Peptides with Dr. Kathleen O’Neil-Smith: Rational Wellness Podcast 130

Dr. Kathleen O’Neil-Smith discusses Peptides with Dr. Ben Weitz.

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Podcast Highlights

3:35  Peptides are signaling molecules. They are bio natural and are not pharmaceutical agents.  If you have a patient in pain, you don’t want to treat the pain, you want to treat the cause, which is what peptides help you to do.  Peptides communicate with our cells and sometimes they enter the cells through pinocytosis and they signal the cell to function better along with the other cells around it to function as a team.

8:07  Most peptides are prescription medications and taken through injection, except for BPC 157 (Body Protective Compound 157) and AOD (Anti-Obesity Drug), which we are focusing on today.  Dr. O’Neil-Smith emphasized the importance of purchasing peptides from a reputable source like from a doctor or chiropractor instead of from China through the internet.  She explained that AOD is a fragment of growth hormone and its action is lipolysis. If you take growth hormone, this can increase glucose and cause insulin resistance, which is not desireable. But when you use AOD, you don’t get these effects. Dr. O’Neil-Smith explained that AOD is effective in conjunction with hyaluronic acid and can be injected into joints to make those joints function more smoothly and to be more elastic. 

11:21  BPC 157 is available in an oral, over the counter form, and also as an injectible and the benefits are potentially amazing and protects the body from many things.  It was first discovered in the gastric juices and it has great utility in the gut.  Dr. O’Neil-Smith explained that if you were to sever the gut or if you were to take a gut and tie a rope around it, you would get a necrotic gut.  If you then take that rope off after three days and you let that necrotic gut sit there and you bathe one half of the necrotic part in BPC and you bathe the other half in saline, 10 days later the gut bathed in BPC grows back.  BPC can be very beneficial for inflammatory bowel disorder, such as in Crohn’s and ulcerative colitis, where it can heal a fragile, bleeding gut and bring it back to health.  If the patient is having an acute flare, it is best to both use oral and subcutaneous injection of BPC.  An oral dosage of 500 mg three times per day would be a good dosage at first to load up, but she noted that there is no reason why you could not take a higher dosage. She also uses it a lot in brain injuries, such as concussions or CTE. 

18:00  Dr. O’Neil-Smith often uses BPC for injuries in athletes, including professional and Olympic athletes.  She notes that BPC is not on the WADA list of banned substances.  While peptides can help heal injuries, they do not provide a boost the way that supratherapeutic levels of testosterone or other anabolic hormones do.  Peptides are bio natural regulatory signaling cells allowing the body to use the body’s own healing properties instead of medicines or drugs. 

22:56  BPC-157 works on multiple pathways in the nucleus of the cell directing the silencing of genes that continue inflammation and promoting the genes that direct blood vessel, connective tissue, fascia, and nerve repair.  BPC is very restorative and regenerative and even stimulates autophagy.  Dr. O’Neil-Smith said that with her patients they need to be taking in the essential nutrients, either orally or through IV.  They need to do either intermittent fasting, time-restricted eating, or the fasting mimicking diet.  They need to have the proper balance of hormones. And then to give peptides makes the most sense.  She also likes to use therapies like sound wave or shock wave therapy to break up the granules and scar tissue to stimulate healing in her office.

31:46  Some of the research indicates that BPC-157 facilitates growth hormone being able to help tendons to heal. (Pentadecapeptide BPC 157 enhances the growth hormone receptor expression in tendon fibroblasts.) Dr. O’Neil-Smith said that for growth hormone facilitation she tends to use CJC 1295 (a synthetic analogue of growth hormone-releasing hormone (GHRH)) and IPA (Ipamorelin) peptides. Dr. O’Neil-Smith explained that using growth hormone is expensive, it requires carefully monitoring insulin levels and using insulin injections, and it will shut down your brain’s production of growth hormone.  There is also a high potential to abuse growth hormone.  CJC and IPA can be used for patients recovering from surgery such as an achilles tendon or an ACL repair.  They can also help with the healing of plantar fascitis and similar conditions.  Dr. O’Neil-Smith uses peptides for recovery from surgery and also for re-regulating insulin signaling, which can be helpful for diabetes and also for weight gain. For an injured achilles tendon she will inject BPC around the tendon and this has been shown in studies. 

39:19  Dr. O’Neil-Smith’s stack for post-surgical recovery in some patients would be BPC, CJC, and HCG, (human chorionic gonadotropin), though she points out that she practices individualized medicine and her recommendations for each patient will be different.  She explained that HCG has a number of benefits, including stimulating testosterone utilization receptor uptake, as well as for repair and regeneration in other ways. 

44:10  BPC can be used to heal the gut, for wound healing, for regeneration of nerves, and for concussion recovery.  It is being researched for its benefits for Multiple Sclerosis. 

46:22  For anti-aging benefits, Dr. O’Neil-Smith recommends the following:  1. BPC-157,  2. Omega 3 fish oil,  3. vitamin D,  4. vitamin K2,  5. NAD  (such as nicotinamide riboside),  6. Resveratrol,  7. Curcumin,  8. NAC,  9. Probiotics.



Dr. Kathleen O’Neil-Smith is an MD with her practice focus on Functional and Regenerative Medicine. She completed a stem cell certification through the A4M.  She is an international thought leader in the clinical use of peptide therapy and she healed her son from a severe TBI with peptides.  She can be contacted through her website Treat Wellness, LLC.  She is now training other doctors through her Peptide Master Class that you can find on her website. 

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com.


Podcast Transcript

Dr. Weitz:                            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to Apple Podcast and give us a glowing review and ratings. That way more people find out about the Rational Wellness Podcast. For those of you who’d like to view this podcast, go to YouTube and you can see a video version.  If you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.

