GLP-1 Safety Explained: Gut Health, Detox, and Choosing the Right Peptide Source

Introduction to GLP-1s and the podcast 0:00

There's really interesting research out there looking at like when you have weight loss and fat loss, you actually can become more toxic. And we have seen this in lab work in patients too, but also those patients will show symptoms too of fatigue, headaches, nausea, GI distress. Your health is shaped by more than symptoms. Through real stories and expert insights, we explore how your genetics, environment, and daily choices affect your wellbeing. We uncover root causes and share practical tools to help you find the healing you need.

Welcome to the Forum Health Integrative Medicine Podcast. Thanks for joining us today. I am Emily Rodriguez, one of the nurse practitioners here at Forum Health in Madison, and I have with me Dr. Drew, who is also here in Forum with us. And today we are going to talk about The safe use of GLP-1s, what we think every patient should know for not only effective support of weight and metabolic health, but also making sure that we're doing it in a safe manner and just understanding deeper kind of behind the scenes about how these peptides work and ways that can use them as a great tool to help support our bodies.

There's no doubt that these medications have absolutely transformed kind of the approach to obesity medicine, cardiac risk, improving metabolic health. And I think they're an incredible tool that we have, but I always tell patients they are being misused in a lot of ways. We think that there is a right way to use them to help improve weight, blood sugar, cardiovascular risk and overall metabolic. So, we're going to talk today about, you know, how to use them as a tool and how address some kind of common concerns that we see in practice.

So Dr. Drew, if you want to a little bit about kind using them a as tool, and what are some of the most important things when we are first starting out that need to do to support the body on a GLP-1. Yeah, I think that was a beautiful interaction, you know, talking about kind of like how these, how this medication really has changed the game when it comes to blood sugar regulation and obesity. And, You know now you can go basically anywhere and, any med spa or functional medics in clinic and you're starting to see these GLP ones,

Assessing candidates and baseline lab work 2:25

pop up. And I think really what we do from a differently or from higher level is really the assessment process when we're considering using GLP-1s. Now, when I say, I'm also making decisions of, hey, since I am a chiropractor, right, i'm not prescribing any medications or anything like that. I still have patients that I can identify that may be a good candidate for these medications. But there's a certain due diligence that we need to have with that. So when we're considering a GLP-1, the first thing that always do is run blood work, right?

Because if we don't have some sort of assessment, we are just really kind of guessing. And on that blood work panel, we're typically evaluating blood sugar markers like hemoglobin A1CC, peptide, insulin, fasting, blood, sugar. And then we also like to look at pancreatic enzymes, amylase, lipase. I don't think very many people are actually doing that. And they're more readily just to prescribe, oh, hey, you want weight loss? OK, here's a peptide. Well, let's really, truly understand that this peptides is here as a tool to move your health in the right direction.

We want to see your markers move in a direction that is conducive to more optimal reference ranges. or longevity, right? And we know that these markers and our reference ranges are much more narrow that are derived from the literature to suggest that if they're outside of those reference ratios that you have a higher cause of all-cause mortality, which is the ultimate goal is to reduce your risk for mortality. And GOP1s, if done appropriately and supported appropriately, can do that. Yes, I think it's amazing.

And the cardiac research alone coming out about reduced cardiovascular events on these medications for patients who are diabetic and non-diabetic is very impressive. But like you said, diving into the deeper labs is so important because we've seen patients really use them as a good tool. They put in the lifestyle work, they are really honing in on diet, making sure, you know, bowel function is good, which we're going to talk more about. And we see not only yes, we'll see weight loss, but we've seen their labs get better.

We know that that behind the scenes work is being done to really improve their overall health. So I think that's great. I would say, I will say the other thing that we do really, really well is laying the foundation for success right there's certain foundational things that you're not going to out peptide right and those are nutrient deficiencies and these are things we evaluate on our initial blood work like vitamin D B12 and folate right magnesium all those minerals and vitamins that we're kind of looking at through either direct lab work or indirect ones, like for example, homocysteine, if that's high, that telling us, you know, maybe we got to look further into B12 and folate.

