Dialogue SHR # 2690 :: The Pep Talk: Immunity, Autoimmunity, peptides and Fasting

Show #2690
DIALOGUE edit
The Pep Talk: Immunity, Autoimmunity, peptides and Fasting
with Guest, Dr. Heather Smith-Fernandez, MD

Immunity, auto-immunity peptides and fasting, and how to use these very powerful tools together.

Carl Lanore: [00:02:01]
Fasting has taken on a life of its own. peptides have taken on a life of their own, although peptides have hit a little bump in the road.

We had all of these amazing peptides being released and introduced as quickly as the science was available on them, but the FDA put their foot on that brake, acting on behalf of the pharmaceutical industry. They have no other reason to stop this and taken a lot of very valuable peptides out of physician's hands.

Dr. Heather Smith-Fernandez, MD: [00:02:37] it really has, and it's such a shame because they haven’t come forth and said why they made this decision. A peptide means 50 amino acids or less and for, for some reason, the FDA decided that that's no longer going to be the definition of a peptide. That wasn't the only decision that they made. Now, they say a peptide is 40 amino acids or less, so there are quite a few very popular peptides that that are no longer able to be made in compounding pharmacies. There were some other things that they changed such as how they're allowed to classify or obtain the raw ingredients, how they're supposed to be putting these molecules together. Anything over 40 amino acids is now considered a protein.

We lost access pretty quickly to one of the most popular peptide combinations with CJC and ipamorelin, the growth hormone, releasing hormone combined with a growth hormone, releasing peptide, very powerful peptide, very well tolerated allowing our patients to get tremendous results and sustainable use of this peptide.

Dr. Heather Smith-Fernandez, MD: [00:04:34]
I could probably spend the whole hour talking about the peptides we don't have available but we still have a really nice arsenal of peptides available to us and we're working toward bringing some of these back in the peptide physician community.

Carl Lanore: [00:05:04]
CJC 1295 without DAC, isn't CJC 1295, it's modified growth factor 1 through 29.

It already had a name, but CJC 1295, which was the long acting secretagogue attached itself to the albumin. It stayed active for up to seven days, but it had greater activity in the first three days. This is actually not a good thing for the human body, because we are not used to having this big trough of growth hormone all the time.

We're used to having troughs and peaks and men and women pulse at different rates. People want them to capitalize on the craze of this is CJC 1295 without DAC. No, then it's not CJC 1295. CJC 1295 is specifically the long acting secretagogues growth, hormone, releasing hormone secretagogue and if it doesn't have DAC then let's just modified growth factor 1 through 29. I kind of feel like they pandered to peoples’ unknowing. What do you think? Am I, am I being too critical of the industry?

Dr. Heather Smith-Fernandez, MD: [00:06:34]
I don't think you're being too critical. There is not a lot of explanation on the background of those peptides and the differences between them.

I prefer anything that can stimulate the body's own natural mechanism. We don't know everything there is to know about how important those pulsatile Functions are, but we certainly know that they're pulsatile for a reason.

The best comparison is the difference between how peptides increase your circulating growth hormone levels versus how recombinant human growth hormone does if you're injecting that. Those are two dramatically different clinical pictures.

Carl Lanore: [00:07:40]
I understand that the FDA is supposed to be the firewall between the safety of the public and predatory Pharmaceutical companies, but that's not working. Why don't they have to provide substantial data to show why they're taking these overreaching actions?

Why doesn't someone in the medical side put together a coalition, say we want the FDA to explain these. I mean, if they're based in science, let's hear it. We'd love to know it.

Dr. Heather Smith-Fernandez, MD: [00:08:26]
We actually did that. We made a mission statement and an agreed upon statement, put signatures on it.

Carl Lanore: [00:09:41]
Another aspect to this is protection of intellectual property. I remember when ARA 290 came out, we did a show and the interest in was phenomenal so much so that it got the patent holders attention somewhere in the Northeast of the United States.

They reached out to my show and they said, you need to take that show down. They also reach out to the doctor I had on and threatened her.

They then reached out to the compounding pharmacists and told them they can't compound this. We have a patent on this. I don't understand how you can patent something that naturally occurs in the body just for the record. You know what I mean?

