Podcasts about GIP

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!In this episode, shot live at the American Diabetes Association (ADA) Scientific Sessions 2026 in New Orleans, Louisiana, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the latest major trial results like CONNECT, TRIUMPH, and TRANSCEND.To begin the episode, Isaacs and Bellini, discuss major highlights from ADA Scientific Sessions, focusing first on the landmark CONNECT trial evaluating continuous glucose monitoring (CGM) in people with type 2 diabetes who are not treated with insulin. They reflect on the evolution of CGM technology, from its early use primarily in type 1 diabetes to its expanding role in type 2 diabetes management, and explain why this trial represents an important step forward for patients who have historically had limited access to CGM.The hosts review the randomized controlled trial findings, emphasizing the significant improvements in glycemic outcomes, including a 1.6% reduction in A1c from baseline and an approximately 0.9% greater reduction compared with standard care. They also highlight the increase in time in range, with participants using CGM achieving roughly five additional hours per day in target glucose range. The magnitude of these findings is discussed as a practice-changing development, with the potential to influence future clinical guidelines and strengthen recommendations for CGM use among individuals with type 2 diabetes who are not using insulin.The discussion also explores the broader implications of the CONNECT trial for healthcare access and insurance coverage. The hosts note that randomized controlled trial evidence has historically played a key role in shaping standards of care and payer decisions, and they suggest that these results may help support wider adoption of CGM by demonstrating meaningful improvements in glucose control and patient outcomes.The conversation then shifts to emerging pharmacologic advances, with a focus on retatrutide, a novel triple agonist targeting GLP-1, GIP, and glucagon pathways. The hosts discuss new data showing substantial metabolic benefits in people with type 2 diabetes, including up to 17% weight reduction and nearly 2% A1c lowering. They highlight how these findings represent a major advancement in diabetes and obesity treatment, particularly as clinicians continue to see increasingly powerful effects from next-generation incretin-based therapies.Isaacs and Bellini explore how these therapies may reshape treatment strategies by allowing clinicians to tailor medication choices based on individual patient needs and goals. They discuss the importance of considering both glucose lowering and weight reduction effects, recognizing that some patients may benefit from significant weight loss while others may require a more balanced approach focused primarily on glycemic improvement.The hosts also address important unanswered questions surrounding the use of highly effective weight-loss medications, including appropriate treatment targets, the limitations of BMI as a measure, and the importance of preserving muscle mass and overall function. They emphasize the need to consider body composition, physical activity, resistance training, and patient characteristics—particularly in older adults or those at risk for frailty—when developing long-term treatment plans.The episode concludes with a reflection on the rapidly evolving landscape of diabetes care. The hosts highlight how advances in CGM technology and novel metabolic therapies are creating new opportunities to improve outcomes, personalize treatment approaches, and redefine the future management of people living with diabetes.Editors' Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

De tweede dag Lauwersmeer staat in het teken van hard werken voor je waarnemingen. We gaan namelijk een geheel rondje Lauwersmeer fietsen en dat is maar liefst 50km. Maar de sfeer zat er direct goed in, want we waren nog geen 20 minuten onderweg of we werden getrakteerd op het prachtige geluid van de wielewaal. En dan is het zoeken geblazen, want ook al is de vogel knal geel met zwart hij blijft verdomde lastig. Een typisch gevalletje; je hoort hem wel, maar zit hem niet. Maar er staan nog meer knallers op het dagprogramma. Zo moet Gip de Blauwborst nog en de mooiste vogel van Nederland: het baardmannetje. Kortom er is genoeg te beleven met als kers op de taart een vogel die menig deelnemer nog niet op zijn of haar lijst had. Arjan is overigens weer zo fanatiek dat hij zelfs de groep geen koffiebreak gunt, maar gelukkig steekt mooi-weer-vogelaar Gisbert daar een stokje voor. Het moet leuk blijven. En dan nog iets anders: De Vogelspotcast bestaat 5 jaar en dat vieren we met prijzen. Hiep hiep Hoera! Om deze prijzen te winnen vragen we ± 5 minuten van je tijd om een vragenlijst in te vullen. We zouden graaag beter weten wat jullie leuk vinden en wat misschien beter of anders kan. Met jouw antwoorden help je ons om de Vogelspotcast te verbeteren én om meer mensen dichter bij vogels te brengen. Je vindt de vragen lijst op www.vogelspotcast.com/vragenlijst - Alvast heel erg bedankt voor jouw hulp!Ps. Al ruim 700 mensen hebben de vragenlijst al ingevuld! Echt geweldig. Onze dank is gigantisch. Partnerships:1) SNP Natuurreizen gemaakt. Wil je ook op Vogelvakantie. Klik HIER voor hun aanbod2) Vogelbescherming Nederland. Het gaat niet goed met de Steenuil en dat is niet best. Daarom halen we met Gip's Big Year zo veel mogelijk geld op om hier wat aan te doen. Jouw donatie zou enorm helpen. Ga naar www.vogelbescherming.nl/bigyear om te doneren. Alvast heel erg bedankt voor uw steun.Zie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

Bongani Bingwa speaks to Dr Siddharth Govender, Medical Director at NADClinic about cracks down on illegal weight-loss drugs, including GLP-1 and GIP medicines, important questions are being raised about what is safe, effective and scientifically proven. 702 Breakfast with Bongani Bingwa is broadcast on 702, a Johannesburg based talk radio station. Bongani makes sense of the news, interviews the key newsmakers of the day, and holds those in power to account on your behalf. The team bring you all you need to know to start your day Thank you for listening to a podcast from 702 Breakfast with Bongani Bingwa Listen live on Primedia+ weekdays from 06:00 and 09:00 (SA Time) to Breakfast with Bongani Bingwa broadcast on 702: https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/36edSLV or find all the catch-up podcasts here https://buff.ly/zEcM35T Subscribe to the 702 Daily and Weekly Newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio7See omnystudio.com/listener for privacy information.

Dr. Spencer and Karl Nadolsky sit down with David W, a nurse practitioner and one of the actual patients enrolled in the Triumph 1 retatrutide phase 3 trial, to break down the data that was just presented at the American Diabetes Association conference and explain why everyone in obesity medicine is paying very close attention. In this episode they cover what retatrutide actually is and why adding glucagon agonism to the GLP-1 and GIP dual agonism of tirzepatide creates a meaningfully different drug with direct effects on liver lipid metabolism, insulin sensitivity, blood pressure, and fat catabolism that you do not see with semaglutide or tirzepatide alone, what David's personal experience in the 12 milligram arm looked like from dose escalation through steady state including the GI side effects that faded by month seven and the heartburn that a low dose PPI fixed quickly, how David went from 240 pounds and a BMI of 35 down to 167 pounds by the end of the trial representing roughly 30 percent weight loss which is right at the trial average, what the Triumph 1 obesity trial found at 80 weeks with the nine and 12 milligram doses delivering nearly 26 and 28 percent average weight loss respectively and almost half of patients on the highest dose losing 30 percent or more, why the 104 week extension data showing patients who stayed on 12 milligrams reaching 30.3 percent average weight loss is being compared to bariatric surgery outcomes, what the Transcend type 2 diabetes trial showed with average A1C dropping to 5.9 percent on the 12 milligram dose in patients who were on no other diabetes medication, why the 41 percent triglyceride reduction and 20 percent LDL reduction are particularly interesting given that the mechanism appears to involve multiple pathways in the liver that tirzepatide and semaglutide do not touch, what the 70 percent reduction in WOMAC knee arthritis pain scores and 60 percent reduction in sleep apnea events mean for patients who have been told their only option is surgery, how Spencer plans to use retatrutide clinically once it is approved and which patients he thinks are the right candidates, why the gray market research peptide version currently circulating is something both doctors strongly advise against, and what Triumph 2 and Triumph 3 are measuring and when that data is expected. The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

We zitten inmiddels in de zesde maand van Gip's Big Year en er staan nu 210 soorten op zijn lijst. Je zou zeggen dat hij goed op schema ligt, maar zo werkt het natuurlijk niet helemaal. Een vogel per dag is in het begin relatief makkelijk, maar het glazen plafond nadert snel in de vogelwereld. Want waar vind je zo snel eigenlijk zeldzaamheden als een woudaap, grauwe kiekendief of smelleken? Gelukkig maken we dit jaar twee buitenlandreizen met SNP Natuurreizen die flink zoden aan de dijk zetten. En in Nederland is ook nog genoeg te vinden, waren we het al snel over eens met hen. Daarom gaan we samen met de Dwaalgasten op Nederlandse vogelreis naar het befaamde Lauwersmeergebied om daar 4 dagen met elkaar te vogelen. De weergoden zijn ons goed gestemd en er zit volgens Arjan een hele bijzondere vogel op ons te wachten!En dan nog iets anders: De Vogelspotcast bestaat 5 jaar en dat vieren we met prijzen. Hiep hiep Hoera! Om deze prijzen te winnen vragen we ± 5 minuten van je tijd om een vragenlijst in te vullen. We zouden graaag beter weten wat jullie leuk vinden en wat misschien beter of anders kan. Met jouw antwoorden help je ons om de Vogelspotcast te verbeteren én om meer mensen dichter bij vogels te brengen. Je vindt de vragen lijst op www.vogelspotcast.com/vragenlijst - Alvast heel erg bedankt voor jouw hulp!Partnerships:1) SNP Natuurreizen gemaakt. Wil je ook op Vogelvakantie. Klik HIER voor hun aanbod2) Vogelbescherming Nederland. Het gaat niet goed met de Steenuil en dat is niet best. Daarom halen we met Gip's Big Year zo veel mogelijk geld op om hier wat aan te doen. Jouw donatie zou enorm helpen. Ga naar www.vogelbescherming.nl/bigyear om te doneren. Alvast heel erg bedankt voor uw steun.Zie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

Description:  How do GLP-1 receptor agonists or GIP agonists work and what is the impact for my psoriatic disease? Hear dermatologist Dr. Ronald Prussick and cardio-immunologist Dr. Brittany Weber answer such questions and more.           Join host Archie Franklin as he takes a deep dive into the use of GLP-1 receptor agonists and GIP agonists and the convergence of systemic inflammation related to psoriatic disease with renowned dermatologist and Vice Chair of the NPF Medical Board, Dr. Ronald Prussick from Washington Dermatology Center in Rockville and Frederick, MD, and, cardio-immunologist Dr. Brittany Weber, Director of the Cardio-Rheumatology/ Cardio-Dermatology Program at the University of Texas Southwestern. Learn more about the use of incretin hormones, the impact of weight management on psoriatic disease, metabolic and cardiovascular risk, as well as results from the TOGETHER-Pso and TOGETHER-PsA clinical trials.  This episode addresses the actions of incretin hormones (GLP-1 receptor agonist and GIP agonist) and how such use may be beneficial in the management of inflammation related to psoriasis and psoriatic arthritis.  Thank you to Lilly for their support of this program activity.  Timestamps: (0:00)  Intro to Psoriasis Uncovered & guest welcome dermatologist Dr. Ronald Prussick and cardio-immunologist Dr. Brittany Weber.  (1:35)  What are incretin hormones and how GLP-1 or GIP receptor agonists (RA) inhibit appetite to initiate weight loss. (3:29)  Why GLP-1 RAs are of interest in the management of psoriasis and psoriatic arthritis. (5:23)  The metabolic, cardiovascular, and psoriatic disease convergence. (7:19)  Will reduction of inflammation impact cardiovascular risk? (10:59) Treatment challenges associated with having psoriatic disease and being overweight or obese. (13:45)  Key points around the use of GLP-1 receptor agonists when managing psoriasis and psoriatic arthritis. (17:06)  Results of the TOGETHER-PsO and TOGETHER-PsA phase 3 clinical trials combining use of an IL-17 inhibitor and a GIP and GLP-1                receptor agonist therapy. (19:07)  Having the conversation of adding a GLP-1 RA medication to a treatment regimen. (22:40)  The paradigm shift of GLP-1 receptor agonists and the impact they can have on shared inflammatory pathways. Key Takeaways: ·       Glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptide (GIP) agonists are two incretin hormones that assist in managing excess body weight -- which as a result can be helpful in managing inflammation in the body.   ·       Psoriasis isn't just a skin and joint disease. It's a complex network of systemic inflammation with shared inflammatory pathways that worsens with increased weight impacting the severity of the disease, and accelerates the risk of metabolic dysfunction, and cardiovascular disease.   ·       The best outcomes occur as a result of multidisciplinary collaboration to address the impact of excess weight and systemic inflammation. If you are struggling to lose weight with diet and exercise, speak with your medical team about your options including the use of GLP-1 or GIP agonists.   Guest Bios: Renowned dermatologist Ronald Prussick, M.D., Medical Director of the Washington Dermatology Center in Rockville and Fredrick, Maryland, specializes in the treatment of psoriasis along with other diseases of the skin, hair, and nails. Dr. Prussick is also a Clinical Associate Professor in Dermatology at George Washington University in Washington, D.C.. Dr. Prussick has a research interest in the impact of diet on psoriatic disease and metabolic health, first becoming interested after being involved in Dr. Joel Gelfand and Dr. Nehal Mehta's work in vascular inflammation trials using FDG-PET/CT scans to view systemic and cardiovascular inflammation associated with psoriatic disease. Dr. Prussick has since participated in the development of the 2018 Dietary Recommendations for Adults with Psoriasis or Psoriatic Arthritis and more recently the position statement "GLP-1 Receptor Agonists in Psoriasis: A Primer from the National Psoriasis Foundation Medical Board". Dr. Prussick is Vice Chair of the NPF Medical Board which provides clinical direction, treatment guidance, and education oversight to the organization and its Executive leaders.  Brittany Weber, M.D., Ph.D. is a cardio-immunologist who is the Director of the Cardio-Rheumatology/ Cardio-Dermatology Program at the University of Texas Southwestern. She is also a member of the Division of Cardiology, a clinical investigator, and imaging specialist. Dr. Weber's research integrates advanced imaging, molecular biology, clinical trials, and population health to understand how systemic inflammation and immune deregulation drives cardiovascular dysfunction. Prior to joining UT Southwestern in 2025, Dr. Weber served on the faculty at Harvard Medical School and was the Director of the Cardio-Rheumatology Clinic at Brigham and Women's Hospital, a nationally recognized clinic addressing inflammation-related heart disease through collaborative, patient centered care. Dr. Weber is also an author on the position statement "GLP-1 Receptor Agonists in Psoriasis: A Primer from the National Psoriasis Foundation Medical Board". Resources: "The Metabolic Collison and How You Can Take Control with Psoriatic Disease" podcast episode with dermatologist Dr. Ronald Prussick and registered dietitian Danielle Cahalan   "NPF Medical Board Issues GLP-1 Primer for Dermatologists" Press Release "Finding My Path to Managing Psoriatic Disease and Excess Weight" podcast episode featuring dermatologist Dr. Erin Boh, patient advocate Brian Lehrschal, and moderator Jennifer Bomberger. 