And if you don't have that on board, peptides only going to do so much, right? For that person's health. I think that is really where we stand out. Yeah, absolutely. So let's talk, you know, one of the biggest, I think, critiques of these peptides first is the side effect profile. And, a lot of patients, when we have this discussion, have a a I would say hesitancy or almost fear around them because of kind of what you read online, what do you in the news of it's causing severe constipation, gastroparesis, like kind shutting down that GI tract because these medications do slow GI transit.

they, which is one of the ways that it reduces appetite. So it does help with controlling, you know, food noise and eating less, but it's not replacing healthy habits. And I, we like to say here in our clinic, if you're having side effects, then your dose is probably too high. But can you talk a little bit about kind of an approach to, cause we always like we do, Dr. Drew sees a lot of gut health patients and that's like a really strong point of his practice is how to how does somebody support their GI track while they're on these meds?

Right. So there's a variety of ways, and I think this is just so important that we touch on this.

Supporting bowel function and hydration 7:10

If you are not pooping daily and you're on a GLP-1, you really need to start asking some deeper questions. You really do need start to find some support because I can't overemphasize this enough. Having a daily bowel movement on GLp- 1 is a must. having a Daily bowel movements in general is must, right? But when you were losing weight, This is much more significant to make sure that we're having a daily bowel movement because of some of the mechanisms that were going to talk a little bit later about detox and where toxins are stored and if we are losing weight at maybe a higher pace than we were used to, how we will be mobilizing them.

But back to the original question of how do we support the GI, it's going be some Individualization, of course, but I would say from a day one, anybody that's listening to it, maybe that on a GLP one from different prescriber or something that I want to get some actionable steps to, there's some things to consider is obviously fiber, right? Fiber is going to have multiple aspects that can really drive our health forward with or without a peptide, right? It's a prebiotic, it helps, is a gentle binder for toxins.

And it's going to help kind of keep things moving along. It gels up in the intestine and it kind create better motility that way. So, number one, I would say, absolutely fiber. Okay. Number two, we can use things like aloe or magnesium. I will put magnesium citrate a little bit above alo, but it's all dependent on the person because we've seen people respond extremely well to something as simple as alibera juice, right? Taking a bit of alibera juice a couple of times per day, you know, kind of gets that GI moving.

Well, it reduces inflammation. There's a lot of good benefits from aloo. magnesium citrate. Also, I should say it's a food, right? We always want to move towards the things that are food at which aloe it is. And then magnesium citrus is another really great one because it s really hard to overdo. Now, everybody knows that if you take too much of anything, it' s going to be harmful, so we don't want t make these claims, but it i s hard o over do and you can dose it to your tolerance, meaning that once you find a good kind of consistency of our bowel movement, then you can either back off or maintain it at that dose there.

So magnesium citrate's a really great way. And then we use other stuff like bowel mover, which is a supplement that has a few different things in it that helps with patients. But I would have to say those two are my favorite. Yeah, for sure. I think another big thing I see is just hydration level. A lot of Americans are very chronically dehydrated. And that's another thing we can kind of see in a lot lab work too, but I ask always patients, are you a good water drinker? And a lotta times they say, no, I'm working on it.

So, remembering this along with the fiber, the importance of hydration, because we're made out of water. We need good hydration for good bowel function. A top-down approach of supporting bowel functioning is how are we eating? are we sitting down? Are we taking time to chew our food well? are We stressed out eating on the run, working through lunch? Or do we actually take some time To eat because it's rest and digest, we cannot our balls don't move well if we're in a stressed Out state. So I think that those are all some really good, you know, baseline, I guess approaches to just ball function.

And then yes, definitely, if a patient's having trouble, they should reach out and let us know because that, You know our, our bowel function is like our big drain. And if we are talking about, you know, there's a lot of trendy supplements out there for detox support. But really, if you give your body some basic support, it's amazing in what it knows how to do to, process various foods. you know, exposures from the environment and get them out of our system. If you're supporting, especially that ball function, I mean, you've got to open up that drain before you try working on that faucet.

