[00:00:00] Joe Christiano: [00:00:00] hey, Hey, welcome back. To another episode of Superman radio it's Monday, today is June 8th, 2023 days away. And I turned 62 62, three days. Luminal. I'm putting four fingers up. I'm like a chimpanzee. I don't even know what I'm doing. We have a great show planned for you today. So we're going to talk about how to recover, not just from an anterior cruciate ligament injury, but really a, this may be the magic to recovering from many injuries faster.

[00:00:33] Got to move my mic away a little bit, tend to talk loud later in the show. Um, some of you may have remembered last week. I kind of implied that. I think I've discovered a way to, uh, get rid of GERD, which is a big problem in the country today. Uh, using a G a peptide called  as a gastric pro kinetic. So somebody in the audience took me up on trying it, and we're going to find out if, [00:01:00] uh, it was a winner or lose.

[00:01:01] Before we do any of that. Of course, we always have to thank our title sponsor, legendary foods. They make a generous contribution to this show to keep it around so you can get great information for free. If you go to eat legendary.com. And use the code SHR you'll get 10% off everything you order seasoned.

[00:01:23] Ahmond's delicious nut butters that have no added sugar. And of course the tasty pastry, which is a pop tart with less than one gram of sugar, nine grams of high quality protein. And, uh, between three and four impact carbohydrates school, unfortunately is out. Otherwise I'd say buy them for your kids and send them to school with them because they won't realize they're eating something good.

[00:01:47] Uh, so check them out, go to eat legendary.com and let them know that, uh, Carl sent you there. Let's see if I can get this done, right. We're going to bring my guest on now. Dr. [00:02:00] Lindsey. Lepley. How are you? Dr. Lepley

[00:02:03] Dr. Lindsey Lepley, PhD: [00:02:03] I'm great. Thanks. So,

[00:02:06] Joe Christiano: [00:02:06] um, interesting study new hope for ACL injuries, uh, adding eccentric exercise could improve physical therapy outcomes.

[00:02:14] And in fact, you even imply that this is, this is much bigger than just treating ACL injuries, right? Correct. So what, what, what study preceded this, that there were unanswered questions that required you to do this, this research.

[00:02:31] Dr. Lindsey Lepley, PhD: [00:02:31] Yeah. Um, first, you know, thanks for the opportunity, uh, to con and speak to your listeners.

[00:02:36] I really were motivated to sort of explore, uh, these notions that ecentric exercises is damaging, um, for, for a very long time, um, to study muscle injuries, scientists have basically taken rodent models and pulled muscle and lengthened it because they've known that's a good way to study, you know, ruptured muscle fibers.

[00:02:57] Uh, but. Muscle when [00:03:00] it's an in contact with the tendon and inside the body doesn't stretch that far. And so a lot of these studies have been sort of. They've been pivotal in sort of our basic understanding of how muscle injury happens and how sir, and how, um, how muscle can recover. But they've been supplied to the clinic and misapplied to, um, athletics because people don't walk around with this disassociated muscles from the tendons from bones.

[00:03:25] Um, so we've been working on sort of changing the narrative. Around that by using different types of experimental techniques to more or less conduct experiments that are more translational and more or less mimic what you would see in the clinic. So that was some of the motivation behind this work.

[00:03:42] Joe Christiano: [00:03:42] So first of all, you said the damage, right?

[00:03:45] So a lot of people think eccentric work damages muscles to a greater degree. In fact, that is a, of, uh, of law lore in, in the bodybuilding community. I mean, you know, we all said, Oh, you gotta be sparing with eccentric work [00:04:00] because it just damages the muscle so dramatically because. It seems to stimulate a greater, um, adaptive response in a protein, synthetic response.

[00:04:10] So it's just assumed that it's doing more damage, but your, your research found out that wasn't really accurate. Right? Exactly.

[00:04:17] Dr. Lindsey Lepley, PhD: [00:04:17] So we used a rodent model in our research and, um, Before your listeners think that that's maybe like a turnoff because we're using an animal model to, to demonstrate what happens in humans, that the benefit of animal models, particularly when it, when you think about musculoskeletal work is like 99% of the biology is maintained.

[00:04:35] So if we do something to a rat or a mouse or rabbit, Um, from a muscle standpoint, it translates really, really well. Um, and what we did was we investigated, you know, this concept of one bout of East centric exercise in a, in a rodent model or in a muscle. What does that do relative to the standard, which is content your exercise, and is it beneficial in terms of promoting and protein response?

[00:04:58] And then also. [00:05:00] What happens in terms of muscle damage, because the fourth floor or the conventional wisdom would tell you that it's, it's a damaging response. Um, so we went and sort of went directly at that question

[00:05:11] Joe Christiano: [00:05:11] and asked, and that's why physical therapists have excluded any type of eccentric work, because the idea is to heal the patient, not re-injured them.

[00:05:21] But so talk about the study. How was your study design? What did you do with these little roads?

[00:05:27] Dr. Lindsey Lepley, PhD: [00:05:27] So there's a market for rodent treadmills. And,

[00:05:32] Joe Christiano: [00:05:32] you know, we, we did so many shows on, uh, on, I've been doing this 14 years. We've done so many shows about rodent model. Studies as it pertains to, uh, physiology and skeletal muscular systems.

[00:05:47] And I'm always amazed by the special equipment that's made just to help rodents build muscle. It's just, it's, it's uncanny.

[00:05:54] Dr. Lindsey Lepley, PhD: [00:05:54] You cut out a little bit during that.

[00:05:55] Joe Christiano: [00:05:55] Uh, it's just, it's just, it's just so funny that we S you still can't hear me. [00:06:00] Hold on. Can you hear me? Can you hear me now? Can you hear me now?

[00:06:05] Okay. Sorry about that. It just amazes me about how, how researchers go to such great extent to make devices that help rodents build muscle loss. You're going to have to put your headphones, put your headphones back on because

[00:06:28] there's a feedback. Let's see if we can get them.

[00:06:33] Okay. Can you hear me? Yeah. You're back in. Okay. So we're good, but yeah, just, I digress. I just think it's funny how we, we worked so hard to help wrote in spilled muscle. That's all. So, so, so you have a treadmill, so, so what did you do? Explain to me how this study was designed.

[00:06:51] Dr. Lindsey Lepley, PhD: [00:06:51] Yeah. So, um, we've selected a strain of rats that are known to like running on treadmills.

[00:06:56] So that was sort of the first thing that we did. And then we also made sure that they were skeletally [00:07:00] mature, meaning that we selected an age range that would be representative of like patients that you would typically see engaged in, uh, physical therapy. Um, so these rats were like teenage rats. Um, So, so, so those are the two basic things that we did with the study design.

[00:07:15] I, in terms of how do you exercise a rodent concentrically or essentially just like you could as, um, a human is if you run downhill on a treadmill from a quadriceps muscle standpoint, if I muscle standpoint that lengthens the muscle. So all we did with the treadmill is we tilted it. Um, essentially, so they ran downhill to exercise eccentrically or we tilted it up.

