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'll 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 everybody. Thank you for tuning in. This is Dr. Lori on this holiday edition July 4th po and we're gonna talk about a topic that actually was requested by popular demand and is one of the most popular topics I've talked about over the last couple years. And as most of you know that the word peptide is my word of 2022 and 2023. And it seems to be everybody's word these days as we're all talking about the peptides that are involved in weight loss. So we're gonna talk a little bit about semaglutide, the myths, the truce, and some other peptides that are probably not talked about enough that are on the horizon and already out there for weight loss. So this may be a two-parter. I'll see how long winded I am. But we're gonna start off by talking about a little bit of the history and the politics of peptides and making the news in the last couple months is the news about basically compounded semaglutide being dangerous and cautions of compounded semaglutide.
Speaker 1 00:02:06 And I wanted to talk a little bit about how compounding has been done for a really long time. Not just the semaglutide, but that these peptides have been available really for a long time. Most of these peptides have been categorized really in the eighties and nineties and now they're finally becoming more mainstream. And when a pharmaceutical company takes it over, what they're able to do is basically put an end group on it, clean it up, and then put a patent on it. And the only problem with that is that once they patent it, they claim rights to the drug. Now it's been compounded by compounding form pharmacies by quite for quite some time, especially semaglutide as semaglutide acetate or semaglutide salt. So sodium. So when compounding pharmacies do it in this way, they're, they're not quote unquote regulated by the FDA A but they've been d a approved for quite some time.
Speaker 1 00:03:02 So now we have this complex situation where compounding pharmacies are making it and pharma is making it. And now we have to worry about how is this going? You know, what's the compliance on this? How are we gonna keep it on the market? Is it gonna get pulled off the market? And I think that's a scary thing for not only people in my industry, but probably people in pharma. You know, it's all about the money, right? So for me it's about treatment and patient satisfaction. So the way this works is drugs like Ozempic and one go V, which are some semaglutide and rebels for that matter, they're on the two injectables. Ozempic and Wago are on the short status list essentially saying the FDA is saying that the medications are in shortage and if there's a shortage of a patented drug, the Alliance for Pharmacy Compounding said, and I quote them that rather the guidance indicates that if FDA-approved drug is listed on the FDA shortage list, it is an FDA-approved semaglutide drugs as FDA semaglutide drugs currently are.
Speaker 1 00:04:03 The FDA will not view compounded versions of it as essentially a copy and quote of the FDA-approved drug. So basically, as long as these drugs are still in short demand and short supply, I should say high demand, then according to the F D A, they can still be manufactured. Now there's also a fine line because these drugs were manufactured prior to pharma taking the drug as well. So I wanna tell people this, that semaglutide compounded as long as it's done in usually larger batches is very safe. So if you're getting it from a reputable company that's you know, that you trust that like we get it from two sources and that's it, then I would absolutely say compounded formulations are just as effective as the pharmaceutical grade or branded I should say, cuz they're all pharmaceutical grade. The sterility is the same, you know, it's still kept in sterile compound.
Speaker 1 00:04:55 They have to make certain sterility guidelines and um, that's still adhered to according to most of these compounding pharmacies and their sterility guidelines that are imposed in them by the F D A. So I just want you to understand that this isn't, they're not dangerous, it's just right now it's a little bit of a legal financial battle and generally who wins is whoever has the most money, which in this case is usually the pharmaceutical company. So I do wanna put out there, I will put out there a bunch of other drugs that are peptides on the market that are not semaglutide. I am a testament that semaglutide in a compounded formulation works. I've been doing it since February and you know, I'm down over 25 pounds eating healthy, exercising a little bit differently, changing some of my portion habits. You know, it's, I just don't want you to think that the be all and end all is just pharmaceutical grade cuz it really is not.
Speaker 1 00:05:45 And it's actually, if you think about it a different way, theirs comes in a pen, which is an autoinject pen, which is great. However, there's very little adjustment of dose that's capable on those pens with our formulations the way we do it, we have a vial in a an insulin syringe and we have a lot more adjustability on dose, which does reduce our side effect profile quite significantly cuz we can go up much slower. Let's kinda dive into this a little bit. So the regulators are basically saying that anything made with a semiglutide sodium sodium salt should not be produced because it is not a regulated FDA-approved ingredient. However, it is the same active ingredient that is in semaglutide and wavy as well as ozempic without the final end group that is basically placed on it per the pharmaceutical companies. Okay, so now that that's out of the way, let's talk a little bit about the difference between some of these new meds.
