Episode Transcript
Speaker 1 00:00:01 Welcome my outside the box thinkers to the Anti-Aging Unraveled podcast, where I am your host, Dr. Lori Gerber. In this podcast, we will explore the fascinating world of personalized anti-aging medicine that considers the whole person inside and out and how all systems are interconnected to each other. In today's world of modern medicine, we often find ourselves like just another number in a system that prioritizes quick fixes over sustainable and more natural solutions. Well, let's get ready for a paradigm shift. In health and beauty, we look far beyond treating symptoms and aim to get to the root cause of our health and cosmetic issues. This podcast is your go-to source for all things natural outside the box and innovative and integrative medicine and cosmetic dermatology. So sit back, relax and get ready to dive deep into the world of functional medicine and aesthetics with me, Dr. Lori Gerber. Let's take a trip down the Real Skin Revolution pathway together.
Speaker 1 00:01:05 Hi and welcome. This is Dr. Lori Gerber, bringing you another podcast and I'm so excited to have you all here today. This is an exciting topic for me in both aesthetics and wellness and functional medicine. It's exosomes the new frontier, and it is almost my word of 2023. I, we all know that peptides are tend to be my word of 2023. However, exosomes are a close second and I'm really excited to talk about these with you and really what they mean to us. I'm gonna try to put it in into plain context for you and make it so that it's, it's a little bit more relevant to treating you cosmetically and possibly even for wellness in the future. So let's get down to the nitty gritty of what are exosomes and basically they're small particles and they're, we call them nanoparticles. They're released and received by almost every cell in the body.
Speaker 1 00:02:01 So for example, they're released from an envelope basically and they contain signaling molecules. They're about 30 to a hundred nanometers in size. So they're very small and these vesicles are a communication system. They tell other cells in the body what to do. They deliver what we call like a molecular payload from cell to cell. They're, they're the directory. They're telling things what to do and what to become and how to do them. And they all have different biologic functions depending on the cell that it's creative from and what's inside the cell. And it has different molecules on the outside, on the inside that are gonna tell everything what to do. And basically we really haven't recognized these the first time. We recognize these about 50 years ago and they originally assumed to be waste products. Um, not that, that weren't really relevant to anything. And what we've come to realize is basically a shedding of the plasma membrane into something that we, we call this exosome or also an extracellular vesicle.
Speaker 1 00:03:03 And that actually became a commonplace term in about 1983 when we realized that these had cellular messaging capabilities and could be extremely interesting. And why would they be interesting to us is really a great question. And really if think about it, we can think that there's three main reasons why they are interesting. The first is that it's a means of intracellular communication and transmission of molecules between cells. So we can use it to create pathways that we want. So we can stimulate our stop certain pathways, for example, spreading proteins, lipids, mRNA, D n a, so we can stop or promote various disease processes. Okay? So that's taking that messaging system and then secondarily applying it to disease. And third, they're great vectors for drugs. So we can help certain drugs and chemicals to get into the cell or signal cells to do certain things. So right now a big field of study is in anti-cancer clinical trials, which if you think about that, we're using our own cellular signaling and technology to introduce this medication into a host sal, which is quite amazing.
Speaker 1 00:04:23 Most cells in the body make these exosomes. So you know, we can use them in a variety of ways Right now another big target is in the immune cells cuz we know that immune cells continuously release exosomes. In fact, most of the data right now that we have on exosomes is from immune cells. And we know that we can affect cellular signaling in the inflammatory cascade and autoimmunity through using exosomes and affecting the immune functions of B cells, dendritic cells, and mass cells which help, which are histamine or allergic response ones. So if we think about that a little bit more closely, we can affect tons of autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, other lupus type or autoimmune diseases, right? So anything that can affect the brain or inflammation, maybe even some long-term bug effects that are actually creating an autoimmune response in our system can possibly be affected by using these exosomes.