[00:07:38] Uh, so they were. For running with their quadriceps muscle predominantly shortening. Um, so those are the two, couple of couple of things that we did I to put rats into different groups and to study this question

[00:07:50] Joe Christiano: [00:07:50] now, I think a lot of people will agree running downhill causes a great deal, more soreness in the quadricep muscles because you're literally the muscle is stretching in a different [00:08:00] fashion than, than a concentric exercise.

[00:08:03] Correct.

[00:08:04] Dr. Lindsey Lepley, PhD: [00:08:04] Exactly. Right. So your muscles basically built up. These foundational building blocks are called sarcomeres. We think of them as sort of like the Legos of muscle. So the way that you have them stacked, whether they're on top of each other or they're aligned end to end, really determine what your muscle is sort of built for in terms of function.

[00:08:22] And if you stress these Legos of muscle, these sarcomeres, if you mechanically tension them and there's some basic scientific evidence to suggest that that's a different way to grow muscle, then if you consistently just shorten it. Uh, so that's sort of the basis that we stand on as to why we think we like egocentric exercise.

[00:08:39] And when we study it and our lab is that there's some evidence to suggest that putting mechanical tension on the muscle by lengthening, it can help grow muscle in a different way. That's just simply not available to you if you're consistently, uh, engaged in shortening exercises.

[00:08:54] Joe Christiano: [00:08:54] And it makes perfect sense when you think about it, because.

[00:08:57] Muscles fibers are designed to [00:09:00] contract they're designed to shorten when you forced them to do the work and elongate. Yes. This is a lot more intensive for, for a muscle fiber. Then just shortening it's designed to contract. It's not designed to manage stress while getting longer. Well,

[00:09:17] Dr. Lindsey Lepley, PhD: [00:09:17] it's designed to do both.

[00:09:18] Right. But I think that like, your body's kind of like lazy and it will take the path of least resistance. Right? So like, If you're not overloading or you're not challenging your body, it says why adapt? And so you need to have some sort of stimulus to say to your body and to trigger as like a communication, like, Hey, you know, there needs to be more sarcomeres here.

[00:09:40] There needs to be more muscle here because there's more tension on these muscle fibers then, you know, they like to typically handle so grow. Um, but if you're consistently engaged in shortening exercises, you don't get that sort of line of communication.

[00:09:54] Joe Christiano: [00:09:54] So when people, and I was surprised, you know, I have an ACL, I lost [00:10:00] my ACL in my left knee.

[00:10:01] When I was 19 years old, I was skiing in great, gorgeous New York at the Playboy club. I had been drinking and doing cocaine all day long. I'm just being honest. Yeah, you could, you didn't. I know you weren't prepared for that. My audience knows me. I talk very openly about my young, younger days, and I came down the Hill and I fell in my bindings.

[00:10:24] Didn't come off and my left leg turned and I felt this snap. And luckily I had a. Uh, a good friend, very close friend whose father played for the Mets. And I went to the Mets orthopedic surgeon who was dr. James Parks at the time. And he said, look, you're not an athlete. We're not going to do a cadaver. You know, that back then it was cadaver ligaments that they replaced it with.

[00:10:47] He said, uh, and I, I was not into bodybuilding or anything at that point in my life. You know, I was just an average guy. And he said, you can make your quads really strong and you won't even know that you lost this ligament. [00:11:00] And, you know, I was young enough where my body responded and sure enough, you know, I spent most of my life.

[00:11:06] Never realizing that I had a missing ACL because I made those muscles strong. And then later on in life, I squatted a lot and I, you know, I hit some real big PRS and stuff. I got my knee knee never gave me any trouble, but there are so many people out there who are missing ACL. They got out of the car the wrong way.

[00:11:24] Like I have a friend of mine who blew his ACL out, getting out of his car. I'm like, how do you do that? He goes, I don't know. It's a big problem.

[00:11:34] Dr. Lindsey Lepley, PhD: [00:11:34] It's a big problem. There's I'm in terms of like orthopedic injuries, this is a very common one. And the challenge with most is that I there's this inadequate recovery of strength, which leads to like a widespread number of negative complications for individuals, one being early onset osteoarthritis.

[00:11:54] So there's some data to show that. Uh, we know the PKG of ACL injury, 16, [00:12:00] uh, and that most people, about 50% of people, whether or not, um, they have surgery or not start displaying some signs of osteoarthritis within about five to 10 years. And there's some data to even show that it's like a 20 year timeline towards your first knee replacement.

[00:12:14] So it's, uh, from a scientific standpoint, it's a good model to study for those that have a muscle problem that turns into sort of devastating osteoarthritis.

[00:12:24] Joe Christiano: [00:12:24] Why, why, why, why is it so difficult to regain the pre-injury strength? Is that because the body has a governing system that says we're not going to reinjure ourselves, so we're just not going to apply as much strength to that muscle.

[00:12:38] Dr. Lindsey Lepley, PhD: [00:12:38] That's good insight. So, uh, there's, there's a host of, uh, folks that are there looking at this problem, um, for those of you that have had ACL injury or seen a friends or family that I've had it, and one sort of unique consequence of it is that right? After the injury and immediately after the surgery, it's people have a really difficult time like firing their quadriceps muscle, making it contract on [00:13:00] its own.

[00:13:00] And there appears to be a really, uh, devastating neurological disruption that happens with an ACL injury. And maybe it's because the ACL itself is sort of narrowly innovated. Maybe it's the number of like inflammatory signals that are going on in the knee joint. Uh, maybe it's a protective mechanism initially to say, Hey, this is very injured.

[00:13:19] Don't use it. But the problem is regardless of the sources, it hangs around, um, and this sort of neurological disruption, I really, um, makes restrengthening the quadriceps very difficult because if you can't contract it. How are you supposed to strengthen it? Right. So it's, it's a unique problem. Um, it's not unique necessarily to ACL injury.

[00:13:41] It's just very devastating with ACL interest. It's very obvious.

[00:13:45] Joe Christiano: [00:13:45] Is there a Gurindji apparatus involved with the ACL? Is there like a feed, uh, a proprioceptive feedback mechanism going on that the body can go, wow, we're missing that now. And the knee's not going to be stable. We can't do too much.

[00:13:58] Dr. Lindsey Lepley, PhD: [00:13:58] You're pretty, you're pretty [00:14:00] on target.

[00:14:00] So there there's a lot of literature to look at many different sources of neurological disruption, one being golgi, tendon, organ disruption. Um, there's some data to show that the brain changes the way in which it thinks about activating the quadriceps muscle. Um, and that's sort of new, newer data that's coming online.

[00:14:19] Essentially. You can think about it as sort of a circuit. And you have bad information coming in now, whether, you know, whether it's, because there's a bunch of inflammatory markers pain, um, the actual disruption of some nerves, but that information in generally equals bad information back out. And there's a host of sort of levels that are probably involved, uh, that, um, you know, are causing sort of these poor outcomes for folks.