You don't want to be running the faucets on high and hitting the liver with supplements without opening up the drain because it's going to cause problems. I would say two things to add on to that. The quality of water, right? Because some people, they're getting dead water. It's not very high training, right? So we want to make sure, you know, if you can find a natural spring or if if can get spring water delivered in glass bottles or something along that side. If you could get reverse osmosis and then charge it with some sort of a structured water device, that's another really great option.

So the quality of water matters, right? We talk about like natural action or analemma, like some of those structuring water devices, it seems like the charge of the water is very important, maybe more important than what we have thought in the past. Using some sort of electrolyte component, if they're not having blood pressure issues, although that is a different conversation, we can use a sprinkle of sea salt. uh you know purple bamboo minerals all those things contain good mineral right and if they're they help with hydration and, if you have structured water along with it those that structured, water can also carry those minerals into the body a little bit better and then the other thing of course you, know that's the number one thing about all, those supplements is diet right in lifestyle But I'm always going to the fact that most people aren't having the best diet ever.

Supplementation there is important. But yeah, of course, right now it's summertime. Get to a local farmers market. Start buying some local organic food. High in cruciferous vegetables, that's a must one on GOP1, having high brassica and crucifix vegetables. Things like cabbage, cauliflower, broccoli. garlic, those are all very great, fibrous vegetables that support detoxification. So yeah, I mean, you nailed it with the diet. I went straight to the supplements, but only because if you're not having a daily diet, You might have to take those actions to get that movement.

But your absolutely right diet is number one, hydration. Those are far more important from just a health standpoint, but in times where the patient isn't moving, you have to get them going. Absolutely. And I think, you know, we'll touch a little bit on, protecting muscle mass because that's gotten everyone knows like, Oh, I have to have good protein. I'd have a good on these protect muscles. Should resistance train, which are all also important. But I sometimes with our hyper-focus on the protein, a lot of people forget about the produce side.

Fruits, veggies. So one of the simple things I tell patients, I have a great handout from the Institute of Functional Medicine. They call it their phytonutrient checklist, and it's a list of different produce by color. And I told patients try to get one every color every day. Between your three meals, as you're planning out your grocery list and your meal planning for the week, see where you can add color into your diet. Because if you are shooting for different colors, you will get a wide range of nutrients, a range And it's going to support all this, like everything we've talked about, you know, nutrients so that your liver can work well, good fiber so the balls work.

Well, and it is all very key. Like you said, it was foundational to being able to lose weight, whether you're on a DLP one or not. These are foundational health things that people should be doing. How much protein do you usually advise patients to get? So depending on where they're at and how many calories are getting out, we might go anywhere from 1.2 to 1 point 6. grams of protein per kilo per.

Protein, muscle preservation, and healthy weight loss 15:30

Kilo. Yep. Okay. Yeah. No. And I think that for a while, some people were hitting pretty high goals and I, obviously it depends on the person in their activity level and whatnot too, and what they're training for and stuff. So, but I. Think that's yeah. In a very range and then. As far as a healthy pace of loss, I think one of the concerns I see sometimes with patients is, are they dosing too high, under-eating, and losing weight really fast? Because that's not good for us either. We say anywhere from one to two pounds a week, sometimes even a half pound a day depending on where they're at in their weight loss journey is still at a health range.

where they're going to see a nice, steady, reasonable loss without, again, we're looking at that side effect profile. How's your energy? Are you getting headaches? are you feeling fatigued? Those are all big signs that maybe you need to stop your dosing for a while or and or for sure decrease it and really focus on more of these kind of I guess, foundational supports. Because if you see excessive rapid weight loss, you're going to see muscle loss. You're gonna see fatigue. Definitely probably hitting some nutritional deficiencies because of under-eating and you are actually at a higher risk of both gallstones and your more likely to gain that weight back when you stop your peptide, which is, you know, a common question of like, how long do I have to be on this?

Am I going to have be honest forever? No, we have seen many patients use it as a tool for a while in a nice, slow, sustainable pace where they've really worked on these lifestyle and behind the scenes. And that's another thing where these labs come in of, like did you have a thyroid disease issue? How are your hormones looking? Like what are all these other factors that play that protect and help support weight? And making sure that we're fixing all this behind the scenes stuff so that when you are able to wean off your medicine, you can sustain that weight loss and maintain really good health moving forward.

