, MD, FAARM, ABAARM

You’re going to do it up to four times a day. The weight-loss dose is four times a day. There are human studies out there about that. I’m going to probably dose it in the 20 units. This is where it gets a little confusing. Oxytocin is in international units. Instead of milligrams, it comes in international units. Then you’re talking about units on the syringe. I’m going to talk about international units, which are the milligrams of oxytocin. I’m probably going to use around 20 international units of oxytocin for patients. depending on their size, where we’re going, and what our goals are. We’ll adjust that. But that’s a good starting point for most of my patients. is where I’ll start, people. I love doing that immediately following a workout. That’s where you’re going to see the anabolic benefits, the growth benefits, and the muscle growth benefits. You’re not getting that catabolism that can occur because you’re not eating enough or whatever afterward. We have a lot of our patients who are taking semaglutide and those kinds of weight loss things, and they are not eating enough to maintain their muscle mass, so we’re seeing them lose a lot. One of the reasons I’m grateful for my bioimpedance analysis machine is that we do that quite a bit, which will send them off to Dexa. Federer will do a bioimpedance analysis. They are so helpful because you can see them losing or gaining muscle mass. So we tell them ahead of time, look, if you’re not losing muscle mass, we’re not going to continue this medication. You’re going to have to give it a break for a month, and then we’ll retest and restart. If you’re doing well, then we also give them.

Jen Pfleghaar, DO, ABOIM

Or the GLP ones. I do see too much muscle. You say we have to take a break. 

Suzanne J. Ferree, MD, FAARM, ABAARM

I let them know that ahead of time.

Jen Pfleghaar, DO, ABOIM

That’s an important point to talk about: you have to wake up your patients and say you need to do resistance training. You need to be hitting protein goals of 30 grams per meal, or around 150 a day, or this is not going to work for you. When you get off of it, you’re going to gain the weight back. Because when I have patients on it, it’s short duration. I’m already setting them up for success with gut health and other things that are all working. They’re on it for three to four months, and then they go off. Maybe they’ll gain a couple of pounds back if it’s around the holidays, but it stays off, and that’s the problem. I see ads all the time on my social media for it. Here you can get a script, a doctor, and the peptide for $300. I’m like, but then you’re going to be on it forever because you’re not doing it correctly.

Suzanne J. Ferree, MD, FAARM, ABAARM

Because you don’t have the whole program. That’s part of the deal: there has to be a whole system that’s in place. We’re talking about making sure they’re doing resistance exercises. We’re talking about making sure they’re changing their diet, fixing their gut, and working on their stress. Because all of that is probably a big reason why they’re going to regain. I will wean them off at the end. I find that patients do better if they wean off. There’s so much research with the GLP1 on protection from cardiovascular disease and neurovascular disease that if we have a lot of patients, I’ll just leave them on long-term, especially if they have a family history. We reach their goal. I say, Let’s just drop it down to the very lowest dose. We’ll have you use it every ten days instead of once a week, and then this will be our treatment. There’s no specific research behind this particular protocol. This is just what I do for my patients. But we just drop them down to the lowest dose and have them persist in using that low dose for their cardiovascular and neurovascular protection.

Jen Pfleghaar, DO, ABOIM

Will you stack the oxytocin with the GLP1?

Suzanne J. Ferree, MD, FAARM, ABAARM

For sure, I’d like the ipamorelin with it too, if you can find it. It can help mitigate some of that. reflux, constipation—some of that slowed gastric emptying. Your audience, I’m sure, is aware that there are several ways that the GLP1 work. One is working on slowing gastric emptying, which is the reason why patients get that reflux and uncomfortable symptoms sometimes. and that’s diet-related. I tell patients what they’re telling themselves when they tell me that they’re having that. It also works on the amphetamine receptor in the brain. It works on slowing appetite in the brain as well. So it becomes thermogenic as well as slowing gastric emptying. It’s not just that it makes you have this decreased appetite at the stomach level. It also works on the brain. That’s why, in about 10% of my patients, we see insomnia as a side effect, just like you would see with fentanyl. just like you would see with any of the other stimulants or weight loss medications.

Jen Pfleghaar, DO, ABOIM

I haven’t had any patients who have had that side effect. But they do say it positively. I had someone say it, and I loved how she said it. It reduced the food noise during the day because she was a stay-at-home mom, and she always had that noise in her head about food. She was able to focus on nutritious foods and protein instead of picking up the scraps that were left by the kids. Let’s switch gears a little bit and talk about GHK copper peptides. I love GHK copper peptides. Let’s talk about it topically. That’s all we have right now for 2024. But if you want to talk about the injectable, there are a lot of cool studies on rats with brain injuries and all of that.