Dr. Heather Smith-Fernandez, MD: [00:10:42]
I'm also a regenerative medicine doctor, so I use autologous products to help all kinds of conditions in the body. I'm a walking billboard for it. I've had lots of my own body parts treated that way. And there's a big concern because one of the things that's really protected PRP is that it doesn't fall under the purview of the FDA because it is your own body tissue. How you process it which equipment you use and all of those things have to be approved and safe, but if now we're leaning into parts of your own body now going to be regulated by a government industry. That's a little frightening.

Carl Lanore: [00:13:35]
Lets talk about auto-immunity for a second. A lot of things are coming forth over the past couple of years that we're now understanding have an autoimmune component. Osteoarthritis was once thought to be the result of weight bearing on the joints. We know that that's not true now because obese people get osteoarthritis in their neck and in their fingers and those aren’t weight-bearing joints. So now we know that it's from inflammation.

Inflammation is the army of the immune system. We're talking about the immune system attacking your own tissue. A couple of years ago, a good study showed that one of the earliest signs of Parkinson's disease was chronic constipation. Now they're starting to think maybe Parkinson's disease has an autoimmune component to it. I'm starting to think that all diseases of modernity, chronic diseases you're not born with, but as you get older you get them are all autoimmune in nature. If you had to look 20 years out, seeing what you're seeing on the front lines, can you predict, we're going to find out this is autoimmune in nature, or this has an autoimmune component to it. Any other diseases that we're treating right now that aren't considered autoimmune in nature?

Dr. Heather Smith-Fernandez, MD: [00:15:10]
What I understand from my practice of medicine is we're going to find a lot of dementia that is auto-immune regulated. We're going to find a lot of psychiatric problems, especially anxiety. We already know that there's a huge link between the gut and the brain, and so much auto-immunity begins or is fueled by some things that are happening in the gut that shouldn't be happening there.

There are behavioral things in younger people that it is an auto-immunity. When I say auto-immunity, I'm talking about a dysregulated immune system, that's just gone off the rails. overworking in this area and underperforming in this area.

I believe that dementia and cognitive decline is a huge problem. It's a massive problem in our country and in other countries where people can't live independently anymore. There's no quality of life for a lot of years or diminished quality of life.

There's a lot of unnamed autoimmune phenomienons. There's autoimmune poly arthropathies there's lupus there's auto-immune presentations that don't even have a name yet. The state of inflammation is really setting us up for a lot of these problems. The other thing is the presence of chronic infection diminishes your immune system, it weakens your immune system and it starts to dysregulate it because you're dealing with this enemy that's constantly there and it can come from overgrowth of certain bacteria in the gut. There's a lot of focus on the teeth, having these chronic persistent infections in the teeth, mold, the presence of mold is not always that easy to identify.

It doesn't show up on blood tests all the time and it doesn't show up in urine tests all the time. But mold just cripples the immune system

Carl Lanore: [00:18:09]
Give me the prelude to the discussion about treating autoimmune disorders with peptides and fasting. How do they work together?

Dr. Heather Smith-Fernandez, MD: [00:18:23]
Most of the time in my practice, I do recommend intermittent feeding. That seems to be the easiest lifestyle change for patients to adopt at least to start with. Some do well with that and go on to do a 24 hour once a week fast, but that daily fast of 16 hours eating in an eight hour window is what we work toward.

So many people are eating right before they go to bed. It's just such a cultural thing for us. Many times they're eating ice cream or cake, cookies or something right before they go to bed. That can be so disruptive to sleep. Or drinking their evening drinks all the way up until the time they go to bed.

We start working on that stuff immediately. I like to get them fasting, not eating until around noon and then they have to stop eating by eight o'clock.

I like to use the growth hormone secretagogues if we're doing intermittent fasting like that, 90 minutes after their last meal, when they're getting ready to go to bed again in the morning, especially if they exercise in the morning as not everybody can exercise in a fasted state.

I think that's a little bit more advanced for some people, but even if they just go for a walk, start getting that mindset on positive things. And the BPC 157 orally is wonderful to be using in the morning and at night in a fasted state. Now, if they're going to fast, like what we do with ProLon where it's a five day fast mimicking program, or they're going to fast for five or six days, I don't usually have them using growth hormone secretagogues, because those programs drop the growth hormone until the refeeding stage.