Speaker 1 00:06:43 What's the difference between semaglutide, which I've already done a podcast on, you can listen to that as well. It was about two podcasts to go so you can listen to that on in detail on semaglutide. But I'm gonna talk a little bit more today about the difference between tze peptide, which is the active ingredient in manjaro and a semaglutide as well as a new one coming to the market and a few other peptides that you might not have heard of. So Eptide is a GLP one agonist, which means it's going to basically work the same as semaglutide but it also affects the G I P hormones, which basically means it has two functions. Dual glucose dependent insulinotropic polypeptide, that's, I know it's even a lot for me. And a glucagon like peptide one receptor agonist. So let's speak English for a minute. Basically it's doing two things and two different ways to make your insulin work better, to make you feel a little more full to actually make your sugars lower and to stop the release of glucose from glucagon in the bloodstream.
Speaker 1 00:07:52 Okay? So it's a very potent add-on to this, basically this pathway. So where we're semaglutide is only does the one, it only has the GLP one hormone receptor, so agonist, which basically works really, really well. So what I'd like to do for a lot of people is start them on semaglutide, really low dose, titrate them up, see how they do. If they're not getting a great effect, then what I'll do is I'll actually wean them over or switch them over to Tze peptide, which is also called the twin cretin, which basically just means that it mimics the two hormone groups instead of just the one. So let's talk about weight loss differences between the two. So on their studies, just to pull these from directly from pharma, cuz of course there's not enough large scale studies with compounded medication we see a 22.5% body weight decrease in 72 weeks.
Speaker 1 00:08:44 So just remember this is a little longer of a study for Monro, which is the tze peptide. The semaglutide in the ozempic gives you an average of 6.1% body weight decrease in 52 weeks. So even though it's a difference of about 10 or 20 weeks, there still a very big difference in weight loss. And w govi, again, similarly, semaglutide also has a 14.9% reduction in body weight after a 68 week trial. So what I want you to kind of take out of this is that it is easier to transition usually for my patients from semaglutide to Tze peptide. And I think Tze peptide does offer a little bit of a stronger weight loss component to it, especially after people are plateaued or if it's just not working for them, if they're not feeling the difference. And when I say feel the difference, usually what you're feeling is a fuller feeling, ability to eat less, possibly a little bit of um, not low blood sugar but maybe a little bit of fatigues because that you notice that your blood sugar sit a little bit on the lower end of normal and and if you're not feeling any of that, it just means that the one receptor agonist at the GLP one agonist semaglutide probably isn't strong enough or isn't sufficient to create weight loss for you.
Speaker 1 00:09:57 And I think that's really important. If the patient is saying they don't feel it and you get up to, you know, half of max dose, then really you might wanna think about switching. Okay, so let's talk a little bit about what the feeling you get with Tze peptide versus semaglutide. So instead of just boosting insulin, which it will, it'll boost insulin production but it suppresses glucagon glucagon production. So it's gonna actually stop the storage of sugar, whereas the other ones basically stop the release of sugar and stop your insulin. This is actually gonna stop the storage of sugar. So, and it also all happens in what we call a glucose dependent matter, which means with Inc incretin hormones or something that the G I P receptor agonist, which is the, the tze peptide, they don't cause hypo hypoglycemia unless you're combining it with other medications.
Speaker 1 00:10:46 So you're not getting the severe sugar low because it only happens if you're really eating too much glucose. Okay? So it does help to ju change your diet as well into a low glycemic or a low sugar diet. The other cool thing about TIR peptide is it's actually thought to lower what we call your set point or the weight your body naturally settles at. So with genetics biology environment, so if we can lower the set point, it actually will increase the likelihood of keeping that weight off. We're actually changing the metabolic response that your body wants to be at. Okay, so the real question is, you know, with semaglutide, can you keep the weight off? And I have seen really good success with weaning people down with diet, lifestyle modification and really realizing what they're doing while they're on these medications. What is the new calorie requirement you're eating?