[00:14:44] Joe Christiano: [00:14:44] Yeah.

[00:14:46] Dr. Lindsey Lepley, PhD: [00:14:46] So our group has sort of looked at that and said like, okay, you know, there has to be a different route than a, to restore muscle, right? Because if you're reliant on shortening and if you can't shorten your muscle very well, is there another way to signal [00:15:00] to the body to grow muscle? And so that among other reasons is another reason why we like ecentric exercise because we think it's sort of like a bypass.

[00:15:08] To those traditional mechanisms that are more or less shut down or difficult to kind of get by in terms of roadblocks, neurological roadblocks. So we also have a series of papers that show that from a neural standpoint, egocentric exercise is beneficial to sort of re-engaging the system, um, after injury as well.

[00:15:29] Joe Christiano: [00:15:29] So. There, again, this folklore around the bodybuilding community is like, you don't want to do is centric or eccentric or too often because it does this damage. So you have to use it sparingly. Is there any truth to that? Do you have to use it sparingly or do you think that that's just because it's so effective at causing a protein synthetic response?

[00:15:51] We think that it's doing more damage.

[00:15:54] Dr. Lindsey Lepley, PhD: [00:15:54] I think there's a lot of unanswered questions. And what we do know is that if your body will [00:16:00] adapt and respond, so, you know, everything needs to be graded and there needs to be sort of a period in, into the exercise, right? You need to kind of get comfortable with it and used to it.

[00:16:11] Uh, but this, you know, the late onset muscle soreness that many people get, uh, with East centric exercise, you know, we have reason to believe that maybe all inflammatory responses aren't bad. And this initial inflammatory response that people see with the eccentric exercise, that's self rectifying, you do nothing, and it goes away within 48 hours, right.

[00:16:33] That would suggest to us that there's not really any damage going on because in true muscle damage, if you do nothing 48 hours, you still have damage.

[00:16:41] Joe Christiano: [00:16:41] Right.

[00:16:43] Dr. Lindsey Lepley, PhD: [00:16:43] The fact that it's self rectifying. The fact that I it's potentially beneficial to the neural system and able to engage channels that you know, are more or less shut down.

[00:16:53] Um, I think all stand on. It's a good thing to think about sort of incorporating [00:17:00] in to, uh, physical therapy is more of a standard of care rather than this like sexy alternative that people use every once in

[00:17:06] Joe Christiano: [00:17:06] a while. You know, the other thing is I've done shows about, because this phenomenon, especially in my audience of, of rhabdomyolysis is common.

[00:17:15] Again, you know, most of us in this, in this audience, we train excessively hard and where are we trying to progress? We're always trying to get stronger or do more reps and so on. And so we've had lots of people in the audience who've had rhabdo. And so I did a couple of good shows on rhabdo and discovered that, you know, creatinine is not.

[00:17:35] The indicator of rhabdomyolysis and in fact, uh, it's uh it's um, uh, I just lost my train of thought, but the, the evidence of muscle damage. As, as his presence of myoglobin, not Korea tonight, myoglobin is what really means. Wow, you, you, you tore up some fibers and, and what was inside of them came out [00:18:00] and, you know, so, so I'm, I'm wondering, like if people could look at myoglobin accumulation, post.

[00:18:06] Eccentric work and, and, and th and validate what you're saying. Like, no, I see. There's no real damage going on here. It's just, it's just, you're forcing the body to super compensate for something that it's really not prepared to do. I think you call it a novice muscle when it hasn't experienced eccentric work before.

[00:18:22] Right.

[00:18:23] Dr. Lindsey Lepley, PhD: [00:18:23] Exactly. So the reason we chose this model is we wanted to, you know, a muscle or an animal model that hasn't like prescriptively run downhill before, right. To say, like, what happens the very first time that somebody tries this and what happens the very first time that somebody tries this at a, at a moderate dose.

[00:18:41] So five minute bouts with two minutes of rest in between, you know, so total of 15 minutes of exercise, what happened. What I will speak to is we do know the folks that I've run their rats for like 90 minutes continuously. So this would be this like really big overdose is that it's not good for muscle, [00:19:00] at least initially.

[00:19:01] And that too big of a stimulus. Initially it most certainly will lead to a damaging response. Um, and it's. And so what I would caution is is that yeah, like if you overload and you really overdo it initially yeah. You can cause muscle damage, undoubtedly. But if you temperate in to an exercise program, a rehabilitation program, there's really no reason to believe that.

[00:19:24] It should be damaging at all in our, in our experiment, what we did took to look at muscle damage, just because those two, those markers that you were talking about was we took the muscle tissue itself, such kind of like a muscle biopsy, except we could take the whole quadriceps. And we stained it to look at muscle fibers that had been lysed or basically split open.

[00:19:44] Um, so we looked to see if the muscle had been disrupted and we used a different type of technique that would basically cause, um, um, marker of, um, Cellular health by all their accounts is way too big to get into a muscle fiber. So if it's [00:20:00] infiltrated and inside of it, it means that the muscle fiber must've first opened and allowed it to come in.

[00:20:04] Right. And we really saw, you know, relative to healthy animals, animals that had seen a single bat of concentrate exercise or a single bag of eccentric exercise, there was no difference. Um, so that sort of speaks to it's good for a protein synthesis response and acutely, if you tempered in right. There really shouldn't be this persuasive per pervasive amount of muscle damage that's been observed in other experiments.

[00:20:30] Joe Christiano: [00:20:30] the more often you do it, you know, your body gets used to things. You know that, I mean, when, when a newbie starts training, they see all sorts of muscle gains and then all of a sudden they don't get it. The more often you do it, you think it becomes less effective.

[00:20:45] Dr. Lindsey Lepley, PhD: [00:20:45] I think that your body, you just always consistently need to challenge your body.

[00:20:48] I think the body inherently is a lazy thing, right? So if you challenge it in one way and your body rewrote muscle or re augments its architecture to handle that stress, then it's good. [00:21:00] Right? So you need to consistently find ways to either increase the tension, increase, you know, the challenge in some way to keep your body engaged.

[00:21:09] Joe Christiano: [00:21:09] Interesting. Interesting. We're going to take a quick commercial break. When we come back, I've got more questions. Have you looked at, um, blood flow restriction, katsu at all in combination with eccentric. If you have, let's talk about it. When we come back from the break, I don't wanna, I don't want to give the, uh, the good stuff away here.

[00:21:25] I want people to stay with us, so, all right, we're going to come right back. Stay tuned. You are watching and listening to super the radio. Feel free to ask questions. If you want here on Facebook, this is the superhuman channel where we use oxygen for the power of good.

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[00:23:10] Over 200%. And the more that I get the better off I am as I age. So check them out, show them some love organifi.com/shr you'd use code SHR and save 15% off your entire order. Great company. I love their products. So when we were going into the break, I asked dr. Lepley. Has she looked at blood flow restriction or katsu in combination with eccentric and you smiled like, Oh, okay, this is something, is this something you're working on or something you've thought of?

