Peptides & Inflammation: Resetting Metaflammation Signaling

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, that’s great. I’m thrilled to be here, and you know, it’s interesting. There’s a lotta smart people out there that are looking at peptides, and you know, obviously, with all the work that’s going on in pharma, the amount of peptides that are in the market, it’s a big growth area for us to be looking at. You know, it’s pretty exciting, right?

Matthew Cook, M.D.

Yeah, it’s amazing. But what’s interesting is in all of these conversations, then once you realize oh, I’ve got all of these arrows that I can use that are kinda therapeutic and interesting, but then how do you, what is the framework, then, that you begin to think about things, and how do you choose which arrows to use when? And so then-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, you know, that’s a big question, right, but I mean, I think it’s probably the most important question. I mean, man, I’ve been doing this work for almost 40 years, you know, seeing three, 400 patients a week in our Ohio Institute and then, you know, still seeing people now a few days a week, and I think it’s important that you get an alignment of where is the person at because, you know, you’re gonna have a lot of arrows, you know, you can pull out, and you can shoot a bunch of really advanced stuff at people, but if there’s not an organizing principle around, what are you trying to accomplish with them? Where’s the most disturbed, what I call metabolic roadblocks, that are affecting the individual? Because a lotta times, if I can do the heavy lifting and correct some things, it becomes much easier to get a person back to what I call homeostasis or that point of what we like to know, you know, is longevity is hey, is that chemistry and biochemistry operating in its best space so that we’re, you know, protecting ourselves, protecting the metabolic processes that are going on as we’re aging, or are we just thinking, “Hey, I’m gonna use some,” you know, “super-peptide that’s gonna protect my telomeres, and that means I’m gonna live forever.” That’s where I think people get into trouble, you know, so that’s kind of the way I look at it is that, you know, how do we look at that process of metaflammation and inflammaging, and then what are the tools and characteristics of, you know, the individual? What tools do we need to apply so that we can begin to, you know, get this person to shift in a direction that’s positive?

Matthew Cook, M.D.

So what is metaflammation?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, metaflammation, what a great. I wish I coulda coined that term, you know what I mean? When I wrote the book “Metabolic Code,” I was talking about metaflammation but, you know, didn’t think enough ahead. So metaflammation’s in the medical literature, as is inflammaging, so basically, your body gets exposed to something, or it could be an innate defect. It could be a genetic predisposition. It could be a stressor, environmental burden. It could be the way you’re eating a certain diet, but for some reason, your body triggers an inflammatory response, and that inflammatory response is supposed to heal the event, and then you’re supposed to go back to homeostasis, or basically your body not being in an inflammatory defense. That’s how your body works. The problem is is that when you get exposed to things, or maybe you’re under a lotta stress, or maybe you have nutrient deficiencies, or for any number of reasons. Maybe you’re just over-training. It could even be something like that, something positive, right? It doesn’t have to be, “Oh, you’re a slug.” It could be something that, you’re working out too much. 

Your body starts to get stuck in inducing too many inflammatory compounds, and that can occur, you know, it’s interesting. When you think of the work of Reckeweg back in the 1950s and ’60s, he talked about this concept of homotoxicology, where the more you triggered inflammation, the deeper and deeper it got into your cells, and that’s what you can think of as metaflammation. So the characteristics of metaflammation are you first start with dyslipidemia. That can occur because maybe you have, you know, inappropriate insulin response, or maybe stress hormones are elevated. You’re triggering inflammatory compounds because of an environmental burden, but you start to see bad actor lipids. The next thing you start to see are shifts in your iron and ferritin, so basically, you upregulate something called hepcidin. You downregulate something called ferroportin, and why that’s important is is ferroportin’s needed to make EPO and make new platelets, and so you don’t make new red blood cells as well. The next feature of this is that because you’re making these inflammatory compounds like interleukin-6 or TNF alpha, you know, things people have heard about a lot, you know, you’re making more of those. Your insulin receptor that is supposed to be functioning to slowly process glucose into your cell and make 38 packets of ATP has to switch the way it makes energy, so with metabolic inflammation, you get changes in your lipids, changes in your iron and ferritin composition. 

You start to become insulin resistant. You start to induce what’s called the Warburg effect, where your body’s making a lot of lactic acid, a lot of tissue acids within the cell. You’re damaging your mitochondria. You’re not making energy the way you should, and then the next step to it, so ’cause this is a process, right? People are moving through time, acquiring and accruing more damage in their cell. Then they start to get problems with neuroplasticity, and they get oxidative damage to their nervous system in their brain, which then creates issues like short-term memory and the kinda systemic neuroinflammation issues that are out there, and why I think peptides hold a lotta value is just for targeting that alone, but then probably most important, a couple other things happen, like you start to lose bone mass as well when you trigger chronic inflammation, but probably the most important is the fact that we start to lose mitochondrial energy production, and we lose our NAD stores in our cells, and that starts to compromise us. Not only are we not making energy, but if we do have an insult like a virus, like what happened with the pandemic, we suck out all that available NAD, and now we start to get into a massive inflammatory cytokine response. So metaflammation is the process of our body unwinding from its point of homeostasis and then moving towards this process of a deeper and deeper-rooted metabolic inflammation that’s going on that leads to tissue and cell damage and inflammaging, or inflammatory aging. I know it’s a long-winded answer, but that’s kinda the process.

Matthew Cook, M.D.

And that is sort of, that’s what we, you and I, see in clinic.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

All the time.

Matthew Cook, M.D.

And then you see, and it’s interesting ’cause you see people, everybody from the teenagers all the way to the people that are in their 80s that are on some trajectory of that spectrum, and you know, and what’s interesting for me, I grew up in Missoula, Montana, you know, and everybody, you know, walked to school and rode bikes, and so I don’t think I saw that except in adults when I was a kid.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right, right.

Matthew Cook, M.D.

But now, you kinda see it everywhere.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, well, absolutely, because I think the exposures are amplified. The, you know, pesticides are amplified. Nobody moves anymore. You walked to school. I walked to school or rode a bike. Now, you know, I’m 61 years old, so you know, back then, I think the bikes, you know, maybe had a steering wheel on ’em even. It was, so the point being is that, you know, I think there’s a lot of forces that work against individuals, and, like, what I try to get them to understand is if you really wanna capture your health, if you really wanna move the needle, it’s work, you know, but it’s obviously worth it. It’s not, and where peptides, I think, help is it gives us an extra shove to get the body to move back into homeostasis, depending on where that person’s at.

Matthew Cook, M.D.