That's an important point as using this as a tool, right? So I think if we are using it as tool we must understand why we would have to have that tool in the toolbox in first place, which is Why is the population so deficient in GLP-1? Because what most people may not understand is our bodies naturally produce GLp- 1 after eating a meal, right? And that helps with insulin release from the pancreas and insulin sensitivity in the peripheral. I think this is an underutilizer. People don't understand that when we have inflammatory markers that are released in the body, that also increase GLP-1.

So that tells you that this is kind of a tool that we could use even greater than just insulin resistance obesity. Because we're seeing anti-inflammatories, we are seeing CRPs go down. You've seen it, I know I have. I was in his 50s, came down below 10, which is insane, right? but what happens why are we glp1 decision in the first place well we have ultra processed foods we're seeing higher rates of obesity we've been seeing gut dysbiosis fiber intake all these other things are influencing our body's ability to make this signaling molecule this glP1 and this is why we are having some of these issues and why it's becoming a great tool for that because we're restoring that signal.

At Forum Health, we uncover the why behind your symptoms. With advanced lab testing, hormone optimization, and cutting-edge therapies, We help you heal and perform your best. And now, through shopforumhealth.com, you can access physician-grade supplements trusted by our providers, supporting everything from adrenal health to focus and longevity. Learn more at forumhealth.com and explore supplements at shopforumhealth dot com. I want to talk about something now pretty unique that I think that our practice has been really focusing on lately.

And that is this idea of what happens when we lose fat. Obviously, GLP-1s can cause fat loss, sometimes rapidly. I guess what's the concern with that? A lot of this is coming from research actually done with patients who have had gastric bypass surgery and they've had rapid fat-loss. And there's several studies that have measured their blood levels of what you would call persistent organic pollutants or POPs. These P O P's are various environmental chemicals that had been studied over the decades.

It's anything from compounds coming out of plastics to pesticides to the stuff that we're exposed to. And they found that when somebody has a significant fat loss, these compounds will increase in the bloodstream. as your fat source. And so that's where we, I think, can dive a little bit deeper into the detox discussion here of like, you know, detox is a trendy word. There's detox teas and supplements and stuff. I mean, for the most case, like we said, our bodies are designed very well. If you give it what it needs, which is, regular bowel movements, good fiber, hydration, making sure you have enough protein, because those amino acids support that liver, liver supportive nutrition like what Drew was talking about with cruciferous vegetables and the allium family.

So, you know, broccoli, kale. sprouts, cabbages, things like that. But there's really interesting research out there looking at when you have weight loss and fat loss, you actually can become more toxic. And we have seen this in lab work in patients too, but also those patients will show symptoms too of fatigue, headaches, nausea, GI distress. We'll see some of those more pronounced I guess symptoms. And then we have to think kind of back of like, okay, again, how do we approach this? So Dr. Drew, can you talk a little bit more about, you know, kind what's going on in the liver and the gut as we're releasing these toxins into the body, into bloodstream?

And what do you need to thing about as far as like a liver-gut approach? Right. So this goes back to what you guys do so well, which is figuring out dosing strategies.

Fat loss, toxin mobilization, and liver detox support 22:00

Because when you're losing weight appropriately, and it's not too fast, right? Our body's ability to detox can, as long as we're, you know, having a bottle of those types of things, our body is ability help to keep up with that detoxification. can be there. And that's why we're always checking on it, you know, and doing, every so often consults to figure out where they're at. But dosing strategies are important. That's number one, because you want to be able to lose this nice and slow. We know that toxins are some toxins, not all, but most, I would say most toxins that are stored in fat, right?

There's some storing, brain and bone, they can stored everywhere, But a lot of the toxins already storing fat. And so as you're breaking out open the sweat, those toxins have to go somewhere, right? Ideally, there's three main ways that we're detoxifying. It's through the stool, urine and sweat. Ideally we are eliminating them as fast as they're kind of coming out. We know that the liver is very, very important for detoxification. And there is, you know, a few phases of detoxification that we need to consider.