Tirzepatide, marketed as Zepbound, mimics the action of GLP-1 and GIP, two hormones naturally released by your gut. These hormones are critical in regulating appetite and how much food you consume. By enhancing the feeling of fullness and reducing hunger, tirzepatide helps support weight loss. Read the Full Episode Transcript: https://pepties.com/common-questions-of-tirzepatide/ Related Links/Products Mentioned: Peptide Podcast Partners Page https://pepties.com/partners/ Buy Peptides online at BioLongevity Labs: Use our link and enter COUPON CODE: PEPTIDEPODCAST  at checkout to receive 15% off your total order:  https://go.biolongevitylabs.com/SH5C Momentous Supplements (we use Creatine, Vital Aminos, Whey Protein) https://crrnt.app/MOME/OqGQOxGA LMNT – More Salt, Not Less.  https://elementallabs.refr.cc/default/u/johnjavit Thorne Supplements (we use Omega-3 with CoQ10, Red Yeast Rice, Zinc) https://get.aspr.app/SH1KvW Organifi Creatine and Shilajit Gummies http://rwrd.io/rlbkajm?c MitoZen (methylene blue for Cognitive Function, Anti-Aging, Mental Clarity) https://www.mitozen.com/ref/cnlwiztypt/ For skin and hair health (Copper Tripeptide-1)  Visit Luminose by Entera for an exclusive offer for Peptide Podcast listeners!  ** Promo code PEPTIDEPODCAST at checkout for 10% off an order or 10% off the first month of a subscribe-and-save. ** https://www.enteraskincare.com/?rfsn=8906839.f93c72 NAD+ Push Patch: https://www.pushpatch.com/

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!In this episode, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss several major developments in diabetes technology and obesity therapeutics, beginning with Abbott's announcement that its dual glucose-ketone monitoring systems, Libre Duo and Libre Duo 10 Day, have received CE mark approval in Europe. The hosts describe the devices as the first continuous glucose-ketone monitors capable of simultaneously measuring glucose and ketone levels through a single wearable sensor, with real-time ketone monitoring intended to identify rising risk for diabetic ketoacidosis (DKA). Bellini explains the rationale for separate 15-day adult and 10-day pediatric sensors, noting higher sensor failure rates and greater activity levels in children. Both hosts emphasize the potential clinical significance of continuous ketone monitoring, particularly for individuals with type 1 diabetes (T1D) using insulin pumps, where interruptions in insulin delivery can rapidly precipitate DKA.The discussion further explores how continuous ketone monitoring may expand the safe use of SGLT2 inhibitors in people with T1D and other high-risk populations. Bellini highlights concerns surrounding euglycemic DKA associated with SGLT2 inhibitor therapy and suggests that continuous ketone data could help clinicians identify susceptible individuals earlier, potentially enabling safer and more individualized dosing strategies. Isaacs underscores the limitations of current ketone testing methods, particularly urine ketone testing, which she characterizes as outdated and insufficient for modern diabetes management. The hosts also review additional patient populations that may benefit from continuous ketone monitoring, including individuals with recurrent DKA, pediatric patients with highly variable glycemic patterns, and hospitalized patients at elevated risk for ketosis due to prolonged fasting or treatment interruptions.Isaacs and Bellini also consider practical questions surrounding implementation, including reimbursement, cost, workflow integration, and compatibility with automated insulin delivery systems. They discuss whether continuous ketone monitoring could eventually become standard of care in T1D and debate the broader implications of widespread ketone data availability, including potential consumer interest outside traditional diabetes populations. Both hosts stress the importance of prioritizing access for patients at highest risk for DKA while acknowledging that broader adoption could reshape diabetes monitoring paradigms similarly to the evolution of continuous glucose monitoring.The episode then turns to recent reports involving Dexcom sensors that were reportedly stolen after being removed from the manufacturing process for quality concerns. Bellini explains that some of the affected sensors may not have completed sterility and quality assurance procedures before entering secondary markets. The hosts caution clinicians to review affected lot numbers and encourage ongoing vigilance until additional information becomes available. They also discuss the challenges of communicating recalls and safety alerts directly to patients, particularly for users relying on standalone receivers that may not connect to cloud-based notification systems.Finally, Isaacs and Bellini review newly released topline results from the phase 3 TRIUMPH-1 trial evaluating retatrutide, Lilly's investigational triple agonist targeting GLP-1, GIP, and glucagon receptors. Bellini summarizes findings demonstrating substantial weight reduction among adults with obesity or overweight without diabetes, including mean weight loss exceeding 28% at 80 weeks and continued weight reduction through 104 weeks without evidence of plateau. The hosts note that nearly half of participants achieved at least 30% weight loss, approaching outcomes historically associated with bariatric surgery. They also highlight low discontinuation rates and discuss the implications of future TRIUMPH studies evaluating retatrutide in patients with type 2 diabetes and cardiovascular disease. Isaacs concludes that the emerging data signal a transformative shift in obesity treatment, with pharmacologic therapies increasingly approaching surgical efficacy and potentially reshaping long-term obesity management strategies.Editors' Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

I fatti risalgono allo scorso 22 maggio. All'uomo, su ordinanza del Gip del Tribunale di Vicenza, era fatto divieto di avvicinarsi all'abitazione e ai luoghi frequentati dalla donna. Il tutto a seguito di una denuncia per maltrattamenti in famiglia.

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!In this special in-studio episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, reflect on major themes and anticipated developments ahead of the upcoming American Diabetes Association (ADA) Scientific Sessions 2026.The discussion opens with Bellini congratulating Isaacs on receiving the ADA Outstanding Educator in Diabetes Award, prompting a conversation centered on Isaacs' forthcoming presentation, “Behind Every Number Is a Story: Transforming Diabetes Care and Education through Technology and Human Connection.” Isaacs reflects on the rapid evolution of diabetes technology over the last decade, from limited continuous glucose monitoring (CGM) access and the emergence of early automated insulin delivery (AID) systems to the integration of artificial intelligence into diabetes care, while emphasizing that successful care remains grounded in human connection and individualized patient experiences.The hosts then preview several therapeutic areas expected to dominate discussion at ADA, particularly the expanding pipeline of incretin-based therapies. Bellini and Isaacs discuss growing excitement surrounding GLP-1, GIP, and glucagon receptor agonists, including anticipated data from triple agonist agents such as retatrutide and emerging oral therapies like orforglipron. They highlight the significance of improved weight-loss efficacy in people with type 2 diabetes (T2D), broader cardiometabolic applications, and the increasing importance of treatment accessibility and affordability. The conversation also explores the expanding role of these therapies in addressing cardiovascular disease, chronic kidney disease, sleep apnea, osteoarthritis, and other obesity-related comorbidities.Technology advancements represent another major focus of the episode. Isaacs and Bellini discuss new CGM-driven insulin titration tools, including Dexcom's Smart Basal feature, designed to address therapeutic inertia among people with T2D using basal insulin. They also examine the growing role of CGM in broader patient populations and discuss evolving ADA recommendations supporting CGM access for any individual likely to benefit from the technology. The hosts express particular enthusiasm for the anticipated arrival of continuous ketone monitoring, including dual glucose-ketone sensors, and consider how these devices may transform diabetic ketoacidosis prevention and patient education, particularly for individuals with type 1 diabetes (T1D).The conversation also highlights continued innovation in insulin delivery systems and connected diabetes devices. Isaacs and Bellini discuss progress toward fully closed-loop AID systems, including ongoing studies evaluating meal-unannounced insulin delivery in T2D. They review emerging insulin pump technologies from Medtronic, including updates to the MiniMed platform and the integration of connected insulin pen systems with real-time CGM data through the MiniMed Go app. The hosts emphasize the importance of preserving therapeutic choice for people who prefer injections over pump therapy or who seek temporary alternatives to wearable devices.Toward the conclusion of the episode, both hosts preview their own ADA presentations. Isaacs discusses an upcoming session on inhaled insulin that will use simulated patient scenarios to explore shared decision-making and individualized therapy selection. Bellini highlights her session focused on skin complications related to diabetes technologies, including allergic reactions and adhesive-related challenges that can interfere with sustained device use. Together, they underscore the importance of addressing practical barriers to technology adoption while continuing to expand therapeutic and technological options for people living with diabetes.Editors' Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

Het spant erom in de laatste aflevering van onze Extremadura reeks: gaan ze de kuifkoekoek vinden of niet... De vogel waar iedereen op hoopte heeft zich tot nu toe nog niet laten zien en naarmate het einde in zicht is, loopt de spanning dan ook flink op. Maar gelukkig is er nog genoeg anders moois te zien. Zo gaan we opzoek naar de oehoe en verschijnt de keizerarend voor een tweede keer ten tonelen. Ook splitst de groep zich voor het eerst op. De ene helft wil nogmaals naar Peña Falcón, terwijl de andere helft een mooie wandeling maakt met als doelsoort de zwarte tapuit. Maar hoe dan ook is iedereen voldaan en kijken we terug op een geweldige week vogelen in Spanje waar we maar liefst 126 nieuwe soorten hebben gezien (waarvan 54 voor Gip's Big Year lijst). Een groot succes! En als we dan ook nog op de valreep de kuifkoekoek vinden, zou dat helmaal mooi zijn. Wie weet... je hoort het in de laatste aflevering.Partnerships: Deze reis is mede mogelijk gemaakt door SNP Natuurreizen. Wil je nou ook naar Extremadura? Kijk dan op de website van SNP en boek deze fantastische vogelreis of naar een andere reis uit hun veelzijdige aanbod natuurreizen.Zie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

Deze aflevering begint met een telefoongesprek tussen Arjan en Gisbert. Arjan is natuurlijk razend benieuwd wat er allemaal gebeurd in zijn aanwezigheid ook al houdt hij Gip's lijst nauwlettend in de gaten. Daarna begint de dag met een geweldige wandeling van 10km. Voor de een doorgewinterde Camino wandelaar een "piece of cake", maar voor Christien een helse tocht. Ze houdt namelijk niet echt van wandelen... (best weird, maar prima). En of het een mooie wandeling was en ook nog eens prachtige waarnemingen. Wat wil een mens nog meer?!De volgende dag gaan we naar DE vogelplek van de Extremadura genaamd: Pena Falcon aka de Gierenrots. Deze plek is de natte droom van menig vogelaar en de parkeerplaats is dan ook al aardig vol als we arriveren. En geen woord gelogen. Zodra we uitstappen zijn de eerste zwarte ooievaars al gespot en is het een walhalla aan gieren. Maar ook de kleinere vogeltjes laten zich zien en zo komen we oog in oog met de befaamde blauwe rotslijster. Het is niet beter samen te vatten dan dat het: ontzettend, geweldig mooi is. Luister maar mee!Partnerships: Deze reis is mede mogelijk gemaakt door SNP Natuurreizen. Wil je nou ook naar Extremadura? Kijk dan op de website van SNP en boek deze fantastische vogelreis of naar een andere reis uit hun veelzijdige aanbod natuurreizen. Zie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

This episode is sponsored by AquaTru. AquaTru - Go to https://AquaTru.com/ now for 20% off (your purifier) using promo code FLIPPING50. AquaTru even comes with a 30-day best-tasting water guarantee. Other Episodes You Might Like: Previous Episode - Roadblocks Women Experience When They're Doing "All The Things" Next Episode - Rebounding vs Whole Body Vibration After 50 Which? When? Worth It? More Like This - GLP-1 Medications for Weight Loss: A 42-Year Fitness Professional's Honest Take Resources: Don't know where to start? Book your Discovery Call with Debra. Leave this session with insight into exactly what to do right now to make small changes, smart decisions about your exercise time and energy. Use Flipping 50 Scorecard & Guide to measure what matters with an easy at-home self-assessment test you can do in minutes. Optimal weight health in menopause isn't about eating less or exercising more—it's about finally understanding what your body has been trying to tell you.  If you've been frustrated with stubborn weight gain, low energy, or conflicting advice, this conversation will feel like a reset. We're breaking down the truth about GLP-1, gut health, hormones, and why your results may have stalled despite doing everything “right.”  This episode shifts the focus from quick fixes to a personalized strategy that actually works with your body, not against it. Because optimal weight health in menopause starts when you stop guessing and start listening. My Guest: Ashley Koff, RD, is an acclaimed weight-health expert, “Hollywood's Leading Dietitian” featured in InStyle and practitioner for more than 25 years. Koff is leading a transformative movement in personalized nutrition, turning “better, not perfect” choices into practical, sustainable strategies that deliver real outcomes.  She is the founder of The Better Nutrition Program (BNP) and author of USA Today bestselling Your Best Shot, which introduces weight-health hormones (GLP-1, GIP, CCK, PYY) as the regulators of weight health, offering the first-ever assessment of their function and a personalized optimization system—shot or not. Questions We Answer in This Episode: [00:02:35] What does optimal weight management really mean in menopause? [00:07:39] Are you ahead of your time and getting pushback for your approach? [00:03:17] What are GLP-1 hormones and why do they matter? [00:25:11] Is the fear valid that GLP-1 stops your body from producing its own hormones? [00:29:49] Should we be talking about something more important than muscle loss first? [00:31:21] How does cortisol actually influence weight health in menopause? How can women address the connection between cortisol, GLP-1, and weight? If this episode made you flip your workout routine — share it!

Na de voorpret aflevering gaat de reis nu echt beginnen. Direct na het ophalen van de busjes, gaan we op weg naar onze eerste bestemming Trujillo waar we de eerste 3 nachten verblijven. Maar tussen het vliegveld en het hotel zijn genoeg plekken om even te vogelen. Zelfs bij de eerste tankstop blijven we 20 minuten staan omdat we de eerste gieren al zien in de verte. Ja mensen, we zijn begonnen. Daarna volgen er nog een aantal stops waarbij Gip's eerste doelsoort wordt gezien: de kleine torenvalk. En ook al was de reis een tikkeltje vermoeiend, dat heb je nou eenmaal met reisdagen, ploffen we met met een voldaan gevoel en een aantal nieuwe soorten in een zalig bed dromend over alle vogels die we deze reis gaan ontdekken. Het is natuurlijk even wennDe volgende dag bewegen we ons naar het steppengebied rondom Trujillo. Dit prachtige natuurgebied biedt huis aan een paar van de topsoorten die je moet zien, namelijk: Spaanse keizerarend, grote en kleine trap, wit- en zwartbuik zandhoenders, bijeneters en Iberische klapekster. Wel is het even wennen voor Gip zonder Arjan op stap, een deelnemer merkt scherp op dat hij toch een beetje onrustig is. Maar gelukkig is onze enige echte Christien mee als content manager en het blijkt als snel dat ze een waardig vervanger is. Ook laten we deze reeks Arjan niet geheel buiten beschouwing. Gip belt elke dag getrouw met zijn leermeester om de dag te bespreken en tips op te halen. Hoe dit gaat zul je allemaal meemaken in de komende afleveringen, maar we kunnen je een ding beloven: het belooft een spektakel te worden. Partnerships: Deze reis is mede mogelijk gemaakt door SNP Natuurreizen. Wil je nou ook naar Extremadura? Kijk dan op de website van SNP en boek deze fantastische vogelreis. Je gaat er geen spijt van krijgen ;) Zie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

https://www.otplinks.comA new GLP-1 and glucagon agonist dropped data that was supposed to rival retatrutide, just without the GIP, and on the surface the results look solid. But that is not the real story. Even when people successfully lose weight, a large percentage gain it back, and for years that has been framed as a failure of discipline or willpower.This episode breaks down new research that helps explain why that happens. A study published in EMBO Reports shows that obesity can leave lasting changes at the cellular level through epigenetics, where gene activity is altered without changing the DNA itself. Researchers found that immune cells remained in a pro inflammatory, metabolically altered state even after weight loss, with some of these changes potentially lasting for years.In practical terms, this means the body does not simply return to a neutral baseline after weight loss. It can continue to operate as if it is still in an obese state, which helps explain why so many people feel like their body is working against them. This shifts the conversation away from personal responsibility and toward biology, reinforcing the idea that obesity is a chronic, relapsing metabolic disease.That distinction matters because it changes how treatment should be approached. If the underlying biology does not fully reset, then short term solutions are unlikely to be effective long term. These medications may not just be tools for losing weight, but part of ongoing management for a system that retains a memory of obesity and requires continued intervention.

Dell’Utri e moglie a processo per i 42 milioni ricevuti da Silvio Berlusconi. Intanto i Gip di Milano annunciano che per un mese e mezzo saranno effettuate solo le attività prioritarie al fine di garantire "i servizi essenziali". Ne parliamo con Sara Monaci de Il Sole 24 ORE. Attentato all’Hilton di Washington. Il commento di Mario Del Pero, docente storia internazionale a SciencesPo, esperto di storia e politica statunitense.