[00:23:42] Dr. Lindsey Lepley, PhD: [00:23:42] And certainly something that I, that we thought of, I. So blood flow restriction therapy has a, like a lot of, um, as you probably know, a lot of attractive qualities to it and sort of that baseline as you for thinking is that you can train at a lower intensity and get the same [00:24:00] results. Um, so microbe has not independently looked at it, but I, my, my joint lab has, um, and what I will say is that the results relative to the ACL literature are.

[00:24:12] Are mixed. Um, some have found it to be beneficial and others have not. And so it may be that there's like a combination or a timing in which it could be beneficial. Um, that needs to be sort of further investigated. What I do know is an animal models where people have purposely tried to cause injury with East centric exercise and they've used blood flow restriction therapy is that they've mitigated the inflammatory response.

[00:24:40] So

[00:24:41] Joe Christiano: [00:24:41] that could be a good thing or a bad thing. Right?

[00:24:43] Dr. Lindsey Lepley, PhD: [00:24:43] I think, I think in this case, it's an inflammatory response. That's most likely associated with muscle damage because they were trying to cause muscle damage. So I think, I think in this case, it actually, at least in these basic experiments may suggest that it might be something worth trying.

[00:24:59] Um, [00:25:00] I don't necessarily think there's a lot of information to say that it's harmful. I think there's some information to say that it's beneficial. I think that it may be most beneficial when you can't quote unquote overload the muscle. And it may be good. Like during that, like, if we're thinking about ACL again, like during the more acute phases of rehabilitation where you're just sort of getting back into strength training and you can't overload because the graph site is healing.

[00:25:24] Right. Um, but maybe when you're back at sort of optimal strength and you can just simply go for it, it might not be as beneficial, or you just may need to train at a very high intensity.

[00:25:34] Joe Christiano: [00:25:34] Right. Yeah. Interesting. And because, because katsu was originally, I actually interviewed the Japanese scientists, I think in 2007 or 2008, they actually created katsu to help in injury management.

[00:25:48] You know, keep, keep people's muscles from atrophying when they couldn't load them. Uh, that early, early research was on the quadricep muscle wall. So, um, so what do you hope [00:26:00] people take away from your research? Uh, this research here. I think

[00:26:04] Dr. Lindsey Lepley, PhD: [00:26:04] what, what we're hoping is is that people don't get turned off.

[00:26:07] That it's an animal model, right? That, that these, this work really does translate quite well. Um, and that people should be a little bit more open minded about this conventional wisdom that Essentra exercise is always damaging, um, because it may in fact be a very low cost way. To grow muscle, right? It's universally available.

[00:26:27] You don't need specialized equipment to make it happen. Um, this study shows that it's good for muscle. It's not damaging. And we have another, you know, good lock of papers that show that it's maybe good for the neural system as well.

[00:26:42] Joe Christiano: [00:26:42] So, uh, we have a viewer of Michael Nipper. He says, I have cerebral palsy and I have afraid ligament.

[00:26:48] How can I strengthen my quads? About the only Lexi like exercise I can do would be exercise, bike, and it has to be Jane driven. [00:27:00] Cause that helps me get the full pedal. I don't know what Jane driven is. If you ever heard of that term before?

[00:27:06] Dr. Lindsey Lepley, PhD: [00:27:06] I have not. Um, I could probably Google it pretty quickly, but what I can say is this has that there are bicycles that will cause.

[00:27:13] Instead of peddling forward, the pedals will more or less kind of come at you and your job is to slow the pedal down. That would cause, so that would cause you to have an East centric contraction. Um, so perhaps looking at sort of MacGyvering, uh, the bike that you have to, instead of you pushing the pedal forward, have it

[00:27:33] Joe Christiano: [00:27:33] push

[00:27:34] Dr. Lindsey Lepley, PhD: [00:27:34] towards you and you try to slow it down would be a way to sort of, uh, integrate that in, um, to your exercise regime.

[00:27:42] Joe Christiano: [00:27:42] Now afraid ligament. So I've learned some things about soft tissue after, after, you know, detaching my tricep and three attachments on my hamstrings. It's like, you start learning stuff. If you start breaking things. And a lot of people who have, uh, [00:28:00] Prolonged bouts of tendinitis. For instance, it turns into tendinosis and tendinosis is actually when these soft tissue, uh, very strong, uh, almost like cables.

[00:28:12] They start to fray and come apart and they lose their true strength capacity. Because now you have just a bunch of separate strings, if you will, as opposed to this cable. And I'm wondering. Does, uh, does this kind of training effect soft tissue as well, or just muscle that we're talking about today? So

[00:28:32] Dr. Lindsey Lepley, PhD: [00:28:32] you're, you're asking now, not just about the muscle component, but like the muscle tendon junction.

[00:28:37] Joe Christiano: [00:28:37] Yeah.

[00:28:39] Dr. Lindsey Lepley, PhD: [00:28:39] So my lab has not been as involved at looking at the muscle tendon junction. Um, probably to directly answer this question, but what I will say is muscle is very dynamic. And tendon is inherently attached to my muscle and of all the systems that I've studied in the bottom body they change. And so I, I [00:29:00] would run with, uh, the, the thinking that it would probably cause a beneficial adaptation, but I would need to do is sort of a deeper dive to give you a concrete answer on that.

[00:29:12] Joe Christiano: [00:29:12] Yeah, because soft tissue is really interesting. It's a vascular, so it doesn't have good blood flow. We did a show a couple of years ago that showed the time to take gelatin or collagen in general is before you train. So that it's in that space around the muscle, because the soft tissue works like a sponge it'll pull in what's outside of it.

[00:29:35] And so you can help, uh, use, um, Collagen collagen hydrolysate or hydroceles whichever one it is. Um, or even like cheap Knox gelatin with a little vitamin C, but you got to take it before you train because there's no blood vessels in soft tissue, so it's not like, Oh, you digest it that travel around your bloodstream.

[00:29:55] It gets us know the soft tissue picks up what happens to be around it. And that has to be [00:30:00] in that, that space around it for it to be effective.

[00:30:04] Dr. Lindsey Lepley, PhD: [00:30:04] Yeah. I mean, there's certainly like a series of literature for those that have like patellar tendonitis. Like one of the strong recommendations is Dewey centric exercise, right?

[00:30:12] So there is a bulk of literature to show. That doing ecentric exercise will help with sort of re-engaging the tendon healing process to keep it away from becoming sicker for lack of better terminology. But the mechanisms at work I wouldn't would require sort of a deeper dive for me to kind of speak directly to

[00:30:32] Joe Christiano: [00:30:32] that because, because when you think about tendons, Really do their work when they're stretching.

[00:30:37] Right. So, so you'll see basketball players that can fly have very, very short gastrox, very short calf muscles. They have this long strap. Of attendant. And so, you know, tend to really Excel when you're stretching them. Cause they, they build up dynamic pressure and then they snap back. And [00:31:00] it just seems to me that eccentric work would probably be beneficial for tendons as well.

