Dr. Suzanne Ferree: Episode Link
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On this episode, we are discussing the benefits of peptide therapy. Dr. Suzanne Ferree is the senior physician at Vine Medical and is Double Board Certified in Family Medicine, Anti-Aging and Regenerative Medicine. Peptide therapy is a medical treatment that uses peptides, which are small chains of amino acids, to improve how the body works. Peptides are similar to proteins that naturally occur in the body, but the body may not produce enough of a certain peptide. Peptide therapy can mimic the functions of naturally occurring peptides, such as hormones, growth factors, and neurotransmitters
TRANSCRIPT:
Welcome back to Hot Flashes and Cool Topics podcast. Today we are going to be talking about peptide therapy with Dr. Suzanne Ferree. She just launched a new book called CounterClockWise – Using Peptides to Renew, Rejuvenate and Rediscover. Welcome to the show. Thank you guys so much for having me. I appreciate you.
I guess my first question is, what are peptides? A lot of people don’t even know what they are. – So you’re not alone. There are actually, most doctors probably don’t know what they are either.
This is kind of a niche specialty to learn about peptides. But the cool thing is peptides, have been studied since the 1920s, they are part of your body. It’s what your body naturally makes.
So things the most famous one is probably insulin, but there are lots of others that are really famous ones that we figured out how to make. So what happened was someone figured out what these little pieces of strings of amino acids do. So if you think about a chicken breast and the protein that’s in a chicken breast. that gets broken down into smaller and smaller pieces in your body. The very tiniest piece is called an amino acid. But if we put 50 of those amino acids together, so that’s a slightly bigger chunk, then we call those peptides. And then a protein is anything over 150 amino acids long. So this is, it’s just a small fragment of a protein.
These are naturally made by your body. And like, like I said, in insulin, but there are several others that are familiar to you, probably things like the blood pressure medicine, lycinopril, I’m sorry, lo -sartan,
and the topical, yeah, the topical anti -microbial called basatracin. If you’ve ever used that, like going to cut or burn, basatracin is also a peptide.
So they’ve been around for years and years. And most people are familiar with the very, very famous one right now called ozempic or stemiglutide that’s been slightly modified from the natural version to make it stay around for a week. So it’s just have to do an injection once a week. But that’s the other famous one that’s out there right now.
In the book, you talked about the different ways that you can receive peptides, injections, transdermal. Can you talk a little bit about the different options? Absolutely. So most of them are available by Injectable. The nice thing about the injectables is we know that it’s getting into your system, it’s not getting digested or broken down in your stomach. Like I mentioned before, these proteins or peptides get broken down into smaller and smaller fragments so that they’re digestible or absorbable by your intestines. So we don’t want them to go through that way if we don’t have to.
Now there are a few that are naturally made in the stomach. So there’s one specifically called BPC 157 that is made by the stomach so it is designed to sustain the low pH or acidic environment of the stomach.
And it’s interesting because that one is involved in helping to protect the stomach against ulcerations. If we use it in other places, so if we give it by injection or if we give it orally even, it can be really helpful in tendonitis or in joint pains in other inflammatory states.
So it’s a very general anti -inflammatory, but when taken by mouth, it can help to prevent. prevent stomach ulcers or to treat stomach ulcers.
What is peptide therapy and how would someone even know to ask for it? So these are just things we know that can be helpful. helpful that are available and they work specifically at the cellular level. So what peptides do is they sort of like the construction manager or the general contractor of your construction project. They go in and tell the cells what to do and then your immune system takes over its part, your intestines take over their part, everybody takes over their part once the construction manager comes in and says,
“Okay.” okay, here’s the plan. Now we need the plumbers and the electricians and the framers to do all of their jobs to build the house. We, it started out being very popular in the bodybuilding community.
That’s where most of it started to be popularized. And then it became easier and easier to use in and to make in a lab. So now we can get access to many of them.
A lot of times these are used in what we call stacks. So this is… is three or four different peptides that are used together. They all work synergistically, meaning they each one contributes to the overall effect of the others, and together they do better than individually they would do by themselves. So a lot of people will use just one, but in the, in a lot of cases, especially in patients who have more significant illness like MS or Lyme disease. will use a combination of these to get at different parts of the immune system or different parts of the the body’s repair mechanisms to help them to recover from whatever illness or injury they may sustain.