Okay, so then now, before we go into peptides, if somebody’s somewhere on this spectrum, and they’re listening. They go, “You know what, I think I have two or three of those things. I’m kinda, my hemoglobin A1C is a little up. I’m kind of type borderline diabetes. I’ve got some high blood pressure.”

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

What are the three or four things that are your go-to lifestyle modifier?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, 100%, I mean, before I do anything, what I would call more avant garde, the very first thing I’m doing with people is I’m evaluating their sleep and making sure they’ve got deep sleep, and if they’ve got a Loop or they’ve got an Oura ring or they’re tracking their heart rate variability, they’re tracking their sleep pattern, I love that because I can start to leverage well, what did you drink? Did you have wine? Did you have alcohol? What, you know, what’s influencing how you’re sleeping? ‘Cause sleep’s super-important, as we all know. The other one is getting people to move, and I don’t tell people, “Oh, yeah, I need you to walk an hour every day.” I tell them, “Can you move for 10 minutes at one time for me?” You know, ’cause for a lotta people, getting them to do a 10-minute walk is a big deal. Now, obviously, some people can take on more, but I’ll start in 10 or 15-minute increments. I just, “Give me a commitment on what you can do each day,” and then I move that commitment up because we know that you’re going to get better oxygenation, better neurochemical balance in your brain when you start to move, and it changes mood, and you start feeling value and self-esteem. 

Incredibly important. The third piece is trying to clean your diet up, and you know, my father was a world class chef, one of the most decorated chefs in the world, actually, so I’ve been around food my whole life, and then I had to learn about how to eat healthy to go on top of that. So it’s really important that people understand, “You know what, no, you’re not gonna have to restrict every last piece of food you eat. You’re not gonna have to be on a modified FODMAP, GAPS, gluten-free monoelement diet, right, because what I find is that when we, and we may need to start people on a low-lectin, modified low-carb, you know, anti-inflammatory diet, right. We gotta start somewhere with them, but the fact is, people have acquired more of this sensitivity. People didn’t have to eat this way 60 years ago, even 50 years ago. And you look around. Go to Italy. Go to Germany. Eat there. People aren’t having the problems we’re having. Now, it could be, yes, it could be pesticides. It could be the glyphosates, whatever you wanna put your finger on it and say, “Oh, my God, it’s that. It’s all the antibiotics. It’s all the H2 blockers,” whatever, but in the end, I think stress plays a huge role in it, and so I’m really big on educating people on making smart selections about food, realizing there’s a sliding scale of carbohydrates based on their level of activity. If you work out 45 minutes a day, and the rest of the day, you’re sitting on your tail, don’t worry about a pre-workout drink, a post-workout drink, an inter-workout drink, and feeding yourself after your workout. 

You know, I hear this stuff all the time. It’s like, “Really? You’re just working out 45 minutes.” You know, they used to plow fields 12 to 14 hours a day on a meal and a half, so I’m big on trying to get people to eat well. I do a lot of intermittent, I don’t wanna call it intermittent fasting. I like people time-restricting their food, like my grandma taught me. Eat breakfast. Eat lunch. Eat dinner. You know, try to do them between the hours of seven and seven, and then I obviously am a big fan of using the fasting mimic diet kits to help stimulate people’s metabolisms. I mean, you know, I sit on your advisory board, but I’m a huge fan of all the research, and then it gets down to what nutrients do you need to help you out? So I find a lotta people are stressed out, and so I’m big on supporting people’s nervous systems to get them back to being able to make better decisions because it’s very hard to make good decisions about the food you eat. 

Am I gonna exercise? When you’re, you know, you get home at three o’clock, and you look at a bag of tortilla chips, and you wanna huge it, right, because the stress hormones are so high, so I’m big on doing that. I’m big on getting simple things like people’s trace nutrients corrected, especially things like magnesium, which are basically void from most people’s diets and have a dramatic impact on metaflammation because it’s so intrinsically involved in, you know, cell energy production and regulation, and that’s kinda the, those are the big things that I worry about with people is, you know, get them eating better. Clean up their gut. Get them to understand the value of sleep, understand the value of stress, and then start to work from there. You know, are you that person that’s bloated and tired in the middle of the day, and you feel like you’re pushing a thought through Jell-O because you’re so, you know, your brain is so inefficient at energy production. You know, are you inflamed? Are your joints aching? Where are you at? What’s going on?

Matthew Cook, M.D.

Okay, so then, I 100% agree with each and every thing that you said. We do all of that stuff, and you know, it’s interesting. We always have this thing we say, that my goal for me and Barb every day is that we have the best meal that is cooked in the Bay Area.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

There you go.

Matthew Cook, M.D.

So we don’t, we’re not depriving ourselves. We’re making maitake mushrooms. We’re making morel mushrooms. We’re doing incredible savory sort of things.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yes!

Matthew Cook, M.D.

And so then, let’s say I just bought that hook, line, and sinker, and you’ve got me, and so now, I come, and I say, “Jim, I’m ready to really do this, and so tell me about peptides. How would you like me to think about them, and where are we gonna start?”

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, great question. First of all, I think there are some key things where I think peptides, hands down, made a huge difference in, you know, the way our practice works. A lotta people who are under a lotta stress, ’cause I measure a lotta cortisol on people, right, both serum and urinary or salivary, and when you flatten your cortisol curve, without a doubt, you’re influencing growth hormone production, and as we get older, right, we have plenty of growth hormone. We don’t release it as much, and a lotta people arguing over this whole concept of IGF-1, and should it be high, and should it be low? In the construct of homeostasis and why I like peptides is I think they help reinitiate proper signaling of your hormones and neurochemicals. So like, you know, the growth hormone analogs, or secretagogues, so the combinations like ipamorelin, CJC-1295, sermorelin, used to be tesamorelin before they decided, you know, we weren’t gonna be able to get that one, I like those in individuals A, if they are aging ’cause it kinda helps in terms of, I think, reinitiating growth hormone signaling response, improving lean muscle mass, but I think more importantly, it helps to reinvigorate people who are under allostatic load. 

So you know, allostatic load is, you know, basically when your brain takes on too much stress, and then it starts to change the way it makes hormones and signals the immune system, and I think that when you can reinitiate a proper circadian rhythm timing for growth hormone, all things start to align, so I like that a lot, and then I like it in individuals that are even younger that have shut that down just due to the amount of excess stress they have, and therefore now, you know, they’re losing lean mass. They’re gaining fat mass. Their sleep circadian cycle is off, and I think that’s a good thought process for well, why would I wanna give something that would help me to naturally secrete growth hormone versus, say, giving growth hormone, right? Which to me, you’re just suppressing it when you give it, so why not try to make your own, do the work that it’s meant to do, and activate the receptors so that you’re able to, you know, grab that growth hormone and utilize it? And I’ve seen beautiful things happen with it, right?