[00:31:04] That that's the only reason why I thought that was interesting with his question there. So I think he did a. Yeah, he's, he's correcting himself. He said, chain, not a belt. So when I peddled the belt comes around, what he meant was chain not, not Jane. So thank you. Thank you for that. So, um, what's the next step for your group to, to, to actually take this and, and make it for humans?

[00:31:29] Like obviously at a lot of rodent model studies lead to human studies is the next step for you to start doing this with people.

[00:31:38] Dr. Lindsey Lepley, PhD: [00:31:38] So we've, we've done. My lab operates on both ends of the spectrum. So we do a rodent work and we do human work as well. We've done, uh, East Centrix in humans after ACL reconstruction, we found it to be quite beneficial.

[00:31:51] Uh, and the question is why, so that's why we've scaled back to do some of the rodent work. And we're in the midst of sort of investigating the yeah. [00:32:00] Clinically. It looks good, but why, right. And when. And how much, right? Those are all like really, really big time questions that need to be answered to help guide rehabilitation.

[00:32:12] Um, but yeah, we're engaged in, um, and have produced, uh, quite a few studies to show that it's beneficial on humans.

[00:32:19] Joe Christiano: [00:32:19] You know, I, I, I'm just getting back to the gym because of COVID, you know, we were off, I took two months off. This is the longest I've taken off in, I don't know, 25 years of, of, of. When I made a decision 25 years ago to drop a hundred pounds, he stopped being a fat slob and start working out.

[00:32:37] And, uh, and, and so this is the longest I've taken off. I mean, even with surgeries, like, uh, I couldn't train my left arm because my tricep had been, so I trained everything else. And when I tore my hamstring, you know, I trained my right leg and my upper body. And so I've taken two months off and I have to tell you, I feel horrible.

[00:32:55] I really do remember that Saturday night live, you look marvelous. [00:33:00] I felt horrible. I feel horrible. I'm just starting to get back into the gym now. And I'm thinking about ways to kind of step it up. And I forgot about eccentric training, to be honest with you. So all, you know, we talked about et cetera, training back in the day.

[00:33:12] And then I thought, well, you know, that's not for me right now, cause I don't want to do too much damage. I mean, I fall prey to those same bro science type. Idiocies like, and it's just refreshing to hear your discussion because I think that except eccentric training is actually something that everybody needs to start thinking about working back in if for no other reason, because it does produce such a profound hypertrophic and PR and protein, synthetic response.

[00:33:42] Given the amount of work you do, right.

[00:33:46] Dr. Lindsey Lepley, PhD: [00:33:46] I mean, that's, that's, well-stated, uh, you know, we're on the, we're on the same pathway in terms of if I'm thinking, um, and it's not to say that, like, people don't do any centrics and exercise, right. Your body, your, your muscle is [00:34:00] always shortening and lengthening. What we're saying is isolated, lengthening exercises, purposeful lengthening exercises.

[00:34:07] Um, probably, you know, deserve, um, more space and rehabilitation and more spaced, uh, and most exercise program.

[00:34:15] Joe Christiano: [00:34:15] Well, and so, and when you look at some of the exercises that we call King, you know, like the squat squat will build muscle, like on your shoulders, it builds muscle all over your body. And when you think about that, really, you know, you start out standing up and then you do an eccentric first as you go down into the hole.

[00:34:34] And then you push out of it. The same thing with the bench, press you start out with your arms extended, and then you do an eccentric and you pull it down to you. So there are some of the movements that are like, we consider like the big primary movers in the gym. They start out as eccentric movements.

[00:34:50] Deadlift, not so much, obviously you're starting dead on the ground, but there are a lot of people who do deadlifts where they take it off the squat rack [00:35:00] and start out standing and then go down, which. Turns it into a primary eccentric mover first,

[00:35:05] Dr. Lindsey Lepley, PhD: [00:35:05] right? Yeah. It's a, it's a interesting type of exercise. I just a brief sort of history lesson on it.

[00:35:13] Cause I think it's interesting to share as the word eccentric means odd. And the reason that eccentric exercise has been given that terminology is relative to concentric exercise. Scientists have not been able to explain how it occurs. Uh, so we've known since like, The 1940s, 1950s, how concentrate exercise works.

[00:35:31] We can explain it very well. Um, you know, people are still publishing, like cross-bridging sliding filament theory papers on like, how does a muscle work when it's lengthening? How do my send an act in interact? And it's not until the last couple of years when people started to understand that.

[00:35:50] Joe Christiano: [00:35:50] I'm sorry about that.

[00:35:51] I have a goat. I have a ghost. I have a goal. Uh, I've been trying to, I've been trying to run the show on a clock and I wasn't paying attention. So we have to [00:36:00] take one last commercial break. And when we come back, we'll wrap up the discussion and we've got a good friend of mine, Joe Christiano, waiting in the wings to talk about his experience using  for GERD.

[00:36:10] I just stumbled onto this. There's a lot of people that have GERD today, uh, and most of them are treated with. PPIs or, or antacids, and then they have trouble, uh, uh, metabolizing food and absorbing nutrients and so on. And I think I've discovered that's exciting. Stay tuned. We'll move over superheroes.

[00:36:30] This is this superhuman channel.

[00:36:35] Welcome back. We're talking with dr. Lindsey. Lepley about eccentric training. And while it's great for injuries, uh, it may be the best thing for your training as well. If you want to add some muscle quickly. And clearly it sounds like it's not doing the damage that many of us thought it was for years and years.

[00:36:53] So you can use it more frequently. Um, maybe people need to start to dive back into it. So I guess the [00:37:00] next thing is for your, your group to get more clinicians to try this with patients now. Huh?

[00:37:08] Dr. Lindsey Lepley, PhD: [00:37:08] Yeah, we're, we're certainly trying to get the word out, uh, you know, opportunities like this help, uh, and, um, to change sort of conventional wisdom about it and incorporate it into rehabilitation.

[00:37:19] Joe Christiano: [00:37:19] So yeah, I see something even bigger than injury. So, so, you know, we have a real problem today, uh, with people who age. They cut back on protein consumption. Cause they have digestive issues. They don't move as much. They lose muscle as they lose muscle, you know, muscle influences, bone mineral uptake. So, you know, if you don't have as much horsepower, you don't need as heavy of a chassis, the body starts to downregulate and makes bones brittle and thin.

[00:37:44] And they become, you know, these walking time bombs waiting to fall and break a hip. They lose muscle dexterity, they lose strength and really. Uh, keeping people. I remember one of my earliest shows I, I, when I first started doing [00:38:00] this show in 2005, I used to say, muscle is metabolic currency. So get into the gym and make a deposit today.

[00:38:07] I said that for like two years, three years, and I started doing shows about how muscle saves lives. And I did a show with a group from, uh, From the California veterans administration that did a longitudinal study, I think it was 16,000 men. They followed them for 20 years. And the guys who were the strongest at the beginning of the study were still alive at the end of the study and the ones that were weakest, they died.