When we're on our end, the biggest thing that can do again is keeping the patient having a bowel movement. It's a bonus if they're staying hydrated and urinating frequently, but still maintaining the electrolyte status. The sweating part right that like sauna a couple times a week. It could be very, very beneficial. So once. I like the thing that you mentioned about detox tea, right? Detox doesn't come in a tea right. So, you know, maybe I would say the biggest benefit from it is probably that it maybe helps you hydrate a little better.

And if it tastes good, great. But there's not, yeah, that is not step one. If you're like, Oh, I need to support my weight loss. Don't go spend money on that. I think. You know, if you look at the phases, the two phases that go, like you said, you have to start with the gut. The guts have be moving because we don't want to upregulate processes in the liver if it doesn't have a way to get out. So, yes, then we go to the lever, phase one, two, biotransformation and conjugation, and then it's looking at, it is all nutrients, vitamins and minerals.

that basically are these co-factors for all these enzyme reactions that help, you know, clean things out of our body. And so I think you, I don't know. What are some of your favorite, ways to support the liver when we're during weight loss? Well, first thing is making sure that we have proper nutrient status, right? So what happens when you're on GFPU? Appetite suppress, okay, we are not eating as much. We want to make sure that we're eating a high quality to get those vitamins and minerals. At the very least, you support with a multivitamin.

to make sure that we have the appropriate nutrients to support detoxification in the first place. I really think that most GLP-1 patients and most patients in general should be on a high quality multivitamin and possibly mineral complex too, depending on what their specific situation is, because especially if they're not eating enough, which is very common. But yeah, even the quality of our food is significantly reduced compared to 50 years ago even as far as how much nutrients is in our, well not as much because our soil is more depleted because of the way we farm.

They've studied this. You can see the trends of what has happened to our soil quality and even the quality of the produce that we're buying. I say that a multivitamin is kind of like a safety net to get making sure you're hitting all those vitamins and nutrients that your body needs. And yes, the quantity definitely matters. So we always recommend, you know, there's a handful of really good quality brands that do third party testing. A lot of them are involved in academic research and they're not necessarily the ones you can buy just over the counter at the store.

So yeah, definitely. I like what you brought up about the multivitamin. Can you talk, what about amino acids as far as liver support? What's the best way to get those? That's what obviously is the protein. But if you don't, I'd like a broad spectrum of amino acid, right? You know, there's so many benefits to if we're not eating enough protein, you know when we eat protein it breaks down into amino acids and amino acid are building blocks. They're building bucks for your muscle. The building block for neurotransmitter in the brain.

So protein really is primary. Okay. If we're having fluid issues, protein could be helpful or amino acids could helpful because they could support things like serotonin, dopamine, and GABA. I like using them more of how we find them in nature or in meat and adding multiple amino acid together. Yeah, just not pushing one pathway. We're supporting them. we're giving the body the basic building blocks and then the Body can do with what it wants to, what feels like it needs to because the Party is 10 times smarter, 100 times smart that will ever be at this.

It will know what to do. it was designed perfectly, right? Yeah. For sure. And I think, you know, a lot of people are asking like, well, what about protein supplements? What about this? This is that, and I have seen patients where it's like that's almost like the bulk of what they're getting for protein is a of highly processed. It's food is better. Food should be first. You know? If you supplement with a high quality protein shake once a day to help, I don't think that bad, but I the source really matters.

Actually, there was just a very popular brand of protein, a Costco brand protein that just tested super high for heavy metals. So this is again, if you are going to supplement with a protein shake. ask us for a recommendation, we'll recommend the brands that we know, again, third-party testing, making sure the product's clean, make sure it's good quality, that it doesn't have a lot of additives in it, but definitely a food-first approach to getting a wide variety of different food sources in to support all those nutrients and stuff as well.

If they can't do it, then that's where I say, okay, maybe to do two scoops of protein, you know, or something along that lines. But, one of the bigger things is making sure that we're maintaining muscle mass. And in cases where they're just not willing to eat, even though the dose is kind of lower or that kind thing, they don't like protein or it's just unattractive to them. then that's where supplementation is important. Yeah. And I would say even patients eating like a vegetarian or vegan diet, they're definitely supplementations becomes key because there are some very key nutrients that only come through animal products, unfortunately.