Speaker 1 00:11:37 What, what's the exercise requirement? What is your ability to, how much sugar can you actually take in without gaining weight? I think that's a really important for people that are insulin resistant At baseline I do a lot of labs on my patients to see are they insulin resistant before we start, not necessarily high sugars but insulin resistant, high insulin levels. And most of them, if they're going through menopause, if they're going through metabolic changes in their life, they are, if they've gained too much weight, okay, once we fix that insulin response, we're able to wean them down and keep them on a lower sugar requirement and keep the weight off pretty effectively. Now that's not to say you can't do these medications once every two weeks, once a month they have a pretty long acting effect on the body. So we definitely see that you can titrate them down and stay on them kind of to keep that body mass leaner and do like a once a month or even a really, really low dose every other week or every week injection.
Speaker 1 00:12:35 Okay? So I'm gonna kind of direct you guys to my podcast on semaglutide specifically to get more information on semaglutide and how it works. But what I wanna kind of touch on is that Tze peptide is more of a, has more of the ability to calibrate your body and where it wants to sit. So I think that's really, really important. But there's other things that go into this, right? I don't believe in one trick ponies what you're eating. I just talked about the quality of your sleep and getting enough sleep. We know that it's crucial to metabolic and brain health. If you're not sleeping and you're just trying to do this as a quick fix, again that cortisol response and that metabolic factor that happens with high or low cortisol will just set you off again with your insulins when you get off this medication.
Speaker 1 00:13:22 So it's really important to have good sleep, it's really important to have good exercise, whatever that is for you, it has to be maintainable. Maintainable exercise is the best exercise. Why? Because we know that you like it and you wanna keep doing it. So I do believe that some kind of strength training and some kind of cardiovascular activity at least three or four days a week, we do know that with all dieting and calorie restriction you will lose muscle mass. I do see this with lowering your glucose levels with these medications as well. So I highly recommend you stay on some kind of lifting routine to try to maintain. You can always rebuild muscle mass comes back. So don't panic, just like a bodybuilder. We're going through a phase where you're gonna have a cutting phase and a rebuilding phase. But I truly think if you keep lifting while you're doing this, you'll maintain a lot more muscle mass and your body and face for that matter will look a lot better.
Speaker 1 00:14:15 We don't wanna lose weight too quickly and we don't wanna lose muscle mass too quickly. And one of the last keys to this, at least as far as I'm concerned with my patients, is taking out stress, the emotional health of your system. And I do recommend meditation for lowering cortisol levels. I recommend even therapy talking to somebody I actually really like. There's a light goggle that I like to use. I'll do a whole talk on that. But it's really interesting and, and the red and blue light helps to reset your brain waves as well. It's key to regulating cortisol levels and stress. And stress drives up insulin levels. If you drive up insulin levels, you're gonna drive up your sugars, which is gonna cause chronic fat and weight gain. So food, sleep, exercise, emotional health, all are part of what we talk about when we go through our patients that are on these medications.
Speaker 1 00:15:05 Because again, this is not a one trick thing. We need to make sure this is maintainable. And one of the questions I get a lot is why can't we just use oral semaglutide or there's the one in the market is rebels. And with rebels the only thing is it's very difficult to absorb. The dosing can be a little tricky. You can't eat, drink anything with but four ounces of water within 30 minutes, it's the side effects can be pretty significant when you start to raise the dose. So I'm not a huge fan of oral, although I think there's more on the horizon with that, but I see a much better response with injectable semaglutide. Okay, so let's talk about what's new on the horizon and has, again, it's been out as a peptide for quite some time and I can, I will not say this right, but it's reride, so R E T A T R U T I D E and its studies are showing about a 24% decrease in body weight, about 58 pounds.
Speaker 1 00:16:03 They're in the mid stages of clinical trials or I think they're actually going to their stage three right now and they were just published if you guys wanna find it in the New England Journal of Medicine. And they're working on their larger phase three clinical trial to go, I believe until 2025. But it is pretty promising and it is basically GLP one. So semaglutide essentially g i p and a glucagon basically receptor basically. So your, the glucagon may reduce, it's actually glucagon so it's gonna reduce your appetite by giving you glucagon. Glucagon is basically gonna tell you to store sugar. Once there's enough it won't allow you to do so. And that is the goal is that you're basically giving yourself glucagon so that it basically makes you feel like you should not be able to store fat. So it has one more efficient and effective way to stop the storage of fat in the system.