[00:38:31] And it was like, Oh my God, you know, strong, really do survive. And we have today a population that invests zero value in muscle. In fact, They'll look at a guy like me and say, Oh, you're just vain. You know, no, I want to stay vital. I want to say strong because I want to live long. And that's why I put value in muscle.

[00:38:51] And this seems to me that this is very valuable to the aging population who has an injured themselves yet, because this is a fast way to [00:39:00] keep muscle on your carcass. I think,

[00:39:03] Dr. Lindsey Lepley, PhD: [00:39:03] I mean, absolutely. I think it's all about just temporary it in. And making sure that people understand how to do this type of exercise.

[00:39:09] I think the other sort of benefit of East centric versus a concentrate exercises, it's less metabolically taxing. So for those that have had heart-related conditions, right? It, it, you can do more by doing less. And it doesn't raise your blood pressure, like, um, and it doesn't cause as many systemic effects as other types of exercise.

[00:39:31] So there's also a benefit to it. Um, from that standpoint as well.

[00:39:34] Joe Christiano: [00:39:34] I love it. I love it. I think it's great work. I hope that you'll consider coming back on the show. Next time you have another study that has been published in this area. Um, so if you, if you'll make sure to keep us apprised of the next paper you publish, we'll, we'll get you on right away.

[00:39:51] Okay.

[00:39:51] Dr. Lindsey Lepley, PhD: [00:39:51] Excellent. Yep.

[00:39:52] Joe Christiano: [00:39:52] Thanks for being here. This is fun. I love your work.

[00:39:55] Dr. Lindsey Lepley, PhD: [00:39:55] Thanks so much. All right. Thanks guys.

[00:39:56] Joe Christiano: [00:39:56] Take care. All right, we're going to take one quick commercial break. [00:40:00] And when we come back, we're going to be joined by a. Joe Christiano. And, uh, he has an interesting story to tell because, uh, he took me up on my challenge to use  to treat some gastric issues.

[00:40:15] Um, he was having, and we're going to find out if. Uh, it was a win or a loss. So stay tuned. We'll be right back with more superhuman radio. This is the superhuman channel doing reps with the weight of the world.

[00:40:31] Welcome back. Hey Joel, how are you? Doing? Wonderful. Wonderful. Okay, so you and I have never really met, right. We've been, we've known each other for a long time. You can see after hours over there. And was that 10 years ago off topic? Yeah. Off topic. Yeah. About 10 years ago. Yes. Yes. Okay, great. Great. So, um, tell you, tell you a story, first of all.

[00:40:52] So you wish you were struggling with, uh, what was called GERD, but some other digestive issues as well. [00:41:00] Right? Two years ago, on mother's day, I kept getting hiccups and burps and it wouldn't stop. And, you know, a couple a while went by and I said, ah, this is a normal, why am I burping all the time?

[00:41:10] Hiccupping all the time. So I went to the doctor and out about an hour and a half away and they did all the tests. Um, you know, they, they under anesthesia, they said, I have GERD, I have a hiatal hernia and I have an ulcer. And one of the solutions was, you know, they said lose weight. Okay, well, I'm not fat.

[00:41:32] I was just gonna say, you've been a bodybuilder your whole life. You're not a fat guy. So I went through all the, you know, I went through all the testing for months with the surgeon and the surgeon said, you're a perfect candidate. Your numbers are off the chart. We got to get this surgery done right away.

[00:41:48] So I got denied from my insurance company because I have terrible

[00:41:50] Dr. Lindsey Lepley, PhD: [00:41:50] insurance.

[00:41:51] Joe Christiano: [00:41:51] And then I got denied two more times on appeal. They considered, I need, I need a surgery called the Lynx

[00:41:56] Dr. Lindsey Lepley, PhD: [00:41:56] procedure.

[00:41:57] Joe Christiano: [00:41:57] It will be that we spoke about. [00:42:00] Where they're putting a, a, a, like band at the bottom of your socks, I guess, which opens up when you need to eat or, you know, God forbid you have to throw up or anything, but it stays seal otherwise allowing under the ass of the co op.

[00:42:14] Right? So my insurance company denied it because they consider it a luxury item. Now, now let's just say, Carl, let's say I wanted to get. Um, surgery, let's say, let's say you want to get breast implants. I can do it on my insurance cover. Right, right. I'll cover this surgery now. So I've been suffering for close to two years and we've gone back and forth and you've given me ideas.

[00:42:38] And that your latest idea was the absolute best one. So, so we started out with the scaling back on caffeine consumption because this has an effect. On the esophageal sphincter relaxes it and opens it up. So do things like chocolate and, and, uh, and ginger, they are known to actually, uh, cause the esophageal sphincter to open for [00:43:00] people who have problems where it's closes too tight.

[00:43:02] There are people can't swallow. Um, another thing that's effective at relaxing, the esophageal sphincter are, uh, phosphodiesterase inhibitors like. Viagra Cialis. A lot of guys who take that stuff, complain about heartburn all the time when they take it. So those are actually therapeutic approaches for doctors who have the exact opposite problem.

[00:43:23] There are people out there who develop Barrett's syndrome or burettes esophagus esophagus from chronic heartburn where now the sphincter doesn't want to open anymore. What's that? It's a big worry of mine. Yes. There's going to be a lot more to, to, to, to, uh, treat me for cancer then this, this surgery, you know?

[00:43:44] Yeah. And that's exactly what happens. Like when you have this chronic problem too long, you get esophageal cancer. Eventually it's just a matter of time. So, um, now keep in mind that I, I talked to a lot of people who suffer from GERD. They also snore. [00:44:00] Some of them have obstructive sleep apnea. And I have contended all along that the reason we have so much obstruct, obstructive sleep apnea today is because people's guts are messed up and everything gets inflamed all the way up.

[00:44:15] And then everything just hangs in the throat closes to get smaller and narrower. And so this is kind of like been in my wheelhouse. I've been looking at this stuff for probably pretty close to nine years now. Why, why do we have the problem with chronic snoring? Why do we have the problem with obstructive sleep apnea?

[00:44:32] People who aren't even fat? My sister was 90 pounds. She had it, like, why did we have this problem? And then when I look at it, neuropathies and I look at these, these conditions that we see at our population, and I keep coming back to the gut. I keep coming back to the gut. It's all starting in the gut now.

[00:44:50] Can I figure out why everybody's guts had messed up? No, with all the crap that's in our food today, it's going to be very, very hard. And there's other things for a long time. [00:45:00] I thought coffee was causing problems and I'm still not sure that it's not. Um, the problem with the gut is that once the gut gets messed up, it can literally take years to fix it.

[00:45:11] And so you really never know if what you're doing is right. If it takes years to see. Changes. Cause it literally takes years for you to see the problems like the problem you developed. It was probably in the making for five years, but it wasn't until it happened that you're like, Oh, and so we expect it to change right away.