So if someone was suffering from fatigue or some other issue and they went in, is this something the doctor has to do a blood test for and then send it to compound therapy?
Like, how do you even, how do you create these peptides out of the body? Yeah. So they are, they are created in a lab. They’re mostly synthetic right now. So they are not, they’re not from an animal source in case somebody’s vegetarian or vegan, they’re not from an animal source. They are synthetic created in a lab, but they have the same amino acid sequence as what your body would naturally make, unless they are specifically specifically modified to make them last a little bit longer.
So let’s say you come into the office and you have fatigue. Hopefully your doctor will do quite a bit of searching and asking about why that fatigue may be present. There’s lots of reasons why it might be present. Fatigue is such a general big overview symptom that can be caused by so many things.
But if sleep and /or poor sleep is one of your problems, then we’re going to look at what you might need as far as a peptide. And there might be a lot of other things that we would do.
Peptides are sort of like the icing on the cake for what we do. So we would make sure that your lifestyle is normal, that you’re doing good sleep hygiene, that you’re managing your stress well, that you are taking care of your sleep environment like there’s no pets in your bed that might be waking you up or snoring bed partners that might be bothering you.
So all those things need to be in place. Peptides aren’t gonna fix a snoring partner. And so, but they may help, there are some peptides that are specific for helping you with getting that deep sleep and improving your REM sleep.
There are several that are available for helping with sleep. If sleep is the problem, again, fatigue can be due to many things. It can be due to thyroid disease and then a peptide isn’t necessarily going to be helpful.
You want to fix the thyroid. So we want to make sure that your doctor does all of those things first. And then if those things are not responding or if there’s none of those present, then we would go on to consider doing a peptide or a peptide stack that might whichever might be appropriate for you.
There are probably 500, 800 doctors in the United States that are certified in peptide therapy that know how to prescribe and administer these medications and they do come from a compounding pharmacy.
pharmacy. So they would need to be prescribed by your doctor who is a specialist and through a compounding pharmacy. – Right, and in your book at the end, you do have, like you have how to reach your place too,
which is Vine Medical Associates. However, you did put a different thing in there where people could try to find it because 800 throughout the United States. But this sounds really fascinating and Colleen had stated that.
earlier, there’s so many things that peptides can help with, which I was reading it and thinking, you know, our target audience is a midlife woman. And there were so many things in there,
you know, things that have to do with menopause. I mean, inflammation, sleep, like you just talked about, hormonal issues. Did you notice any,
like, what was the difference you noticed when you treated it midlife women? women, if you started treating them with different peptides? What was the result with that? And what have you found to be helpful? So I am my own avatar, you know, when people ask me, who is your book written for? And I say, it’s written for me. It’s exactly what I’m looking for. You know, I came to this journey with an injury of my own and had just was just approaching menopause.
And of course, we all, I’m sure you’ve heard this before you all talked about this. on your show, where menopause really begins around the age of 40. So you need to begin looking really early for when that starts and begin treating really early because the earlier we get your body used to being on hormones,
the better it responds. If we wait until we’re 60 or 70 before we start treating, it’s a little bit more tricky and a little bit more complicated. So starting as early as possible is ideal.
ideal. That the things that we’ll see is women will be able to lose so will they’ll change their body composition. So they’ll be able to lose a fat and gain muscle mass,
which is one of the things we have trouble with in midlife is gaining weight around the middle and then losing our muscle mass. And of course, you can’t gain muscle mass without exercising. So I’m going to also encourage that you are in the gym doing some weight training,
you know, doing a bar class, do with a trainer. I’m a huge fan of working with trainers because I think that we all need to have that, not only the accountability, but also the guidance on,
so that we protect ourselves and don’t injure ourselves. Over the age of 40, we’re at greater risk of injury. And so this is also one of the things that peptides can be helpful for is both preventing injury,
strengthening our tendons, strengthening our muscles, but also, also in recovery from an injury. So this is really where they shine. And when we talk about using these in the bodybuilding community, of course, the bodybuilding community is using,
you know, super physiologic way higher than needed doses for their purposes. But for us who are just trying to every day continue functioning the way we’ve been and keep us, you know,
sort of optimize our existence, they’re really helpful for things like sleep or things like optimizing body composition, improving fat mass. mass, improving muscle mass. So you’re not going to really see a weight loss per say,
although there are peptides that are specifically for weight loss. But what you may see is a change in body composition. So your body is healthier in general because of that.