Dr. Spencer Nadolsky and Karl sit down with Dr. Adam Auton, geneticist at 23andMe, to break down a brand new paper using data from over 27,000 people that identified specific genetic variants linked to how well GLP-1 medications work and how likely someone is to experience side effects. 23andMe has over 11 million people in their research database and used voluntary survey data on medication use, dosage, duration, weight loss, and side effects to match against genetic profiles at scale, making this one of the most powerful datasets anyone has brought to this question. In this episode they cover how genome-wide association studies work and why scanning 600,000 genetic variants at once lets researchers find signals they never could have predicted in advance, why the first signal that jumped out of the data was a variant right in the GLP-1 receptor itself and why that was the moment the team knew they were on the right track, why the same variant that predicts better efficacy also predicts a higher risk of side effects and what that tells us about how the drug is being processed, why tirzepatide users showed a separate signal in the GIP receptor that modulates side effects rather than weight loss, why carrying both variants could make someone 14 times more likely to experience side effects on tirzepatide, why genetics explains roughly 10 percent of weight loss variation and what the other 90 percent looks like, why women tend to respond better than men and why diabetics tend to respond less well, what the future of this research looks like including who regains weight after stopping and whether those patterns are genetically predictable, and why heritability is a statistical measure that gets badly misunderstood even by clinicians. The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

On March 28, 2024, the seventeenth session of the Europan architecture, urban planning and landscape competition was held at the Cité de l'Architecture et du Patrimoine in Paris. Anne-Charlotte Depondt was invited to moderate a media moment for conclude of the program, reflecting on the European dimension of the competition.Former winners and members of the Europan 17 jury took part in the debate:John EDOM, architect, anthropologist, New South, international member of the E17 juryYann HOULLARD, architect and urban planner, Collectif MAYA, winning project E17, Défendons les Palantins, France, team based in Spain Nathanael PINARD, architect, Collectif Carré Noir, special mention project E17, The Butterfly Effect, SpainBéatriz SALADICH, architect and landscape designer, Barcelona, jury member E17, special mention project E16 Charlotte SAMPSON, architect HMONP, representative of the "Switch on the swales" project in Graz for E17 AustriaElena TEJERO, architect, winning project E17, BOCAMAR: the seams of the water, SpainAt a time of intensifying global conflict, this was an opportunity to highlight the european building practices and recall the fundamentals of the competition, with its ecological DNA rooted in territories. A rich exchange of ideas from young architects, urban planners, landscape architects and one anthropologist, all working to shape the world of tomorrow. An expert debate that will be invaluable for future applicants to the competition, to reinforce the motivation of those who want to apply outside their own borders, and to create envy! An unprecedented exchange for anyone in search of constructive, resilient solutions.As part of a partnership between Europan and Com d'Archi, we'd like to give you a summary of these exchanges, which Daniel Andersch Architecte & Urbaniste de l'Etat* (State Architect & Urban Planner), Director of the Europan program @GIP, presented to the public.Many thanks to the competition organizers for this invitation and partnership.*Ministère de l'Ecologie, @GIP Europe des Projets Architecturaux et Urbains_EPAUImage teaser DR © EuropanWith the voice of AliSound engineering : Ali Zogheib___If you like the podcast do not hesitate:. to subscribe so you don't miss the next episodes,. to leave us stars and a comment :-),. to follow us on Instagram @comdarchipodcast to find beautiful images, always chosen with care, so as to enrich your view on the subject.Nice week to all of you ! Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

The obesity medication landscape just changed — again. One brand-new pill is already in pharmacies, and five more are in various stages of approval. But the real story isn't the drugs themselves: it's what they're revealing about how your metabolism actually works, and why willpower was never the problem.This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor break down six metabolic medications — two newly FDA-approved and four in the pipeline — covering everything from a flexible new oral GLP-1 pill to drugs that target the brain's central metabolic pathway directly. Dr. Cooper explains the science behind each one, who might benefit, and what the pipeline tells us about the future of metabolic care. This is the most comprehensive drug update the show has done, and it arrives at a moment when the field is moving faster than ever.Key TakeawaysFoundayo (orforglipron), approved April 1st, is the first small molecule oral GLP-1 — no empty stomach requirement, no cold chain, and potentially lower production costs long-term.The amylin hormone may uniquely address both "I'm nourished" and "I weigh enough" signals in the brain — making the amylin pathway a powerful and underutilized target.Retatrutide (Lilly's triple agonist targeting GLP-1, GIP, and glucagon receptors) is showing unprecedented effectiveness plus significant non-scale benefits, including fatty liver reduction — but is still years from approval.The brain's melanocortin 4 receptor is the CEO of metabolism — regulating energy expenditure, appetite, and insulin — and new drugs targeting it represent the deepest intervention yet.Many of these medications are showing weight-independent benefits, including improvements in kidney, liver, cardiovascular risk, sleep apnea, and joint health that have nothing to do with how much weight is lost.Notable Quote"Everybody focuses on appetite, and you just need to eat less. But now with these medications and how they actually affect our biology, it becomes very clear that there's so much more to this." — Dr. Emily CooperLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.comFat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care.Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.

For the last year and a half, the talk of construction sites and Bay Street was about a string of violent incidents targeting GFL, the waste management giant, and GIP, its sister construction company. There was suspected arson, vandalism, and executives' homes were targeted in shootings in both 2024 and this past March. Earlier this month, police made an arrest in connection with the 2024 shootings: Ilan Philosophe, the founder of a competing company, Astro Excavating Inc. The Globe's Robyn Doolittle and Tim Kiladze spent the last year and a half reporting on this, including hours speaking with Philosophe before his arrest. Today, they bring us the full story about the shootings, menacing and hostile text messages, and fights over lucrative construction contracts. Questions? Comments? Ideas? Email us at thedecibel@globeandmail.com Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This conversation dives headfirst into one of the most controversial and least understood side effects of GLP-1 medications, what many are now calling the “Ozempic personality.” In this candid interview, Dr. Spencer Nadolsky joins On The Pen to unpack the growing reports of anhedonia, a flattening of motivation, desire, and emotional highs that some patients experience, especially at higher doses of tirzepatide and similar therapies.What starts as a discussion about how these medications work in the brain quickly turns into something much deeper. We explore how GLP-1 and GIP receptor agonists don't just reduce hunger, they fundamentally alter the brain's reward system, dampening cravings, food noise, and in some cases, the very drive to seek pleasure at all. That is where the idea of the “Ozempic personality” begins to take shape, not as a diagnosis, but as a shared patient experience that is only now being taken seriously.Dave opens up about his own journey, spending years at the highest dose and slowly realizing that while the medication gave him control over food and blood sugar, it also quietly muted parts of his identity. Hobbies faded. Motivation shifted. The highs and lows of life became more… flat. And it wasn't until stepping away that he could see the contrast clearly.Dr. Nadolsky brings clinical perspective to match the lived experience, explaining how this isn't classic depression, but something more nuanced. Patients aren't necessarily sad, they just stop wanting things. He shares how often this shows up in his practice, how he identifies it, and most importantly, how adjusting dose rather than stopping treatment altogether can restore balance.The conversation also raises bigger questions about transparency in clinical trials, what drug companies knew about these “anti-hedonic” effects, and why something so impactful may not have been formally tracked. At the same time, both Dave and Dr. Nadolsky emphasize what matters most, these medications are still life changing, even life saving, but they are not one size fits all.If you've ever felt like something changed beyond just your appetite while on a GLP-1, this is the conversation you've been waiting for. It puts language to an experience thousands are having but struggling to explain, and it gives you something even more important, a path forward.Watch the full interview to understand the reality behind the “Ozempic personality,” how to recognize it, and how to work with your doctor to find your own sweet spot.

This special Tick Boot Camp Podcast crossover features the full International Lyme and Associated Diseases Society (ILADS) webinar recording, “At the Frontlines of Chronic Illness: Conversations with ILADS Experts.” In this dynamic panel discussion, leading clinicians and specialists unpack why Lyme disease and other infection-associated chronic illnesses are so misunderstood, why testing fails so many patients, and what it really takes to heal—brain, immune system, mitochondria, and terrain included. Moderated by Rich Johannesen (Tick Boot Camp), the panel delivers practical insights and hopeful, patient-centered guidance for anyone navigating complex chronic illness—whether you're a patient, caregiver, clinician, or advocate. Featured Panelists Chris Winfrey, MD — Psychiatrist; Medical Director, New Image Wellness Nicole Bell — “The Lyme Disease Engineer”; CEO, Galaxy Diagnostics Tania Dempsey, MD — Medical Director, AIM Center for Personalized Medicine Melanie Stein, ND — Naturopathic Doctor; Author focused on cellular wellness and healing terrain Host/Moderator: Rich Johannesen (Tick Boot Camp) ILADS Intro: Ali Moresco (ILADS) Episode Highlights ILADS Mission and Why This Webinar Matters The webinar opens with ILADS' mission: improving diagnosis and treatment of Lyme disease and associated illnesses through research, education, and policy. ILADS emphasizes physician training and patient-centered care, while also supporting the educational mission of ILADEF. Rich frames the night as a rare opportunity to hear from experts working at the front lines of complex chronic illness—especially for patients who've been dismissed, misdiagnosed, or told their symptoms “don't make sense.” Segment 1: Brain Health, Neuroimmune Illness, and Why Lyme “Feels Like Dementia” Chris Winfrey, MD Dr. Winfrey introduces a core theme: Lyme is not only an infection—it often behaves like a neuroimmune illness. Key takeaways: The brain is a high-energy, high-immune-demand organ, uniquely vulnerable to infection-driven inflammation and toxicity. Lyme can disrupt brain function through: Blood flow issues Synaptic dysfunction Myelin damage Network-level disruption, not just “neurotransmitters” He describes brain function through networks that Lyme can destabilize: Default Mode Network (internal reflection) Salience Network (switching between networks) Central Executive Network (planning/organization) Action Network (execution) Autonomic Network (regulation) Limbic Network (threat/fear response) The result: patients often describe “brain shutdown,” confusion, cognitive impairment, and even dementia-like symptoms. A major reframing: Emotions are not “non-physical.” They are measurable physiological states. Lyme-driven nervous system injury can create emotional disturbance because the biology is disturbed. Segment 2: Poly-microbial Infection, Fight-or-Flight, and the Belief-Healing Loop Winfrey + Rich Discussion Rich frames humans as spiritual, emotional, and physical beings, and asks how chronic infection impacts both body and emotional resilience. Key points: Lyme can cross the blood-brain barrier and affect virtually any organ system. The nervous system becomes a “central battleground,” and measurement is hard because nervous system dysfunction isn't captured well by simple bloodwork. Rich and Dr. Winfrey explore how illness disrupts perception, decision-making, and our ability to interpret the world—especially when gut function and intuition feel “offline.” The healing paradox: Chronic stress and “fighting your way to healing” can backfire. Dr. Winfrey emphasizes that healing requires a parasympathetic state—rest, digest, repair—and that this often involves acceptance, surrender, trust, and safety. Segment 3: The State of Testing—Why So Many Patients Test Negative Nicole Bell (Galaxy Diagnostics) Nicole shares her personal motivation and professional mission: testing determines treatment, reimbursement, and belief—and too many patients are failed by existing tools. Indirect testing (antibody testing): The standard approach relies on antibodies—meaning it depends on the immune system behaving predictably. But Lyme and other stealth pathogens evade and suppress immune responses. Even in controlled research models, two infected subjects can show completely different antibody patterns. Immunosuppression (illness severity, medications like steroids, immune dysregulation) can reduce antibody reliability. Direct testing (pathogen detection):Nicole contrasts Lyme testing with illnesses like COVID—where you use tests that look for the pathogen itself (PCR/antigen), not just antibodies. Why direct detection is hard in Lyme: Pathogens can be low abundance They can be tissue-sequestered Sampling matters Why urine can matter for Lyme: Lyme may not stay in blood, but it can shed proteins/antigens that filter into urine. Galaxy's approach includes methods to capture, concentrate, and detect those markers. New diagnostics focus: Genus-level screening for the “3Bs” (Borrelia, Bartonella, Babesia) Reducing guessing when symptoms overlap and co-infections “masquerade” as each other Segment 4: Immune Dysfunction, Mast Cells, and Why Antibody Testing Can Go Haywire Tania Dempsey, MD (AIM Center for Personalized Medicine) Dr. Dempsey explains the immune system through two major branches: Innate immune system (fast, primitive defense) Adaptive immune system (antibodies, longer-term response) Mast cells as first responders: Mast cells detect “danger” and release inflammatory mediators (histamine and many others). In chronic infection, mast cells can remain persistently activated, releasing hundreds of inflammatory compounds. Why antibody tests fail (two patterns): Immune suppression → insufficient antibody production → false negatives Immune chaos → excessive, inappropriate antibody production → confusing positives - Positive Lyme bands “everywhere” - Positive autoantibodies without classic autoimmune disease patterns - “Everything looks positive” because signaling is dysfunctional Her central philosophy:It's not only about killing the bug. It's about fixing immune regulation so the body can actually clear or control infection. She also names the broader context: modern toxic load (mold, plastics, pesticides, “forever chemicals”) primes the immune system into dysregulation before infections even arrive. Segment 5: Advanced Immune-Modulating Tools Therapeutic Plasma Exchange + SOT Dr. Dempsey discusses therapies she's excited about, especially for complex, stuck cases: Therapeutic Plasma Exchange (TPE / plasmapheresis): Removes plasma (where antibodies, inflammatory mediators, and “garbage” accumulate) Replaces with albumin (and sometimes IVIG) Concept: reduce inflammatory burden + toxic load to reset the terrain SOT (Supportive Oligonucleotide Technique): Molecular targeted approach designed to reduce replication of specific pathogens More targeted than “wide-net” antimicrobial approaches Used strategically after lowering inflammatory/toxic burden She emphasizes: not for everyone, not a universal cure—but promising enough to merit formal publication. Segment 6: GLP-1 Agonists and Mast Cell Stabilization “Brain-melt” moment, revisited Dr. Dempsey explains why drugs commonly known for diabetes/weight loss may have immune benefits: Mast cells have receptors for GLP and GIP hormones Patients showed improvements beyond weight: cognitive function, inflammation, immune stability She describes: Semaglutide (Ozempic/Wegovy) Tirzepatide (Mounjaro/Zepbound) Emerging triple agonists (GLP-1/GIP/glucagon pathways) Her clinical approach has moved these agents earlier in care plans for immune stabilization in select cases. Segment 7: Cellular Healing, Mitochondria, and the Terrain Melanie Stein, ND Dr. Stein brings it home: healing often stalls when we focus only on killing pathogens, but don't repair the cellular damage. Core concepts: Lyme damages cell membranes, disrupting what goes in/out and how cells communicate. It contributes to mitochondrial dysfunction, reducing ATP (energy currency). If cells stay in “alarm mode,” healing remains blocked. Cell membrane therapy and terrain support: IV and oral lipid support (phospholipids, phosphatidylcholine, omega fatty acids) Personalized support based on lipidomic patterns Supportive therapies to reduce oxidative stress and “toxic fats” Focus on signaling safety to the body—so repair can resume Cell Danger Response:A key theme: even after infections reduce, the body may remain stuck in a persistent defense state, requiring cellular and nervous system support to exit “danger mode.” Regulation Before Eradication Panel Reflection Round As the panel closes, several themes converge: Limbic system + autonomic nervous system regulation is foundational “Regulation becomes before eradication” Healing requires safety, predictability, and nervous system calm Chronic illness can block our ability to connect—especially in relationships—because survival physiology dominates Dr. Dempsey adds that limbic retraining / nervous system reset is often the first step she starts with in her practice. Question and Answer Highlights Lyme and Cancer? The panel notes emerging signals connecting tick-borne illness and certain cancers, but emphasizes that more research is needed to determine causality. Herniated discs, connective tissue, and chronic infection The discussion highlights potential links through: connective tissue disruption collagen damage mast cell mediators (enzymes that affect tissue integrity) infection-driven inflammation Cross-reactive antibody results (example: Brucella) The group explains how antibody testing can produce confusing results due to immune dysregulation and cross-reactivity—another reason why interpretation and test methodology matter. Nasal testing / sinus terrain While not a mainstream Lyme diagnostic route, the panel references nasal/sinus colonization (especially with mold-related or chronic inflammatory patterns) as a terrain factor that can influence recovery. Resources Mentioned Center for Lyme Action – State of Lyme Disease Research paper (Nicole Bell collaboration) ILADS Provider Search International Lyme and Associated Diseases Educational Foundation (ILADEF) Donations (supports education and clinician training) Final Message to Listeners This episode is a reminder that Lyme disease and infection-associated chronic illness are not one-dimensional problems. The path forward often requires: better diagnostics immune regulation nervous system support cellular repair personalized care and hope that the body can recover when the right puzzle pieces come together