Suzanne J. Ferree, MD, FAARM, ABAARM

Yes. it works at the cellular level. This is the bioregulator peptide because it’s under four amino acids that go in and affect the expression of DNA. We know that’s what’s happening. But at the skin level, it’s changing the stemness of your stem cells on the skin. It is improving the way they work. I find it works best if you’re using it with a derma stamp, needling, or whatever. You’re going to be doing a roll or whatever you’re going to use. We use it for our hair as well as for our facial skin. then you can also use it. I use it on the backs of my hands, my forearms, and the tops of my knees. all of that for sun exposure over my lifetime. Because I’m a sun lizard. But I love using those copper peptides. One of my favorites is the Vitali brand. They do a great job because the other things they combine with it help with absorption. There are some hyaluronic acids, some algae, and brown algae, which are moisturizing and hydrating. Those are excellent as far as improving the appearance of fine lines and wrinkles. Then also, I’ve seen some improvement and things like scars. If facial scars are something patients have had around their eyes or whatever, even if they are surgical. If you’ve had microneedling or other procedures that you’re taking, it helps with mitigating some of the side effects from those procedures.

Jen Pfleghaar, DO, ABOIM

It’s great. There were a lot of studies on hair growth, hair follicle size, and wounds, and they did head-to-head studies on wounds. and it worked well. I’ve used it on my kid’s wounds before, trying to delay not having oral antibiotics, just helping with the topical, this weird, like, little abscess he had. It’s great. Unfortunately,  it’s not used a lot in wounds,  which you think it would because it helps bring a little bit of angiogenesis to that skin, which is good for bringing oxygen to the wounds. When you go into chronic wounds like pressure ulcers and all that stuff, that’s important. It used to be injectable, or we used to be able to get that. I wouldn’t use it a lot in my practice. I don’t know if you did or not.

Suzanne J. Ferree, MD, FAARM, ABAARM

We use it a lot for joints. If they were, if patients were having osteoarthritis or chronic tendon injuries, we’d use it around the joint, either subcu. I wouldn’t use it intraticularly. In conjunction with other peptide therapies that we would use for joints, we would be using the GHK as a systemic therapy. We would also do that systemically for patients who are experiencing hair loss; you’re treating for hair loss. and they do great when you can add them to the regimen.

Jen Pfleghaar, DO, ABOIM

It’s so exciting. I love using it post-procedure as you said, and microneedling, lasers are great. Now let’s talk about this book that, at this time, will be out, and it’s called Counterclockwise Book. I’m guessing it’s about longevity and anti-aging. Yes, exactly. it’s exciting. Most of the books that are available right now are directed towards providers. This is directed towards patients, mostly because I feel like most of our consumers because of Instagram, etc., are well educated. They know what they’re going through. They’re coming to their doctors with information. They’ve done their Google search, and they’ve done their Instagram search. So they’re coming to you. We just have to realize, as providers, that’s what’s happening. We want them to come to us. There used to be a clothing store, if you’re familiar with it, called Syms, SYMS. They said an educated customer is our favorite. They had our best consumer, so. An educated consumer is our best customer. That was their tagline. I feel the same way about my patients. I want to love it when they come to me with all of this information. I love to be able to clean it up for them a little bit and then redirect to say,  this is what we should do. Thank you for coming to me about this. I love it when they’re coming to us. This book allows them to see themselves in the place where they might be using peptides. using peptides for migraine, using peptides for weight loss, using peptides for energy, things like SS 31 and Humanin, and using peptides for cognitive health. 

Every chapter is a standalone. They don’t have to read the chapter; the book goes straight from one end to the other. If they have a specific concern, they can go directly to that chapter that’s related. They’ll see some patient stories from my patients, whose names, of course, and some of their details have been changed, but they have all agreed that they can be part of the book. That’s exciting because I love that they’re having such great success that they want to be part of what we’re doing. There are stories in there that explain how this patient came to need this, what their circumstances were, and how we use them. Then there’s a lot of high-level science, and then there’s a lot of deep diving, there in case you are interested. There are a lot of references so that patients if they are curious about that patient, who most of our biohacking community is, will be able to go in and do some research and see what I’m talking about. I tried to keep up with the most up-to-date research that is available on each of the peptides discussed, and there are probably 20 or 30 peptides discussed in the book. And then peptide stacks that they might want to use because a lot of them work better in combination than each one alone. They can be very synergistic as they work together.

Jen Pfleghaar, DO, ABOIM

That sounds amazing. What a good resource! I love that. There are not a lot of good peptide books out there. This is so exciting to have as a resource for patients and practitioners. Everyone probably needs to read this. How can everyone find your book? How can they find you if they want to be patient? How does that work?

Suzanne J. Ferree, MD, FAARM, ABAARM

Finding the book, it’ll be available on Amazon and at local bookstores. Then if you can find me on Instagram @drsferree. Then you can find me at vine, as in grapevinemedical.com.  If you want to be a patient, you can go to vinemedical.com and go to our new patient. There’s a tab to click on to become a patient.

Jen Pfleghaar, DO, ABOIM

Awesome. Thank you so much, Dr. Ferree, for sharing all of your knowledge today at the Peptide Summit.

Suzanne J. Ferree, MD, FAARM, ABAARM

Thank you, Jen. I appreciate your time.