Speaker 1 00:05:27 The exosomes right now are in clinical trials are being used IV for inflammatory disorders. There are several trials going on in the United States on this right now and like I said, they're also being used for medication delivery for cancers specifically. So interesting fields of interest for exosomes in what I would say integrative medicine and health and wellness, which is the other half of my business, right? And even if we don't use them iv, we're seeing really great results with decreasing inflammation in and around joints and um, tissues. So for example, chronic injuries, shoulders, knees, ankles, we're seeing them injected locally, not even necessarily intra particularly with some of those peptides that I've been speaking to in my last podcast and actually getting some great anti-inflammatory results in the area that last pretty significantly long time depending on the person. And again, it just can be do done locally, it does not have to be injected intraarticular.
Speaker 1 00:06:29 So extremely interesting field with the medicine side. And let's talk a little bit more about how they work and what they do. And we're basically, when you get an exosome and it's released, it's gonna tell a cell to become something. It's gonna be say, hey do this or become this. And it actually can change what we call the phenotype of the cell. So what is it going to, basically the phenotype is what it looks like or what it's going to do. All right, so the mechanism of action is basically for the anti-inflammatories purposes, you're thinking it would shut down macrophages and help with this massive immune response that we're basically getting from the inflammation and the cytokines that are being released. Okay? Macrophages can be defensive and they can exhibit regulatory anti-inflammatory. So whether we upregulate or deregulate these cells, we can get either resolution either way actually we would get resolution of inflammation.
Speaker 1 00:07:29 These also produce natural growth factors which are huge for the skin. So we know that we're seeing a ton of exosome therapy for skin and this is really where there's a big interest right now. Um, and a lot of my peers and colleagues is using these exosomes which have growth factors and anti-inflammatory properties and pushing them into the skin. So you know, what we can achieve is actually enhanced collagen elastic tissue. There are data studies to suggest that we have increased elastic tissue and collagen with pushing these exosomes underneath the skin, usually via microneedling or another needling device such as Morpheus and actually stimulating collagen and cellular proliferation underneath the skin. So also for wound healing we see that for scar tissue even or even closing diabetic ulcers, using these topically and applying these on a regular basis can help with wound repair and skin healing.
Speaker 1 00:08:30 So one of the companies that I use, their main focus is on wound autoimmunity, aesthetic subq, anti-inflammatory response and I inflammatory response. And actually in ophthalmology, um, we are seeing them used for a medication delivery. Okay, so let's talk about how we, how we buy these things. So you know, there's a little bit of confusion I think over how these are manufactured, how they're delivered and how, how we get them to you. And just to kind of give you an example of, again, a company that I use that is Exo Cell Bio. They are a company that actually makes the one of the most potent exosomes on the market, meaning they have that up to the highest concentration, the highest purity, but they make a variety of different concentrations. And I think that's really important in when you look at the prices on the market, we're talking about tons and tons of different concentrations of these little itty bitty vesicles in solution and you wanna make sure that you're getting one that's appropriate for the area that you're treating.
Speaker 1 00:09:32 You know, if you're doing it for hair restoration, which is a huge I guess pinpoint right now for the exosomes and hair growth, you actually need a pretty high concentration of exosome and that is more expensive. So when you're looking at price point and you're seeing someone that's extremely cheap on the market, please take into consideration what exosomes are they using and how concentrated are they. Okay, and since I brought this up and we're talking about hair, let's talk a little bit about the difference between P R P, which is taking your skin, or sorry, picking your blood, spinning it down and taking your platelets and using them as a cell cellular messenger essentially to stimulate new production or new signaling of hair growth or collagen formation and what we would call secret zones or exosomes. What is the difference? Well, you know, P R P is basically dependent on age.