Today, I'm pulling together some of the most impactful conversations from the last three months on the Podcast. From breaking down the pitfalls of trendy weight loss drugs to uncovering silent heart health risks, and exploring how mitochondrial transplants and trauma healing are rewriting the story of resilience, these moments have truly shifted my perspective on what it means to pursue lasting wellness. Here are the full episodes: #401: Personalization Is EVERYTHING: The New Science of Weight Health, GLP-1s, and Building Lasting Longevity With Ashley Koff #414: Drop Dead Healthy? Why "Fit" Women & Men Still Have Fatal Heart Attacks! l Dr. Regina Druz #419: Origin Of Disease Is Hiding In Your Cells! Doctor Reveals How To Fix It Now l Dr. Natalie Yivgi-Ohana #421: Why You Can't Hack Longevity Until You Heal Hidden Stored Trauma! l Dr. Aimie Apigian #417: Feeling Depressed? Watch This First (It Might Not Be What You Think) l Dr. Cynthia Keller l Ep  Episode Timestamps: Welcome and quarterly recap intro ... 00:00:00 Longevity is about pattern recognition, not single breakthroughs ... 00:00:41 GLP-1s require personalization, not a one-size-fits-all approach ... 00:04:25 GLP-1 hormone assessment and individualized plans ... 00:06:03 Delayed/suppressed GLP-1 function needs lifestyle changes ... 00:08:04 GLP-1 agonists enable, but don't replace, foundational health tweaks ... 00:09:06 Heart health: sick fat disease, inflammation and cardiac risk ... 00:12:30 GLP-1 and GIP peptides have powerful anti-inflammatory effects ... 00:15:35 Menopause amplifies pre-existing heart/metabolic risks ... 00:18:22 Mitochondrial transplants: emerging therapy for rare diseases ... 00:24:04 Every disease linked to—or helped by—mitochondrial function ... 00:27:00 Trauma healing is phased; start with the gentle approach ... 00:31:21 Chronic survival state rewires the nervous system ... 00:40:02 Covid's gut impact can trigger mood issues, fixed with key nutrients ... 00:50:00 Our Amazing Sponsors: Mitopure Gummies by Timeline - These clinically researched gummies support mitophagy to help renew your mitochondria and boost cellular energy, giving you a stronger biological foundation for resilience—visit timeline.com/nat20 to get 20% off. Quantum Upgrade - Supports nervous system balance without wearables or apps—just effortless, 24/7 quantum energy streaming. With 21+ studies showing measurable improvements in stress and cellular function, it's easy to try for yourself. Visit quantumupgrade.io/NAT and use code NAT15 to start the free 15 day trial. Daily Gut Detox by Just Thrive Health – A gentle, science-backed detox powered by clinically proven immunoglobulins that bind and remove toxins while supporting your gut, immune system, and digestion—without harsh flushing or discomfort. Visit JustThriveHealth.com/NAT20 and use code NAT20 for 20% off your order, risk-free. Nat's Links: YouTube Channel Join My Membership Community Sign up for My Newsletter Instagram Dr. Bill Lawrence Episode

What if weight loss has never been the right goal in the first place? In this episode, Dr. Taz sits down with registered dietitian Ashley Koff, RD, author of Your Best Shot, to unpack why the conversation around GLP-1 medications is much bigger than Ozempic, Wegovy, or tirzepatide alone.This episode reframes the entire GLP-1 conversation by shifting away from weight loss as the goal and toward what Ashley Koff calls “weight health.” Instead of treating Ozempic, Wegovy, tirzepatide, and related medications as magic fixes or villains, the conversation explores the deeper hormonal ecosystem behind appetite, blood sugar, digestion, inflammation, body composition, and metabolic health.Ashley explains that GLP-1 and GIP are part of a larger family of peptide hormones made in the gut lining, and that when this system is disrupted by poor digestion, stress, gut lining damage, nutrient insufficiency, dehydration, medications, or microbiome imbalance, the body's weight regulation becomes suboptimal. She argues that many people are not failing at weight loss. Their body simply does not have what it needs to function optimally.If you're dealing with weight changes, food noise, metabolic dysfunction, or feeling like your body is not responding the way it should, and want deeper, root-cause support, join the Circle here: 

GLP-1/GIP Drugs & HRT in Midlife: What the New Data Suggests for Women's Health | The Menopause Master Show | Episode 273 

 Are GLP-1 medications like Ozempic the only path to weight loss and metabolic health or is there more to the story? In this episode of the IRH Clinician's Corner, Margaret Floyd Barry sits down with registered dietitian and personalized nutrition expert Ashley Koff to unpack one of the most talked-about topics in health right now: GLP-1 medications, metabolic signaling, and sustainable weight management. With over 25 years of experience, Ashley shares a refreshing, clinically grounded perspective that goes beyond trends and into what actually works long-term. Inside this episode, we explore: The fascinating origin story of GLP-1 medications (inspired by the Gila monster) and how they became a weight loss breakthrough The four key "switch" hormones that regulate metabolism, appetite, and weight—and how they actually work together Inside Ashley's GLP-1 Optimization System, including her signature "pizza framework" for assessing root-cause imbalances Simple, practical ways to assess your own digestion, hydration, and metabolic health at home Clinical strategies to reduce and manage GLP-1 medication side effects while supporting long-term results   If you're a clinician, health coach, or someone navigating your own metabolic health journey, this episode will help you cut through the noise and understand what's actually driving results.

Het is eindelijk zover de reis in samenwerking met SNP Natuurreizen gaat van start. Op het moment van luisteren bevinden niet Arjan en Gip zich in het vliegtuig, maar is de eerste vervangen door Christien... Gip moet namelijk zijn Big Year wel halen en in Nederland alleen gaat dat niet lukken. Samen met begenadigde gidsen en een schare fans gaan we dus ons geluk beproeven in Spanje. En we maken er een heus podcast seizoen waar [tromgeroffel...] Arjan gewoon bij is. Door de moderne techniek van tegenwoordig kunnen wij op hoge kwaliteit podcast opnemen op afstand. Zo kan leermeester Arjan voldoende instructies geven zodat er minimaal 60 soorten op Gip's Big Year lijst komen. Kortom, het wordt ouderwets genieten. Zie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

How Continuous Glucose Monitors Can Optimize Metabolic Health—and Where GLP-1 Drugs Fit: Emergency physician-turned-preventive/metabolic medicine specialist Dr. Paul Kolodzik of Metabolic MD reveals how continuous glucose monitors (CGMs) are a tool not only for diabetics but also for non-diabetics and pre-diabetics to personalize diet, sleep, and exercise by seeing real-time glucose patterns instead of relying on fingersticks or A1c averages. Kolodzik describes CGM use in his clinic (two-week diagnostic wear, then therapeutic guidance), highlights insulin resistance, fasting insulin testing, glucose variability, and the role of low-carb eating, intermittent fasting, and strength training to improve metabolic syndrome, triglycerides, and fatty liver. They discuss CGM sourcing/cost, device mechanics and accuracy, possible future noninvasive wearables, and GLP-1/GIP weight-loss drugs, emphasizing supervised, limited-dose use with protein and lifestyle changes to avoid muscle loss and weight regain. A free PDF of Kolodzik's book is offered HERE.  

Resources for the Community:___________________________________________________________________https://linktr.ee/theplussidezFind Your US Representatives https://www.usa.gov/elected-officials ______________________________________________________________________This isn't medical advice — always talk to your doctor before making any health decisionsIn this episode of The Plus SideZ, we break down the latest GLP-1 news and what it actually means in real life.We're joined by Dave (Man on Mounjaro), who shares his firsthand experience coming off a GLP-1 after years on treatment, while we also unpack emerging research and what's coming next in this space.This conversation covers both data and lived experience, including:• What new studies say about stopping GLP-1 medications • Why benefits may reverse after discontinuation • Real-world weight regain, hunger, and metabolic changes • Mental health and brain-related effects tied to these medications • The difference between GLP-1 and GIP and why it matters • New and emerging medications being studied for neurological and metabolic conditions • Where treatment may be headed next beyond weight lossThis episode connects the dots between science, patient experience, and the future of obesity treatment so you can better understand what's happening now and what may be coming next.Whether you're on a GLP-1, considering one, or thinking about long-term use, this is a must-listen conversation.Guest Host:  Dave Knapp @OnThePenPodcast______________________________________________________________________Join this channel to get access to perks:   / @theplussidez______________________________________________________________________#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy #ObesityCare #PatientAdvocate #GLP1Community #RealGLP1StoriesSend us Fan Mail! Support the showKim Carlos, Executive Producer TikTokInstagram Kat Carter,  Producer TikTokInstagram 

Join My Private Group: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://theaxioncollective.manus.space/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Website: ⁠https://hunterwilliamshealth.com/⁠Email List: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://huntershealthhacks.beehiiv.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get My Book On Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://a.co/d/avbaV48Download⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Supplement Sources: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamssupplements.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon Storefront: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/hunterwilliams/list/WE16G2223BXA?ref_=cm_sw_r_cp_ud_aipsflist_R7QWQC0P1RACB2ETY3DY⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Socials:Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/hunterwilliamscoaching/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Video Topic Request: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamsvideotopic.carrd.co/⁠⁠⁠⁠⁠In this episode, I'm breaking down two peptides that I think are about to blow up: mazdutide and survodutide. Both are GLP-1 and glucagon dual agonists. Think of them like retatrutide minus the GIP component. And that glucagon piece is what makes them special.I go through the trial data for both compounds. We're talking up to 21% weight loss with mazdutide and 80% liver fat reduction. Survodutide earned FDA breakthrough therapy designation for MASH based on a 62% resolution rate. These are serious numbers.Here's what most people don't realize. These two peptides are NOT the same. Mazdutide runs close to a 50/50 split between GLP-1 and glucagon agonism. Survodutide is roughly 8 to 1 in favor of GLP-1. That changes everything about tolerability, appetite suppression, and how much metabolic burn you're actually getting.I also cover practical use cases. Cycling off reta without losing momentum. Choosing between the two based on whether you need more appetite control or more energy expenditure. Dosing guidance for people just starting out. And why escalating too fast is still the number one mistake people make with GLP-1 peptides.

Is everything you know about obesity and diabetes wrong? Join Emmy Award-winning journalist Kym McNicholas and interventional cardiologist Dr. John Phillips on The Heart of Innovation as they sit down with world-renowned endocrinologist Dr. Anastasios Manessis. In this episode, we dive deep into the rapidly accelerating world of metabolic health to separate fact from fiction. What We Cover: GLP-1 Breakthroughs: We go beyond the headlines to discuss the real-world impact of GLP-1 and GIP receptor agonists in managing chronic disease and cardiovascular health. The New Bag Gastric Balloon: Kym and Dr. Phillips explore the latest non-surgical innovations, including the recently FDA-cleared Allurion Gastric Balloon System. This swallowable technology—often referred to as a pill-sized bag—occupies gastric volume to support weight management without the need for surgery, endoscopy, or anesthesia. Myth-Busting Obesity Care: Dr. Manessis addresses common misconceptions about weight loss medications and the shifting clinical standards for 2026. A Holistic Approach: Learn how endocrinology-driven strategies combine nutrition, exercise, and medicine for long-term health optimization. About Our Guest: Dr. Anastasios Manessis, MD, FACE, ECNU, ABOM, is a double board-certified endocrinologist specializing in diabetes, metabolism, and obesity medicine. As the lead at Endocrine Associates of West Village PC, he is at the forefront of innovative, patient-focused metabolic care. Don't miss this essential guide to the new hope—and new meds—changing lives in 2026. Subscribe to our channel for more life-saving breakthroughs! SHAREABLE LINK TO WATCH: https://youtube.com/live/dAJZsb8WQJ0?feature=share #ObesityTreatment #DiabetesCare #GLP1 #WeightLossInnovation #GastricBalloon #HeartOfInnovation #MedicalAdvances #DrAnastasiosManessis #KymMcNicholas #DrJohnPhillips

GLP-1 medications like Ozempic®, Wegovy®, and tirzepatide are dominating headlines—but what if the real breakthrough isn't just the shot, but understanding the body's own weight-health hormones? In this powerful conversation, Dr. Anna Cabeca—triple board-certified OB-GYN and The Girlfriend Doctor—sits down with renowned dietitian and personalized nutrition pioneer Ashley Koff, RD, to unpack the science behind GLP-1, the deeper root causes of metabolic dysfunction, and how we can activate the body's natural appetite-regulating hormones. Together they explore why weight health is about far more than calories or willpower. Ashley shares her personal journey into functional nutrition, the hidden hormonal ecosystem behind appetite and metabolism, and how digestion, gut health, and lifestyle choices influence the hormones that regulate cravings, satiety, inflammation, and metabolic balance. Ashley also introduces the framework from her new book Your Best Shot: The Personalized System for Optimal Weight Health—GLP-1 Shot or Not, revealing why sustainable health comes from personalized strategies—not quick fixes. If you've wondered whether GLP-1 medications are right for you—or how to support your metabolism naturally—this conversation is packed with practical, empowering insights. Ashley Koff, RD is the founder of The Better Nutrition Program, Nutrition Course Director for the UC Irvine Susan Samueli Integrative Health Institute's Integrative and Functional Medicine Fellowship, and faculty at the Integrative and Functional Nutrition Academy. A practitioner for more than 25 years, she is recognized as one of CNN's Top 100 Health Makers and has been called "Hollywood's Leading Dietitian" by InStyle.   In This Episode, You'll Learn: • What GLP-1, GIP, PYY, and CCK actually do in the body • Why weight health is an ecosystem—not just calories in vs. calories out • The hidden role of gut health and digestion in appetite hormones • The "Pizza Framework" for building metabolic health foundations • How lifestyle, timing of meals, and microbiome health influence metabolism • When GLP-1 medications may help—and when foundational health must come first • Practical strategies to quiet "food noise" and improve satiety naturally   Key Timestamps 00:00 – Welcome to The Girlfriend Doctor Show 01:00 – Why GLP-1 medications are changing the conversation about metabolism 03:00 – Ashley's personal story and turning point in nutrition science 09:30 – The gut, trauma, and the origins of metabolic dysfunction 13:00 – What GLP-1 and other weight-health hormones actually do in the body 20:00 – Why digestion and gut health drive hormone balance 23:40 – The "Pizza Framework" for metabolic health foundations 28:00 – How meal timing affects hormones and metabolism 32:00 – Supplements and microbiome strategies that support GLP-1 naturally 36:00 – Ashley's book Your Best Shot and how to personalize your approach   Memorable Quotes 1. Ashley Koff: "Weight health isn't about willpower—it's about physiology. When the body has what it needs, the system works the way it was designed to." 2. Ashley Koff: "There is no one ingredient in the recipe that makes metabolic health work. It's about finding the right recipe for your body." 3. Dr. Anna Cabeca: "We don't just want weight loss—we want weight health: strong, confident, vibrant women living in bodies that feel good." 4. Ashley Koff: "Your digestion is the crust of the pizza. If the crust isn't right, nothing you put on top will work the way it should." 5. Dr. Anna Cabeca: "Willpower is physiologic. When you support your body's metabolism and hormones, your ability to make healthy choices comes back."   Connect With Guest Ashley Koff Instagram: @AshleyKoffApprovedWebsite: https://thebetternutritionprogram.com/about/ Book: Your Best Shot: The Personalized System for Optimal Weight Health – GLP-1 Shot or Not: https://thebetternutritionprogram.com/your-best-shot/ Connect With Dr. Anna Website: https://dranna.comInstagram: https://www.instagram.com/thegirlfrienddoctor/ YouTube: https://www.youtube.com/@thegirlfrienddoctor TikTok: https://www.tiktok.com/@drannacabeca Facebook: https://www.facebook.com/thegirlfrienddoctor