Speaker 1 00:16:59 We're gonna talk about some really cool breakdown fat breakdown products in a few minutes as well that are not FDA approved but I use all the time for weight loss with my patients that we've been using for quite some time that are peptides that are made from compounding pharmacies as well. This particular one is through pharma at this point. Like I said, it was produced originally by compounding pharmacies. However, I don't believe that this is in production right now by any compounding pharmacies. So at the end of a 48 week trial, the average was 24.2% down and like I said about an average of 57.8 pounds, okay? The side effects are very similar in nausea, some of the constipation and or diarrhea and a little bit of if you get, if you eat too much, a little bit of vomiting due to delayed stomach emptying, which is basically part one of the mechanisms of semaglutide.
Speaker 1 00:17:51 Okay? So I hope all that science didn't bore you guys, but I'm getting to the really fun, interesting, at least as far as I'm concerned, peptides that you probably don't know a lot about. And I'm gonna go through, I think I'm just gonna go through three today and I'll do a whole nother peptide lecture cause there's so many of them. So I'll go through three that are really, really popular. The one is called a O D, actually I'm gonna start with CJC 1295. I've talked a little bit about this over the years the last year that I've been podcasting and it is one of my favorites. Almost all the major compounding pharmacies make this. It's a 30 amino acid peptide and it's an analog to growth hormone. So it's gonna stimulate your body to make more of its own growth hormone. So what does that mean?
Speaker 1 00:18:37 Well, growth hormone I always say is like the life force. We're always figuring out how to get more growth hormone from pituitary and it leans you out, it gives you energy. It's one of those hormones that we know is like the vigor or the life force. So it actually targets adipocytes and raises your fat metabolism. So adipocytes are basically fat cells and it's gonna ba, it's gonna improve your lean muscle mass, it's gonna give you better endurance, it's gonna help with sleep cycle and it's gonna help with your fat burning. So we stack that a lot with something called EPA morlin, which is also, it helps to give a longer half-life of the medication up to six to 10 days so that when we cycle it, it does a little bit of a better job when we're cycling it. But the main effect in general is stimulating growth hormone.
Speaker 1 00:19:24 It can increase growth hormone levels by 200 to a thousand percent, which is a huge range, right? But it really depends on the person and the ability for them to actually produce more. So I like to do it and that can happen up to six days. So I kind of like to do five days on and then two days off and then sometimes I'll cycle a week on a week off, but for the most part I'm doing five days on two days off and then I'm doing three months on, three months off. And that gives the body a chance to produce some of its own growth hormone as well, depending if we're doing it for recovery because it can help with recovery if we're doing it for fat loss changes my the way I dose it. So, but the whole point of this is fat metabolism increases, the burning of the fat increases with increasing your growth hormone.
Speaker 1 00:20:12 So one of my favorite ones pretty widely available, definitely can get it for anybody that's in one of my programs and I really like it from, I love it for my athletes as well. So let's talk about one that isn't talked as much about, it's A O D 96 0 4 and I feel like this is talked about a little bit more maybe two years ago before semaglutide came out. But it's a 15 amino acid peptide and it's really similar to growth hormone and it's a really potent anti-obesity peptide. So it actually promotes fat burning, which is huge. And I, I do use this in conjunction at times with some my semaglutide just to let you know and my tze peptides because they do work synergistically. So what it does is it targets fat enriched areas of the body and actually promotes the breakdown of that fat.
Speaker 1 00:21:01 So who doesn't need that, right? You can't obviously target fat loss, but in areas where you don't have fat it is not gonna function. So what it does is it uses that extra fat for energy expenditure. So on a keto type or a low sugar diet, this is gonna work fabulously because you're not gonna have extra sugar lying around and it's just gonna go to the fat and actually start to break it down. And the nice thing about that is it's not causing any low blood sugars. So it's not giving you this low glucose response, which a lot of people that don't tolerate semaglutide or don't do well at lower sugars do really well on a O D 96 0 4 because we're not getting that low. So A O D 96 0 4 is FDA approved as a weight loss peptide. Obviously dosage is you to be careful with dosage and using it in the right hands of the right provider, but it is one of the peptides that is approved by the F D A for compounding.