Today our topic is peptides with Dr. Kathleen O’Neil-Smith. Peptides are short chains of amino acids that are connected by peptide bonds, but they are shorter than proteins. The general rule is that a protein contains more than 50 amino acids. Insulin is generally considered to be the first peptide discovered, but it actually has 51 amino acids, so apparently that’s not a hard and fast rule.  Peptides are just generally shorter and proteins are bigger. Peptides have many functions in the body but some function is hormones and signaling molecules and regulators of various metabolic processes in the body. There are peptides that can have a significant effect on memory and cognitive function, weight loss, muscle growth, immune modulation, gut health, sleep, and anti-cancer, among other effects.

Today we’re going to focus most of our discussion on BPC, body protective compound 157, and it has benefits for healing of soft tissues like tendons, nerves, as well as the lining of gut, and many other tissues in the body. Dr. Kathleen O’Neil-Smith is a magna cum laude graduate of the Boston University School of Medicine. She also has a degree in exercise physiology and she was an athlete on the national rowing team for 39 years and then was a coach for six years. Her current practice is focused on functional and regenerative medicine, and she completed a two year fellowship on this.  She also recently completed a stem cell certification through the A4M American Association of Anti-Aging Medicine. She’s also an international thought leader in the clinical use of peptide therapy, and she healed her son from a severe brain injury with peptides. Thank you for joining us today, Dr. O’Neil-Smith.

Dr O’Neil-Smith:               It’s good to be here. It was nice to see you at the conference in Seattle six weeks ago and to keep in touch, and to know that I’ll be seeing you again at your place in Santa Monica.

Dr. Weitz:                         Cool. So what are peptides?

Dr O’Neil-Smith:               Well peptides are signaling molecules. They’re a means of treatment. They’re bio natural. So when I think of the body, I think that there are many ways to heal it. Conventionally, as an internal medicine doctor, I used to think about pharmaceutical agents, but pharmaceutical agents are generally not helping the body to rebuild. They’re basically treating a symptom. So you can take a blood pressure med and you can reduce blood pressure but that doesn’t treat the root cause.  The medicine that we use is not something that was bio natural to the body. When we think of peptides … when I think of the way I want to treat the body, I want to treat the root cause. I don’t treat pain. You’re a chiropractor. You may see some pain. You may see some brain … some brain injury. You may see some concussion. You may see some joint injury. You never treat pain. You treat the cause of the pain.

                                         If you just treated pain, you’d give them Oxycontin, right, and we have an opioid crisis. If you want to treat the cause of the problem, you have to understand whether it’s structural, mechanical, or functional, or both. Generally it’s both because even if you got an injury that’s structural, right? Even if you got a torn labrum in the hip or in the shoulder, you’ve got a structural problem, but you also have a functional problem.   The functional problem is all the fire alarms and the molecules that are released from that joint problem. When they’re released from the joint problem, the cells start to have crosstalk between them and they signal each other, inflammation, fire, and it’s like fire alarms going off, like in a fire in California, in many different counties.

                                         When we use a peptide as opposed to a medicine, a peptide works as a fire alarm, but to put out the fire it’s natural, as I said, generally speaking. They occur in the body naturally and they occasionally in varying amounts at varying times. As a fire alarm, it goes cell to cell to cell saying, “Hey, this inflammation in here,” in the joint pain for example, the labrum injury. “We’re going to come together. I’m going to do my job as one cell to resolve this inflammation and repair without scar, without fibrosis, without making the tissue more dense, the fascia tissue more dense. I’m going to heal this appropriately. I’m going to regenerate this tissue appropriately, and I need all you other cells around me, the fire departments, to get on board and to do your job.”  That’s called autocrine signaling where one cell tells itself how to do the right thing and not just be a runaway inflammatory cell that becomes scarred, and paracrine signaling that tells the cells around it, or the departments around it, “We’re going to work together to pull this in and not get scarring, but to get healing, as full function back as we can of that particular injury.”

Dr. Weitz:                         And paracrine is essentially another word for hormones, right?

Dr O’Neil-Smith:               No, I mean paracrine … hormones are very kind of more direct. If you use a hormone like an estrogen and progesterone, testosterone, male or female, whatever, and you give someone a hormone, which I’m all in favor of if they’re bio natural, and we need to restore balance, and that’s a whole other topic on fascia that’s fascinating, and the receptors in fascia, the hormone receptors in fascia. But at any rate, the hormone will attach to that cell on a membrane in a receptor and it will go create this whole internal effect within the cell and go to the nucleus and the gene and get inaction.  So if you use testosterone, an action is to increase libido or to increase muscle mass, a muscle, to grow back a muscle. If you use a peptide, peptides actually enter the cells in different ways. They don’t always attach to a receptor on the cell’s surface. They pop into the cell like a dart. They get into the cell with something called pinocytosis, and then they will cause this whole signaling effect, and it’s really cool. It’s a little bit different. So we call them signals, cell signaling molecules, molecules that signal the cell that they’re near and all the cells around it within that tissue, within that organ, to function as a team.

Dr. Weitz:                         Cool. So are peptides prescription medications or are they over-the-counter like nutritional supplements?

Dr O’Neil-Smith:               Both, both. Many of them … most of them are prescription medications, but the ones that we were thinking to focus on today are over-the-counter and there are supplements that you can get … I certainly wouldn’t buy them from China because you don’t what you’re getting. I would buy from a reputable source like a doctor, a chiropractor, an acupuncturist, whatever, who knows that they’ve gotten them from a reputable source.  BPC and AOD are the two peptides that are available pretty readily, and those are all over social media right now because they’re very, very effective.

Dr. Weitz:                         What is AOD?

