Peptide & Hormone Therapies for Health, Performance & Longevity | Dr. Craig Koniver

Episode 197 Oct 7, 2024 Episode Page ↗
Overview

Dr. Craig Koniver, M.D., discusses therapeutic peptides like GLP-1 analogs for weight loss and BPC-157 for inflammation, alongside NAD, methylene blue, and methylated B vitamins. He emphasizes working with knowledgeable physicians for safe and effective use to enhance mental and physical performance.

At a Glance
18 Insights
2h 29m Duration
23 Topics
8 Concepts

Deep Dive Analysis

Defining Peptides and Their Therapeutic Potential

GLP-1 Agonists for Weight Loss and Metabolic Health

Microdosing GLP-1s to Mitigate Muscle Loss

BPC-157: Anti-Inflammatory and Healing Peptide

Sourcing Peptides and Anabolic Steroids

Importance of Physician Guidance and Compounding Pharmacies

Pentadeca Arginate (PDA) as a BPC-157 Alternative

Growth Hormone Releasing Peptides: Ipamorelin and GHRP-6

Tesamorelin, Sermorelin, and Peptide Stacking Strategies

Coenzyme Q10 (CoQ10) for Mitochondrial Support

Off-Label Prescribing and Physician Trust

MK-677 and Hexarelin: Growth Hormone Secretagogues

Methylated B Vitamins for Homocysteine Reduction

Pinealine and Epitalon for Enhanced REM Sleep

Glycine for Nervous System and Liver Detoxification

Future of GLP-1 Compounding and Access

FDA-Approved Stem Cell and PRP Therapies

Thymosin Alpha-1 and Cerebrolysin for Brain and Immune Health

Methylene Blue for Cognitive Enhancement and Mitochondrial Function

NAD Infusions and NMN/NR for Energy and Recovery

PT-141 for Libido and Potential Side Effects

FDA Peptide Bans and Pharmaceutical Industry Dynamics

The Profound Impact of Positive Mindset on Health

Peptide

Peptides are chains of amino acids, defined as 40 amino acids or less. If a chain exceeds 41 amino acids, it is classified as a protein. The human body naturally produces hundreds of thousands of peptides, which perform a vast array of biological functions.

Off-Label Prescribing

This refers to the practice where physicians prescribe a medication for a condition or use that has not been specifically approved by the FDA. The vast majority of prescribed medicines in America are used off-label, as long as the drug has received FDA approval for at least one indication.

Compounding Pharmacies

These are specialized pharmacies that create custom medications for individual patients, often by combining or altering ingredients. They are highly regulated by the FDA and state boards of pharmacy, ensuring purity and allowing for tailored dosages and combinations of compounds.

Growth Hormone Secretagogues

These are peptides that stimulate the body's own pituitary gland to release more of its natural growth hormone. Unlike direct growth hormone administration, secretagogues work by enhancing the body's endogenous production, typically without causing negative feedback that shuts down natural hormone synthesis.

Mitochondrial Electron Transport Chain

This is a fundamental process within the mitochondria, the 'batteries' of the cell, responsible for generating ATP (chemical energy). It involves the sequential transfer of electrons across five cytochrome hubs, where nutrients like NAD, CoQ10, and methylene blue play crucial roles in facilitating efficient electron flow.

Methylated B Vitamins

These are B vitamins (e.g., methyl B12, methylfolate) that have an added methyl group, which makes them more bioavailable and effective for certain metabolic processes. They are particularly important for lowering homocysteine levels, a biomarker associated with increased cardiovascular risk, by supporting liver detoxification pathways.

Phase Two Liver Detoxification

This is a critical stage in the liver's detoxification process where fat-soluble toxins are converted into water-soluble compounds, making them easier for the body to excrete through urine, stool, sweat, or breath. Glycine, glutathione, and various polyphenols are key agents that support this phase, often independently of Phase One detoxification.

Autologous Cell Therapy

This therapeutic approach involves taking a patient's own cells (e.g., for Platelet-Rich Plasma or PRP) and reintroducing them into the same patient's body. Under FDA guidelines, this is permitted as long as the cells are processed and returned to the patient within a four-hour window.

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What is a peptide?