Speaker 1 00:10:31 So you're taking your own blood and what we know is that you're gonna get a much lower concentration of these messenger, these basically platelets or the good growth factors that are even in the platelets, it decreases with age and we're using, you know, let's just say it's a 65 or a seven year old person and we are gonna have a lot less effectiveness as and as opposed to someone who's in there maybe forties. So we know that that is not as effective in giving the signaling or the messaging. And exosomes also have a lot more ingredients if you will, inside of them. So you know they're gonna get these signaling molecules that are much higher concentration and much more growth factors and cytokines and things that are basically able to turn things on and turn things off as opposed to just the platelets which do have some of signaling but not to the extent that that SECRETISM or an exom would have.
Speaker 1 00:11:25 They both have really good benefits for reducing downtime of, of lasers and actually enhancing collagen. But I think what we're seeing, and I think most of my colleagues will agree is the exosomes reduce the inflammation so much better than P R P P R P. You're gonna get, you know, some collagen regeneration but not getting the decreased inflammation and actually decreased downtime with some of the procedures to the extent that we get with the exosomes. So you know, I think the biggest takeaway is that P R P as compared toomes or exosomes just doesn't have the growth factors. For example, the company that I use, their exosome is called Exo X has 450 growth factors. P R P in general has 12. So we're talking about massive differences in the amount of signaling that's able to be be achieved and therefore anti-aging and anti-inflammatory and collagen regeneration.
Speaker 1 00:12:20 And then the other big one, like I said is that takeaway about age, age is a big factor when we do these things. And I think we underestimate how age is going to affect your treatment outcomes and we don't discuss that enough with the patient, especially when we're using these kind of products. Um, and lasers because your body has to be able to regenerate that collagen tissue. So for someone who is a little older that you're taking them through a series of maybe Morpheus and that's a microneedling with deep radio frequency, which is fabulous because it delivers the energy at the bottom of the, of the skin essentially in the dermis what we're getting is increased collagen formation but in an older person, how much are they able to do that? And I think using these exosomes in combination with these therapies will enhance their effects much more than P R P will.
Speaker 1 00:13:09 So just for example, of the quantities that we're using in these exosome liquids, we're going from about a 5 billion I we have access to a 12,000,000,025 billion and a hundred billion. And when we kind of go in this order, the 5 billion we're using mostly for face under eye, the small facial area procedures, a larger aesthetic procedure, we're probably going up to about a 25 billion And then for hair restoration scalp for full head and we're at about a hundred billion every once in a while. If it's small areas of hair, we'll do about a 25 billion. And really all you need to do to do hair restoration with these in general is to have them needle under the skin or injected directly underneath to stimulate hair follicle growth. So we know that the studies are extremely, extremely promising for autoimmunity and they're very promising for aesthetics. And I think the biggest thing with these is it's non-surgical.
Speaker 1 00:14:09 We're not talking about huge amounts of downtime, maybe some inflammatory response just because of a foreign material underneath the skin and just some inflammation. But that inflammation goes down pretty quickly as the nature of what the exosomes tend to do cuz they're so anti-inflammatory. So let's talk a little bit about quality and how these are produced. And I think what we wanna understand is that they are free of DNA n a or genetic material. They're screened for all infectious processes and any kind of basically what we would call disease process. So these are what we, what we typically use are mesenchymal stem cells, which they're umbilical cord stem cells. They make exosomes, those exosomes are what's harvested and what they do is they actually will use a screening process to look for certain growth factors. For example, I'll just rattle off a couple B M P five G D F 15 vegf, which is V E G F I L six i L 10.
Speaker 1 00:15:13 Some of the ones that are pretty common, we have one that's called TGF beta three. So those are some of the basically growth factors that we wanna include in these great exosomes. We also make sure that they're in that specific particle size that we're looking for. We're not giving you massive particle sizes because they're not gonna be very effective. They're looking for about 70 to 150 nanometers in diameter. So those are the ones, they're ultra filtrated to ensure that no bacteria, fungus, any kind of other organism are in the solution and that we're getting that specific nanometer of um, exosome. And they actually will use a, um, I'm gonna read this out from their website, uncontaminated high fidelity and all highly functional cells and the donor tissue is screened for all pathogens to ensure it's negative for any communicable disease. And I will also point out that these are all pre covid samples that are being used from the company that I particularly carry.