We know that as we age, growth hormone is depleted, and a low growth hormone in an older person increases the risk of death from all causes. So we can give you you a growth hormone secretogog,
which is a peptide that mimics the natural peptide in your brain that causes you to secrete growth hormone. So we would give you that peptide, it’s typically available by injection,
then your body will make its own growth hormone and make it in larger amounts than it would without the growth hormone secretogogs. So now we’ll see that your body begins to hand to create energy better,
all of this. cells of your body are way more efficient in how they create and use energy. And so that’s how we get this great change in body composition and the ability to recover.
So this is where we see the most benefit is in this recovery. So I’m sure you’ve noticed your 20 year old daughter or son can go and not exercise at all and they can go run a marathon and then they get better.
Two days later, they’re back to their normal functioning, whereas you or I. will be, oh, oh, oh, oh, oh, oh, oh, right as we go. And so these help us to get back into that lower age recovery process where we’re able to go and do more things and not have that three or four or five or longer days of recovery post -workout.
– In your practice, when you do see midlife women like Bridget was saying, “What are some of the conditions that women are in?” peptides work best for? So I see sort of two sides of patients.
One is the sicker patient, like I said mentioned about the patient who has MS, a patient who has mold sensitivity. You know, a lot of us are more sensitive to mold as we age. We know to sit more because the estrogen depletes,
estrogen is this beautiful anti -inflammatory. So we’ll see that sort of category of sicker patient that is more toxin sensitive. And then we’ll see the other side of patients who are generally healthy.
They just want to optimize their health. So for example, they have a great podcast that they want to continue doing like flashes and cool topics. And they want to be able to do that really effectively and they don’t want to have anything like their health interfering with their ability to do that.
So that’s where we’ll see either super healthy people that just want to optimize their health. or in people who do have some illness that need to recover from those illnesses. You know,
another thing that in the book was the talk about dementia. And you did say, look, if you’ve already, you’re in dementia, you know, that’s not going to reverse that. But could you talk about how peptides can help your brain health?
Exactly. So just like the peptides will help your cells of your body. like your muscles, for example, to recover, one of the things that happens as we age that contributes to dementia and other neurodegenerative diseases is the inability to create and use energy efficiently.
So your brain cells, the nerves in your brain become inefficient at how they make and use energy. So if I can encourage those brain cells to be more efficient in how they do that,
then they are are better able to handle the stressors of life. So we are every day exposed to all kinds of toxins, the lead in the air from car exhaust,
from gasoline, what the mercury in our dental fillings, all of the things that we’re exposed to every day, the plastics and everything. So if we can help ourselves to be able to efficiently remove those and cleanse ourselves from that.
And then if we can help ourselves to be more efficient in how they use energy, then they are better able to function in day -to -day life. And so now a cell that may have been failing or struggling because it was inefficient now is better able to do things.
So it’s kind of fun because the cells begin to function like they should have. They start to communicate with other ones. There are a few few peptides that are specifically that have increased your production of a protein called brain -derived neurotrophic factor,
BDNF. BDNF causes growth and development of nerve cells so that now your cells communicate with one another in a way more efficient manner. So not only are they increasing their ability to create and use energy,
but they’re also communicating with other cells. So the interactions among the cells. become more efficient as well. And then that’s how you’re able to maintain your brain function.
We also will see some of the peptides will improve inflammation in the brain and that inflammation going down also contributes to decreasing the risk of you developing dementia.
– What are some of the side effects that have been noted when you’re taking peptides? – Mostly they’re local. injection reactions. That’s probably the biggest side effect that people notice.
And they’re not very common. Even local skin reactions aren’t super common. There are a few people that will have those. There’s a group of growth hormone secreticogs that can cause some flushing.