[00:45:28] Right. Does it now, most doctors will treat this disorder with a proton pump inhibitors or antacids. This is a horrible idea. The reason it's a horrible idea is cause now you end up with nutrient deficiencies and we know that proton pump inhibitors are linked to heart failure. So there are proton pumps everywhere in your body.

[00:45:49] It turns out in your brain and your heart, not just in the stomach, making hydrochloric acid. And so now we find out that that people who aren't PPIs longterm, they end up with heart failure and [00:46:00] now they're linked to dementia and there's some people say it's because the nutrient deficiencies and other people say no, there's proton pumps in the brain.

[00:46:06] So this is the way they, they treat it as, as a rule. However, There's another class of drugs that they can treat these disorders with. They're called gastric pro kinetic agents. But the problem with them are that they change the heart rhythm dramatically. Like they can, if you take these drugs, these gastric prokinetic agents, they can actually throw you into heart attack or atrial fib, or tachycardia.

[00:46:36] They obviously work on the Vegas nerve. Because the vagus nerve controls, heart rate, the Vegas nerve also controls something else and that's called gastric emptying. Okay. So I'm just connecting the dots and why I called you and said, you want to try and experiment. So one of the things that is, uh, a gastric prokinetic agent is [00:47:00] grilling your, your stomach produces this hormone ghrelin.

[00:47:05] It's the hormone of appetite. When your stomach starts producing ghrelin, it goes to the brain and it says, we're hungry. We need to eat. But growing has other effects to the presence of ghrelin in the gut, tells the stomach we're going to be eating soon. We got to do a really good job of not just digesting this food, but moving it down into the small intestine so we can put more food in.

[00:47:30] So ghrelin actually increases the effectiveness of. Of digestion, meaning that you're going to get more out of your meal than you normally would. It also increases a phenomenon called peristalsis. And what peristalsis is, is peristalsis is the small intestine goes in a like waves and it. It squeezes down and waves to move the food.

[00:47:56] So the food, the stomach can go take this from [00:48:00] me. And the small intestine goes, I'm ready. Give me everything you want. So this, this phenomenon of peristalsis is like squeezing a tube of toothpaste, your intestine squeezed up down, squeeze it down so that more can enter from the stomach. And when you look at ghrelin in general, it actually improves.

[00:48:19] The entire process of gastric emptying. Now, why is this important? Well, here's why, because what happens in the GERD phenomenon is if the food doesn't move out of the stomach in a timely fashion, it's the gases build up in the stomach. The esophageal sphincter has a breaking point of 20 milligrams of water.

[00:48:43] Like, like, like a blood pressure cuff reads and mercury. They use water. When the pressure can push 20 milligrams of water up. That is when the esophagus goes, I can't handle this anymore. I'm opening up and it lets the contents of the stomach come out because [00:49:00] it's the body goes, it's not moving down. We must have to throw it up.

[00:49:05] So this is the first step to vomiting. The esophageal sphincter relaxes. You start to burp. Food comes up, acid comes up, but in your case, you actually vomited, correct. Oh, Carl, I it's embarrassing to go to a restaurant. We had third row seats to Frankie Valli. Um, you know, and I would eat dinner and I had to force myself to keep this food down for two and a half hours.

[00:49:32] It's like that common. We, we leave a restaurant, I throw up all over myself. It can happen immediately or it can happen, you know, three or four or five hours later. I'm like, why is this food still in my stomach? Five hours later. No. Great question. Exactly. Now, now your doctor has never asked you any of these questions.

[00:49:48] Did they say, how fast do you feel like you digest foods? Does it feel like continue your stomach? Did they say they call it the radioactive egg test where I eat these eggs? And then they take a picture of my stomach every, [00:50:00] I don't know, half hour, hour, it took close to like a five hour test, but, um, they told me that was normal.

[00:50:05] That you was fine. They would say you were fine. No problem. Okay. So you would, you will literally, I'm sorry, go ahead. I'm sorry. What's that? No, go ahead. He prescribed, there were needed. They took were an entity and off the shelf because it was cancer causing they, they prescribed you Baclifin were supposed to be like a muscle relaxer

[00:50:24] Dr. Lindsey Lepley, PhD: [00:50:24] and like,

[00:50:25] Joe Christiano: [00:50:25] and you know what, when I went off, all of them, I felt no better, no worse.

[00:50:29] And I was eating a hundred times a day, which is not good either. Yeah. So. So it's clear to me that this disorder involves the vagus nerve because that's what controls the esophageal sphincter. That is what controls the gastric emptying and food motility out of the stomach. And of course, ghrelin affects the vagus nerve as well.

[00:50:52] Well, we have a form of ghrelin that many of us in the bodybuilding community have been using for deck Mount probably 15, 17 years [00:51:00] now. And that's, . And , if you take a high enough dose makes you hungry, but it also makes the food go through your faster. Now, whenever I say this people go, Oh, but then you're not getting all the nutrients.

[00:51:13] No, it not only it not only makes the food go faster, but it ramps up digestion. You digest your food better and faster, and it gets out of your stomach faster. So it's not going to be in there. Making you burp, literally festering in your stomach until you just vomit, or it starts to come up as, as indigestion.

[00:51:33] Then you take, you take anti antacids and sure. You don't feel the acid burning you anymore, but your food isn't moving fast. In fact, now it's going to move slower. Cause you just, you just knocked out all the hydrochloric acid in your stomach. So you and I talked, actually, we didn't talk on the phone. Did we?

[00:51:51] We just messaged and I said, Try taking 125 to 200 micro grams of  15 to 20 minutes [00:52:00] before a meal. So now let's go back to that first day you ordered your GHR. You sent me a picture. You showed me. I had it. Tell me about the first time you used it. The first dose I did, I did the 20, which was probably 200 words of Dolly too much.

[00:52:14] So my blood sugar dropped and I was starving. I had my meal and I was looking for more things like buckle down. So. Um, and it was, uh, you know, it's, it feels, it feels different than the food feels different. It's I may have, I make burp here and there after a meal, don't get me wrong. But you know, except for a couple of blips I've had in the past week, we've got can't handle salad.

[00:52:38] It's too light. It comes up. What can't you handle anything light like salad or vegetables? It just, I figured, okay. I'll care about big sale. Let's see if this works. And then as I threw it up in a little while, so this is the vegan myth, right? So salad takes so long to digest. And this is why people don't know this.

[00:52:58] And you probably do, but if you go [00:53:00] to Italy and you eat at an Italian restaurant, they give you the salad. Last, the Aunty pasta is what you have first. In America, they give you the salad first. So basically they take the thing. That's going to take the longest to digest. That's the slowest moving and put it in front and I'll put everything on top of it.

[00:53:16] It's the stupidest idea in the world in Italy, you get a salad at the end of your meal because that's, Roto-Rooter, it's going to follow through after everything else and it's going to clean everything out, but it also digests. So slowly terror. Yeah. So other than other than salad, you've been taking one, 125 micrograms before every meal now.