Matthew Cook, M.D.

100%, and I, you know, it was the in vogue thing when I first came to functional medicine, like, in 2000, in the early 2000s.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

Growth hormone was really in vogue.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, right.

Matthew Cook, M.D.

And then you would see a lotta those patients that were a little bloated, and they had those stereotypical, the people were hitting a lotta home runs, you know, back then at that time, and I was taking care a lotta those people in anesthesia, and you know, I always felt like something was a little imbalanced because they were driving that one segment of the hormonal system too hard, and then when I see people on the growth hormone secretagogue said things overall seem a lot more balanced, and the circadian, we’ve certainly seen a lotta people will tell me, “God, I sleep better. Oh, my Loop Data.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right?

Matthew Cook, M.D.

My Oura ring data’s a lot better,” you know, with us.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Absolutely.

Matthew Cook, M.D.

Do you have most people take it at the night, or in the morning or sometimes both?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, sure, I mean, typically, well, we start ’em at night, and then sometimes, if they’re more interested in body composition, we’ll have them do it twice a day, morning and night. Obviously, you avoid taking in carbs and fats, you know, for a good 30 minutes to an hour after you would do that, and even for protein, I have people wait, but if they wanna, if they’re starving, they wanna drink a little amino acid, you know, mix, fine, and you know, the only time we do it a third time a day is if somebody’s incredibly catabolic or, you know, approaching kind of a cachexic kind of a situation, but typically once or twice a day, see how it goes, and that’s why I like that kinda segment of peptides. I think another area that’s incredibly important, one of my favorite peptides, especially for just people who have lost energy production for any reason. I don’t care if you’re a survivor of the pandemic or you’re a metabolic syndrome person, right, just metas, prediabetic, “Oh, I feel sluggish. My muscles get achy when I exercise.” I love MOTS-c.

Matthew Cook, M.D.

Oh!

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

MOTS-c, for me, which is a mitochondrial catalyst. It helps to invigorate insulin receptors. People lean out on it, and it’s because in metaflammation, remember when you’re metabolically inflamed, you turn off what’s called GLUT4 transport, and when you turn off GLUT4 transport, now, I’m making two packets of energy per molecule of glucose instead of 38, and so I’m gonna be a slug. I don’t have any choice, and it’s one of those interesting things that people, I think, you know, for the longest time, people would say, “How can you be a diabetic and drink that Coke? How can you be a diabetic and wanna reach for that cookie?” If you understand their chemistry, they’re reaching for it to survive because they’re gas-sucking SUVs metabolically.

Matthew Cook, M.D.

Right.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And so what I like about MOTS-c, and what I find is the epidemic in America, 50% of the population’s prediabetic or diabetic. About 80% is overweight, 42% obesity. People are in a crisis, or what I would call a pandemic, of mitochondrial inefficiency.

Matthew Cook, M.D.

Mm-hmm.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And so I really like MOTS-c because it brings people back to having energy, and that’s not just, you know, people that are overweight. I’m talking about athletes who’ve been overtrained, and they kind of do the same thing to their mitochondria. They just look better.

Matthew Cook, M.D.

How long will you put ’em on it, and what kind of dosing algorithms do you like?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, sure, I mean, typically I do five milligrams twice a week. I like the lyophilized version. Lyophilized, I think, is a more stable version, and so I like that five twice a week, and it really depends on where they’re at. If we’re reaching for a weight loss goal using something like MOTS-c with maybe a, you know, there’s another peptide called AOD, you know, the 9064, which is a growth hormone fragment that helps to burn fat. You know, you could do those together, but I mean, what I do for folks is well, where’s your energy at? Are you following your diet? What’s your sleep like? How’s your stamina? What’s your heart rate like? Because I look at things like resting heart rate as a measure of metabolic capacity. You know, when your resting heart rate’s below 62, say between, you know, 48 to 62, and you don’t have bradycardia, you know. You don’t have any kinda problems. That’s a really good sign that you’re not sympathetic dominant, and we know that people that have a heart rate of, says, 62 to 70, that’s another whole issue because now, you’re increasing your risk for cardiovascular disease when you just get into the upper 60s even. It starts to increase that risk. So I really look for how long do I need to use a peptide? Well, it’s as long as I think I need it to help somebody reestablish homeostasis, and maybe the older they are, the longer they need to be on it, but I certainly don’t think they need to be on it, you know, forever. You know, it’s at least 90 days to six months, though, typically.

Matthew Cook, M.D.

Okay, so then I’m gonna recap on one thing, but I love where this is going because as we look at this sort of lifestyle progression of metaflammation.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right?

Matthew Cook, M.D.

And so then, if we superimposed upon that our hormone status.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

That’s right.

Matthew Cook, M.D.

Over the arc of our life, our hormones are going down, and so then you say, “Well, maybe we could support them,” and then, but if you start taking hormones, then that turns your body’s production of them off totally, and so then, you’re, like, “Okay, I got that to deal with.”

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

That’s another problem. 

Matthew Cook, M.D.

That’s another problem, and so then for the growth hormone secretagogues, you can kinda maintain that, and it has all of these different pleiotropic, different effects, that are supportive.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right, right.

Matthew Cook, M.D.

Then, so that’s category number one. Category number two, which is, I’m so glad you said this, this is, as somebody that takes care of a lotta sick people, what happens is as you’re going along and that metaflammation is getting worse, you told me that the next, after lipid dysregulation and all these things, all of a sudden, our mitochondria don’t work as well, and so then, everything, the mitochondria’s everything, and so then once that starts to not work well, now, you don’t have energy, and then if you don’t have energy, then you can’t do any of the things that you’re supposed to do from DNA repair to just maintenance of our biochemistry.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, autophagy, right, the energy just to clean up!

Matthew Cook, M.D.

To clean up, yeah, exactly. So just like a house, and so then, I also have found the mitochondrial peptides in MOTS-c is so helpful there because just having a little energy that’s not sort of like the speedy kinda stimulating more. It’s just a more natural, good, efficient horsepower energy, and then that has all of these side effects that are positive.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Absolutely, and you know, I think that’s the biggest trouble that happens is people start to lose that mitochondrial capacity, what do they reach for? You know, caffeine, ephedra. That was the biggie, right, and for a long time, and then now, it’s, “Oh, well, I need Adderall. I have adult ADD.”