So you’ll have sort of a red flush. Your skin will flush after you take it. it. That’s not an allergic reaction per se, but it can be uncomfortable for a few minutes,
maybe last about 10 or 15 minutes. One of them that is a mimicker of melanotan or of alpha melanocytes stimulated from when your brain produces MSH,
which is a, which is a helper with both skin tanning, but also with inflammation in the blood. And so if we give you that exogenous leave as an injection,
that one can cause some flushing as well. And it can cause tanning of the skin, which is one of the reasons why we give that peptide. So I’ll use that one in patients who have, who are going on vacation,
for example. If you’re going on vacation, I want you to use this every single day for the two weeks prior to your vacation because it will improve the way that your skin cells are. are able to protect you against sunburn.
So you’ll use that every day and then it’s anti inflammatory properties. So it’s effective also for general inflammation and the inflammation that can come from sun exposure. That’s,
you know, it’s not just vanity. There is a health reason behind it, you know, and I know you said in the book that a lot of body builders, but if they’re in their competition, they, you know, they like to have the tanning,
but there is a health reason behind it. And there was, you know, another thing you talk about the weight loss, but also treating Hashimoto’s, which can happen, have two siblings that have Hashimoto’s.
And it really can wreak havoc, especially presence itself at midlife. And can you talk about how that could be helpful? So there are a few of the peptides we use that come from the thymus gland.
Your thymus thymus gland sits right behind your breast bone next to your heart, and it is involved in producing some of the cells that help us to fight off infections. It was very,
very busy during the last pandemic that we had. So there are peptides that are produced from that thymus gland that we have available to us that are made synthetically in the lab.
Those peptides can improve and have been shown to improve. Hashimoto. So Hashimoto is the production of antibodies against your thyroid gland.
So when you see that the thyroid has antibodies and we can look at a blood test and see that you have these antibodies against your own thyroid gland, and so often we’ll see that patients will have hypothyroidism.
The symptoms are sort of fatigue and weight gain and tiredness they’ll be sensitive to cold as compared to other people. And when we see those things happening, we’ll do blood tests and we can see that they have antibodies and that their thyroid is under functioning.
That’s because it’s being attacked by these antibodies. The antibodies in your body are supposed to attack things like viruses and bacteria, but in this case, they’re attacking your own thyroid gland. And there’s lots of theories about why this happens.
If we can give you some of the thymus gland peptides. they can alter the way your body produces these antibodies in the first place, decreasing those antibodies. So now your thyroid is able to,
instead of biting off the antibodies that are attacking it, it can now do its job, which is producing thyroid hormone. And so now people can go back to normal functioning of their thyroid and maybe even get off of their thyroid hormone.
So you were saying, can you say that name of that again that particular one and if you were going to get this what is that called if you were getting the injection what is the injection called?
So in our practice we would use thymus gland peptides and there’s specifically thymus and alpha one is one that we use and it has been studied in Hashimoto’s patients with Hashimoto’s.
These are compounded you’d get them from a compounding pharmacy prescribed by a doctor. Yep. You note in in your book that as of January, the FDA is planning on banning a list of peptides,
and you share your thoughts on that. I thought that would be important for the listeners to know about. Sure. So there are lists of medications that compounding pharmacies are allowed to or not allowed to compound.
The FDA has allowed that to compound, I’m sure you’re aware and probably seen in the news about the shortage of the semi -glutide peptides that are out there.
There’s a big shortage. So the pharmaceutical companies in the presence of the shortage called on the compounding pharmacies to help them meet that need for the semi -glutide that was the high demand.
Well, now the pharmaceutical companies have… created their own production labs. They’ve come out with their own, they’ve gone back and realized they needed to do more production and then they’ve made up for that lag.
So they have, so now they don’t need the compounding pharmacies to continue making them anymore. So a list of these peptides were placed on what we call category two,
which means that the compounding pharmacies are no longer allowed to compound them. It is no longer allowed to compound them. because the peptides are not safe. There were not reports of the peptides being unsafe or having adverse reactions.
And there was no evidence of them being ineffective. It is nearly because the FDA decided to take them off of the list. Now, there could be lots of reasons for that.