It's In the News, a look at the top headlines and stories in the diabetes community. This week's top stories: Metformin may help stem macular degeneration, retatutride moves forward, T1D and demntia link studied, lots of news from ATTD and more! Announcing Community Commericals! Learn how to get your message on the show here. Learn more about studies and research at Thrivable here Please visit our Sponsors & Partners - they help make the show possible! Omnipod - Simplify Life All about Dexcom  All about VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  transcript with links:  Welcome! I'm your host Stacey Simms and this is an In The News episode.. where we bringing you the top diabetes stories and headlines happening now. A reminder that you can find the sources and links and a transcript and more info for every story mentioned here in the show notes. Who's in Vegas? I'll see you there at the Breakthrough T1D summit this weekend. And we have two Club 1921 events for health care providers and patient leaders happening in April – head on over to the website for more. Okay.. our top story this week: XX Metformin may be linked to the slower progression of age-related macular degeneration (AMD). Among people with diabetes who were older than 55, those taking metformin had a 37% lower chance of developing intermediate AMD over a five-year period compared with individuals who were not using the medication. It's one of the leading causes of vision loss in the US and many other western countries. These researchers now say a clinical trial is the next step. https://scitechdaily.com/scientists-discover-surprising-eye-benefit-of-widely-used-diabetes-drug/ XX new study suggests people with type 1 diabetes may be nearly three times as likely to develop dementia compared with people without diabetes. Similarly, people with type 2 diabetes may have roughly twice the risk of dementia compared with those without diabetes. However, the study found an association rather than proof of causation, meaning diabetes was linked to dementia risk but was not shown to directly cause it.   https://www.usnews.com/news/health-news/articles/2026-03-19/both-types-of-diabetes-increase-dementia-risk XX Researchers in Japan say they've developed an insulin pill… in mice.  The study, published in the journal Molecular Pharmaceutics, tested the delivery of oral insulin by building a carrier peptide called DNP-V. This peptide helps to transport insulin through the small intestine, where protein drug absorption is usually poor. The result was a rapid and significant drop in blood glucose, as well as a sustained (longer-term) decrease. The mice's blood sugar was reduced to near-normal levels. Although the researchers are optimistic about the findings translating to larger therapeutic models, they noted that the results in mice do not guarantee the same outcome in humans, and that more research is needed. https://www.foxnews.com/health/needle-free-diabetes-management-could-horizon-study-suggests   XX   Lilly says it's next-generation obesity drug retatutride cleared its first late-stage trial on Type 2 diabetes patients. The drug lowered hemoglobin A1C by an average of 1.7% to 2% across different doses at 40 weeks compared with placebo, and helped patients lose an average of 16.8% of their weight. Retatrutide also met the study's second goal, helping patients at the highest dose lose an average of 16.8% of their weight, or 36.6 pounds, at 40 weeks, when evaluating only patients who stayed on the drug. When analyzing all participants, including those who discontinued treatment, the highest dose of the drug helped patients lose 15.3% of their weight. The company was also "very pleased" with the relatively low discontinuation rates due to side effects, which were up to 5%, he added. But Lilly has yet to file for approval of the drug for obesity or diabetes. The company expects to report findings from seven additional phase three trials on the drug by the end of the year. Still, retatrutide's A1C reduction doesn't appear to be the greatest Lilly has seen within its portfolio: The highest dose of Zepbound lowered the measure by more than 2% at 40 weeks in two separate trials on diabetes patients. Dubbed the "triple G" drug, retatrutide works by mimicking three hunger-regulating hormones – GLP-1, GIP and glucagon – rather than just one or two like existing treatments. That appears to have more potent effects on a person's appetite and satisfaction with food than other treatments.   https://www.cnbc.com/2026/03/19/eli-lillys-obesity-drug-retatrutide-clears-late-stage-diabetes-trial.html XX   The MiniMed Flex gets FDA approval. Thi is a new design from the company formerly known as Medtronic. It's about half the size* of the MiniMed™ 780G pump, no screen – smartphone controlled – and has the SmartGuard™ algorithm with Meal Detection™ technolog. At commercial launch, MiniMed Flex™ will support the company's newest sensor portfolio, including Simplera Sync™ sensor and the Instinct sensor, made by Abbott. MiniMed also announced the MiniMed™ Forward Program, which allows customers who start on the MiniMed™ 780G system to upgrade to the MiniMed Flex™ system for $0. MiniMed Flex™ is cleared for individuals ages 7 and older with type 1 diabetes, and for individuals 18 years and older with insulin-requiring type 2 diabetes. https://www.prnewswire.com/news-releases/minimed-announces-fda-clearance-of-minimed-flex-the-companys-smallest-insulin-pump-featuring-its-first-smartphone-controlled-design-302716864.html   XX Lots of new out of the recent ATTD conference.. some headlines: New study from the UK shows that Ketone Monitoring Could Significantly Reduce DKA Risks in people with type 1 and type 2. This was a study by Abbott which recently submitted a continuous dual glucose-ketone monitor to the FDA for clearance – if approved, it could be available in the U.S. later this year. -- The first modified insulin producing cells are still working 14 months after transplant – without the need for immunosuppressive drugs. This is from Sana which now plans a study of a new therapy.. same gene-editing strategy with lab-grown, stem-cell-derived insulin-producing cells. -- Protein looks like it helps avoid lows during exercise. Both high and low doses of whey protein before exercise were effective, significantly reducing the risk of hypoglycemia by five to 10 times.   Researchers noted that the body's response to protein was rapid (within 20 minutes), which suggests taking it close to the beginning of exercise could be beneficial for preventing hypoglycemia. Though more research is needed, there was also evidence showing protein intake could be beneficial for prolonged fasting and preventing overnight lows. -- More info about type 1 and GLP medications. Researchers at ATTD presented the results of a small, seven-month study assessing the effectiveness of semaglutide for people with type 1 diabetes and obesity. During the trial, 36% of participants taking semaglutide spent more than 70% of their time in range, less than 4% of their time below range, and lost more than 5% of their body weight compared to those not taking semaglutide.   Treatment with semaglutide was also associated with reductions in cholesterol and blood pressure. Based on all of these changes, the researchers calculated that the participants who received semaglutide had significantly reduced their risk of heart disease over the next 10 years.   Other studies show that since 2020, prescriptions of GLP-1 medications have grown exponentially for adults with type 1 diabetes between the ages of 18 and 85. https://diatribe.org/diabetes-research/top-diabetes-news-attd-2026   XX Lots of talk about fully closed loops.. CamDiab unveiled theirs.. called Liberty.. which the company says it's the world's first fully closed loop commercial launch. CamDiab offers the FDA-approved mylife CamAPS FX app for automating insulin delivery in MyLife's (formerly Ypsomed Diabetes Care's) insulin delivery pumps. The mylife CamAPS FX on iOS has full compatibility with leading continuous glucose monitors (CGMs). Those include the FreeStyle Libre 3 and Libre 3 Plus from Abbott and the Dexcom G6 so customers can use their preferred device. https://www.drugdeliverybusiness.com/camdiab-unveils-fully-closed-loop-insulin-feature/ XX Insulet reported data on a fully closed-loop automated insulin delivery system in people with Type 2 diabetes. The 24 people in the trial spent 24% more time in the target blood glucose range using the system than when receiving standard injection therapy. Insulet plans to start a pivotal study this year and aims to launch in 2028. Rival insulin pump manufacturer Tandem is on a similar course. Tandem CEO John Sheridan told investors on an earnings call last month that his team plans to start a pivotal trial this year to support a filing with the Food and Drug Administration in 2027. Medtronic disclosed the start of a pivotal trial of its Vivera fully closed-loop algorithm last month, shortly before spinning off the program as part of the MiniMed initial public offering. The algorithm, which is designed to eliminate carb counting and manual food bolusing, achieved a mean time in range of 73.8% without manual user input in a feasibility study.   https://www.medtechdive.com/news/insulet-posts-clinical-data-on-fully-closed-loop-insulin-delivery-system/814516/ XX Congrats to all honored by the 2026 National Scientific and Health Care Achievement Awards from the American Diabetes Association! Shout out to Diana Isaacs, PharmD, BCACP, BC-ADM, CDCES: 2026 Outstanding Educator in Diabetes Award and to  Korey Hood who receives the Richard Rubin award. Dr. Rubin was a pioneer in behavioral science and committed to keeping the person with diabetes at the center of research and care.

Na drie keer ongeveer dezelfde biotoop uitgekozen te hebben richt Gip zijn pijlen ditmaal op zee. En waar moet je zijn als je zeevogels wilt spotten? Juist, de Pier van IJmuiden. Weten jullie het nog? In aflevering #30 gingen we opzoek naar de The Big Five van IJmuiden. Nu staan we er weer, maar hopen op nog iets extra's, of nog beter; iets onverwachts...Deze podcast is mede mogelijk gemaakt door:Vogelbescherming Nederland - Wil je een gratis magazine uit de aflevering? Ga dan naar vogelbescherming.nl/tijdschrift en meld je aan.Sprinkl - Voor iedereen met groene vingers en die biologisch wilt tuinieren. Bestel je planten dan bij www.sprinklr.co/ en krijg eenmalig 5 Euro korting bij een bestelling van minimaal 30 Euro met de code VogelspotcastBio SNP Natuurreizen - Wil je mee met Arjan en Gip naar Cyprus in september. Wees er dan snel bij. Ga naar SNP CyprusDwaalgasten - Lid worden van de leukste vogelcommunity van Nederland? Word lid van de dwaalgasten via Petje AfLuistervinken - Wil je niks missen van Gip's Big Year? Luister dan ook de extra afleveringen via Petje AfZie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

In this essential episode, Dr. Fiona Lovely tackles a massive "information vacuum" surrounding some of the most talked-about medications today. With women aged 50–64 now the primary users of GLP-1 and GIP medications, Dr. Lovely steps in to provide the critical nutritional and physiological guidance that is too often missing from the standard prescription process. She clarifies that for millions of women, these are not "vanity tools" but life-changing medicines for treating chronic diseases like obesity and metabolic dysfunction. Dr. Lovely breaks down the science behind semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), explaining how they mimic natural hormones to regulate hunger and insulin. However, she warns that simply taking the medication without a support plan is "wishful thinking" that can lead to muscle loss and frailty. To help you thrive while on these medications, she introduces her Six Foundational Pillars of Support: Hydration: Why thirst signals disappear alongside appetite and why 2–3 liters of water daily (plus electrolytes) is your best defense against nausea and fatigue. Protein & Muscle Preservation: The non-negotiable need for high protein intake to prevent sarcopenia and the "trade-off" of metabolic health for physical frailty. Resistance Training: Why you must send a signal to your body to keep its muscle through simple, home-based bodyweight exercises or resistance bands. Fiber: Managing the common side effect of constipation by hitting a 25-gram daily target through food first. Nutrient Gaps: Why eating less means absorbing less, and how a "morning stack" of micronutrients and greens can bridge the gap. Mental & Emotional Support: Preparing for the "emotional surfacing" that happens when food is no longer available as a coping mechanism. This episode is a masterclass in health sovereignty, empowering you to move through the menopausal transition stronger and more resilient, rather than depleted.   Thank you to our sponsors for this episode:

Join us as we review and appraise recent practice-changing articles. In this episode, we cover the latest in GLP-1s and GIP agonists for CVD, Type 2 Diabetes, and Obesity, valacyclovir to treat Alzheimer's, weight regain patterns after medication-induced weight loss, and a deep dive into the data behind deprescribing – and behavioral science to increase deprescribing behavior.  Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Alex Chaitoff (@alexchaitoff), Nora Taranto (@norataranto), & Matt Watto (@doctorwatto).Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMECredits Written and Hosted by: Nora Taranto MD, MSCE; Alexander Chaitoff MD, MPH; Paul Williams, MD, FACP,, & Matthew Watto MD, FACP Cover Art: Nora Taranto MD, MSCE Reviewer: Sai S Achi MD, MBA, FACP Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer GLP-1 + GIPs vs GLP-1s for patients with T2DM and Obesity – SURPASS-CVOT  Weight Regain after Weight loss  VALAD – Valacyclovir in patients with early Alzheimer's  Nudges to increase Deprescribing  Outro Sponsor: MedStudy Qbank Study less. Remember more. Pass confidently.Medstudy.com/CurbsidersCURB15 for 15% offSponsor: FIGSWe've teamed up with FIGS, and now Curbsiders listeners can get 15% off at Wearfigs.com with code FIGSRX. Sponsor: QuinceRight now, go to Quince.com/curb for free shipping and 365-day returns. Sponsor: A Dangerous DiagnosisTo get 20% off use DIAGNOSIS20 at www.penguinrandomhouse.com/books/808848/a-dangerous-diagnosis-by-shantanu-rai/paperback/

In this Mini Mikkipedia episode, Mikki breaks down the rapidly growing world of obesity pharmacotherapy, focusing on GLP-1 receptor agonists like semaglutide and the newer dual GLP-1/GIP drugs such as tirzepatide. With more people beginning these medications, understanding how they work—and how to use them effectively—has never been more important. Mikki explains the biology behind appetite regulation, the clinical trial data showing significant weight loss, and why these drugs are best viewed as long-term treatments rather than short courses. The episode also dives into the practical realities many people face once they start therapy: managing common gastrointestinal side effects, protecting muscle and bone during weight loss, and setting realistic expectations about outcomes. Whether you're considering these medications yourself or supporting someone who is, this episode provides a clear, science-based guide to navigating the experience.Highlights:How GLP-1 and GLP-1/GIP medications regulate appetite and metabolismClinical trial results: expected weight loss with semaglutide vs tirzepatideWhy weight regain often occurs after stopping the drugsPractical strategies to manage nausea, constipation, and other GI side effectsProtecting muscle and bone with protein intake and resistance training Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwillidenNZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nzSave 20% on all Nuzest Products WORLDWIDE with the code MIKKI at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comCurranz supplement: MIKKI saves you 25% at www.curranz.co.nz or www.curranz.co.uk off your first order

Short Bio: Ashley Koff, RD, is the USA Today bestselling author of Your Best Shot (HarperOne), founder of The Better Nutrition Program (BNP), and a pioneering voice behind the emerging weight health movement. A practitioner and thought-leader with more than 25 years of experience, Ashley has helped redefine how we approach weight, shifting the conversation from weight loss to weight health, a science-based framework focused on metabolic function, hormonal regulation, and sustainable outcomes. Through her work with patients, clinicians, leading brands and companies, and health organizations, Ashley has developed practical systems that translate complex nutrition science into personalized strategies people can actually implement. A trusted expert featured across major media and a sought-after educator for health professionals, Ashley has been recognized as one of CNN's Top 100 Health Makers and named “Hollywood's Leading Dietitian” by InStyle. Through her clinical work, educational programs, and writing, Ashley continues to lead a growing movement toward better, not perfect, nutrition that supports long-term metabolic and weight health. Long Bio: Ashley Koff, RD, is the USA Today bestselling author of Your Best Shot (HarperOne), founder of The Better Nutrition Program (BNP), and a pioneering voice behind the emerging weight health movement. A practitioner and thought-leader with more than 25 years of experience, Ashley has helped redefine how we approach weight, shifting the conversation from weight loss to weight health, a science-based framework focused on metabolic function, hormonal regulation, and sustainable outcomes. Through her work with patients, clinicians, leading brands and companies, and health organizations, Ashley has developed practical systems that translate complex nutrition science into personalized strategies people can actually implement. In Your Best Shot, Ashley introduces the concept of weight-health hormones, GLP-1, GIP, CCK, and PYY, as key regulators of weight health. The book presents the first functional assessment framework for these hormones along with a personalized optimization approach designed to support weight health whether using GLP-1 medications or not (“shot or not”). A trusted expert featured across major media and a sought-after educator for health professionals, Ashley has been recognized as one of CNN's Top 100 Health Makers and named “Hollywood's Leading Dietitian” by InStyle. Through her clinical work, educational programs, and writing, Ashley continues to lead a growing movement toward better, not perfect, nutrition that supports long-term metabolic and weight health. Links: Connect with Ashley on The Better Nutrition Program, Instagram, LinkedIn, and buy her book Your Best Shot