Matthew Cook, M.D.

Mm-hmm.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, no, you have adult mitochondrial capacity loss is what’s going on. So I think it’s incredibly important because what is happening is people drive more stimulants, more sympathetic tone, meaning you’ve got fight or flight and no, it’s not. When you stick in that fight or flight perspective, you’re driving more endothelial dysfunction. Your blood vessels are getting stiffer. Your immune system is becoming challenged. You’re creating proinflammatory chemistry in your brain that’s now signaling across the body, and it’s kind of really important to understand that what you just said, getting people to have a natural energy pattern. I feel good. I have energy. I’m able to do my daily tasks efficiently. I’m able to exercise efficiently. I don’t feel like I gotta be jacked because I have people coming to me that they’re doing 600 milligrams of caffeine before they go in the gym.

Matthew Cook, M.D.

Right.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And they think that’s helping them.

Matthew Cook, M.D.

Right, yeah, it’s interesting, and so then, on the one side, we’re having this conversation about endothelial function and health, and the other side of the equation is you said something that a couple people might be interested, is losing weight, and I’m reminded of that Jimmy Buffett song, “Losing weight without speed, eating sunflower seeds.”

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Exactly.

Matthew Cook, M.D.

So you just mentioned a great way to lose weight without speed, which is this combination of this growth hormone fragment plus MOTS-c. Take me into that a little bit and how you like to dose that and think about that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Sure, so I mean I still go with, you know, MOTS-c. Five milligrams twice a week for me works just fine in the majority of people. If you wanted to go a third time a week, I’ve had people do that, but typically, five twice a week is good, and then the growth hormone fragment, AOD 9064, is the fragment that really helps with burning of fat, and I’ve done 25 units twice a day to go with it.

Matthew Cook, M.D.

Okay.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And I’ll do that for about an eight-week period or a 12-week period. Diet’s gotta go with it, and I love starting them even with a, you know, doing it like a ProLon kit, like, the first five days just to kinda kickstart autophagy, right, and then get it going, and then okay, for how long? Probably a 12-week event, and then I typically will flip them over to, you know, more of just the secretagogues, and maybe they need to be on MOTS-c more. The biggest thing to know about, you know, for me anyway with MOTS-c is you just can’t forget that your body needs chromium, magnesium, vitamin B3 as principal drivers of that insulin receptor. So you know, don’t forget about the fact that you still need nutrients, and look, I’ve done a lotta research on weight loss. I mean, the stimulant weight loss plans, we know just fail, I mean, and when people go back to them because their brain’s foggy, not because they really desire to be back on a program. They want the hit that makes them feel like they got energy again, which is unfortunate, right, because we haven’t helped them to crack that code for getting energy every day like they should have. 

You know, and so I think it’s really important for that, but I think the biggest thing is that you still have to have the lifestyle habits. I mean, did I wanna be on the treadmill 50 minutes this morning? I would think I would’ve enjoyed just sitting and reading this morning, but I know I need to be on there because I’ve got this great family history of, you know, my brother was 476 pounds at one point. My mother was obese. My father was obese. If I don’t exercise and watch what I eat, people that see me go, “Oh, well, you don’t have to worry about it.” Well, no, not really. I gotta worry about it every day, but I’m like you. Cook great foods that taste delicious but are healthy, and then you have to exercise, and then you have to make sure you got your trace nutrients in balance and in check, and then that allows these peptides to really take off, and I’ve always been an advocate for people understanding, you know, balance as much to your lifestyle as you can. Now, is it true that if I just used MOTS-c, would I get more energy? Probably; you know, there’s people that just take it and don’t do a lot of other things, and they get great energy, and they feel good, but it’s are you maximizing it? And that’s the way I look at it is how do you maximize applying, you know, a peptide to the, you know, to the process?

Matthew Cook, M.D.

Now, just parenthetically sort of related to that whole conversation, and I think that there’s a big overlap because if you look at the people on sort of the metaflammation, and they’re on this spectrum of mitochondrial dysfunction that a lotta those people struggle with weight loss, and so they’re maybe thinking, “Oh, okay, this could be good for me ’cause I can balance my hormones and help with weight loss.” On the other side of the coin, a lotta those people also have a lotta brain fog, and that’s like trying to, you said something that I stuck in my mind, like a thought you’re trying to push through Jell-O. That was a good one.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right, yeah, pushing a thought through Jell-O. When I ask people that, they look at me. This is how they answer. I said, “So you feel like, you know, you’re pushing a thought through Jell-O?” And they look at me, and they go.

Matthew Cook, M.D.

Oh!

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

“Yeah, I do.” Right?

Matthew Cook, M.D.

Yes, that’s funny.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

But so often, right? It’s interesting. I mean, I try to ask people questions that they can relate to. If I talk to them about do they feel like they have cognitive loss or cognitive, you know, disturbances, they go, “I don’t know,” but if I say, “Do you feel like you’re pushing a thought through Jell-O?” They go, “Oh, my God, that’s exactly how I feel. If I hit two o’clock, I just can’t get that thought there,” and I think that’s important to understand. There’s a gut-brain connection, right? You got the enteric nervous system between the gut and the brain, and if you’ve got food allergies, you’re triggering inflammatory compounds, creating a leaky blood-brain barrier that then is triggering a lot of the oxidative damage, but then, you could do something like have a TBI that creates a leaky gut, right? It could go either way. You could have a head injury. You could be exposed to things like environmental burden or stress or lime or biotoxin illness, right, that can be triggering these inflammatory processes, and that’s why I think it’s important to look at, well, what do we do to support brain health, right? I mean, how do we do that? I mean, obviously, I mean, I’ve done a lotta research in that area with, like, that Synapsin nasal spray, which isn’t a peptide, but you know, did all that developmental work and, you know, have got it out in 50,000 people’s lives now.

Matthew Cook, M.D.