I could certainly postulate what I think, but I know that what they have done is removed them from the FDA. ability for a compounding pharmacy to make them. What’s exciting about that is now we have the ability to use our creative brains and come up with new peptides because there’s thousands and thousands and thousands of them.
We were sort of leaning for a little while on this pile of 20 or 30 peptides and now that they have been removed from the compound list, moved to a no compound list,
list. It just means we need to be creative and find some more peptides. So there are several new ones that have come out recently that the compounding pharmacies are making. So it’s been kind of fun to go back to the research lab and figure out what’s next for us.
– When it comes to the cost of these, it doesn’t vary with what the peptide is or what is the cost? Our listeners I know are very cost conscious about,
you know, as they should. should be as they should. Yes. Yeah. So the oral ones, of course, are typically less expensive. There are a few of them that are currently available actually over the counter.
There’s one called BPC 157. That’s available from a company called Health Jevity. And it’s, it is available over the counter. You don’t have to have a prescription for that one. There are other ones that are available by prescription only and you can get them through compounding pharmacies or The oral ones tend to be less expensive.
The injectables tend to run between, depends on who you get it from, which pharmacy you get it from, but they tend to run somewhere around $200 a month. And so we like to switch them up if you’re using one at a time,
obviously it’s $200. If you’re using two or three at a time, that’s gonna be 200 times two or three. So this gets kind of pricey after a while. If you’re getting them, so for example, semi -glutide,
if you get, if you’re using two or three at a time, that with cash and your insurance doesn’t cover it, that runs about $1 ,500 a month. If you get it compounded, it runs around $300 a month, $400 something in there.
If you, and so you just have to kind of look for where you’re going to get them, you can imagine that might have contributed to some of the decision -making for the FDA. And so it is,
there are around $200 or a little bit more than that per month and then if you’re doing stacks of course it’s more than that. We tend to ask people to take breaks so you’ll do that for two or three months and then you’ll take a break for two or three months and then you go back to doing it again for two or three months.
Sometimes we’ll have people switch which stacks they use so you might use stack A, you know three peptides for one for three months and then the second three months you’ll use a different stack of peptides. So they typically run around $200 each.
Um, and then they’ll be, um, uh, if you’re doing stacks, it’ll be a little bit more. That was one of my questions to you. How long are you on? Cause I know with semi -glutides, you have to be on forever.
So is it the same for any type of peptide therapy that you have between the breaks, your, you’re like on offer the rest of your life. So it depends on whether you.
you want to feel great the rest of your life. Good point. Semiclutide is Semiclutide in our practice, we have we typically will have people use it. We have them set an intention at the beginning of their treatment.
What is your intention for this therapy? What is your goal? And a weight loss goal? And we set that with the client so that we know that we have a reasonable goal for them to reach. We also want them to be able to lose fat mass and not muscle mass.
And unfortunately, unless you’re doing something intentional to prevent muscle mass loss, a lot of people who take things like semi -glutide will have muscle mass loss.
So we make sure that they are doing an adequate amount of protein in their diet every day. We make sure they’re doing some resistance exercise to maintain their muscle mass, even though they’re losing weight.
weight so that they come up. So we actually do take patients off of semi -glutide when they get to their goal weight. In some cases, in some cases,
because we know it has some benefits, there’s been some really interesting research in its prevention of heart disease and its prevention of brain disease. And so we will use, well, let’s say for example, I have a patient who’s who needed to lose some weight,
but she also has a family history of dementia. So when we reach her goal weight with our program, we said, okay, you can either come off of this or you can drop your dose down to the minimal dose in the idea that with our goal of preventing you from developing neurodegenerative diseases going forward.
So we’ll do a lot of other things to also help prevent that, but this is just one of the things that our armamentarium in this patient’s case to help her to lower her risk of neurodegenerative disease.
So in some cases, cases, we’ll take people off of it completely and in some cases we’ll continue it maybe at a lower dose or a less frequent dose, maybe every 10 days instead of every week, just depending on how the patient responds.
– And I have a question about injectables. So, so you go to the compounding pharmacy. So do you have to give yourself the injection? I mean, I don’t, I’m like, ooh, I’ve never had to do that.