Wat is vogelen eigenlijk ontzettend moeilijk! Gip heeft dan misschien wel 250 soorten op zijn Nederlandse lijst staan, dat krijg je als je autoles krijgt van Max Verstappen in een Ferarri, dat gaat snel. (flashback aflevering #01) Gelukkig begint hij na vijf jaar niet helemaal bij nul, maar vogels in vlucht herkennen blijft rete lastig. Maar goed, we wisten waar we aan begonnen en de lol zit er flink in. De Biesbosch een gouden greep, want de lijst is flink gespekt. Welke soorten er precies bijgeschreven konden worden hoor je in deze aflevering. Partnerships:Vogelbescherming Nederland - Wil je een gratis magazine uit de aflevering? Ga dan naar vogelbescherming.nl/tijdschrift en meld je aan.SNP Natuurreizen - Wil je mee met Arjan en Gip naar Cyprus in september. Wees er dan snel bij. Ga naar SNP CyprusDwaalgasten - Lid worden van de leukste vogelcommunity van Nederland? Word lid van de dwaalgasten via Petje AfLuistervinken - Wil je niks missen van Gip's Big Year? Luister dan ook de extra afleveringen via Petje AfZie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

Today, I had the honor of connecting with Ashley Koff. She is a leading voice in personalized nutrition and the founder of the Better Nutrition Program. With over 25 years of experience and the groundbreaking GLP-1 Optimization System to her name, she's helped redefine how we approach sustainable weight health. In our conversation, we dive into how her book reframes the concept of healthy weight. We explore integrative perspectives on digestive health and GLP-1s, why many women blame themselves when they struggle to lose weight, and how Ashley's framework helps them remove that self-blame. We also discuss issues surrounding info-besity and the “less is more” approach, natural ways to support appetite regulation and satiety signaling, key areas of digestive health, and the importance of detoxification. Ashley also shares the red flags she sees in women who are undernourishing themselves or over-fasting, things to consider when you want to stop taking GLP-1s, and her opinions on new drug therapies. Join us for today's thought-provoking and insightful conversation around metabolic health and weight-loss resistance for women in middle age, perimenopause, and menopause. IN THIS EPISODE, YOU WILL LEARN: The interconnection that exists between digestion, hormones, and metabolic signaling How the hormonal fluctuation that occurs in perimenopause disrupts women's digestion What drives satiety?  How GLP-1 medications simply amplify, extend, or mimic an existing communication loop within the body rather than creating new pathways Why do women blame themselves when they cannot lose weight? How info-besity blocks the body from doing what it is naturally designed to do  Why detoxification is essential for supporting natural digestive and metabolic processes The red flags that indicate undernourishment or over-fasting in women What you need to think about before stopping GLP-1s Bio: Ashley Koff, RD, is the USA Today bestselling author of⁠ Your Best Shot⁠ (HarperOne) and founder of⁠ The Better Nutrition Program⁠ (BNP). An acclaimed weight-health expert and practitioner for more than 25 years, Koff is leading a transformative movement in personalized nutrition, turning “better, not perfect” choices into practical, sustainable strategies that deliver real outcomes. Your Best Shot introduces weight-health hormones (GLP-1, GIP, CCK, PYY) as the regulators of weight health, offering the first-ever assessment of their function and a personalized optimization system—shot or not. A trusted expert featured across major media and a sought-after educator for health professionals, Ashley has been recognized as one of CNN's Top 100 Health Makers and featured in InStyle as “Hollywood's Leading Dietitian.” Connect with Cynthia Thurlow   Follow on ⁠X⁠, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia's ⁠website⁠ Submit your questions to ⁠support@cynthiathurlow.com⁠ Join other like-minded women in a supportive, nurturing community:⁠ The Midlife Pause/Cynthia Thurlow⁠  Cynthia's⁠ Menopause Gut Book⁠ is on presale now! Cynthia's⁠ Intermittent Fasting Transformation⁠ Book ⁠The Midlife Pause Supplement Line⁠ Connect with Ashley Koff ⁠The Better Nutrition Program⁠  On ⁠Instagram⁠ and⁠ Substack⁠ On other social media: @Ashley Koff

Send a textSpeaking of Women's Health Podcast host Holly Thacker, MD sat down with Cleveland Clinic internist and executive health physician Richard Cartabuke, MD to map out how a single, coordinated visit can compress a month of care—advanced labs, imaging and expert consults—into a focused plan you can actually use. From there, they go deeper: why direct genetic testing beats ancestry kits for medical decisions, how proteomics and multiomics translate your biology into priorities and where whole genome sequencing is headed as targeted therapies arrive.Data is only useful if it drives daily choices, in the interview learn how to turn complex readouts into simple steps: strength training, protein-forward meals, sleep regularity, blood pressure control and stress habits that lower cortisol. On the therapeutic front, they explore GLP‑1 and GIP agonists beyond weight loss—microdosing schedules, inflammation reduction and organ benefits—plus practical ways to access legitimate medication through manufacturer programs and avoid risky compounding. They wrap up the interview with a clear takeaway: start earlier than you think, build a baseline you can track and use precision tools to focus effort where it matters most.Support the show

Spontaan vertrekt Gip in de middag richting OVP waar Arjan een excursie heeft geleid. Het kwam even zo uit, dus niet tot in de puntjes uitgedacht zoals een vogelaar met een missie zou moeten doen... Maar tja in de Oostvaardersplassen is vast genoeg te zien om aan de nu al befaamde lijst van Gip's Big Year (GBY) toe te voegen. En ja hoor. We zijn nog maar 100 meter onderweg of het is al raak. Maar er wordt er ook eentje gemist. Later in de Petje af aflevering komt Gip er wel op terug en kan alsnog de rover op zn lijst aanvinken.Partnerships:Vogelbescherming Nederland - Wil je een gratis magazine uit de aflevering? Ga dan naar vogelbescherming.nl/tijdschrift en meld je aan.Vivara - Meer vogels in je tuin? Koop dan nu vogelvoer en vogelhuisjes van onze eigen vogelspotcastlijn en voor je het weet zit je tuin vol vogels. Check vivara.nl/vogelspotcast voor het assortimentSNP - Wil je mee met Arjan en Gip naar Cyprus in september. Wees er dan snel bij. Ga naar SNP CyprusDwaalgasten - Lid worden van de leukste vogelcommunity van Nederland? Word lid van de dwaalgasten via Petje AfLuistervinken - Wil je niks missen van Gip's Big Year? Luister dan ook de extra afleveringen via Petje AfZie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