Speaker 1 00:21:54 And so the only side effects that I usually see with this is just like similar to semaglutide in that a little bit of headache, a little bit of indigestion just from breaking down your fat and some nausea, maybe some stool irregularities. But it does reduce cholesterol as well because we're breaking down fat and hopefully the liver cooperates or we fix the liver and we excrete things appropriately. So we do love this as a compound. I would say that's probably one of the better ones over the last several years that have been out for specifically targeting fat. So then there's something called teslin, which was originally used to treat H I V lipodystrophy. And what that means is basically fat in the wrong places or the breakdown of fat in the wrong places. So this peptide actually decreases visceral, sorry, adipose, which means around the organs.
Speaker 1 00:22:46 Okay? So that's the fat we don't like, right? That's the fat that causes diabetes, that's the fat that causes us to have fatty liver disease. So it is a growth hormone releasing analog as well. So it's gonna, all these hormones are stimulating growth hormone are actually the first one on this one and it's gonna target your hepatocytes to increase the fat metabolism and your adipocyte. So it's actually gonna work in two directions, which is why it works on some of your lipid profile as well as the fatty organ fat. Okay? So it actually has been shown to maybe work or help some cardiovascular diseases. So just because of the ability to break down that visceral fat, which is that organ fat. So Tessa Marlin is not FDA approved. Little hard to get as far as a compound goes right now. It used to be a little bit easier.
Speaker 1 00:23:32 I feel like we're shifting a little bit towards some of the newer ones right now. But a O D 96 0 4 and CJC 1295 with EPA morlin tend to be kind of the more popular ones at this point. But this is a really promising kind of on the horizon thing and I do see it kind of coming back at some point. Okay, we got two left I think I can get through. So one is called five amino one mq, oh should I say that again? Five amino one mq. So it is pretty unique. It actually is a derivative of what we call methyl quinolone and it blocks the effect of nicotinamide methyltransferase, which means basically it's blocking the levels of nicotinamide or N A D plus. A lot of you have heard of N A D. So basically it raises your cellular metabolism. We're basically enhancing the energy requirements of your cells, basically speeding them up.
Speaker 1 00:24:32 So when we do that, it actually will go into your fat stores and use those for energy and will also decrease the synthesis of fat because it thinks it needs more energy. So this is really quite efficient and very eloquent actually. I actually really, really like this. It's a little hard to find. I think this is on the horizon. This is gonna be one of those up and coming peptides that I think people are gonna reach to when they either don't work with semaglutide or it doesn't work well enough. And I think that five amino one MQ is an awesome, awesome option. And the great thing is, is what we do is we do it again, we cycle it. So two to three months on speed up everything and then two to three months off helps with metabolic disorders, reverses obesity and actually increases energy production.
Speaker 1 00:25:22 I really find this to be the future of helping people with a chronic fatigue or maybe even chronic bug issues where their energy levels are just so low and we can't get their cellular metabolism fast enough. Okay, so last one, one of my favorites that's probably a little underutilized as well. And this one is commercially available, just f yi five amino one MQ is not FDA approved, neither is this last one. That doesn't mean you can't get them, it just means that they're not one of the peptides that are FDA approved for use. So Mott C M O T S C is a 16 amino acid peptide and it's expressed by a mitochondrial gene. And we know that the mitochondria are a huge powerhouse, right? They are signaling and energy powerhouses and they regulate almost all metabolic functions in the body. So they literally are what's turning glucose into usable energy.
Speaker 1 00:26:14 So if we can work on the actual mitochondria, we can make your metabolism faster. And that's basically what we're seeing. Preliminary studies with this show evidence for improved control over blood sugar, especially in those with um, obesity or type two diabetes. It also shows that one of the targets is skeletal muscle for MO C. So it enhances insulin sensitivity and skeletal muscle. So it basically makes your muscles use sugar more efficiently and increases glucose uptake into those cells, which is really important one for being able to work out more efficiently having a higher metabolic function. And two activates what we call the A M P K pathway, which is gonna help you with energy and activity level and having higher basically metabolism and effectiveness with what you eat. Basically taking that energy and utilizing that efficiently. So they like to call it an exercise mimetic, meaning it kind of imitates what exercise would do to your body cuz it actually is pulling glucose into these.