[00:53:36] Yeah, so four or five meals a day. Um, the only thing I don't take it, uh, I, I do drink some like, uh, some branch chains throughout the day, but I sip it. So I figured I don't want to eat it before that, but

[00:53:46] Dr. Lindsey Lepley, PhD: [00:53:46] before a protein shake

[00:53:48] Joe Christiano: [00:53:48] or are you allowed to eat a lot of fish? Cause it was always an easy for me to digest rice.

[00:53:53] I'm very boring eat or when it comes to, you know, diet, I haven't had a real, real bad meal on this stuff yet. That'll be Wednesday. That'd be a true [00:54:00] test. What is it? What is a bad meal to you? What, what is it that you have birthday? So we're going to go to Italian restaurant. So, you know, red sauce kind of kills me.

[00:54:08] So I'll probably do like a white floss, you know, maybe an appetizer or something, our chokes, French, you know, typical. Typical Guinea Guinea meal. Yeah. So I'm not sure Carl, do I stay with the same dose? I take it a little bit more or do I just no, no. Stay with the same dose. You don't, you don't need more.

[00:54:24] It's going to do what you need it to do. And I predict that you're going to be able to eat that red sauce and it's not going to bother you. Okay. So, so, so now how long have you been using the  before meals now? How long has it been? I think today's the seventh day and it's 90% better. Like I said, I've had blips, but it's like.

[00:54:44] When after I have a meal, I have to sit in a chair and sip water and not do anything afterwards. Normally, you know, which is, which is pretty terrible when you want to enjoy your life and go train and this and that, but it seems like I can actually have a meal and go do things now, you know, it's, [00:55:00] it's a lot different.

[00:55:01] Yeah. The food is moving out of your stomach the way it used to. Now, people keep asking me, do you think that this will correct the problem? I think it can. I think that. I think that there's one, when the food moves too slow, it can lead to a lot of other problems in the small intestine. So I think by mimicking the way the food should move over time, I think you're going to go one day and forget to take your shot and your food's going to move, but that's going to remain to be seen how long that takes.

[00:55:32] Um, you know, it, I really do think that there could be a chance that this will correct the problem completely. Over time of use, but now think about the number of people that are out there today who have GERD. I mean, it's like 60 million people in America complain about having GERD and doctors and not even thinking about GHR P six as a, as a [00:56:00] possibility.

[00:56:00] Not at all. In fact, I don't think any doctor would even recommend it if after hearing this, even though it works. Even though it works because it's, it's not, you know, if they're just going to put you on proton pump inhibitors or antacids or something like that, because that's what the medical literature suggests.

[00:56:18] People aren't even going to take a look at this when they really should a hundred to 200 micrograms of GA Charpie six, 15 to 20 minutes before each meal. Even if you don't have GERD, it's going to make you digest your food better, faster. But don't use MK six 77. So somebody said to me, well, I can just use MK six 77 because doesn't it have a prokinetic effect as well.

[00:56:43] It does. But the problem with MK six 77 is it's too long acting and it actually, the more you use it, the less growth hormone you produce from it. It actually exhausts the pituitary to the pituitary. Can't keep up and you literally [00:57:00] stop producing less and less growth hormone. This is a better alternative.

[00:57:03] You take it before a meal and it wears off after the meal and you're, and you're done. It doesn't matter. Now, do you feel tired of sluggish at all? No. So MK six 77 people say, Oh, I feel so tired when I take it. Yeah, because it's too long acting. This is alternative. I tried the MK six 77 and maybe wanna just.

[00:57:22] Eat everything in sight for six hours. Like, you know, I'm a go bone as it is. I like to eat, you know, you're raised a certain way. Being Italian grew up in the pizza industry. The last thing I needed something to eat, maybe eat more food. Right? So bottom line is right now from where you stand you're, this has solved the problem.

[00:57:42] It's not fixed it. You haven't yet cured, but it's solved the problem in the short term, right? It's 95% better Carl than it than it ever was before. I wanted to publicly, thank you for trying to help me out with this situation when no one else cared enough to do so. I mean, a lot of [00:58:00] course, of course. I'm I'm look, man, I'm trying to figure this stuff out for myself too.

[00:58:04] I suffered with LPs laryngeal, um, uh, LPR. So it's instead of GERD, I have this lemony taste, so, but it starts with GERD. So my esophageal sphincter opens up and it comes up into the top of my throat, but I don't get a burning feeling from it. And I found out, I discovered when I was taking  it wasn't bothering me.

[00:58:29] And that's when it started to Dawn on me. That's when I started to look at, I mean, there's studies on humans using GHR P six as a gastric prokinetic doctors should be using it. It has no side effects per se. And if any, Oh, the best shot I take is right before bed. I actually take. So instead of just taking , um, I go to, uh, peptide sciences.com and I buy the combo.

[00:58:54] It's uh, it's the CJC 1295 without deck. So it's short acting with [00:59:00] J choppy six. I take 200 micrograms of each before a meal and I take 200 micrograms before bed at night. I sleep deeper. And if there is any food that didn't move, it moves it out, moves it right out. I wake up in the morning. I don't, I used to wake up in the morning burping.

[00:59:18] I'd be like, I haven't eaten since six. O'clock what the hell am I burping? It's very frustrating. You know, it's like, it's like, it controls your life. It controls what you're doing. And when you can do it, so many people don't realize that their food is not being digested. It's just sitting in their stomach.

[00:59:34] So many people don't realize it. They just take it for granted that they finished eating and it's gone. And it's literally, and you know, if you had one of these people who you ate at six o'clock and you had some red peppers and you're getting ready for bed, you know, four hours later and you burp and you taste red peppers, they're still in your stomach.

[00:59:52] You didn't digest them. And I really think that this slow digestive motility and the food hanging [01:00:00] around in the stomach could actually be contributing to the CBO, the small intestinal bacterial overgrowth, because the food is just sitting in there and it's just festering. It's not moving peristalsis.

[01:00:09] Isn't working. It's not moving the food down towards the large intestine and the colon. It's just hanging out in there and it's rotting. So I think that  could be a remedy for a lot of people out there. Even if they don't have Frank heartburn, Frank GERD, it could actually be a, if you feel like your food, doesn't move.

[01:00:26] Get some GHR pizza, go to peptide sciences.com. They're not a sponsor, but they gave me a code that our audience can use SHR for 10% off. Give it a try if you suffer from I'm glad to hear things. And now I bet Joanne wants to kiss you again. Yeah again. Right. So there's that right? So there's that? Uh, it's great to have you on the show brother.

[01:00:48] He's got great to be here. All right. Take care. Bye bye. All right, so that's it for today's show. Thank you to Joe Christiana for coming on and talking about that. Hopefully will help more people. Uh, and tomorrow's Tuesday. We [01:01:00] have the blueprint power hour. We'll see you then. Thank you for watching today.

[01:01:03] See you tomorrow.