Peptides are small chains of amino acids, typically 40 or fewer, that perform various roles in the body. They are distinct from proteins, which have 41 or more amino acids.

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Can GLP-1 agonists like Ozempic be used safely for weight loss without significant muscle loss?

Yes, by using microdoses of compounded GLP-1 agonists and losing weight slowly (two pounds or less per week), individuals can mitigate muscle loss, especially when combined with adequate protein intake and resistance training.

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How does BPC-157 work for injury repair and inflammation?

BPC-157 is a highly anti-inflammatory peptide that can upregulate growth hormone receptors and initiate fibroblast migration, aiding in the repair of ligaments and tendons. It works systemically, meaning injections can be administered anywhere and still benefit a specific injury site.

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Why is it important to obtain peptides from a physician or compounding pharmacy?

Sourcing peptides from a physician or compounding pharmacy ensures purity, established potency, and absence of contaminants like lipopolysaccharides (LPS), which can cause severe inflammatory reactions. Compounding pharmacies are FDA-regulated and allow for customized dosages and combinations.

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What are the benefits of growth hormone-releasing peptides (GHRPs) like Ipamorelin and Tesamorelin?

These peptides stimulate the body's own pituitary to release growth hormone, leading to benefits such as improved sleep, better skin tone, enhanced recovery from exercise, increased durability, and reduction of visceral fat, without directly administering exogenous growth hormone.

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What is the role of Coenzyme Q10 (CoQ10) in health?

CoQ10 supports mitochondrial health by facilitating electron flow at cytochrome 3 in the electron transport chain, which is crucial for ATP (energy) production. It is considered an 'insurance policy' for mitochondria.

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Why are methylated B vitamins recommended, especially for cardiovascular health?

Methylated B vitamins (e.g., methyl B12, methylfolate) help lower homocysteine levels, an emerging marker for cardiovascular risk, by supporting liver detoxification pathways and methylation processes in the body.

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How can Pinealine improve sleep, particularly REM sleep?

Pinealine is a peptide that appears to stimulate the pineal gland, potentially enhancing melatonin production and improving the quality and duration of rapid eye movement (REM) sleep, which is crucial for neuroplasticity and emotional regulation.

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What are the benefits of Glycine supplementation?

Glycine acts as an inhibitory neurotransmitter, calming the nervous system to aid sleep, and also supports phase two liver detoxification, helping the body excrete toxins more efficiently.

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What is Methylene Blue used for in health and performance?

Methylene blue binds to cytochrome C oxidase in the mitochondria, acting as an oxygenator and cognitive stimulant. It can enhance brain function, memory, and energy, and has shown antiviral properties.

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What are the benefits of NAD infusions and supplements like NMN/NR?

NAD infusions can lead to rapid improvements in energy, mood, cognitive function, and recovery from infections, potentially by fueling mitochondrial function and other unknown systemic effects. NMN and NR are precursors that can increase NAD levels.

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Why has the FDA recently banned or restricted many peptides from compounding pharmacies?

The FDA's actions are likely a combination of genuine intent to oversee a rapidly expanding and sometimes unregulated market, and pressure from pharmaceutical companies seeking to develop and patent their own versions of these highly effective compounds for significant profit.

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How does a positive mindset impact overall health?

A positive mindset is profoundly impactful, overriding many physical challenges. While not negating real suffering, choosing to pivot towards positivity can lead to more positive outcomes, enhance resilience, and contribute to overall well-being and purpose.

1. Cultivate Positive Mindset

Actively choose to frame decisions and thoughts positively, as cultivating a positive mindset can lead to more positive outcomes and override many challenges in life.

2. NAD Infusions for Vitality

For broad health benefits including enhanced cognitive function, mood, energy, and sleep, consider a loading dose of five 750mg intravenous NAD treatments over 10 days, followed by a monthly maintenance dose.

3. Subcutaneous NAD Injections

As an alternative to NAD infusions, inject 100 milligrams of NAD subcutaneously five days on and two days off to experience similar benefits.

4. Boost REM Sleep with Pinealine

To significantly increase rapid eye movement (REM) sleep, consider using injectable Pinealine, potentially combined with glycine, as it may also lead to sustained improvements in sleep quality.