Dr O’Neil-Smith:               AOD is anti-obesity drug. That’s really not a great name for it. It’s a peptide. It’s a little fragment, a small fragment, of growth hormone. Growth hormone … I used some slides. I’m not sure if you have them, but growth hormone … and AOD was on that. Growth hormone is about 200 amino acids which contains the peptide. AOD is a fragment of growth hormone, so it would be under 50 amino acids, so it’s 15 or whatever it is amino acids.  So that particular fragment of growth hormones has particular actions, and the action of AOD is lipolysis. So breaking down fat, which is really desirable. Growth hormone as its whole can increase glucose and can cause some insulin resistance and that’s not desirable. When you use just the AOD fragment, you don’t get the insulin resistance. You don’t get the elevated glucose and you don’t get fat deposition.  When you use AOD you get breakdown of fat, metabolism of fat, so fat loss. The other really … I don’t use a lot of AOD for that particular purpose, but you can. I do have some patients that do well with that. The other way that you can use AOD is in joints because it also heals soft tissue and cartilage. So it can come as creams. It comes in many ways but it also comes as an injectable that you can do sub-q or that you can put into joints. You can put with hyaluronic acid, which is very soothing and lubricating for joints, so you get good movement in every direction, up/down, all around, diagonally, you name it. You get the gliding and sliding and elasticity of that joint.  So you can combine AOD and HA, and you can use them together within a joint, and I do that often, often, a lot.

Dr. Weitz:                         Yeah some of the collagen supplements contain HA.

Dr O’Neil-Smith:               Exactly, exactly. But when you put AOD with HA, it’s very beneficial. I love AOD/HA. It has many of the benefits of growth hormone, because it’s a small fragment and not a lot of the downsides of growth hormone. So it’s very, very good.

Dr. Weitz:                         So now BPC-157 is both oral and injectable. Is there an advantage to one over the other in certain situations?

Dr O’Neil-Smith:               BPC is a miracle. I work with-

Dr. Weitz:                         I mean when I got that booklet from Dr. Holtorf and started going through these studies, it was … I mean this is ridiculous. The benefits are so amazing, either this is the new wonder drug or it’s snake oil.

Dr O’Neil-Smith:               No. It’s really not. I can tell you a couple of stories about it.  So I work with another doctor in Florida, Dr. Akey. She’s visited and spent time with the doctor who discovered BPC.  He discovered it in the 1990s and since then he teaches at the Zagreb Medical School, so he has been studying this extensively.  When you visit his lab and you meet him personally, you know he’s the real deal.  When you see the work he does and he shows you within his lab the benefits of it, it literally is miraculous and mind boggling.  It’s funny because in the states BPC is … everybody loves BPC.  It’s called Body Protection Compound 157, thus it protects the body from many things.  It was originally by Dr. Sizgorich in Croatia founded to be in the gastric juices. So where we first understood its utility was in the gut and obviously we found it in the gastric juices. What can it do for the gut? We know that it can heal the gut. I teach a lot on BPC to the stem cell group, to the anti-aging group, to everybody, to a lot of doctors and patients, clients, and the public.  BPC for the gut, if you were to sever the gut … if you were to take a gut and you were to tie a rope around it and cut it off, you get what? Necrotic gut. If you then take that rope off after three days and you let that necrotic gut sit there and you bathe one half of the necrotic part in BPC and you bathe the other half in saline, 10 days later the BPC grows back.

Dr. Weitz:                         Wow. That’s pretty amazing.

Dr O’Neil-Smith:               You can see it grossly looking at it. You can see it under the microscope, and it’s the most remarkable thing ever. So it works in the gut. We use it a lot. I use it a lot in any gut dysfunction. I use it a lot when there’s a brain injury because you’ve heard me talk about the gut. The gut and the brain you heard during that whole series of lectures are directly connected.  So whenever there is an injury in the brain, a concussion, an athletic injury, CTE if you think that you’ve got an ex-athlete who’s really had a lot of concussions. They don’t really complain of a concussion but things are disrupted, I always use BPC in an injury that’s in the brain or in the gut.  If someone has inflammatory bowel disorder, I’ve used it a lot in Crohn’s colitis, in ulcerative colitis, to heal that fragile friable bleeding gut and to bring it back to health.

Dr. Weitz:                         So let’s say you have a patient with Crohn’s or ulcerative colitis and let’s say they see you and they’re having an acute flare. Will you use the BPC right away and if so how much and how long will you use it for?

Dr O’Neil-Smith:               So back to your original question about whether I use it sub-q or oral, in an active flare, in an acute flare, I always do sub-q, particularly … you know we don’t know how well the gut’s going to work if we give it orally. So in a sub-q flare and in an acute flare, you’re going to want-

Dr. Weitz:                         But you want it to go in the gut right? Because the gut’s what’s injured.

Dr O’Neil-Smith:               The gut is what’s injured but the gut is usually injured from the inside out as opposed to the outside in. You quiet down what you deliver to the gut. You quiet down food. You quiet down all of those different things. You might give some nutrients in other ways. Definitely if you’re going to use the gut, use it in a liquid way. Use elemental diet, which is broken down food to keep the calories in, to keep the weight on, but you’re not going to want the gut to have to do a lot of work, so you’re going to want to really quiet the gut.  If you quiet the gut and you give a little BPC, most people tolerate it orally but sub-q … I would attack anything acute from the inside and the outside. I’m coming from all angles. If I’m in a war zone, I’m coming from every angle. If there’s something acute going on, I’m coming from every angle. So I’m always going to, in an acute situation, use a sub-q and an oral. If all you have available to you is an oral, load up. Load up.

Dr. Weitz:                         So how much is loading up?

Dr O’Neil-Smith:               Load up would be certainly multiple times a day. You can’t take too much.

Dr. Weitz:                         For what dosage?

Dr O’Neil-Smith:               Well the dosage I think on an oral, like Dr. Holtorf’s product is about 500. So when you take that 500, you can take that twice a day or three times a day, and you can do that until you feel things quiet down. Then you can begin to reduce and go down to once per day.

Dr. Weitz:                         So 500 is in one capsule. Could you take 1000 three times a day?

Dr O’Neil-Smith:               Why not? Won’t hurt you.

Dr. Weitz:                         I don’t know.

Dr O’Neil-Smith:               Yes, you can.

Dr. Weitz:                         Okay.

Dr O’Neil-Smith:               There’s never been found, in the 30 years that it’s been studied, a lethal dose, or a dose that’s harmful. There’s no lethal dose.