Tell us about the mechanism of that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, that’s interesting. It’s a 90% ginsenoside, R3 ginsenoside, and it’s got multiple mechanisms of action. Probably the most prominent is the downregulation of microglial cell activation. So you know, your immune cells, your big immune-trafficking cells in your brain are microglia, and the microglia, when they get activated, turn on a lot of oxidative forces, or inflammatory, because you’re trying to rid yourself of a problem, but the problem is that microglial cells don’t turn off very easy, so when you have microglial activation, it’s kind of a slow burn of damage to your neurons and your nervous system. So when you use ginsenoside R3, it helps to inactivate, you know, that, but it also keeps the calcium channels intact, downregulates NMDA, helps in terms of BDNF, or brain-derived neurotropic factor, to be increased so that you help with rebudding of neurons, so there’s actually several interesting mechanisms that have been shown in the research on that, and I think it’s why adding things, when you start to add things like that with peptides like Cmax and Selank, where you’re really upregulating neuronal integrity, neuronal protection, and then that rebudding and pruning of the dendrites, right, that’s what you’re really trying to do because once your brain gets under excess stress: you hit your head, you get super-stressed out, you’re sleep-deprived, whatever it is, once that occurs, your progenitor cells, or your stem cells for your neurons, they don’t bud, so you’re supposed to bud, like, new neurons, you know, like a newly pruned dendrite. About every four to six weeks, you can do that, but if you’re under metaflammation, if you’re under chronic stress, the cortisol and the NMDA receptors that are on that stem cell stop it from progressing and budding, and that’s where I think peptides even add more value to kinda help with that regulation of that inflammatory signal that allows for that neuron to, and that makes a lotta sense, right, ’cause diabetes, right? Type 3 diabetes is called Alzheimer’s, right? So metaflammation once again leading to those cognitive issues that occur in individuals.

Matthew Cook, M.D.

How do you like to dose the Cmax and Selank?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

You know, that’s interesting. I mean, yeah, I’m probably at 30 units of Cmax. Selank, we’ll do, you know, intranasally, and so I’m trying to think of what the intranasal dosage is that we use on that, but what do you use?

Matthew Cook, M.D.

Well, so I like to use, like, 750 micrograms of both of ’em, and then sometimes, I’ll do one of ’em. Sometimes I’ll do both of ’em together. I’ll have a cohort that is kind of a smallish cohort, but there’s people that have had anxiety, and a lotta times, this is women that are friends of mine that’ve had anxiety and sleep issues for a long time.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

And not really that I even knew they were that anxious, and then I just kinda, they’re friends, we started talking then, but then I’ve started to notice this in patients, and then the combination of Cmax and Selank at that dose subcutaneously at night, they told me, “This is the first time I slept in 20 years.”

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Wow! Interesting.

Matthew Cook, M.D.

And so then, that’s pretty interesting because the, you know, I don’t know if that’s the BDNF or Cmax mechanism, or is this a GABA-Selank mechanism or-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Selank with a GABA side. Right?

Matthew Cook, M.D.

Or is that sorta, and so then, that’s-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Or both.

Matthew Cook, M.D.

Or both; the other thing is that we’ll take, you can just buy. This is a cheap way to do this. You can buy the nasal spray containers, and then if you take a 10 milligram vial of Cmax and a 10 milligram vial of Selank that you get, and then you can mix those up in five cc’s, and then you can do that, and generally, and if you do five cc’s of that solution, a nasal spray’s gonna be about 200 micrograms. If you do 10 cc’s, then it’ll be 100 micrograms.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right, right.

Matthew Cook, M.D.

And so then, so well, what we’ve had-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Did you see any one work better?

Matthew Cook, M.D.

What’s that?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

What works better for them? Are they do well intranasally, or do they do better SubQ?

Matthew Cook, M.D.

I think SubQ by far works better, but then I also think that having something that’s in the refrigerator that, I like kinda what these things, I like a little diversity, like I like a little, you know, a little shot of something that you can drink. I like a little sublingual that I can take, and then nasal spray.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, yeah!

Matthew Cook, M.D.

So then because I’m probably gonna forget to take peptides one day for sure, or you know, and so then-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, without a doubt.

Matthew Cook, M.D.

So it’s like that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah.

Matthew Cook, M.D.

I also wanna echo what you said, then. If you think about those neurological patients. You know, 15 years ago, when I really was getting into this, I thought, “Oh, you know what I’m gonna do, I’m gonna fix people with neurofeedback,” because I was gonna train. There’s a part of the brain that was off, and you know, you have all these kids with ADHD.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right, gonna wake up that portion of their brain.

Matthew Cook, M.D.

Wake up that portion of the brain instead of giving ’em a stimulant, which is the same thing. The stimulant for ADHD is the same thing that we’re trying to give to the person who has weight loss because I think they’re on the same spectrum.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, without a doubt. Their dopamine reward cascade is way off.

Matthew Cook, M.D.

And so then, interestingly, the mitochondrial peptides, then you start to turn those mitochondria on, I don’t need to do LORETA training to turn that part of the brain on because suddenly, that brain just turns on, and then as soon as that part of the brain has energy, then it can do its job, you know.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

That’s right.

Matthew Cook, M.D.

So then, it’s kind of, like, interesting to think about, neurological peptides that are actually working on a mechanism, while at the same time, we’re sorta turning those cells on.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yes, exactly.

Matthew Cook, M.D.

And then when I think neurology, a lotta times I think immune, and I know you know a lot about the immune system and immune stuff, amino peptides. Tell me about how do you think about immune stuff vis-a-vis that conversation?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, I mean, you can’t get away from the fact that, you know, you always have these two sides to your immune system, right? You’ve got this innate and adaptive immune system, and the more that we create these shifts in your immune system or imbalances in them, the more we’re likely to create some sort of attack somewhere. Somewhere or another, you’re either gonna get an attack, or you’re not gonna have a good defense. It’s kind of how it works. So when you look at the thymic peptides, and you know, thymic peptides have been around a long time. I mean, they were orally given originally. I mean, I remember giving, you know, gland thymus. I still give gland thymus extracts, freeze dried, lyophilized, lots of thymic peptides, you know, and then we went to the thymic protein-A packets that you would tear open, and you’d pour ’em underneath your mouth, and they were specific, you know, more refined thymic peptides, but I think that, you know, when you start to look at neuroimmune, so when you hear the term neuroinflammation, by default, that means that there’s an immune activation that’s taken place and that that immune activation is chronically there, and you know, I loved TB4 because of its immunomodulating effect because I find that, for a lotta people, you know, not people that are actively in an infection where they need more natural killer cells, right. 

So that’s where thymosin alpha 1 became so big, right? We could really crank up, you know, the defense, but what I really liked about TB4 was its ability to immunomodulate, so whether I’m looking at, you know, people with autoimmune thyroid or, in terms of their brain, it’s a component of regulating their immune system. I mean, BPC-157, which has this, wow, massive pleiotropic effect, neuroprotective, right, so cognitive, neuroprotective, seems to be a big benefit if people have a, you know, a head hit. Super-protective for repairing the permeability of the gut. I think the immune-regulating compounds, and it’s really tough to kinda start to separate because if I’m anxious and nervous and we do your protocol: Cmax, Selank, I settle my nervous system down. My immune system starts to go back into balance from that, and that’s why I try to work with people and go, “Where are we gonna focus your peptides?”