Speaker 1 00:27:15 Think about your muscles, working, working, working. It's basically doing that without you having to work out all the time. So it's using these muscles to uptake the glucose. And so it's really, really interesting. The other interesting thing is, is it doesn't stimulate the insulin response. So we're not putting an extra strain on the pancreas, which I find to be really, really interesting too. And my future of using this I really feel like is maybe cycling it with the semaglutide. So doing semaglutide, tze peptide whatever, three months or get the weight off, then cycling with MOT C, maybe cycling with some five amino one mq, even some of the CJC 1295 with EPA elin. And depending on what the patient is complaining about or what the function like if their insulin was high to begin with or if they're a workout person, they never had good sugars, which is me, I would benefit probably from MOT C combined with the Tze peptide.
Speaker 1 00:28:10 So Mott C is really interesting. You're promoting fatty acid metabolism and the liver. So basically breaking it down and excreting it, you're helping the mitochondria to regulate so you're giving them better metabolic energy and basically working on all cylinders you're protecting against age dependent insulin resistance, obviously helping with weight loss, reducing metabolic stress, improving exercise capacity, which I think is one of the biggest ones with this particular peptide in my athletes. It actually helps to prevent osteoporosis cuz you're increasing muscle mass and you're improving glucose regulation and helping with bone density. This actually helps to create osteoblasts and put down new bone, which is huge for people that are osteoporotic or osteopenic and have DEXA scans that are not so great. I have used MATC and gotten some really nice results, especially with testosterone replacement. So those are the ones that I think for today that I'll talk about.
Speaker 1 00:29:09 That was 40 minutes of me kind of blabbering on to you about science. But I think the takeaway point of this is that there are peptides out there that are not necessarily made by pharma that work really well. And this argument right now about not using compounding peptides, I think right now it's money driven, it's monetarily driven and obviously everything in this world is driven by money. However, I think that the peptides that are compounded for the most part have been very safe and effective. And like I said, going through reputable sources, not going to some fly by night online company that's just shipping it to you and not following up with you, not making sure that it's working for you or checking labs or making sure that this is right for you, um, is really important. And let's talk about like legality. So, and the United States peptides are prohibited for human consumption by the F D A, most of them even when prescribed by a doctor.
Speaker 1 00:30:05 However, like I said, the semaglutide and the A O D 96 0 5 are both on the FDA approved list. Now the unfortunate thing is, is there's not any large scale studies to show the efficacy other than our clinical data. And what we've been seeing with these peptides since basically the early nineties, and I think it's really important to understand that big pharma is driven by money and compounding pharmacies. Yes, of course they're driven by money, but a lot of the non-traditional therapies are driven by results and patient driven data. And it's really important to work with a provider that understands these mechanisms and understands what's really going on in your system and is willing to look outside the box. And I joke and always say look at the triangles or the triads and how they connect. And I think that's really important. That is what I do.
Speaker 1 00:30:55 That is my method. And my method is to basically look at all of your symptoms and all of your lab work and really put the puzzle pieces together because they do all connect the gut immune brain, thyroid, adrenal, pancreas, your hormones, testosterone, estrogen, progesterone and more as well as your basically cardiovascular system. They're all connected, right? So we're looking for clues and symptoms and listening to stories and that's, that's what I do. I take all of that information and I put it together and I come up with like a a basically a piece of paper that describes you in what I call triangle terms. It's could be called the trilogy maybe because I could say that it's the trilogy, but this is what I do and it's really important to make sure you go to a provider that does that. So if you like what I've talked about today, feel free to subscribe to my podcast Anti-Aging Unraveled and go to my
[email protected].
Speaker 1 00:31:51 So M Y D O C T O R L O R i.com. You can sign up to be on our mailing list as well. You can purchase my supplements, you can also do a rapid prescribe questionnaire that helps me give you recommendations from supplements or you can just dive in and go for a full intake and fill out our wellness questionnaire and we can get you started remotely across the country. So I'm really excited to bring these to you. Stay tuned. I will do another podcast on more peptides and their functionality and how we use them, and I'm really excited to bring these to you because I think, again, my word of 22 and 23 is peptide and let's just put this all into perspective and not let the media and social media markets drive our perspective and just make sure we get good clean education. So with that note guys, I will see you for my next podcast and stay tuned for the next Anti-Aging Unraveled. Have a great night.