Dr. Weitz:                         And do you get better benefit? What level do you think … Do you think 500 is where you get the maximum benefit or what do you think?

Dr O’Neil-Smith:               No I think it really depends on the person. I think that’s why it’s important to work with someone like you or with a doctor who understands this stuff because they’re going to help you figure that out. I would say that mostly in my practice I have used the sub-q and the oral. If I’m using the sub-q, an injection in the belly, small little insulin needle, a little bit of BPC, I will only do the oral once a day.  If I don’t have any sub-q … if they don’t have it for some reason, they’re somewhere in another country. They call me or talk to me about an injury or something acute, I’ll say take oral one, three times a day. That’s the most I’ve ever had to do. So I really have never had to do that. I might do IV. I mean I’ll do it every which way I can depending upon how significant. If it’s a chronic injury … even with athletes. So I’ve used BPC in a lot of elite-level athletes, NHL, NFL, active athletes.  If you’re going to use BPC and it’s not on the WADA list. I hope it never it is. It shouldn’t be on the WADA list. If you’re going to use BPC-

Dr. Weitz:                         A WADA list is the list of banned substances, right?

Dr O’Neil-Smith:               Correct. If you’re going to use BPC in an athlete, I basically tell them they’re going to need … Well one it’s good in the setting of inflammation. So it’s not like they have to stop playing. They can get the benefit of this and some healing from this even in the setting of inflammation, which is contrary to what most people think. People think that you have to stop … that steroids have to be done and then you use a peptide. No, never use a steroid if you can avoid it, ever, ever, ever. Steroids are like Oxycontin. They put out the signal, which is what pain is. They put out the signal, which is what inflammation is, and they don’t allow for healing. They’re wrong. So what we want to do is use something that will redirect the signal to heal.

Dr. Weitz:                         You say that professional athletes can use them. What about Olympic athletes?

Dr O’Neil-Smith:               Yes, yes.

Dr. Weitz:                         But I don’t think they’re allowed to use any injectable substances.

Dr O’Neil-Smith:               Yeah, no well that’s different. I mean the problem with having been on the Olympic team and coached the Olympic team and all that kind of stuff, I mean I remember, Ben, when I was in the 80s racing the Russians before 1984 when they didn’t show up in Europe. When they showed up and we all went into the bathroom and we had to collect our urine to see if we were on anything, and they passed and got to keep their medals, we were all dumbfounded. I was young then. I was still in college and I thought they’re doing hormones. Why aren’t they being found?

                                          When I learned about peptides six years ago, seven years ago, maybe a little longer … the ones that we’re talking about … I realized they weren’t using hormones. They were using peptides. So peptides … they’re not like hormones. They’re not something you can get supratherapeutic on. Testosterone, if a normal range, let’s pick a number 800. If I give Manny Ramirez testosterone, he can go from 700 to 2500 and be aggressive and whack that ball or whatever right? But that is supratherapeutic levels. You can do that with hormones. You can detect that. you don’t get supratherapeutic levels with peptides. So it’s a whole different ballgame.  These, remember, are more bio natural and they just go in and they do their job silently, quietly. They don’t make you a super human. They just make you able to heal more easily.

Dr. Weitz:                         So but are Olympic athletes allowed to use these injectable peptides?

Dr O’Neil-Smith:               They’re not on the list.

Dr. Weitz:                         They’re not on the list. They’re not even supposed to use injectable vitamins.

Dr O’Neil-Smith:               I know.

Dr. Weitz:                         So I would think the injectable ones would potentially be a problem, right?

Dr O’Neil-Smith:               It depends. It depends on … I have athletes that try for the Olympic team. I would have them go to their staff in NHL and NFL and everything else. They go direct to their person and what their person there will do, and it’s not always the same person. It’s not like the doctor, the athletic trainer, or the nutritionist. It’s whoever it is … whoever their relationship is with. What they’ll typically do is send a sample to their lab and say is this okay?  I would say that 100% of the time it comes back okay.  So I have it tested because I care enough that they are well.  So if I have in the NHL a Boston Bruin who’s had a brain injury or a massive concussion, why would they not be allowed to be treated appropriately?  So we have to begin to bridge the gap with the things that are dangerous, the testosterones that are overly used, the anabolic steroids that are overly used.  These are not anabolic steroids.  These are bio natural regulatory signaling cells allowing the body to use the body’s own healing properties instead of medicines or drugs.

Dr. Weitz:                         How does BPC-157 help with the healing of tendons?

Dr O’Neil-Smith:               BPC-157 works on multiple pathways in the nucleus of the cell directing gene silencing and gene promotion. So they silence the genes that continue runaway inflammation and promote the genes that basically … a lot of nitric oxide enhancements. They don’t just do blood vessel repair.  BPC also does nervous system repair.  When I think of an injury, we all talk about blood vessels.  Well the knee doesn’t have a lot of blood vessels. Joints don’t have a lot of blood vessels.  So it’s not really that we want mostly blood flow there because that’s not a natural state for a joint like the knee.  What we want is the nerve endings to not be inflamed.  For the milieu or the bath or the soup that the nerve endings are bathing in to be appropriate. So BPC is very good at allowing for cleanup and that’s called autophagy. You’ve probably heard a little bit about autophagy. Autophagy is-

Dr. Weitz:                         Related to fasting especially or ketogenic diet.