What if the reason you’re not healing isn’t that you need another diagnosis? 0:08 It’s that your cells aren’t receiving the right signals. Because the body doesn’t run on diagnosis, it runs on 0:16 communication. And peptides are one of the most powerful, most misunderstood 0:21 tools we have for cellular signaling, immune balance, tissue repair, gut 0:27 lining support, metabolic control, brain signaling, sleep cycles, and even sexual 0:35 wellness. Today, I’m going to do what most people won’t. Define peptides in 0:41 plain English for you. break them into categories by what they’re best at and 0:47 tell you which ones are FDA approved on the list and which ones are commonly 0:53 used off label or investigational with the evidence that actually says these 1:00 work. This is going to be a powerful episode and if you’ve ever felt like you’re hearing hype without clarity, 1:07 this one’s for you. So, as usual, grab your cup of coffee or tea and settle in 1:13 as we talk about peptides that can fit into your healing journey. We’re going 1:19 to have a short word from our sponsor. You know, we got to do that. That’s how we stay on the air here. So, we will be 1:26 right back after this. Did you know sweating can literally heal your cells? 1:32I nfrared saunas don’t just relax you. They detox your body, balance hormones, 1:37 and boost mitochondrial energy. I’m obsessed with my health tech sauna. And 1:42 right now, you can save $500 with my code at healthtechalth.com/drmuthqen25. 1:54 All right, here we go, guys. I am excited to dive into peptides with you. 2:00 So understanding peptides is foundational, right? And I’ve been 2:06 studying peptides now for about nine years. Um, and I find that they are 2:13 incredible. Um, so I want to break down for you what peptides actually are, what 2:19 they do, and some of the top peptides that are available today, and how they 2:25 can be utilized. Because I think it’s really important. And I think it’s it’s there’s a lot of confusion out there about what these things actually are and 2:32 are they safe? Are they not? When do we use them? What’s the science behind them? So, we’re going to dive in and 2:38 we’re going to talk about all things peptides. So, let’s get ready here. Here we go. So, peptides are short chains of 2:45 amino acids and they typically range anywhere from 2 to 50 amino acids and 2:51 they’re linked by peptide bonds. So think of them as the superglue that holds the amino acids together. They sit 2:58 between the amino acids and they are full proteins in terms of their size and 3:04 their complex structure. And what makes peptides particularly interesting in 3:10 medicine is their role as signaling molecules. They’re essentially the 3:15 body’s text messages carrying specific instructions to cells and tissues. And 3:21 unlike our proteins which often serve as structural roles or act as enzymes, 3:28 peptides typically function as hormones, neurotransmitters and growth factors and 3:33 they bind to specific receptors on the cell’s surfaces or within the cells and 3:39 they trigger this effect. It’s like a cascade effect of a biochemical reaction 3:45 that ultimately changes the cellular behavior. So basically, it’s changing 3:50 the way the body’s cell structure acts. And this is why peptides can be so 3:56 incredibly powerful and therapeutic when you introduce the right peptide signal. 4:02 Now, you could theoretically redirect cellular processes toward healing, 4:07 towards metabolism, immune balance, tissue repair. Any of those things can 4:14 be manipulated to do a certain thing once we add the peptide. The challenge 4:19 in peptide medicine though lies in distinguishing between those peptides that have been rigorously studied, 4:26 proven safe and effective and approved by regulatory bodies like the FDA versus 4:31 those that exist in what we call the gray zone of a promising clinical data. 4:36 But they really lack human validation so far. And this distinction is critical because the presence of a plausible 4:43 mechanism does not guarantee safety or efficacy in living humans. So, this is 4:50 really important and we’re going to dive in and look at some of the research on all of these different peptides that are 4:56 available and I’m excited to say there’s some amazing peptides being studied right now that unfortunately are not 5:01 available. But I can’t wait to see them hit the market for us because it is going to be a gamecher as far as health 5:09 and longevity. So there is a quality control issue and there is a hidden 5:14 variable in peptide medicine with this and it’s one of the most underappreciated aspects of peptide 5:21 therapy particularly for non-FDA approved peptides. It’s quality control. 5:26 When we discuss pharmaceutical medicines, we take for granted that the pill contains what the label says. Not 5:32 always true depending on where it comes from. You guys, if you’ve heard my episodes before talk about how many of our medications are made in China and 5:41 have been contaminated with other things, you will realize that that is not always true. So, just because it has 5:48 the FDA stamp of approval on the medication, it still does not necessarily mean it’s safe and we still 5:54 need to do our homework on it. So, sorry for digressing on you guys, but you know, when we get a medication, we we 6:00 think that what the amount says is what is there, doesn’t have contaminants, it’s manufactured with good 6:06 manufacturing practices. You’ll see that listed as GMP on the bottle, and it’s been stored properly, it’s been 6:12 maintained stable, and with research peptides and compounded formulations, 6:17 none of this can be assumed. So, I will share a story with you. There was a gentleman that was purchasing these 6:24 peptides online from a research facility and um did not know that they were 6:30 coming from China and he was ordering a particular growth hormone peptide and 6:35 after a little while he had he had done fine for the few first few bottles. After a little while he started having 6:42 some complications. He started getting really irritable and angry and ragy and 6:47 he didn’t quite know what was going on. And so he decided to go get some testing done. He had some blood testing done and 6:53 his testosterone level was over 5,000. So for those of you who know what testosterone level should be for a guy, 7:00 they really shouldn’t be any higher than about 1,00200 would be absolute max that we’d want to see. Now he was taking 7:06 testosterone but not to that degree. And prior to adding this peptide, his 7:12 testosterone was very stable. What they ended up finding out was the peptide that he was getting, whoever was 7:18 manufacturing it added testosterone to the peptide. They felt like if if it had growth hormone, that was great, but if 7:25 it had growth hormone and tes testosterone, all the better. And he didn’t know that. And this is the 7:31 problem that we can have with peptides if you don’t source them properly. if you’re not working with somebody that 7:37 knows how to source them and can prove that they are what they say they are. Um, I’m sure there’s a whole bunch of 7:42 studies out there too of people getting these peptides and paying hundreds of thousands of dollars for them over their 7:48 lifetime and finding out they were nothing more than just sterile water. So, you really do need to be careful 7:53 with your quality control. Now, this kind of leads us right into the next topic that we’re going to talk about and that’s the manufacturing question, 8:00 right? The FDA approved peptides are manufactured in facilities subject to 8:05 the FDA inspection rules following our GMP regulations and these facilities 8:11 must validate their manufacturing process, demonstrate consistency batch to batch, test for purity and potency. 8:18 They need to test for bacterial endotoxins and sterility and they need to maintain detailed records. So, when a 8:25 pharmaceutical company submits a drug application, the FDA inspects the manufacturing facility as part of the 8:32 approval process. If you’re getting peptides from a different country, none of that is happening. And there are some 8:38 ways for us to determine if that is what you’re getting. Typically, the rule of thumb is if your peptides are coming 8:44 with a different colored top, every one of them has a different colored top. Those are typically being sourced out of 8:49 China. I wouldn’t say that’s 100% but that’s kind of the rule of thumb that people follow. So compoundingies these 8:56 are thearmacies that make our bio identical hormones. They can make medications in any dose or strength or 9:02 route. There are thousands of them in every not that not in every state but 9:08 there are thousands of them around the country right now. So these compoundingies are registered as 503A 9:15 facilities. They do traditional compounding for individual prescriptions, right? Like they can make 9:20 thyroid, they can make LDN, they can make estrogen. You can also have a 503b 9:27 facility, which is an outsourcing facility. And these companies produce larger batches of products. They’re they 9:34 have some oversight, but they’re less stringent than for FDA approved 9:40 manufacturers. And state boards of pharmacy regulate a 503A pharmacy. And 9:45 the FDA can inspect the 503b facility, but doesn’t preapprove any of their 9:52 compounding products. So, they can inspect it, but they don’t approve them. So, research chemicals and these 9:58 suppliers operate essentially with no oversight. They explicitly market products for research use only, not for 10:06 human consumption to avoid FDA regulation. If they put that on their 10:12 product, they don’t have to comply to what the FDA is saying. And there is no required manufacturing strategies or 10:19 standards, no required testing, no required sterility assurance, and no enforcement mechanisms if products are 10:26 mislabeled or contaminated. So basically, they don’t have the liability, but that doesn’t mean that 10:31 all of them are badies or bad suppliers. It just means they don’t have to comply 10:37 to the FDA rules. Now, there are many of these companies that I’ve seen and I’ve talked to that do do a lot of this. They 10:44 do test their product for sterility. They do test their product to make sure it is what it says it is. They don’t 10:51 have to, but they do. So, if you’re going to decide to use a company that 10:56 has research only, not for human consumption, at least ask for their 11:02 proof of testing so that you know that the product you’re getting is what it says it is and that it’s clean. Because 11:08 this is where we run into the problem is in purity. So in purity peptide 11:13 synthesis can produce not just the targeted peptide but also related 11:19 peptides with deletions, substitutions, truncations or truncations of amino 11:25 acids. Sorry. And this high performance liquid we call it uh chromatography can 11:30 separate these related impurities and quality and quantify the actual target 11:35 of the peptide content. So a certificate of analysis is what you want to ask these companies for. This shows the HPLC 11:44 the testing mechanism with greater than 95% or ideally 98% purity which 11:51 indicates a higher quality product. So this certificate of analysis can be fabricated may not represent the 11:57 specific batch being sold. It happens. We need to know not everybody is honest. Not everybody, you know, does what they 12:03 say and it does what’s right. But at least you at least they’re giving you something and you have some security. 12:10 and then choose a company that was referred to by someone else that has done some homework as well. In in 12:16 commercial research, there’s independent testing and they research peptides and this has been really shocking 12:23 variability that they’ve seen. Some products contain 50% or less of the 12:29 claimed peptide and some contained primarily degradation of the product or manufacturing impurities and some 12:36 contained bacterial endotoxins at levels that could cause fever and systemic 12:42 inflammation if it was truly injected. And I would also worry with some of those problems, you know, depending on 12:48 what impurity or bacterial endotoxin was there. If you’re using a product to boost your immune system and your immune 12:54 system is already compromised, these bacterial endotoxins can actually make you sicker instead of what you want it 13:02 to do, which is making you better. So, sterility is always an issue with anything that is manufactured, 13:08 especially things that we’re doing as an injection. Peptides are intended for injection. They must be sterile. They 13:16 must be kept safe. And pharmaceutical manufacturers conduct this sterility testing on every batch. 13:22 Compoundingarmacies should conduct sterility testing particularly for high-risisk compounded 13:28 sterile preparations and research chemical suppliers may or may not conduct any testing. So injecting 13:35 non-sterile material can cause local infections, abscesses at the injection 13:41 site and or if the bacteria enters the bloodstream could potentially be 13:46 life-threatening and you could have sepsis. Now, excuse me. We saw this 13:52 happen in a compounding pharmacy uh gosh, it’s probably been 10 years ago 13:57 now, I think. um they unfortunately had a strep uh contamination in their 14:03 product and they weren’t testing it. It was a large compounding pharmacy out of Florida and they were making products 14:08 that were being injected into the joints and um these people got very very sick 14:14 and some of them died and um some of them got very very injured by this uh 14:21 complication that happened. So it’s not like this doesn’t happen. It does, but it doesn’t happen often. And that’s what 14:28 we have to know about. And so, when we’re talking with you guys about storage and stability, it’s really 14:34 important to make sure you maintain your peptides well. So, many peptides are unstable at room temperature. They 14:41 require refrigeration or freezing. We tell everyone to make sure you’re refrigerating your peptides. That way, 14:48 there’s no question about it. when it stays cold um it prevents or slows down 14:54 the process of uh bacteria growing in it. So some of these peptides actually 14:59 degrade very rapidly in the solution and they must be reconstituted immediately before use and reconstitution of the 15:07 peptides really has limited stability often just days to weeks not months. So 15:13 improper storage, temperature, um changes during shipping or prolonged 15:19 storage of a reconstituted product can lead to degradation into inactivity or 15:25 potentially even a harmful breakdown of the product itself. So if you have a product that’s been sitting in your 15:30 refrigerator for a month or two months or 3 months or 6 months, just throw it away. It’s not going to be any good. 15:37 you’re not going to actually get the peptide and the uh potency that you’re looking for anyway out of it and the 15:44 potential of you introducing an endotoxin, a bacterial endotoxin is quite high at that point. So you just 15:50 really don’t want to take the risk, excuse me. So what practitioners, what 15:56 should we do and what should patients do? Well, for any peptide therapy, we 16:03 want to source our verification. know where the peptide product comes from. Is 16:08 it an FDA approved product? Is it a 503b compounding? A research chemical 16:14 supplier? Is there a certificate of analysis? Request and review this COA. 16:20 And you want it to show purity greater than 95% but ideally greater than 98%. 16:27 You want that identity be identity to be confirmed by mass spectromedy. Uh 16:33 sterility testing should be done. Bacterial endotoxin testing should be done. Batch number matching of the 16:39 product that you received should be done. Proper storage. You want to know that this has been refrigerated or 16:46 frozen as directed once it’s been mixed. Look at the expiration dates for reconstituting your peptides. Track that 16:53 reconstitution date and discarded accordingly like we just talked about. Monitor for your adverse effects. Even 17:01 with the perfect quality control, monitoring for adverse effects is essential with questionable quality and 17:08 vigilance is really critical here. I know it’s frustrating for a lot of patients when they have to get several 17:15 bottles and they only last a week or two. right here, you guys. This is why 17:21 they only last a short period of time because once they’re mixed, they start 17:26 to degrade and they won’t be good and you won’t get the benefit from it. So, 17:31 it’s really important with these research peptides specifically, practitioners should recognize that all 17:38 recommending products without quality assurance violates the fundamental medical principle of first do no harm. 17:45 If a patient is determined to use research peptides despite counseling, providing guidance on quality 17:52 verification, requesting those COAs, using pharmaceutical grade sources when available, proper testing, this all 17:59 reduces harm, but doesn’t constitute necessarily that recommendation. Now, 18:06 that being said, today it’s very difficult to find peptides by the compoundingies because of what the FDA 18:13 has done. So most of the peptides that are available to us have been labeled 18:18 not for human consumption, not because they’re not good products, but because 18:25 of what the FDA did. And this is how these companies have been able to 18:31 continue to provide peptides to the medical community. And if you know you 18:36 have a good company, then you’re, you know, you’re still taking the risk, right? But at the end of the day, the 18:42 reason they’re doing that is to protect themselves from the FDA, from liability. Um, so just kind of know that there is 18:50 some talk in the community with um Bobby Kennedy that this is going to change and 18:55 they are going to bring peptides back to the compounding pharmacies. Now, we don’t know which ones they’re going to 19:01 bring back. Uh, will it be all of them? Will it just be some of them? What’s going to happen here? Um, is it going to 19:07 go to the pharmaceutical companies like our GLP1s did? We don’t know what that’s going to look like quite yet. Um, but it 19:14 is coming and that is positive news. So, let’s talk now about FDA approved 19:21 peptide medications. So, this is the metabolic revolution, right? GLP1 19:28 and our dual increeting agonists. This is an exciting time. GLP-1s are amazing. 19:35 Um, a lot of people are skeptical, a lot of people love them, a lot of people hate them. Whichever side of the fence 19:42 that you’re on, I understand. But I want to talk about the science of it today 19:48 and what it actually means for people. So, the story of GLP1 glucagon like 19:54 peptide one represents one of the most significant advances in metabolic 19:59 medicine in the past several decades. GLP-1 is an accretin hormone. It’s 20:05 gutder derived peptide that potentiates insulin secretion in response to food 20:11 intake. And the body naturally produces GLP-1 in the intestinal L cells, but it 20:17 rapidly degraded by the enzyme DPP4 giving it a halflife of only about 2 20:24 minutes. So this rapid breakdown made in therapeutically impractical until 20:31 research was developed and modified the analoges that resist the enzyme degradation. So for those people who 20:39 never feel full when they’re eating, never feel satisfied when they’re done, this is because their body is either not 20:46 producing enough GLP1 or it’s not getting the signal right. And this is a 20:51 leptin issue. This is an insulin issue. It’s a GLP-1 issue. It’s a complicated 20:56 issue. This is not anything that the person is doing wrong. It’s what is happening to their body. And so GLP1s 21:03 have really revolutionized this. So one particular GLP-1 that we have is 21:09 semiglutide. And this GLP-1 agonist is what changed everything in the world of 21:16 metabolic medicine. Semiglutide is marketed as ompic for type 2 diabetes 21:23 and it’s marketed as WGOI for chronic weight management. It is a modified 21:29 GLP-1 analog with 95 or sorry 94% amino acid sequence uh homology to human 21:37 GLP-1. So it means that it’s it’s just like our own GLP-1 that we make. This 21:42 modification includes specific amino acid substitutions and the addition of C18 21:50 a fatty acid chain which allows the peptide to bind to albumin. Now this 21:56 albumin binding dramatically extends the half-life to approximately one week 22:01 enabling one weekly dosing which is a major advantage over the earlier GLP-1 22:07 agonists that require daily or twice daily injections. The mechanism by which 22:13 semiglutide works is multiaceted. At the pancreatin level, it binds to GLP-1 22:20 receptors on the pancreatic beta cells enhancing glucose depending sorry 22:27 enhancing glucose dependent insulin secretion. This glucose dependency is 22:33 crucial. It means the peptide only stimulates insulin release when blood glucose is elevated. This dramatically 22:41 reduces the hypoglycemic risk compared to insulin or even uh sulfuras. 22:47 Simultaneously semiglutide suppresses glucagon secretion from pancreatic alpha 22:53 cells further improving glycemic control. This is really amazing because 23:00 over the years when we’ve used insulin, which is also a peptide by the way, you 23:05 had to dose it just right because if you didn’t, you would produce so much insulin that it would crash the blood 23:12 sugar and then somebody would have too low of a blood sugar. They’d be hypoglycemic and they’d have to eat more 23:18 sugar and then they’d have to modify the insulin again and the person would be going up and down, up and down, up and 23:24 down all day long. And that created a lot of problems for people and so this 23:30 helps to stabilize that so it is not such an intense change. Now in the GI 23:36 tract semiglutide delays the gastric emptying particularly pronounced during 23:41 the initial weeks of therapy. This slowing of the gastric emptying contributes to the sensation of being 23:48 full and early satiety that patients often describe. However, this effect 23:54 tends to attend to weight over time as the body adapts through the appetite 24:00 suppressing effects generally persist through central mechanisms. So, when we 24:05 talk about what is actually happening, we’re slowing that digestive process down. That’s why people aren’t so 24:11 hungry. It’s why they’re not eating so much. This is why people can develop constipation with these products because 24:17 it’s slowing the body’s digestive tract down. Now some people will call this 24:22 gastroparesis. Um gastroparesis is actually different. 24:28 It is when we lose control over what’s happening in the in the colon like the 24:34 nerves and things like that just stop working. I have never seen that with the GLP1s that we prescribe in micro doing. 24:42 um it’s been documented. It can happen, but again it a lot of it is dosing and a 24:48 lot of it is staying on top of your client and what’s happening and what’s going on and what you’re doing and making sure that they do have good 24:54 motility still. So a lot of these things can be mitigated if you have problems 24:59 with them. Now one of the most profound effects of semiglutide occur in the 25:05 central nervous system. GLP-1 receptors are widely distributed in the brain 25:10 particularly in the hypothalamus and the brain stem area where we are involved in 25:15 appetite regulation. So when when wilding and colleagues published their 25:20 landmark step one trial in the New England Journal of Medicine in 2021, 25:25 they demonstrated that participants receiving 2.4 4 milligrams of semiglutide weekly achieved an average 25:32 weight loss of 14.9% of their body weight over 68 weeks. Now, I want you 25:39 guys to really understand this. We’re talking roughly 15% body weight loss 25:45 over a year, longer than a year. 52 weeks is a year, right? This is 68 25:50 weeks. So, it took longer for them to lose. We’re not talking about giving 25:55 somebody a dose to lose 15% of their body mass in a month or two. That that 26:01 is not healthy for any of us. That is not what we’re talking about doing here. Now, they compared this to placebo and 26:08 the placebo was only 2.4%. So, that is a significant difference. 26:14 And even beyond the numbers, patients reported something very qualitatively different, a reduction in what’s now 26:21 called food noise. Everybody knows what food noise is. We’ve talked about this long before GLP1. It’s that craving. 26:28 It’s that part of your brain that just keeps thinking about I want to eat something. You know, that was actually 26:34 reduced and they didn’t expect to see that happen. Now, this refers to the constant mental preoccupation with food, 26:42 the intrusive thoughts about eating, the difficulty in feeling satisfied. Semi-glutide appears to appears to 26:49 modulate reward pathways in the misolyic system reducing hedonic eating and food 26:57 cravings. Now there are also great cardiovascular effects of semiglutide 27:02 that extend beyond weight loss. Uh the sustained six and select trials 27:07 demonstrated significant reductions in major adverse cardiovascular events uh 27:14 mace in high-risisk populations. The select trial published in 2023 showed 27:20 that semiglutide reduced cardiovascular death, non-fatal myioardial inffection 27:25 and non-fatal stroke by 20% in adults with overweight or obesity and 27:31 established cardiovascular disease but without diabetes. So this suggests that 27:37 mechanisms beyond glucose control and weight loss possibly including 27:42 anti-inflammatory effects, improvements in endothelial function and favorable 27:47 changes to lipid profiles. Now I will tell you the clients that I work with that are on GLP1, 27:53 they will tell you that their inflammation has been significantly reduced. We are also seeing really 28:00 amazing results in lipid profiles. um part of its weight loss, but there is a 28:06 component to this that is lowering the triglyceride levels because it’s related to sugar and how the body’s processing 28:11 it. And we’re seeing better profiles, less need for statins as a result of 28:17 that. If if you want to listen to my episode on statins, I have one on that. Uh they are not my favorite medication. 28:24 I think it’s overprescribed and overused um and not really affecting or 28:29 addressing the problem. So these things can really be helpful. There’s also some 28:34 uh ramblings going on with GLP-1s saying that they may be able to help with 28:40 addiction in the future because of where they’re finding it affecting the brain and how it affects the food noise and 28:47 the cravings that we have for food and the addiction for food. Could it potentially help with other addictions 28:53 down the road? We’ll have to wait and see on that one. So semiglutide’s FDA prescribing information also includes a 29:00 box uh boxed warning about thyroid sea cell tumors. So in rodent studies 29:06 semiglutide caused dose dependent and treatment duration dependent sea cell 29:12 tumors at clinically relevant exposures. So while it’s unknown whether or not 29:17 semiglutide causes uh thyroid cancer tumors in humans and the rodent thyroid biology 29:26 differs significantly from humans, the drug is contraindicated in patients with a personal or family history of 29:33 medillary thyroid carcinoma or in patients with multiple endocrine neopl neoplasia syndrome type two. it is 29:42 uh contraindicated for safety effects with that. Um I have seen endocrinologists okay GLP1s to be used 29:50 in patients who’ve had other forms of thyroid cancer just not the meillary 29:55 thyroid cancer. So there is possibility there. Now the most common side effects 30:00 are gastrointestinal. It’s nausea affects about 20 to 44% of patients 30:06 depending on the formulation with diarrhea, vomiting, constipation, abdominal pain, and also frequently 30:13 reported in clinical trials. I see this in my clinic, too, especially dose dependent. Um, and it happens early on 30:20 when you’re first starting the medication, but seems to settle out over time. The one that I would add to this 30:26 that I don’t think they have on here is an increase in acid reflux. We also see that quite often uh especially in people 30:33 who suffer with acid reflux to begin with. Now these effects are typically most 30:40 pronounced during the escalation and they like I said often improve over time 30:45 but more serious but less common adverse effects include acute pancreatitis. 30:51 The medication needs to be discontinued immediately if this is confirmed. You can see some diabetic retinopathy 30:57 complications in patients with pre-existing retinopathy and acute kidney injury. Um, this usually happens 31:05 secondarily to dehydration from the GI effects. There are some gallbladder disease um that can occur and people who 31:13 have a sensitive gallbladder will describe uh discomfort with that. I’ve 31:18 even seen some people who’ve had their gallbladder out on GLP1s at the higher doses complain of similar pain that they 31:25 used to have when their gallbladder was in. So, really important to just kind of monitor these symptoms and work closely 31:32 with somebody that understands them and can be on top of them quite quickly if this happens. Excuse me. From an 31:39 integrative medicine perspective, semiglutide really represents a powerful tool, but it’s not a standalone 31:46 solution. Remember, the medication addresses one aspect of the metabolic dysfunction, the signaling systems 31:53 controlling appetite and glucose homeostasis, but it doesn’t address the root cause that led to the metabolic 32:00 disease in the first place. Patients who rely solely on the medication without addressing the ultrarocessed food 32:07 consumption, the ccadian disruptions, the chronic stress, the sleep apnea, or 32:12 underlying hormonal imbalances often experience weight regain when the medication is discontinued. 32:20 The drug is also not a substitute for addressing the emotional and psychological drivers of eating 32:26 behavior, including the unresolved trauma that may manifest as emotional eating. I think this is really important 32:33 because we don’t address the trauma issue enough with clients and we need to 32:38 be looking at that. There is a huge trauma effect out there these days that is I don’t want to say leading to or 32:45 causing but it is definitely contributing to chronic illness and it’s not being talked about enough. So we 32:52 really need to be talking about this and addressing this trauma aspect. Now the next GLP that one that I want to talk 32:59 about is trespathide. This is a dual agonist. It takes center stage. It is my 33:05 favorite GLP one. Trisepatide is marketed as Mangjaro for type 2 diabetes 33:11 and Zepbound for chronic weight management and it represents the next 33:16 evolution in increantbased therapy. This is a dual agonist a 39 amino acid 33:23 synthetic peptide structurally based on the human glucose dependent insulin tropic peptide so GIP sequence but 33:31 modified to activate both the GIP receptors and the GLP1 receptors. So the 33:37 addition of the GI GIP agonism to the GLP1 agonism appears to create this 33:46 synergistic effect that goes beyond simply adding the two mechanisms together. So the GIP like GLP-1 is an 33:55 increant hormone secreted by what is called the K cells in response to nutrient intake. It enhances glucose 34:02 dependent insulin secretion but it also effects on atapost tissue metabolism 34:09 potentially improving the insulin sensitivity in fat cells and influencing 34:14 how the body stores and metabolizes fat. So some research suggests that GIP may 34:20 also have effects on energy expenditure though this remains an area of 34:26 investigation. So basically what we’re saying is this drug may actually help 34:32 people who are insulin resistant or insulin sensitive, not just somebody who 34:38 has problems with glucose control. So, this is super exciting because it opens 34:43 up the door for all of these people for decades that we’ve been trying to manage with insulin resistance and trying to 34:50 prevent diabetes and honestly most of the time have been unsuccessful 34:56 unless you can keep your diet at 50 grams of carbs or less a day, which is extremely difficult. Um, and take some 35:04 supplements that may or may not work and or take some metformin that may or may not help. this drug actually really 35:11opens that up and helps in that capacity. So there was a clinical trial 35:17 called the surmount clinical trial which demonstrated that trespathide produces 35:22 even more substantial weight loss than semiglutide. In the surerount one trial published by uh J tree I might have said 35:31 that wrong. I apologize if I slaughtered your name and colleagues in the New York England Journal of Medicine in 2022. 35:38 Participants receiving the highest dose of trespide, which is 15 milligrams, achieved an average weight loss of 20.9% 35:47 of their body weight over 72 weeks, compared to 3.1% with placebo. This 35:54 level of weight loss approaches what’s typically only seen in beriatric surgery. So, this is amazing because if 36:02 this medication works and we don’t have to do beriatric surgery, stomach stapling basically, um, oh my gosh, it’s 36:11 amazing. There are so many complications and risks that go with stomach stapling and the different procedures that they 36:17 do these days. People don’t absorb their nutrients properly. They have to do liquid nutrients. It’s very complicated. 36:24 It’s very challenging. Many of these people gain their weight back. Um, and 36:30 this procedure is not fun to go through. So, if we could change that and change 36:35 the lives of people who’ve really been struggling, it is amazing. And I will tell you that I have seen this work. I 36:42 have seen people lose 100 150 pounds on these medications over a year or two 36:50 period of time. It is definitely slower than beriatric surgery on some standpoints, but that is okay. You don’t 36:56 want that rapid weight loss. It’s not good for you. It’s not healthy for you. It doesn’t look well. You know, we want 37:03 to do this safely and effectively in the best way that we can possibly do that for you. Now, the adverse effect profile 37:10 is similar to semiglutide. It’s dominated by gastrointestinal effects. 37:15 Nausea, diarrhea, decreased appetite, vomiting, constipation. These were all commonly reported in the surmount 37:22 trials. And like semiglutide, tricepide carries a blackbox warning regarding the 37:27 thyroid sea cell tumors based on the rodent data and it shares the same contra indications in patients with a 37:34 family history of thyroid cancer and men too. So the mechanism behind why 37:40 tepatide often produces more substantial weight loss than GLP-1. The agonism 37:45 alone remains under investigation, but it may relate to the complimentary effects on the different aspects of 37:51 energy homeostasis or to GIP’s effects on atapost tissue and potentially on 37:58 central central nervous system pathways that GLP1 alone doesn’t fully address. 38:03 Now patients often report even more profound reductions in food noise with tricepide compared to GLP1 and uh sorry 38:12 GLP1 the agonists through this is anecdotal and hasn’t been regularly 38:17 quantified in quality studies. So I’ve done both uh personally and in my 38:22 practice. I really like trespide better than semiglutide. For me I had too many side effects with semiglutide. uh I had 38:30 less side effects with trespathide. I also plateaued on semiglutide which I 38:35 didn’t really care for. And with Tresepide, I haven’t plateaued and I’ve been able 38:42 to lose about 25 pounds in um a year and a half and I’ve been able to maintain 38:49 that. Um and I continued to use it because I do have a strong family history of cardiovascular disease. And 38:56 if this could help me so that I don’t follow my family lineage with cardiovascular disease, I am all for 39:03 trying to do that. I’ve watched too many of my family members suffer from this. I’ve lost my dad at a very young age. I 39:09 lost my grandfather at a young age to it. All of their brothers to this. And I don’t want to be that same person. So 39:16 that is why I chose to do that. And I think it’s really important for us to take a look at that and understand that. 39:24 Now, I know this has been a really long podcast and I don’t typically do podcasts this long. I have a whole host 39:31 of information on additional peptides. So, I’m going to break this up for you 39:36 guys and I’m going to do another episode and we’re going to pick up where we left off here with these peptides so that we 39:43 can actually start to dive into different peptides as well. So, check 39:48 out my next podcast show when we’re going to dive into the peptides that 39:54 talk about sexual wellness, immune function, and all the other cool things 39:59 that we can do with peptides. So until then, remember to like, share, and 40:04 subscribe. It really helps us get out to other people and share our information, 40:10 and join us for our next episode as we continue the talk about peptides. 40:15 Welcome to Let’s Talk Wellness Now, where we bring expert insights directly to you. Please note that the views and 40:21 information shared by our guests are their own and do not necessarily reflect those of Let’s Talk Wellness Now, its 40:28 management, or our partners. Each affiliate, sponsor, and partner is an 40:34 independent entity with its own perspectives. Today’s content is provided forformational and educational 40:40 purposes only and should not be considered specific advice, whether financial, medical, or legal. While we 40:48 strive to present accurate and useful information, we cannot guarantee its completeness or relevance to your unique 40:56 circumstances. We encourage you to consult with a qualified professional to address your 41:01 individual needs. Your use of information from this broadcast is entirely at your own risk. By continuing 41:08 to listen, you agree to indemnify and hold Let’s Talk Wellness Now and its 41:14 associates harmless from any claims or damages arising from the use of this 41:20 content. We may update this disclaimer at any time and changes will take effect 41:26 immediately upon posting or broadcast. Thank you for tuning in. We hope you 41:31 find this episode both insightful and thought-provoking. Listener discretion 41:36 is advised.The post Episode 256 – How Peptides Work, Benefits, and FDA-Approved vs Off-Label Use Explained first appeared on Let's Talk Wellness Now.