Matthew Cook, M.D.

Mm-hmm.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Because they all can start to kind of come together and provide benefit, and before you know it, when you’re first a devotee of peptides, right, how many can I take? ‘Cause you’re reading about ’em, and then you start to understand, all right, what’s appropriate? What do I need to do for this person now? And so you know, for me, in terms of, you know, inflammation response and soft tissue, I know one of my first exposures to peptides was on my son’s Lisfranc injury in high school. You know, he had a Lisfranc injury. I did TB4, BPC, and actually, back in the day, it was GHRP-6 ’cause it was, you know, still out on the market, so he gave those three, and by the time he went to surgery, they had a hard time finding where the tear was, and he had virtually no hematoma, and literally where I found it to be interesting was he also was a track athlete, so his football season ended, but within four months, he was spinning on that foot and throwing a discus, ended up winning the California State Championships, but only five months to six months out of the Lisfranc injury, and if people are listening, a Lisfranc injury is a real common injury in pro football ’cause it’s this torsion injury on your foot, and basically, you sever a ligament in your foot, and it really hurts bad, like, you can’t run on it at all. You can’t really put pressure on it at all. Typically takes 12 to 18 months for that to repair.

Matthew Cook, M.D.

Yeah, apparently, do you know that story? Napoleon’s general was named Lisfranc, and so-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I did not know that!

Matthew Cook, M.D.

Oh, yeah, so he’s riding along, and his horse, and then gets knocked off, and so his foot’s in the stirrup, and so then the foot is stuck in the stirrup, and that basically rips the ligament structure that connects basically the metatarsal to the proximal foot because you can imagine that that foot’s stuck in there, and you’re getting dragged by the horse.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right?

Matthew Cook, M.D.

And so then, and so then football sort of could do the same thing, that traumatic thing, and then I, basically, my old life, I used to do anesthesia for the surgery all the time, and so I would do, like, completely put the foot asleep. I would do a sciatic nerve block in the popliteal fossa, and I would do all of this stuff because it was so painful and brutal, and then that’s just like this, you hate it when you hear of somebody that you know had that, you know.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right?

Matthew Cook, M.D.

And then, I’ve had similar experiences where we, you know, I’ve had people that had sort of Lisfranc fractures that didn’t end up having surgery.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

Which seemed inconceivable to, like, a life that I had lived in the past, and most of them

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

still require surgery, but peptides for musculoskeletal things, particularly stabilizing ligaments and things like that is, which peptides did you use for him?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

TB4, BPC-157, and then I actually gave a GHRP-6. I gave a, you know, trying to wake up the growth hormone receptors on his tissue, and worked out really well. I had a guy that was a tactical instructor that couldn’t lift his gun anymore. Like, he had a labral tear, a teres minor tear. They’re telling him he’s gonna need surgery, and so my nurse practitioner went to work on him, and then we, you know, worked with him on doing his injections, and you know, six months later, he’s out teaching and can, you know, do what he does, and it’s amazing what can happen with connective tissue.

Matthew Cook, M.D.

Yeah.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

It really is.

Matthew Cook, M.D.

It’s also, you know, interesting. Sort of as you think about things, if you’re injecting into a ligament, the structure and fascia, with a peptide, if you think of it, you’re putting a drug that has a benefit, but it has a dose, and so then, even if you’re close, it starts to spread and get everywhere, and so then what we would typically would do is to use a ultrasound to see the needle and watch that fluid go above and below the ligament and potentially into, if there’s a tear.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

But compared to other things that we liked, like exosomes, we would like a lot, but there’s a certain amount of growth factors in there, and we’re being charged for that, and we’re being charged a lot for that. The peptides, and I still will have a lotta people that are years out and say, “Oh, yeah, I still don’t have any pain in my shoulder,” and so then, to me, I’m so interested in the next five years to sort of build this experience because you get a kind of a spectrum of what you get out of the, from peptides, and you get a spectrum of what you’re gonna get out of regenerative medicine and stem cells, and so then suddenly you build this model, but I think when we sit back and get on a podcast in 20 years from now, we’re gonna say that that is a dominant aspect of medical care.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Absolutely, yeah, without a doubt. Well, I mean, what, you know, you’ve got hundreds of peptides that are now coming into the marketplace or being researched. You know, as somebody has probably mentioned on your summit, insulin’s a peptide. You know, I mean, we’ve been looking at these since the 1930s. They’re infiltrating all aspects of healthcare, and I think, you know, where the real value, once again from my perspective, is that when I look at that model for aging and realize that as people are moving through time, either their cells are in a homeostasis of getting rid of debris, appropriate signaling cell to cell, appropriate signaling organ to organ, and they’re sustaining that as they’re aging, so they have a better health span, right? They’re living more vitality longer, or there’s a degradation at the cellular level, where now, the signaling’s misconstrued, and now I’m making more tissue acids, and now I’m inducing more mitochondrial damage, and now I’m gaining weight and feeling fatigued and having aches, and now, I’m cognitively turning on my neuroinflammation. Regardless of whether it’s, you know, an exposure or just my lifestyle, the bottom line is where I think peptides add that next layer of value is helping us to reinitiate that signaling of hormone to hormone, neurochemical to neurochemical, cytokine regulation versus autophagy, right? We get these inflammasomes that start to just get released excessively, and when you have excessive inflammasomes, by default, you stop the cleanup of your cell. Autophagy is downregulated. So it’s more than just, “Oh, I’m gonna fast and induce autophagy.” You have to downregulate the inflammatory chronic signal so that your cells can remember how to clean house again, and that’s why I think it’s important to understand peptides play a role in that reregulation, just as all the other lifestyle factors we talked about that count.

Matthew Cook, M.D.