Speaker 1 00:16:19 I use two different companies and they're all pre covid. So I think what you wanna look at is, is the company reputable? Are they using what we would call a single cell line? Are we not? And we're screening these for size potency, D N a, making sure there's no other genetic material growth factors. Those are the big questions that you wanna ask when you're injecting or even microneedling these into the skin. You do get what you pay for with exosomes unfortunately. So you know, we wanna make sure that we're doing you justice if you will, that you're asking the right questions. But I will tell you the results are phenomenal on skin texture, skin elasticity. I love it for the under eyes, I love it for the neck, that thin skin on the neck that we just can't seem to tighten up. It's lovely there And for those really fine lines that we can't seem to kind of get underneath, even with some of our really thin fillers when we're using Morpheus, it's a great adjunct to get those lines to get extremely, so much better improvement.
Speaker 1 00:17:24 So, and then the studies are actually starting to show as well that microneedling or pushing them in with needles just under the skin surface is just as effective if not more effective than even taking a needle and just lightly going under the skin with these exosomes. So I think what you'll find is when you start reading it does get confusing. So I encourage you to read about certain companies, like I said, said Exo Cell Bio has a great website with some great information about their exo X exosomes. But the other option is just to really look up mesenchymal stem cell exosomes for aesthetics and anti-inflammatory options. And you'll see some really, really interesting results. I think if you had asked me 10 years ago, maybe even 15 years ago, the quality of these exosomes were not as good as they are now and they're not as, they weren't as clean as they are now.
Speaker 1 00:18:21 So the ability to get these extremely clean, precise products to repair cells and regenerate collagen and elastic tissue is pretty phenomenal. So what I'll say is that right now I am using them for hair restoration. I am using them for under eye rejuvenation, I'm using them on this skin for skin tightening and neck for neck tightening and we're using them with our Morpheus, which is phenomenal. It just enhances the results and makes it that much better. And um, I think that I do a little dabbling on myself for joint repair and help with inflammation. We will be doing more of that moving forward as we start to get higher quantities of the exosomes in stock cuz it does require a couple treatments consecutively before you get long lasting results. So I really encourage you guys to look this up, read about it, ask me questions, feel free to send me messages on Instagram.
Speaker 1 00:19:20 You can go to Lori Gerber do on Instagram and private MessageMe. I will also answer questions via email. My new email is lori l o r i my dr laurie.com and you can spell that all out. So it's lori l o r i my dr laurie.com. You can send me any kind of questions that you might have. You can also go to the website and send me a rapid consult request and I would be more than happy to help you there as well. So a lot of ways to get in touch with me guys. I would love to hear from you, I'd love to hear from you when I post about this online. Feel free to like put some comments in and and ask questions there as well. And we will be talking about some peptide creams and how we can use those with your exosomes and the next couple weeks.
Speaker 1 00:20:08 So stay tuned for our next podcast talking about using peptides in conjunction with your exosomes topically. I'm really excited to bring that to you as well. And as always, stay tuned to my podcast Anti-Aging Unraveled and look for the next episode. On a side note, I will be launching a members-only Patreon page. I'm really excited to do this. Patreon, if you don't know what it is, it's a site that basically is for learning and some private content. It's a private feed. So I'm really excited to be able to bring that to you for teaching. For my physicians out there that wanna learn more about this growing field of what I call call integrative aesthetics, feel free to join me on the Patreon page. And I did just post on Facebook a link to go on my wait list, but it will be out soon under my name Dr. Lori Gerber. So on that note guys, until next time, I will see you at the anti-aging unraveled in a couple weeks. Have a good one.