5. Glycine for Sleep & Detox

Take 3-5 grams of oral glycine at bedtime, increasing to 10 grams if necessary, to calm the nervous system, aid sleep, and enhance liver detoxification.

6. Methylene Blue for Cognition

Take up to 10 milligrams of methylene blue orally in the morning, around three times a week, to boost cognitive function, aid mitochondrial oxygenation, and potentially provide antiviral benefits.

7. Daily CoQ10 for Mitochondria

Take 200 milligrams of Coenzyme Q10 (CoQ10) daily in the morning to support mitochondrial function by facilitating electron flow at cytochrome 3, which may also help reduce migraines.

8. Lower Homocysteine with Methylated B

To reduce elevated homocysteine levels and cardiovascular risk, take ample methylated B vitamins (e.g., methyl B12, methylfolate, TMG, methionine), ideally in the morning.

9. Source Peptides Safely

To ensure safety and purity, obtain peptides only from a physician who works with highly regulated compounding pharmacies, and build a trusting relationship with your doctor.

10. Microdose GLP-1 for Weight Loss

When using GLP-1 agonists like semaglutide or tirzepatide, use microdoses and aim to lose 2 pounds or less per week to avoid muscle mass loss.

11. Combine GLP-1 with Sermorelin

To counteract muscle loss associated with GLP-1 agonists, consider combining them with growth hormone-releasing peptides such as sermorelin.

12. Resistance Train with GLP-1

When taking GLP-1 agonists, perform resistance training and consume adequate protein to help prevent muscle loss.

13. Use PDA for Inflammation

As an alternative to BPC-157, inject 250-500 micrograms of Pentadeca-arginate (PDA) daily, five days on and two days off, to reduce inflammation and aid recovery.

14. Cycle Peptides 5 On/2 Off

To maintain the potency of peptides and supplements, use a dosing schedule of five days on and two days off, as continuous exposure can decrease effectiveness.

15. Ipamorelin for Sleep

Inject Ipamorelin (100 micrograms or less) before sleep, avoiding carbohydrates for 45 minutes prior, to improve sleep quality and overall vitality without significant side effects.

16. Tesamorelin for Visceral Fat

To reduce visceral fat, which is fat around the organs, consider using Tesamorelin, a peptide that has received FDA approval for this specific purpose.

17. Hexarelin for Energy

Inject 100 micrograms of Hexarelin in the morning to experience a clean energy boost and improved endurance without stimulating appetite.

18. Sublingual NMN for Growth

Consider taking sublingual NMN daily to potentially accelerate the growth of hair and nails.

No good has ever come from a negative thought.

Dr. Craig Koniver

If I can help people lose weight first, literally by using something like trisepatide, semaglutide, and I've seen this, they're now excited. I mean, I met with a client yesterday here in Los Angeles, and she literally looked at me and said, 'You've changed my life.'

Dr. Craig Koniver

Peptide therapies sit somewhere between doing nothing and supplementation and those more advanced hormone therapies. And that's why peptide therapies, I believe, are growing in popularity. They can augment specific hormone pathways. They can augment specific, in fact, multiple processes within the brain and body to augment health, but they don't tend to operate in that negative feedback cycle by shutting down one's own endogenous production.

Andrew Huberman

Most of the medicines prescribed, particularly in America, are prescribed off-label, meaning they've never, ever been approved for what they're used.

Dr. Craig Koniver

If you've got something going on in your gut, you should take oral BPC because it's going to target it right then. And I found, you know, if we're injecting, it actually works better than the oral. And then it came up, well, what if I've got an elbow injury? Should I inject it in my elbow? And we found, actually, don't. It's going to work systemically.

Dr. Craig Koniver

If you use something for a long time, you're going to get less out of it over time. Anything you expose yourself to continually doesn't work as well.

Dr. Craig Koniver

Your podcast and what you do has been so successful at a time during the pandemic when people lost so much trust in people like me... you in particular, providing this very stable, vetted information that people can trust and have a starting point.

Dr. Craig Koniver

If I had to pick one thing for people, engaging in NAD would be it.