Dr O’Neil-Smith:               Okay so it relates to everything in the cell because autophagy is auto, self, auto means self. Phagy … phagy is clean up. Clean up yourself. You make a mess in your room, clean it up. You make a mess in your cells, clean it up. It’s naturally occurring housekeeping of a cell. So fasting allows for autophagy or housekeeping because you don’t keep sending in food that needs to be metabolized and creates waste.  Food always creates waste. That’s why we stool. Food in the body, not just in the gut, creates waste. In the cell it creates waste. When we fast we allow for better housekeeping, better cleanup of the gut and of the body. That’s ketogenic, that’s fasting mimicking diet with Valter Longo’s protocol at USC. That’s other protocols for dieting. But with peptides we allow for autophagy as well and we clean up-

Dr. Weitz:                         It’s interesting because my general sense of peptides, and especially since I had found out that bodybuilders are using it and athletes. It seems like when we look at the whole anti-aging continuum, it seems to me anyway … maybe I’m oversimplifying things, that we have this … we have the growth signals and then autophagy is part of the … We’re in starvation mode. The body can’t grow because it doesn’t have the necessary ingredients. So that’s when it starts breaking down its own cells to scavenge the amino acids for protein.  Peptides seem to be as part of the growth stimulation factor is not the starvation factor. So I’m surprised to hear that.

Dr O’Neil-Smith:               Woops oh hang on. Sorry the meeting has been upgraded. Okay. Yeah go ahead.

Dr. Weitz:                         Yeah, am I confusing things?

Dr O’Neil-Smith:               No. When I think about the body I think about catabolism/anabolism. You’re breaking it down. You’re building it up. Most of the things in medicine that we do and that happen every day from the time you wake up to the time you go back to bed … go to bed, is catabolic. It’s breaking you down. Same thing when you go to the gym. You’re breaking down. The goal is to break down and build appropriately back. The goal is to get through the stress … good stress, bad stress, whatever of the day and then restore at night.  We are in a fast paced society. The amount of housekeeping that needs to be done is enormous, completely different … every six months it’s bigger. It’s like the clean up of the environment. It’s big. So the reality is, is that mostly what we do in medicine is we just stop the signaling. We never really give the regenerative potential. We just put out the fire but we never rebuild back. So you’re sitting there with a burned building and you never rebuild it back. You’ve got to restore that.  What peptides do as the … So food and fasting mimicking diets or fasting will just stop the fire. Using peptides, they are regenerative. They’re going to build back with the fire burned. It’s a really important way and I think that the primary thing … You know one of the things that … There’s a lot of systems and there’s a lot we don’t know and a lot of doctors like to keep it very simple and work with what they know. That’s great. Work with what you know and then build on what you know.

                                         So when you think … right now the thing I’m thinking about the most in terms of pain and in terms of joints and in terms of injury, and in terms of a gut injury, a brain injury, whatever it is, my passion is brain and soft tissue injury. Kind of everything. But when you understand fascia, fascia is probably the largest organ in the body. Think about that white bright glistening component on meat and you cut through the layer and you’ve got more and more fascia. You understand this. Fascia is so contiguous and so abundant in the body.  Fascia happens in layers. Between those layers of fascia with the collagen, the different types of collagen, one, two, three, four, you name it. All of the different nutrients that collagen needs, they’re also many. Fascia has hormone receptors. It has receptors for estrogen, for progesterone, for testosterone. Who talks about that? Who thinks about that? We get afraid of giving too much of something but we need the right amount of testosterone, of estrogen and progesterone in men and women in order for that fascia to glide and move in all directions, and to be elastic and to be able to withstand the wear and tear of everyday.

                                                To rebuild that, we also need those signaling molecules because they help to keep the nerves, the free nerve endings in that fascia healthy. So the peptides are one component of many things. I make a pyramid when I treat my patients and I think of a house in the middle of an ocean being battered by a hurricane, then a tornado and whatever. That house is sitting on a rock and that rock has to be solid. That foundation has to be solid. So you have to start with having adequate ingredients available to build the body back, which are nutrients.  Whether you give them IV, whether you give them orally, make sure they’re getting in and make sure that the body is receiving them. To do anything else, peptides and other things, if you don’t have nutrients, it doesn’t make sense. If you haven’t cleaned up with a little fast here and there, it doesn’t make sense. Intermittent fasting, time-restricted eating, a little ketogenic, a little fasting mimicking diet prolong, whatever it is you do, you’ve got to be doing some of that. You’ve got to know you’re getting nutrients in.

                                         The second thing in my pyramid going from top to bottom, foundation is bottom. Foundation here … is how do we use hormones? What is the balance of hormones that we need? You really restore some hormones. It might even be progesterone in a man, a little bit, because that’s going to help that fascia move. They have to have an adequate level of estrogen 20 to 30, whatever it is. It can’t be zero with Arimidex. That doesn’t make sense. Arimidex is going to destroy joints.

                                         After hormones the next thing I would think of is if we have a sound wave therapy machine or something like that to break up the granules that are floating around and wanting to heal you. Those contain some peptide-like molecules. Those granules want to be popped to give you the healing ingredients that you need. So some sound wave therapy if you have that. And if you have access to peptides, oral, over-the-counter, or sub-q, I think those are next. But you don’t want to give peptides like a BPC if someone doesn’t have B12, if someone doesn’t have B1, if someone doesn’t have an antioxidant, if someone doesn’t have a magnesium. Why are you going to give a peptide? You’ve got to know that they’ve got the ingredients for that peptide to work.

Dr. Weitz:                         Yeah and you’ve always got to start with the basics, diet and lifestyle. One of your articles I was reading about BPC-157 and tendon injuries seem to be that it had this positive interaction with growth hormone and it seemed to facilitate the growth hormone being able to help the healing of tendons.

Dr O’Neil-Smith:               Absolutely. It will never be one thing alone. For a growth hormone, I like to use another peptide. I don’t use growth hormone in my practice because of the downsides of growth hormone and because of the abuse around it. You can’t-

Dr. Weitz:                         At one time it was getting to be kind of popular in anti-aging circles but it’s sort of fallen out of favor I’ve noticed.

Dr O’Neil-Smith:               Yeah, yeah, it’s totally out of favor because it can be abused. It’s also very expensive so it’s really hard to maintain. If you’re going to do growth hormone regularly, once you shut down your brain’s production of it, you need to use this. If you’re going to do growth hormone regularly, it’s going to cost you $15,000 a year. You’re going to have a difficult time getting it. It’s going to be very difficult because in order for a doctor to prescribe it in a safe way and in a way that the board regulates, you have to have insulin. You have to have specific testing with insulin, etc. That’s just not something I get into.