So, but going back to liver support and detox and making things, making sure things A lot of B vitamins and certain nutrients, B12, are pretty much animal sources. So they may need to supplement with some of those things where this kind of goes back to that lab discussion of where are nutrient levels on the labs to make sure that your body is getting the support it needs to help move things out. The same thing for liver, too, is on extending the patient's exposure, right? If they've had high exposures of heavy metals or Or mold or some of these other things, right?

Then you might, you know, we might take it a little bit slower. There may be some times where we. Want to add in some heavier detoxification support, like maybe some binders or. You may want to have some. Things that will speed up the liver pathways and it has to be done supervise that has been done with somebody that knows what they're doing right and we talked about the three faces the lever right so you know everybody wants to focus on glutathione. glutathione we're seeing that everywhere oh yeah because the evidence is now coming out like people are catching up that this this is a problem that that toxins are stored in fat that when we lose fat too quickly that toxins are going to be mobilized and so what what do you see on instagram you're saying practitioners talk about glutothione well yes that is one part of phase two detoxification right one par but you can There's many other parts of that that need to be supported, especially getting it out of this step.

So people will also say milk thistle. Well, what we know about milk, this is that it will actually keep the toxin in the cell a little bit longer. Is milk. This is potentially helpful for deliver. Yes. But couldn't potentially create harm if we have a lot of toxins by keeping the toxins stored in, in this cell, a bit. Absolutely. And these are things that practitioners are not talking about. They don't know. About it. and this. Why we continue our education on this, We know that there's certain products and I'm going to share this product this first, but I want you guys to know, that if you're on any sort of medication, especially in SSRI, you should not use this.

These are only should be used under the supervision of your provider is things like St. John's work. St John work can be can help speed up phase three of the liver get get the toxin out of liver and into the violin and out into digestive tract, but we know St. John's work is good at doing that. And if you're a candidate for it, that may be a possible intervention. People aren't talking about that, people aren t talking that you need to speed up phase three for detoxification. They only want to focus in on some of these other ones.

And this is why it's important to have a provider that's continuing their education. We talk about this, Emily. It's like, OK, we have this information that toxins are being mobilized, you know, and more providers are talking about. You know you have the decision to make. you can either pivot, understand the research, pivot and modify our approach, or we could choose to ignore it. And you just can't choose ignore. This is too big of a problem that we need to be talking Yeah, absolutely. I mean, we want these to make people healthier.

Yes. We want to see healthy weight loss, but we also want people to become metabolically healthier, to offload some toxic burden, and we really want them to feel good. Something I think too about weight loss and you know these are all conversations too of like what if I'm taking this and I am not losing weight or I m not seeing the results. This all comes into play too because a lot of these things if they're not being supported well can inhibit your ability to lose weight. And I've seen patients not lose well if their under eating on a peptide or under-eating in general.

But another key component that I, maybe we should have started with this, but is still foundational is cortisol and sleep. Cortisol and Sleep, I would say plays a role. I've had patients on a GLP-1 doing really well, having good steady weight loss, and then all of a sudden it's like they can't lose. And a lot of times there's a huge stress component to it. There's sleep disruptions. I think screens, I mean, how many of us aren't guilty of laying in bed at night scrolling our phones and stuff, but that exposure spikes cortisol, inhibits our melatonin, and then we don't sleep as well.

And melotonin is a master antioxidant and helps support rest and repair.

Stress, sleep, and circadian rhythm 34:10

So having a healthy balance of cortisol managing stress while being able to sleep well and wake up rested is all vital to weight loss. And another key concern in our patients, both GOP ones or not, is hair loss. I just read a really interesting study about the melatonin controls a lot of the receptors around our hair follicles in terms of protecting us from hair lost. And this idea that, I mean, scrolling your phone at night could be causing your hair to fall out, essentially is kind of what I inferred from this, not just that.