Okay, so I’ll take that. So then, given that, let’s say that infections and toxicity are a relatively significant driver of metaflammation and of this whole conversation. As so then, at least in the United States, thymosin alpha-1 and thymosin beta-4 are less available.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

Because of some regulatory factors. Interestingly, we were talking about musculoskeletal. There’s a patent out for thymosin beta-4 for peripheral neuropathy, so then you begin to realize, oh, okay, suddenly, these molecules have a variety of effects, so they’re good for nerve, good for tendon, good for the brain, but on the immune side of the equation, you know, thymulin has been sort of a newcomer on the scene, AP-7. Tell me your thoughts about that, and how are you using it, and how’s that been for you?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, mean, I’ve been pretty happy with it. Certainly don’t have the years of it down ’cause it just came out over the last year. I use it pretty similarly in dosing as to TB4, typically 500 micrograms, you know. I’ll do 500 micrograms to actually one milligram, you know, up to a couple times a day. I really like, and one of the biggest reasons thymic peptides are important is that either through infection or stress or aging, our thymus gland stops making mature thymic cells. They make what’s called adolescent thymic cells, right, and so when they’re not matured, you cannot get the appropriate defense, right, as you’re aging against an incursion, which is, you know, a bug or a toxin, typically a bug, and so I like thymulin. I mean, I’ve been very happy with it in terms of helping to boost people’s immunity and to get them to, you know, kinda countermeasure against, once again, you have to remember, if someone’s in that metabolically inflamed state, they grow more yeast. They have more dysbiotic flora. You know, their terrain, if we think of that concept of homeostasis. Well, what am I growing? I’m growing weeds and bugs that I shouldn’t have, or am I growing beneficial flora and cofactors that my body needs, and I think when you think of people are compromised with, you know, their kinda chronic candida, chronic dysbiosis, chronic cortisol issues, the need for those thymic peptides become more important because you’re in an environment that’s more cytokine-rich, and the thymic response has been, you know, sequestered, right. It’s reduced, and so that’s why I like thymulin. Works great, and think it’s a, you know, like, once again, great that we’re able to have something in that family, to be able to utilize it.

Matthew Cook, M.D.

And that kind of is, you know, we think, okay, metaflammations is going like this over our life. It’s raising, and then we talked about hormones kinda fall off a cliff, especially growth hormone. The thymic proteins and peptides kinda fall off a cliff too, and then that’s right when people start to get infections. I mentioned this the other day. You know, they say pneumonia is the old man’s friend, but that’s a relatively dark statement.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

It’s number five cause of death on people, you know, the geriatric population, is the fact they can’t fight off a flu bug.

Matthew Cook, M.D.

Yeah, and so then, I think this is something that, for me, as a clinician, you know, is having people who, oh, every year, even people in my family, every year, they would get sick, and when they got sick, they would get bronchitis, and it would be chaos for two weeks, and then a little thymic support, and you see those people do a lot better, you know.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, yeah, they do that, and if you can get their M cells going, right, using things like beta 1,3 glucan so their memory cells can actually, you know, identify what the heck’s going on and attack as needed.

Matthew Cook, M.D.

How would you like to dose that?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

I use beta 1,3 glucan 500 milligrams three times a day. If I’m using the German nanotized, you know, beta 1,3 glucan, which is kind of an enhanced buccal-absorbed spray, that’s, you know, in more like the 50 milligrams. It’s about a tenth of the dose ’cause it’s pharmaceutical-grade nanotized, you know, proven absorption, you know, works on the Dectin-1 receptors to improve immune response and T killer response.

Matthew Cook, M.D.

Okay, so then, we kinda covered immune. We covered mitochondria. There’s all this overlap. We’re kind of into the musculoskeletal conversation. Another topic that’s near and dear to my heart because it relates to everything is connective tissue, and so on my list of questions to ask you is the GHK-Copper, which we have really enjoyed. How do you like to use it? What are some of your thoughts about that?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, so I mean, even the GHK-Copper and the GHK-Copper hyaluronate, right. So there’s a one that has hyaluronic acid bonded to it as well. I like both, one if you’re trying to stimulate collagen synthesis. Say you’re doing it aesthetically, right, the hyaluronate can be really supportive. Also for hair, you know, getting hair to regrow. The hyaluronate’s really great. Typically on GHK-Cu, I’ll do 10 to 20 units of GHK-Cu, and then I’ll, you know, I like spot-dosing it, so where’s the trouble, and I’ll apply, you know, for short bursts to get healing because the copper actually helps with, you know, getting integration of proline and hydroxyproline, which is really important for the knitting of your, healing of your skin and tissue in an area, so I’ll do 10 units twice a day, and then just kinda fade out to 10 units daily, and then I like it as a maintenance, you know, three, couple, three times a week, you know. Add a little bit of GHK-Cu. I think the copper’s really good.

Matthew Cook, M.D.

Mm-hmm, it seems to play well with others also, in terms of, like, you can mix. We’ve been impressed with the whole aesthetic side of the equation of those peptides, and I have to tell you that I think we’re in this sort of, we’ll look back at this moment as this is like the moment, the Botox moment, you know, when everybody is kind of, you know.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, yeah.

Matthew Cook, M.D.

But I predict that there’s gonna become an ethos of a more natural but real healthy look, and then I’m kind of starting to do, like, things where I’ll talk people into cutting back on Botox and sorta intersperse peptides in the face, and you can do BPC and-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

BPC, GHK-Cu, you can do a little bit of ipamorelin too, right, I mean.

Matthew Cook, M.D.

Have you been doing that in the face? That’s awesome.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah.

Matthew Cook, M.D.

What kinda, same type of dosing that you normally?

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, just a few units. You don’t need a lot, and you know, one of our instructors that I had at the Peptide Society, Dr. Bucay, who was South America surgeon, but big aesthetics practice. I mean, she is kinda, like, super-famous there, and now, she’s in the US. She teaches a completely natural aesthetics. Like, she activates the PRP, or PRS, that she makes with peptides.

Matthew Cook, M.D.

Yeah, so I went to her. Like, I went, I was there.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, were you there for the lecture?

Matthew Cook, M.D.

Yeah, I was there.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

That’s right!

Matthew Cook, M.D.

Yeah, and so then, we’re doing that now, and so then, basically, what she does is she makes what’s called a plasma gel, and so then, she’ll take blood out, and then your blood is kinda 50%, let’s say, plasma, and 50% cells, so then she takes that plasma, and will separate it out into two parts, so one part, she will cook and heat up until it turns into a gel, and then the other part is just plasma, and then she’ll mix the peptides with the plasma and then mix the peptides and plasma with the plasma gel, and then that is just your own natural body stuff, and it’s gonna have the peptides, and it has everything there, and then it gets you a little filler.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And glow.

Matthew Cook, M.D.

And but then, that’s naturally releasing over time, and it looks good, and it feels a little different ’cause, like, if you get filler, then you kinda start to palpate around. You feel that.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, it’s like whoosh, whoosh.

Matthew Cook, M.D.

A little crunchy.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah!

Matthew Cook, M.D.

Sometimes it doesn’t break down, and then we are a little concerned about that just because that is something that could be a biofilm that infections can get on, and if you get an infection on your face, it’s the worst thing that has ever happened to you.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right.