Carl Lanore: [00:20:57]
A lot of people think fasting raises growth hormone. And it does temporarily during the initial fasting period when ghrelin is doing its job. But once, once hunger passes, you stop making growth hormone ghrelin leaves and it just suppresses somatostatin.

People put a lot of faith in ghrelin and ghrelin agonist. I even hear some doctors inappropriately telling their patients all they need Ipamorelin and maybe they can get a little something out of it. But if you’re not using a growth releasing hormone, in conjunction with a somatostatin blunting agent, you just don't get the response.

Dr. Heather Smith-Fernandez, MD: [00:23:32]
Another peptide, when we're talking about fasting and even with inflammation and immunity that isn't affected by fasting, well not actually a peptide, it's actually a small molecule. It's pentosan, polsulfate pentosan. Pentosan is a really interesting substance. I have just some incredible turnaround stories with pentosan by itself, not even in combination with the other peptides, I usually combine it with when it comes to that joint. Pain and dysfunction.

Pentosan actually starts repairing articular cartilage, which is really a Holy grail for us. When you can use an intramuscular peptide two courses a year, and you're regrowing, articular cartilage, you're slowing the osteoblastic activity, stimulating chondracytes slowing down osteoblasts and modulating matrix metalloproteinases. So you're actually creating a healthier joint environment in all of your joints, not just in one that you're sticking a needle into.

Dr. Heather Smith-Fernandez, MD: [00:25:44]
I put together a PDF of the 10, most common conditions treated with peptides and some of these peptides we were bringing to market, though now there's a little delay on them, but I felt like it was still relevant for everybody to know how powerful peptides are and all of these different areas where peptides are serving us as human beings to prevent disease, to keep us healthy, to keep us sharp and enjoying life and participating in our lives.

The 10, most common conditions treated with peptides. There are probably some peptides in there you may not have heard of so it’s kind of exciting. Check it out and just enjoy and I hope you're as excited about peptides after reading it as I am.

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Carl Lanore: [00:31:31]
So you were talking about polysorbate. I had a doctor Dr. Alan Dunn, and he had a clinic in Florida called the intraarticular growth hormone recovery Institute. He was treating athletes and average people who were slated to get knee replacement but who wanted to try something else before they went in and did this very invasive procedure. He would inject 20 IUs of growth hormone in it may have been large molecular weight, hyaluronic acid gel, and he would use ultrasound and go into the capsule joint of the knee. He would squirt 20 IUs in there once a week for three weeks. In six months cartilage was not just chondrocyte sprouting, but the blood vessels from bone on bone, which starts to sprout out of the bone and then chondracytes would grow from those. He showed perfectly that you can regrow cartilage

Carl Lanore: [00:33:23]
Talk about peptides to use during feeding states.

Dr. Heather Smith-Fernandez, MD: [00:33:28]
During feeding states, I definitely like BPC 157. I use it in fairly high doses. It's been shown to be safe in extremely high doses. I've seen that in myself and in my practice.

In most of the cases, it's very effective at that rather than, you know, going for Tums or something that isn't really terrific for your gut. You can take BPC and resolve those symptoms. You can also take it in a fed state and then it's going to absorb really well.

The other two peptides for sure that I tell people to take with something in their stomach are Melanaotan and PT 141. Melanotan is a tanning peptide and it can make people feel very nauseated and that nausea is much more severe if you're in a fasted state.

Carl Lanore: [00:34:52]
I use Melanotan every morning. I compound my own intra-nasal spray at home and I never get nauseous, no matter how large of a dose I do. If I inject it, I will absolutely get nauseous. I've noticed also that the more melanin you have in your skin, which I obviously have a bunch the more nauseous you get. I know a lot of fair-skinned people that will inject it and don't feel nauseous at all.

Dr. Heather Smith-Fernandez, MD: [00:35:32
I'm about as white as they come and I get pretty nauseous with it but I think it probably has something more to do with the constitution.

Carl Lanore: [00:42:47]
So what about hormones? I mean, for say a 58 year old, man, he's got to need testosterone by now.