If we don't have a healthy cortisol balance and a good melatonin level and aren't sleeping well, you might not see good weight loss. You might gain weight.You might see your hair fall out. That's one of the reasons we know stress can cause hair loss, but that comes into roll here because a lot of patients on a GLP-1 will say, oh, my hair's falling out, Well, the actual mechanism of the medication doesn't cause hair loss directly, but nutrient deficiencies on it, under eating on, it toxic mobilization.

Yes. Oxidative stress. So if you mobilize toxins and cause that, that could cause irritable and then yes, stress, sleep, all that. Really, you know, we've, I always say it's a tool, It is a. It's an amazing tool. I've seen it change people's lives. These, these peptides, But I think that it has to be used well in a comprehensive, lifestyle program. If a patient, I would say a lot of times that stress component is being ignored in a lotta patients where they're gaining weight, they can't lose weight.

Even when they go on a peptide, and it is such an important part. I always say it's one of the most important things to fix. It's the hardest thing to fixed probably. Stress is around us, but there are ways that we can protect our sleep, support our bodies to try to change how we cope with it. versus like we can't get rid of it, but we could cope with it in different ways and make sure that we give our bodies a chance to step away and rest. It's all about getting our bodies to adapt from stressors.

And what we want to do is kind of change or reframe what stress actually is and where it's coming from too, right? Everybody wants to talk about the emotional stress. Oh, I had this fight with my spouse or our work isn't going well, et cetera, that guy cut me off in traffic, those are emotional, stressor, but we also have physical stressers. We have physiological stresser. These are all things. We can get stress from the light that we're, you know, that were getting here, right? From just these, these LEDs or, those high light, energy light bulbs, Right?

That we all have. And that is disrupting our ability, especially at night to produce let's own it. Right. Yeah. So melatonin being a very potent in redox because it can be an antioxidant to help neutralize some of those free radicals and maybe why we're seeing hair loss is one of these things along with nutrient deficiency. Um, it makes total sense. So I think Emily, I this would be a great time to kind of just talk about some sleep strategies and strategies that we use. And so maybe, maybe throw out some products to, um, you know, where to look of how we can, really what we're talking about is circadian rhythm and how that all impacts our health.

Yeah, absolutely. Yeah. We should probably do a whole other episode on this, but yeah, in general, I think some of the best supports for this are the free ones. Get outside in the first, try to within the two hours of sunrise, get outside for at least 15 minutes of direct sunlight, ideally 30. You know, step outside at lunch. It's best to be 30 minutes before sunrise. If you could get out there and see the gate and gaze at the sun rising up, that seems to me the Yeah, definitely. But to try to be realistic for people, I try as soon as they can within that time.

If they're working inside all day, which a lot of us are, step out at lunchtime for a few minutes to get that sunlight. And then keep your mornings bright. Keep your nights dim. Try to get off your screens a cup, you know, an hour or two before bed. If you're just building up to this, try to keep your lights down, light candles. Again, outside for a night walk or evening walk, watch the sunset. That is a great way to try and support your circadian health, which is, again, really, like I said, a foundational to supporting stress balance, weight loss, detoxification as well, everything.

Yep. There are actually interesting studies done that look at artificial light exposure and blue light, exposure in, on body fat and weight gain. And there are actually study where they looked at, I read one, oh gosh, it was a while back, but they were looking at people who slept with a TV on in their, in the room and they saw significant weight, gain over a period of years and. Like I said, a lot of it is that blue light exposure spikes cortisol, which then inhibits your ability to have your melatonin rise at night.

And that all plays a role in immune health, weight management, metabolic health. So I think that we should definitely do another talk on this too. But these are important things to think about. Yes, I'm going on a GLP-1, but do I have my foundations in place? So I hope this has sparked some good ideas for patients and some things think. I know when we have your visits, there's usually so many things we talk about, and it's hard to go into depth on everything. But if you have questions, concerns, definitely let us know at your visit.