                                         But CJC and IPA, another peptide, are peptides that I would consider using. Those are peptides that are growth hormone releasing hormones and growth hormone releasing peptides. They’re a little bit different. GHRH, GHRP, different. So GHRH basically will have some effects of growth hormone and it will regulate that, and GHRP will be more like a ghrelin effect. Similar to BPC because the ghrelin and the ghrelin receptors are throughout the GI tract, because the GI regulates so much of the healing that goes on in our body from the mouth all the way through to the anus.   At each phase of the way, there’s different pH’s. There’s different microbiota or bugs. There’s different utilization of food. Water absorption, etc. So the entire GI tract, not surprising, is releasing many of these peptides as signalers to the rest of the cells around the GI tract. Are we in danger? Are we safe? Do we let this in? Do we keep this out? Is there a bug here? Is there a parasite here? What’s going on and how do I keep the body safe? So GHR-

Dr. Weitz:                         Those are injectables, peptides?

Dr O’Neil-Smith:               Those are injectables. CJC and IPA or GHRH and GHRP are injectable.

Dr. Weitz:                         And you need a prescription for those?

Dr O’Neil-Smith:               You need a prescription and you need to regulate them because there are many ways that you could use them. You could use them for healing a joint if necessary. You can use them for someone who has growth hormone deficiency. You can use them for-

Dr. Weitz:                         For recovery from surgery, say?

Dr O’Neil-Smith:               Absolutely. I always use them in my patients for recovery from surgery. You can also use some of these peptides for insulin signaling to re-regulate insulin signaling because diabetes type 2 and weight gain and adiposity, being overweight, is really a big issue. So we can use these to regulate how the body uses fat for energy, sugar for energy, and make it more efficient.

Dr. Weitz:                         Do you have a combination or they used the word stack in some bodybuilding circles. I’m sure other circles that you would use for say an athlete recovering from Achilles tendon repair or an ACL.

Dr O’Neil-Smith:               Okay let’s take an Achilles. Achilles is amazing. Plantar fasciitis a massive problem. I will absolutely use BPC. I will-

Dr. Weitz:                         And this is post-surgery or even just recovery from an injury without surgery?

Dr O’Neil-Smith:               I’m a big prehab girl. You may pregame in California for your sports games, but I prehab before surgery. That’s kind of a principal that we use anyway. So prehabbing means prepare for surgery. Why would you go into surgery? You wouldn’t go into a game that you wanted to win without preparing for it. Don’t go into a surgery that you want to have a good effect from before doing that. I know for you, your motto is, “For those of you who have no time for healthy eating, you’re going to pay the price later,” right?

Dr. Weitz:                         Right.

Dr O’Neil-Smith:               Find the time now because you’re paying the price later. It’s the same thing for surgery. It makes zero sense to me that you would ever consider a surgery without prehab. So prehab would involve peptides. Now I know the surgeon is going to tell you stop everything before you go in for a surgery. BPC oral is never going to change your bleeding time. BPC oral is going to help it. Stop it for 48 or 72 hours. I have no problem with that. But if someone were going to have an Achilles tendon, BPC alone injected can heal an Achilles tendon. That has been shown in studies.

Dr. Weitz:                         And is it injected around the tendon?

Dr O’Neil-Smith:               Mm-hmm (affirmative). Injected in the tendon. So you can inject it in the tendon. You can inject it …

Dr. Weitz:                         In the tendon or near the tendon?

Dr O’Neil-Smith:               All around. It doesn’t have to go directly in the tendon.

Dr. Weitz:                         Right all around it.

Dr O’Neil-Smith:               Right there. Because remember it’s like the fire department. It’s cell signaling. It’s going to recruit to bring in other cells to do healing. Typically when there’s an injury, and I’ve done this with very well-known athletes, I make a triangle around the injury and I inject around that injury with BPC. You get healing. Even people who are suspicious or suspect realize that they get amazing healing with that. You can also use it at the same time as you do that … I’ve sent people home in the last two days to do the triangulated injection, a little tiny, little bit, just like somebody might do a Botox. That’s a toxin. We’re injecting something that’s healing. It’s a tiny little, just like a Botox needle. Little bit around that, just like they do … I don’t know how they do … I don’t do Botox, but if they did Botox here they’d do … all over. You do that with the BPC and then you put some BPC sub-q, intra-abdominally, no problem. It works together.

                                                It gets the signaling from a distance. It gets a signaling locally. You could do that with insulin. For someone who needs insulin for sugar and they need it to live, when you give insulin in the abdomen, even though the brain cells need it, it gets there. There’s signaling pretty quickly. So you don’t have to put it in the head. You can put it in the belly and it will get where it needs to go. We do that all the time for insulin. Type 1 diabetics who wear pumps, they stick the pump in their tush. They stick the pump in their lower abdomen. They stick the pump in their arm.  No matter where you stick this, it’s going to get to the site it needs, just like BPC.

Dr. Weitz:                            So what would be the stack? You’re going to use BPC-157. What else would you use for somebody who needs recovery from surgery quicker or better?

Dr O’Neil-Smith:               If they’re all in, if they’re all game, I’m probably going to do BPC, CJCE with a growth hormone derivatives, and I might even do HCG, human chorionic gonadotropin, HCG, LH, luteinizing hormone. I would probably do those three. I’ve used that many many times.

Dr. Weitz:                         Do you use HCG even if they have healthy testosterone levels, because HCG is a precursor for … it stimulates your gonads to produce more testosterone, right?

Dr O’Neil-Smith:               Mm-hmm (affirmative) it can increase free testosterone, and the testosterone’s action in the body. I probably would use a little bit, yeah, because HCG … This is where we get trumped up. When you understand that HCG, as you just said-

Dr. Weitz:                         You mean we’re all going to turn orange? I’m just kidding.