Dr. Heather Smith-Fernandez, MD: [00:42:55]
Probably we're seeing younger and younger people needing hormone optimization. We could talk for hours about why that is. There's a lot of theories but the reality is that it's happening and maintaining optimal levels of testosterone is really important. That's the basis for preventative health. If your doctor isn't really familiar with hormone optimization, you might want to find somebody who can do tests and, and look at that from a preventative health standpoint, not just, oh, your testosterone is 230, it's fine, because it's not.

Carl Lanore: [00:43:32]
It’s funny, I've been doing the show for this is my 16th year. When I started doing the show, the low end for men, of testosterone was 489.About five years later, it dropped down to a 320. Today I think it's 260. The lab assay, at places like quest. Now they're saying masculinity is a spectrum and we are seeing more and more young boys going into puberty with very low levels of testosterone to spark their pubertal changes. We're seeing alterations in their personalities and some other executive functions later on in life when they're 30 and 40 years old, as a result of not having the tests and the scientist that I had on, a brilliant guy, said, we need to start thinking of masculinity as a spectrum.

Dr. Heather Smith-Fernandez, MD: [00:45:36]
Yeah, not a future I want to be a part of. Let's work hard to fix it. What you said was actually really key. Look at how the level of acceptable testosterone levels has lowered and lowered and lowered. What does that tell us that tells us that our lab norms? This big span of normal doesn't mean the span of normal, healthy people

Carl Lanore: [00:46:05]
It's the span of a sick population of people. Like everybody has type two diabetes so they change the blood sugar level norms instead of -25 being diabetic they move it up to 250 because everybody's at 125.

No, you don't change the target because nobody can shoot straight. You get them to shoot straight. That's what they’ve been doing with some of these lab values.

Carl Lanore: [00:46:31
In 2005. I did my first show about dilates. The anti-androgen. it's in plastics in those plug in air fresheners. There's failure, they're being vaporized into the air. They look like androgens, but they don't act like androgens.They have a high affinity to the engine receptor and they block the ability for testosterone to get the receptor. This is the same thing as neutering a child. That's what these are. We live in a sea of Xeno estrogens, phytoestrogen Xeno, androgens, vital androgens, and we wonder why we have people that are confused about their own sexuality.

The brain forms in the third trimester. The genitalia forms in the first trimester, if your mother was exposed to hormones in the first and then other hormones in the third, you'll be mismatched for the parts that you were born with.

Dr. Heather Smith-Fernandez, MD: [00:47:54]
We have a lot of external hormone exposure. We promote trying to be aware of that in food, but there's just a lot of it out there.

Carl Lanore: [00:48:03]
You talk about mold and a lot of doctors today talk about mold and infections. Can these infections be tested by blood work? Can you test somebody and see they’ve got an overload of this pathogen.

Dr. Heather Smith-Fernandez, MD: [00:48:21]
It's very hard to do in blood work. Some of these things hide inside the cell and that's what makes it difficult. You'll see people get exacerbations of illness and feel better when they fast. You can't always look at somebody and know what their bio burden is. It can be really hidden. When they start to fast or they start to clean out their body.

Dr. Heather Smith-Fernandez, MD: [00:57:50]
Probably my most dramatic and exciting story is, I have a patient who had end stage arthritis in both thumbs, really bad pain and was starting to lose function.

He was a guitar player, a fairly serious guitar player, five hours, a day of guitar playing, played in a band at night and things like that. Middle-aged person, but a lot of wear and tear on those joints. He was told by the surgeon that they need to be replaced. There's nothing else to do for them and if you have them replaced, you have a 50% chance it's going to feel better ana a one hundred percent chance you're not going to play guitar anymore. So he really struggled with that. We had done PRP and had some success for about eight or nine months, but it was pretty uncomfortable for a week and he just felt like it wasn’t a good long-term solution.

So I said, let's try pentosan. He was so doubtful, but by the third week of treatment, he had no pain in his thumbs and was back to playing full guitar. Just amazing.

Carl Lanore: [00:58:48]
Wow. That is so cool. I’ve got to look into this. This is, this is good stuff. Dr. Heather, thanks for making time to be on the show today.

Dr. Heather Smith-Fernandez, MD: [00:59:03]
It was my pleasure. Thank you so much for having me

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