Reach out if have concerns. If you're having side effects or issues on your peptide, And then I've one, I don't know if you have anything else to share Dr. Drew. I have one other thing I just, they know all about this stuff too. That I'd been trained on all of this staff, right? I think we covered a lot and I want to make it digestible and you know, actionable things for the patients. or future patients to actually come and walk away with and be like, I learned something today. I'm going to start implementing this or, you know, feeling a little bit more comfortable going into a consultation for a weight loss peptide and knowing that this is much more about weight-loss.

We're driving health with the side effect of losing weight. Yeah. Yes, absolutely. Weight loss is a side-effect of these meds for sure. or this can be done really poorly. We've seen it happen both ways, right? Yep. Yep, absolutely. I think that's the other thing is, here's where I really think we should add. Let's talk about the quality of peptides, where we get the peptide from. And some of these gray market peptids, because you're seeing all that. People aren't going to do these. It's exploding.

You're seeing this grow so much faster than any other medication, and you're getting new and more and different GLP ones. So I don't think this is going anywhere. I think it's only going to continue to skyrocket. Giving patients an understanding of why it is so important to source these from a really, really good pharmacy.

Peptide sourcing and safety concerns 41:40

Yeah, absolutely. So I say right now there's kind of like three categories of where people are getting these from. There are the commercial branded FDA approved peptides like the Monjaro, the Wigoby, Ozempic, and those are coming through commercial pharmacies produced by big drug manufacturers. They're very standardized dosing that goes either a vial or a pen that patients are dosin. And I have patients on them. I think my, I guess my biggest critique about those is that there's not a lot of flexibility with the dosing and that they tend to dose people up high pretty fast.

And I've had patients even who are diabetic or pre-diabetic on them who I will usually recommend actually, you know what, You don't have to go to the maximum dose. Let's walk it down a little bit and really work on these foundationals first. And then second category that we work with a lot as well is through an FDA approved compounding pharmacy. So these are pharmacies in the United States who are have permission through the FDA to make these medications. They are inspected usually multiple times a year.

they're using quality pure ingredients that go through third party testing. You know, you know what you're getting very and there are there's unfortunately a variety of different types of pharmacies. There's two main categories of compounding pharmacists, but we have worked with our pharmacy that we use mainly we've worked for years. We have a great working relationship with them. They're very compliant. But they work closely with the FDA. they have high quality product and it's just your source.

Your source matters a lot. And then now we have this other category that's really exploded and they're calling it the gray market peptides. So people research peptide. People are ordering them on the internet for usually they look like the price looks pretty good. But what you order is, you know, what's your spend is what? You're going to get for quality. And I just actually, we meet pretty regularly with, various pharmacists and stuff. I was on a meeting a couple of weeks ago with one of our pharmacist that we partner with and he said they're.

pharmacy orders these gray market peptides, they will buy them off the internet and then they send them for third party testing. And they have never seen one come above a 20% potency as far as like what they say is in it is what's in. They advertise as 99% or and whatnot, not a single one he said has ever been above 20%. So then your concern is, what else is there? Where is it coming from? Also you spent, yeah, maybe it looked cheaper, but you're also getting not what you thought you were getting.

And so I really discourage people from ordering that. I actually had a patient who came in on a gray market peptide who had really bad liver enzymes. We stopped that, I was like, please stop that! We did a little bit of support, rechecked labs, they improved. So you might be getting some potentially dangerous products as well when you're not, you don't know what you are getting. so i really caution people for ordering things through there. But it is, the source matters. If the price looks too good to be true, it probably is.

So really, definitely always ask us if you have questions about sourcing. Yeah, 100%. And like you said, you might be injecting something potentially harmful. And this is just similar to supplements. You want to make sure if your ingesting it or inject it, that you had the highest quality and you're certain that it is the high quality. Yep, absolutely. Okay, Dr. Drew, I think we talked about a lot today. As always, if anybody has any questions or concerns or thoughts, or if you're interested in talking about a peptide or you are already on one and you have concerns, definitely reach out to the clinic.

We would love to talk with you and have a great day, everyone. Thank you for joining us on the Forum Health Integrative Medicine podcast. Each episode, we help you understand your health from every angle and inspire your lifelong wellness journey. Follow the show, share it with someone who needs hope, leave a review, and take the next step toward feeling your best at forumhealth.com.