Matthew Cook, M.D.

Pretty much. And so then, I was enormously impressed by her. I think she’s an angel, and I was just like, for me, it was the highlight of the-

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Awesome, I’m gonna let her know that because I think her work is incredibly novel.

Matthew Cook, M.D.

Yeah, and so then, that’s the pitch for your whole, everything that you’re doing, I’m super-impressed on that front.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Oh, that’s great. No, I think aesthetics over the next 10 years, if you’re not really focused as a practitioner that’s doing aesthetics, and you’re not focused on learning these types of techniques, I think you’re way behind ’cause I’m like you. I have a lotta concern over what people are putting, you know, in their face just from the standpoint of immunologic changes, biofilm grafting, I mean, all of that stuff, right, and so to be able to use your own body’s cells to rejuvenate your own collagen and really create a natural beauty, I think is just, it’s where people need to go.

Matthew Cook, M.D.

Yeah, the other thing about this one, and this is just an interesting one to kind of think about, the fillers and sort of those alternatives. It’s interesting, like, you have all of the aesthetic people over here, and then you have, like the regenerate, I come more from kinda the regenerative, musculoskeletal side of the world.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, yeah, right, sure.

Matthew Cook, M.D.

And so then, we’re not, we traditionally have not been that concerned about aesthetics. We’re just like, “I wanna go play football this weekend. I’m trying to fix it.”

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, how do I make this joint work again? 

Matthew Cook, M.D.

Yeah, exactly. However, how we think about things is what’s the blood supply? What’s the nerve? What’s the muscle? How do we fix all of that stuff? And the topic that came up in the course that I took was we need to begin to think the way that we think about joints and the rest of the body about the face because we need to get these muscles active, strong, think about blood flow, think about, ’cause the side effect of that is it looks good.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Right, exactly. Well, now, you’re gonna be an aesthetics doc, it sounds like.

Matthew Cook, M.D.

Well, we are, and then so we do, like, the BBL, and then we do the all of the facial injections, and I used to do, you know, injections in the eye and everything as an anesthesiologist.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Sure, sure.

Matthew Cook, M.D.

And so we’re kind of, and we’ll do, we interestingly will do, you know, nerve blocks in the face if we’re doing procedures or as anesthesiologists, and fundamentally, I think that the using regenerative and peptide kinda modalities actually is gonna change the whole trajectory of the aesthetics because it’s really inside-out healing.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah, yeah, it’s dead by the time it’s out there. We gotta get, you know, you gotta get it going from the inside. Yeah, no, I thought that, I was real happy there, and then, you know, obviously, all the work that Dr. Kathleen O’Neil-Smith was talking about with, you know, her work with the fascia, once again, if you start to think of your body as this universe, right, and you know, opening up the fascia, you know, and the fascia obviously being the little thin membrane that’s around all your muscle tissue, it kinda can get twisted and contorted, and now you get hypoxic areas in your tissue. When you think of the physical medicine, I remember I was at the NBA summit lecturing pre-COVID, everybody there was either orthopods or regenerative medicine docs, right, and then there was me. You know, I’m talking about blood and chemistry, and they looked at me like, “All right, what’s this guy talking about?” And I said, “Look, I don’t know how you separate biomechanics from biochemistry. If I mess up the fascia, I trigger inflammatory compounds, and if my diet’s not right and I don’t have enough nutrients, I trigger inflammation that affects my biomechanics, and I think it’s that really deep understanding of just what you’re saying. 

Joints, connective tissue, the connective tissue matrix by far carrying so much information about inflammation signaling that’s going on. Another reason I think peptides are important is the fact, well, why is BPC have such global effect? I think it’s because the connective tissue matrix is being modulated in terms of the metalloproteinase activity, so you’re getting a lot less of the, like, MMP-9, metalloproteinase-9, metalloproteinase-3, signaling that is triggering a lot of this kinda prothrombotic, proinflammatory, ischemic type of chemistry, and that’s why I think it’s, you know, those types of connective tissue therapies, I think, are much more global. I remember reading a book by Pischinger called “The Connective Tissue Matrix,” and it blew my mind, I mean, ’cause it was just, like, I mean, there is so much information being translated through that connective tissue. That’s why I think we’re seeing these dramatic effects when you’re using things like, you know, even using thymulin. I mean, I’m just going ahead and using that with BPC. You start to see these global benefits because we’re getting that modulation.

Matthew Cook, M.D.

Right, and interestingly, the thymic peptides, so thymosin beta-4, but thymosin alpha 1, thymulin, they’re all seem to be helpful for nerves because I think nerves have a lot of immune stuff related to them.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Absolutely.

Matthew Cook, M.D.

And so then, my sorta piggyback on that is sort of, the main thing that I was sort of known for was nerve hydrodissection, but basically, that means, you know, if you imagine when you rip open a chicken, and you see that cobweb kinda stuff, what we do is we use a ultrasound, and we put a needle in there, but then when we inject, it spreads through that cobweb type of thing, and that actually is one of the best ways to deliver, I think, peptides, but almost anything because it spreads, and it spreads around the arteries and around the nerves, and then it starts to move through the lymphatics, and so whether you do that in the face, or whether you do that for the knee, then it will heal the lymph nodes that drain that joint or that part of the body.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And I think you’re bringing up a part that is so important, and you know, a lotta people don’t realize that the lymph isn’t just collecting garbage. It’s also involved in the signaling of inflammatory chemistry.

Matthew Cook, M.D.

Mm-hmm.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

And so it’s great to get that flow and great to get that signaling. I happen to think that what you’re doing when you’re, you know, modulating that lymphatic response is partly that you’re downregulating inflammasome activity so that the lymph is no longer participating in the signaling of that inflammation response.

Matthew Cook, M.D.

Mm-hmm, 100%.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah.

Matthew Cook, M.D.

Well, it’s a 100% delight to talk to you and be with you, and thank you for all the amazing sort of work that you’re doing both kind of with people and also educating doctors and helping to change the world.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Well, it’s fun. It’s pretty fun when somebody comes in and tells you how much better they feel. I don’t know if there’s a better feeling, so you know, and I love it when I get to talk with docs who are like yourself. I mean, you are so accomplished, gifted, and applying knowledge in your art, right, because that’s what counts is we get this knowledge, and we kinda, how do we mold this, make it work? So it’s awesome. Thanks for having me.

Matthew Cook, M.D.

Well, I look forward to what we’re gonna discover next. Have an awesome day.

James B. LaValle, R.Ph., C.C.N. M.T. DHM, DHPh. N.D.

Yeah. All right.