So do you have to give yourself the injection? – Yes. – Yes, so in our office, we’ll bring you in the first time you get your prescription. So you’ll get your prescription delivered to your house. And then we have you come in for a visit with one of our really terrific specialized nurses who will show you how to do the injections yourself.
She actually has you do it right there in front of her. These are tiny little insulin syringes. They’re itty bitty, you barely even feel the stick. And I usually have people give it to them, give it to themselves in their buttock unless you have a C -section scar,
which is a… great place to do it because most people have a little bit of numbness around your c -section scar but if not the other great places to do it. Sorry I’ve had two. I don’t have a c -section scar.
Sorry. So you have a numb place which is a great place to inject it but the other place you can inject it that doesn’t hurt very much is the top of your buttock. It tends to be less sensitive.
I have plenty of that. I have plenty of that. (laughing) – Yeah, that’s a great place. And then you’re not really looking. You’re kind of looking in the mirror. It makes you kind of think you’re not. You know, I’m not really injecting myself.
You know, you’re kind of looking over your shoulder, at the mirror, looking to do the injection. And so, or someone else can give them to you. – Yeah. – Oh, I’m sure that. – John! – John! (laughing) – We talk a lot about our primary care physicians physicians and how they may not even know about the options for hormone therapy and I would kind of gather a guess that they know even less about peptide therapies.
So if someone was interested in learning more, would they go to a functional nutritious, like where’s the best place for them to start to find someone who does peptide therapy? – Absolutely,
so there’s a couple places in the book about what you need to know about what you need to know about what you need to know about what you need to know about what you need to know about what you need to know I think the book is a great place to start. You know, it’s very user -friendly. It’s written for audiences that are much like your audience.
And it’s specifically written to women. So there are some unique dosing regimens and unique stacks that are for women in particular. There’s a few things in there about infertility,
et cetera. But if you wanted to find a provider, there are a couple of different companies. A4M, which is the the educational group for physicians around the country, that does a peptide course that’s American Academy of Anti -Aging and Regenerative Medicine,
we call it A4M. They have a provider directory on their website. So just a4m .com, provider directory, and you can find people who are peptide certified. It’ll say that on their profile,
the providers that are peptide certified, you can see that on their profile. profile. And then there’s another company called SSRP, which is seeds scientific research and performance. And they also do peptides certification.
They also have a provider directory. And so those are things you can look up on the internet to find a provider that is specialized. A lot of providers don’t talk about the fact that they do peptides because of the FDA scrutiny and oversight that’s happening right now.
We don’t want to call attention to ourselves. So there is, there is, there are a lot of providers who do it, but don’t make it really obvious that they do. It might be one word mentioned in their website or one word mentioned on their Instagram,
as opposed to a big thing. If you go on Instagram, you can look up the hashtag peptide therapy and a lot of doctors will use that as their sort of,
this is how I do it. That’s very helpful. Yeah, that’s very helpful. And you’re located, are you in Atlanta? Is that correct? I am. Okay, that’s yeah,
only four hours from where we are. We’re in Nashville. Yeah, I can. Nice. We do telehealth visits and I am licensed in Florida, Tennessee,
Alabama and Georgia. Oh, good to know. That is really good to know that’s that you do. I was going to ask about telehealth, so that’s great. Great. – Yeah, awesome. – In states other than those,
you’d have to come to Atlanta at least once a year in order to be a patient. – Oh, it’s a worthwhile trip. Land is great, so. – Yes, there’s a lot to do. – Yes, Nashville’s fun too.
I was just there seeing Teddy Swims at the Ryman. It was amazing, Ryman’s great. – The Ryman’s great. – We love them. – Yes, yes. – It’d be nice if they had backs to the chairs as you get older.
– But. what are you going to do? The pews. The pews are the pews, but sometimes it would be nice. They’re designed for people in the 1900s, so you know,
they were smaller. It’s intimate, though. It’s a nice thing. Yes, it is. Thank you so much, Dr. Fareed, for coming on. We appreciate all the information on peptide therapy. We’ll have all your links in the show notes,
and we appreciate your time. Yes, thank you so much. much. -Thank you so much.