Dr. Craig Koniver

GLP-1 Microdosing for Weight Loss

Dr. Craig Koniver
  1. Obtain compounded semaglutide or tirzepatide from a physician and compounding pharmacy.
  2. Start with a very low microdose.
  3. Increase dosage slowly to achieve a weight loss of 2 pounds or less per week.
  4. Ensure adequate protein intake and engage in resistance training to preserve muscle mass.

Pentadeca Arginate (PDA) for Anti-Inflammation and Recovery

Dr. Craig Koniver
  1. Inject 250-500 micrograms of PDA subcutaneously daily.
  2. Follow a schedule of 5 days on, 2 days off.

Growth Hormone Releasing Peptide Stacking for Fat Loss and Durability

Dr. Craig Koniver
  1. Combine Ipamorelin (up to 100 micrograms), Tesamorelin (2 milligrams), and Pentadeca Arginate (250-500 micrograms) into a single subcutaneous injection.
  2. Administer the injection at bedtime, ensuring no carbohydrates have been ingested in the previous 45 minutes.
  3. Follow a schedule of 5 days on, 2 days off.

NAD Intravenous Loading Dose

Dr. Craig Koniver
  1. Receive 750 milligrams of NAD intravenously per session.
  2. Complete 5 treatments within a 10-day period.

NAD Intravenous Maintenance Dose

Dr. Craig Koniver
  1. Receive 750 milligrams of NAD intravenously per session.
  2. Administer approximately once a month for ongoing benefits.

NAD Subcutaneous Protocol

Dr. Craig Koniver
  1. Inject 100 milligrams of NAD subcutaneously daily.
  2. Follow a schedule of 5 days on, 2 days off.

Glycine for Sleep and Liver Detoxification

Dr. Craig Koniver
  1. Start with 3,000-5,000 milligrams (3-5 grams) of oral glycine at bedtime.
  2. If no noticeable effect after a few nights, double the dose to 10 grams.
40 amino acids or less
Peptide length definition Distinguishes a peptide from a protein
41 amino acids or more
Protein length definition Distinguishes a protein from a peptide
300,000
Body's natural peptide production Approximate number of peptides made by the body
150
Therapeutically used peptides Approximate number of peptides used therapeutically over the years
2 pounds or less per week
GLP-1 weight loss rate Recommended maximum weight loss rate with GLP-1s to avoid muscle loss
500 micrograms
BPC-157 starting dose (injected) Daily subcutaneous injection dose
5,000 micrograms
BPC-157 higher dose (injected) Higher daily subcutaneous injection dose observed clinically
250-500 micrograms
Pentadeca Arginate (PDA) starting dose (injected) Daily subcutaneous injection dose, 5 days on, 2 days off
100 micrograms
Ipamorelin max dose Maximum dose for binding the growth hormone receptor
100 micrograms
GHRP6 max dose Maximum dose for growth hormone releasing peptide 6
100 micrograms
Hexarelin max dose Maximum dose for Hexarelin
2 milligrams
Tesamorelin ideal dose Ideal dose per administration
200 to 3,000 micrograms
Sermorelin dosing range Broad range depending on goals
200 milligrams
CoQ10 daily dose Recommended daily dose for mitochondrial health
2,400 milligrams a day
CoQ10 safe upper limit No harmful effects observed up to this dose
>7
Homocysteine elevated risk threshold (some labs) Indicates increased cardiovascular risk
>9
Homocysteine elevated risk threshold (most labs) Indicates increased cardiovascular risk
3,000-5,000 milligrams
Glycine starting oral dose Recommended at bedtime for nervous system calming and liver support
10 grams
Glycine higher oral dose Increased dose if initial starting dose is not effective
10 milligrams
Methylene Blue oral dose Recommended maximum daily oral dose for cognitive enhancement
50 milligrams
Methylene Blue IV dose (in-office) Higher dose used intravenously in a clinical setting
750 milligrams
NAD IV infusion dose (common) Common intravenous dose for significant benefits
45 minutes to 2 hours
NAD IV infusion duration (common) Typical duration for a 750mg infusion
$500-$1,500+
NAD IV infusion cost Approximate cost per infusion, can vary by location
100 milligrams
NAD subcutaneous injection dose Daily subcutaneous injection dose