Dr O’Neil-Smith:               We’re going to get orangutan hair. We’re going to be the products of orangutan. That’s a joke from I don’t know Saturday Night Live or Larry King Live, somebody. At any rate, Bill Maher. HCG, when we think of it, we think of it as predominantly increasing testosterone. That’s not how I think of the peptide HCG. It does that. It’s one of its actions. I think of HCG as a luteinizing hormone and I think of that as having other benefits in the body that repair and regeneration and growth.

Dr. Weitz:                         Oh really? Oh I never thought of it like that.

Dr O’Neil-Smith:               100%. That’s not what anybody talks about. It’s like if we make … There’s a medical food called DEPLIN. It’s a folate. DEPLIN, methyl folate, has been approved to come on the market for depression. I use methyl folate a lot. My people see that it’s on the market for depression and they don’t want to take it. I’m like no, no, no, no. That’s just what it’s approved for. This has many benefits, and you’ve already felt them. You took it before you knew it was for that, and now you don’t want to take it. This has many benefits. It’s the same with peptides because peptides are what we call pleiotropic. Pleiotropic is if you put the peptide in the middle and you create all of the spokes coming off, it has many spokes, so testosterone utilization receptor uptake would be one spoke for HCG, so I would use HCG as well.

                                                So I would definitely use BPC. I would definitely use a growth hormone derivative, not growth hormone, and I would probably use a little bit of HCG.  I mean there are other things I could use. When I treat a patient, I don’t treat just the condition.  It’s not like you come in and my brain goes, “Achilles injury, boom you get this.” I say, “Achilles injury. How’d it happen? What was the milieu when it happened? Let me get some measurements, prehab, preop. Let me figure out the other things you’re going to use, and that’s going to determine my stack.” I don’t have a one stack. You can’t come in and get a number one in my practice because I treat the patient, not the injury and not the disease.

                                                The injury is a component of the patient, but the injury happened in that patient, so I do personalized medicine where I treat the patient, not the disease with the number one through 10. You don’t get number seven because you have a shoulder injury or a number four because it’s a hip injury. I have to understand why did that injury happen in this patient and those are the things that will help me determine what the stack is going to look like. But within my stack I have nutrients. I have hormones. I have 20 to 25 peptides. I have sound wave therapy. I have exosomes. I have all kinds of different tools and I have to look at the labs for that patient, the biomarkers, to see why did this happen in that patient.  Did they have Marfan syndrome? Were they just on an antibiotic and tore their Achilles? Because levofloxacin, which people will use for a UTI. It’s a bad choice of an antibiotic-

Dr. Weitz:                         For tendons…

Dr O’Neil-Smith:               You’re going to rip your Achilles. I have three patients that that happened to. You’ve got to be careful and you’ve got to think before you use.

Dr. Weitz:                        Yeah all the fluoroquinolones.

Dr O’Neil-Smith:               Right.

Dr. Weitz:                        So BPC can be used to heal the gut. Do you use that as part of your gut protocols?

Dr O’Neil-Smith:               I would say because BPC is so pleiotropic with all those spokes at the wheel and so easy to take and affordable. It’s my number one. It’s my number one. I would say everybody. You can use BPC for a wound. I have a patient, 92-years-old, that had a wound. I had her daughter put the capsule and make a paste and put it on the wound. You can use BPC for a wound. You can use BPC for the gut. You can use BPC for a concussion. It helps to regenerate nerves. It’s being studied presently in MS.

Dr. Weitz:                         Cool.

Dr O’Neil-Smith:               Multiple sclerosis. The initial is that it’s beneficial. So if BPC can heal the brain, why not use it? If BPC is … Ben, three principles whenever you treat somebody, is it safe? Is there a possibility that there’s toxicity? With growth hormone there is. With testosterone there is. There is not with BPC. So is it safe? There’s no toxicity.

Dr. Weitz:                         Are there any downsides?

Dr O’Neil-Smith:               Not that I know of.

Dr. Weitz:                         What about downgrading receptor sensitivity?

Dr O’Neil-Smith:               No indication. So BPC safe. Second principle. Three principles. Effective. Effective therapeutically?  Is it going to help heal?  Is it cost-effective?  I think it fits both, safe and effective, therapeutically and cost-effective.  Then the third question is, is it sustainable?  Will it help to sustainably heal something?  Yes.  So BPC is a no brainer.  No pun intended.  It’s good for the brain. It’s good for the joints. It’s good for a wound.

Dr. Weitz:                         So some people would say hey if I take it all the time and then I have an injury, I might not get a beneficial effect.

Dr O’Neil-Smith:               Well it’s not like BPC is the only thing that’s going to heal an injury. You can change the dosing. If you take it all the time, you might not get the injury.

Dr. Weitz:                         Right so it sounds like this could be part of an effective anti-aging program just to take on an ongoing basis.

Dr O’Neil-Smith:               Yeah so if you were going to think about what are the best anti-aging … or rather than that, the best products that you would use for a health span as opposed to a life span.

Dr. Weitz:                            Yeah I just did a podcast very recently and we talked about that with Dr. Kaufmann. She’s got a whole book on anti-aging. She has really some great protocols there.

Dr O’Neil-Smith:               It’d be interesting to know, but everybody has their favorites and it’s probably based on their experience with what they see. Omega 3, hands down. You need omega 3. It makes no sense not to have it. I measure those levels. Everybody is ridiculously deficient. I think the dosage would be between five and 10,000. If somebody has a bleeding diathesis and they could bleed a lower amount, there is no reason to not take this on coumadin because that’s crazy. So I think omega 3.

                                         I think vitamin D, which is not a vitamin, it’s a hormone. It got promoted when Pluto got demoted from a planet. Vitamin D got promoted to a hormone. Vitamin D is really essential for the immune system. It’s really essential for the soft tissue and generally it’s going to be between two and 10,000, depending upon what you’re treating, International Units per day.

Dr. Weitz:                         Vitamin K2?

Dr O’Neil-Smith:               Vitamin K2. You can take that with it. It makes it easy. Now you just have two supplements. You’ve got omega. You’ve got D with K2. The third I would probably do is BPC because it’s easy, it’s affordable, it’s effective. Take a low dose. It’s going to keep you well. The fourth I might consider would be probably an NAD plus. That’s to keep-

Dr. Weitz:                         I’ve been using the NR, nicotinamide riboside.

Dr O’Neil-Smith:               It comes in many forms, but one way or another, get some NAD. It could be as an ATP fuel. It could be as NAD plus. There’s many different ways of getting it, and you’re familiar with that. The next product that I might use is probably a match with resveratrol versus curcumin/turmeric. So I think those are really, really beneficial. Curcumin and turmeric are similar. There are really good forms of curcumin.  Find a good form. Stick with that form. Go with that.  The next product, again resveratrol, you maybe can get that by I don’t know start with drinking two ounces of dark tart cherry juice a day a day instead of buying a supplement.

Dr. Weitz:                         Therapeutic dosage requires 26 bottles of red wine a day.

Dr O’Neil-Smith:               There are some good supplements out there for resveratrol as well.

Dr. Weitz:                         I definitely take every one of those. I’m on the same page with you. Plus tocotrienols, astaxanthin.

Dr O’Neil-Smith:               NAC.

Dr. Weitz:                         NAC. Acetyl-L-carnitine.

Dr O’Neil-Smith:               And then probiotics. I mean probiotics are a little tricky. I would say that everybody probably needs a probiotic with I don’t know 25 billion whatever it is. If they can find a probiotic with resistant starches, fantastic. Those are the prebiotic. The resistant starches are key. Those are more fibrous. They’re very good. You could take resistant starches alone. Phenomenal. So that’s really…

Dr. Weitz:                         As long as you don’t have SIBO.

Dr O’Neil-Smith:               Yeah you want to get your bowel moving before you do that for sure. You want to not be constipated when you do that. And then the things not to do, right, if you didn’t grow it, can’t pick it, don’t eat it. Really important. The longer the shelf life of the food, the shorter your shelf life. Really basic stuff.  Salt.  Get rid of sodium chloride.  We don’t have a sodium deficiency in our body but because the sodium is so high it makes our magnesium low relatively.  It makes our potassium low.  It makes our zinc low.  It makes many minerals low.  So absolutely really be cognizant of those processed foods. They’re full of salt.

                                                If you can figure out the foods that glutamate is in, or monosodium glutamate and where it’s hidden in foods, that’s really important. So if you look up MSG hidden sources or you look up Russell Blaylock, who is an MD, whose really just written some phenomenal books on that, on excitotoxins and how they kill your nervous systems. MSG being one of the major ones, glutamate … I think it’s really important to understand that.

                                                Those are some things to get rid of. Those are some things to add. I think that those are kind of universal. Those are if you come in and you want the number one in my practice, you just got it.

Dr. Weitz:                            That’s great. Awesome. Thank you, Dr. O’Neil-Smith. So how can patients and/or practitioners get a hold of you to find out about your programs and seeing you as a patient, etc?

Dr O’Neil-Smith:               So you know it’s really funny but in the last year, year-and-a-half, I decided to lead. Not to create followers, but to create leaders. I have developed a couple of things with another doc who we work quite closely together with because we have the same why. Simon Sinek says why are you doing this? Our why is to really leave a legacy of making a difference in medicine in a new way and being thought leaders.

                                                I have a program where I teach doctors and that program is a master class. We do that through Zoom. We finished our first master class, which was nine months. We’re going to shorten it to a six-month window. We basically meet on Zoom with a number of clinicians. You can look at treatwellness.com and see information for that. It’s called the Treat Wellness Peptide Master Class, but it’s principles about that. So that was amazing. The doctors … we just got their survey. It’s been amazing. The goal is to lead and create more leaders.  I want colleagues. I want a doctor like me in every state that you can send somebody to if you need help. I also know that in the trenches are the people that I work with, whether they’re the health coaches in my office, the PA in my office, whatever they do, psychologist in my office. Those people are probably more important for me. We teach those. We have a program that we’re developing through full scripts where we teach other than MD/DO, all about these things and how they can use them in their practice and how they can know when to refer and be on a team, and be leaders in their industry.

                                                Because we want to change brain health and we want to change gut health, and we want to avoid continuous injury. The other thing that I have is a website that’ll be published this week called Fire Em Up … Firrimupdoctors.com, and on that website we’ll have podcasts like you have that are designed to just be educational and direct to people like you, people like health coaches, people like really good body workers, athletic trainers, nutritionists, etc., who can be working with patients. It takes a village.  On there we have docuseries with experts, podcasts with experts, teaching on principles on medicine to try to avoid people from having a life span and not a health span. So firrimupdoctors.com. That’ll be out this week. You’ll see us doctors with their patients in the clinic giving an example of specific cases. You’ll hear experts like Dr. Fasano, Alessio Fasano from the Mass General who is a gut health expert and mucosal immunity. You’ll hear hormone experts. You’ll hear brain experts like Dr. Perlmutter. We’ll have all of these doctors on there.  Then we’ll also have … whenever we’re at a conference we’ll do a Facebook live. We’ve got Facebook live conferences in the past. We’re going to promote those as well just to educate. It’s free education. Come on. Learn about who you should go see and for what particular thing that is ailing you. So you don’t only treat the symptom of bloating or pain or headache. You treat the root cause. You get to the cause of that symptom and you make it go away more predictably. Maybe not for good because we can’t predict that, but maybe more predictably.

Dr. Weitz:                         That would be great. If you could email me those links, I’ll make sure to put them in the show notes.

Dr O’Neil-Smith:               That’d be good. Great. I will do that.

Dr. Weitz:                         Thank you, Doc.

Dr O’Neil-Smith:               You’re so welcome. Thank you, and thank you for the work that you do.



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