We gaan naar de Groene Jonker. En nu is dat op zichzelf niet zo bijzonder, we zijn daar immers al een aantal keer geweest met de podcast, maar het is de eerste keer dat Gip zelfstandig een locatie heeft uitgekozen. Op basis van tips van Arjan en uitgebreid onderzoek (not..) is hij met deze plek op de proppen gekomen. Z'n gedachtengang; veel water (dus eenden en ganzen) en riet. Zijn eigen hoop is dat hij minimaal 10 nieuwe soorten op z'n lijst kan bijschrijven. Arjan is kritisch: is dit wel de beste plek.. je gaat het horen!Partnerships:Vogelbescherming Nederland - Wil je een gratis magazine uit de aflevering? Ga dan naar vogelbescherming.nl/tijdschrift en meld je aan.Vivara - Meer vogels in je tuin? Koop dan nu vogelvoer en vogelhuisjes van onze eigen vogelspotcastlijn en voor je het weet zit je tuin vol vogels. Check vivara.nl/vogelspotcast voor het assortimentSNP - Wil je mee met Arjan en Gip naar Cyprus in september. Wees er dan snel bij. Ga naar SNP CyprusDwaalgasten - Lid worden van de leukste vogelcommunity van Nederland? Word lid van de dwaalgasten via Petje AfLuistervinken - Wil je niks missen van Gip's Big Year? Luister dan ook de extra afleveringen via Petje AfZie het privacybeleid op https://art19.com/privacy en de privacyverklaring van Californië op https://art19.com/privacy#do-not-sell-my-info.

This episode covers: • Microplastics Are Destroying Male Fertility and Metabolism New research is putting microplastics in a category most men still are not taking seriously: direct reproductive and hormone risk. A 2024 study detected microplastics in every human testicle examined, with polyethylene and PVC among the most common polymers. PVC is especially relevant because it's often tied to chemical additives that can disrupt endocrine signaling. The broader body of evidence points to micro- and nanoplastics crossing barriers like the blood–testis barrier, driving inflammation and oxidative stress in the testes, and showing associations with impaired sperm quality and hormone disruption. The longevity move here is reducing overall load: better water filtration, less plastic food contact, no heating food in plastic, fewer packaged foods, and taking indoor dust and air quality seriously, especially for men thinking about fertility now or hormone resilience over decades. • Sources: – Study (PubMed): https://pubmed.ncbi.nlm.nih.gov/38745431/ – Coverage: https://people.com/microplastics-in-every-human-testicle-infertility-8651215 • Fear of Aging Is Linked to Faster Biological Aging A new study ties aging anxiety to measurable acceleration in biological aging using DNA methylation clocks. People who reported more worry and negative beliefs about aging showed faster epigenetic aging signals, and the molecular differences clustered around stress and inflammatory pathways. In plain terms, chronic threat-mode thinking around aging maps onto biology that looks older on the clocks. For a longevity audience, this is a practical reminder that mental inputs affect physiological outputs. If your day-to-day mindset is constant pressure and decline narratives, that can show up downstream in stress biology and inflammatory tone. A smarter play is building a longevity framework around function, strength, purpose, and community, alongside the usual pillars like sleep, training, and metabolic health. • Source: https://medicalxpress.com/news/2026-02-older-links-health-faster-epigenetic.html • Additional source: https://www.nyu.edu/about/news-publications/news/2026/february/aging-anxiety.html • Retatrutide, the Triple-Agonist Weight-Loss Drug Pushing Bariatric-Level Results Retatrutide is a triple agonist that targets GLP-1, GIP, and glucagon receptors, and the weight-loss numbers being reported are massive. In a 68-week study in people with obesity and knee osteoarthritis, the highest dose group averaged about 28.7% body-weight loss, along with meaningful improvements in knee pain and function. This is the next phase of incretin medicine: multi-agonist drugs that can move body weight by a quarter or more. For biohackers, the performance and longevity angle is implementation: preserving lean mass through resistance training, hitting protein targets, monitoring micronutrients, and building a maintenance plan that doesn't collapse the moment the drug stops. The upside is cardiometabolic risk reduction at scale. The key is running it with structure. • Sources: – Eli Lilly release: https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-delivered-weight-loss-average – Coverage: https://nypost.com/2026/02/18/health/people-dropped-out-of-retatrutide-trial-for-losing-too-much-weight/ – Background: https://news.harvard.edu/gazette/story/2026/02/whats-next-for-glp-1s/ • AI Can Predict 130 Diseases From a Single Night of Sleep Stanford's SleepFM project shows how much long-horizon health information is encoded in sleep. Researchers trained a foundation model on roughly 585,000 hours of clinical polysomnography data from about 65,000 people. From a single night of sleep study signals, the model could estimate risk for 130 conditions, including dementia, heart attack, heart failure, chronic kidney disease, stroke, atrial fibrillation, and all-cause mortality, and it generalized across cohorts better than simple demographic baselines. The big implication is that sleep architecture and micro-patterns (stage distribution, fragmentation, breathing stability, micro-arousals) function like a dense biomarker stream for systemic aging and disease risk. Expect better sensors and more validated risk dashboards over time. Right now, this is another reason to treat sleep as a core diagnostic pillar, not just a recovery habit. • Sources: – Stanford Medicine: https://med.stanford.edu/news/all-news/2026/01/ai-sleep-disease.html – Paper (Nature Medicine): https://www.nature.com/articles/s41591-025-04133-4 • Living at High Altitude May Protect Against Diabetes by Turning Red Blood Cells Into Glucose Sinks For years, population data has suggested lower diabetes rates at higher elevations. New mechanistic work is pointing to a surprising driver: red blood cells changing how they handle glucose under low oxygen conditions. In hypoxia, red blood cells can behave like glucose sinks, pulling more sugar out of circulation and improving glucose tolerance, which may help explain the protective association seen at altitude. The downstream potential is a new class of altitude-mimetic approaches that target erythrocyte metabolism as a glucose lever, separate from appetite suppression or classic diabetes pathways. For biohackers, it expands the metabolic toolkit and reinforces that oxygen environment and blood physiology matter more than we've given them credit for. • Source: https://medicalxpress.com/news/2026-02-red-blood-cells-sugar-high.html • Dietary Supplement Regulatory Uniformity Act and the Future of Supplement Access A proposed bill is aiming to stop states from layering extra rules on dietary supplements beyond federal law, creating one national standard instead of a patchwork of state-by-state restrictions. Industry groups are supporting it as a way to reduce confusion and compliance chaos, especially as some states explore age limits or special labeling requirements for certain supplement categories. The strategic implication for biohackers is that regulation shapes access. Uniformity can stabilize availability, but it also raises the stakes of federal decisions on controversial ingredients. This is one of those policy stories that quietly determines what stays on shelves, what disappears, and how much innovation survives in the supplement space. • Sources: – NutritionInsight: https://www.nutritioninsight.com/news/npa-crn-supplements-us-fda-legislation.html – Congressional release: https://langworthy.house.gov/media/press-releases/congressman-langworthy-introduces-dietary-supplement-regulatory-uniformity-act – NutraIngredients: https://www.nutraingredients.com/Article/2026/02/05/new-bill-aims-to-end-state-supplement-regulations/ All source links are provided for direct access to the original reporting and research. New episodes every Tuesday, Thursday, Friday, and Sunday. Keywords: microplastics male fertility, microplastics testosterone decline, blood–testis barrier toxins, endocrine disruption plastics, sperm count microplastics, epigenetic age acceleration, fear of aging methylation, biological aging mindset, stress inflammation aging, retatrutide triple agonist, GLP-1 GIP glucagon weight loss, incretin drugs obesity treatment, muscle preservation on GLP-1, SleepFM AI model, sleep disease prediction, polysomnography risk scoring, dementia risk sleep data, altitude diabetes protection, hypoxia glucose metabolism, red blood cells glucose uptake, altitude mimetic therapy, Dietary Supplement Regulatory Uniformity Act, supplement regulation federal preemption, FDA supplement policy, biohacking news longevity, metabolic health optimization Thank you to our sponsors! - HeartMath | Go to https://www.heartmath.com/dave to save 15% off. - BrainTap | Go to http://braintap.com/dave to get $100 off the BrainTap Power Bundle. Resources: • Get My 2026 Biohacking Trends Report: https://daveasprey.com/2026-biohacking-trends-report/ • Dave Asprey's Latest News | Go to https://daveasprey.com/ to join Inside Track today. • Danger Coffee: https://dangercoffee.com/discount/dave15 • My Daily Supplements: SuppGrade Labs (15% Off) • Favorite Blue Light Blocking Glasses: TrueDark (15% Off) • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Join My Substack (Live Access To Podcast Recordings): https://substack.daveasprey.com/ • Upgrade Labs: https://upgradelabs.com Timestamps: 0:00 – Intro 0:19 – Story 1: Microplastics in Testicles 1:44 – Story 2: Fear of Aging Accelerates Aging 3:30 – Story 3: Retatrutide Weight Loss Drug 4:42 – Story 4: Sleep Predicts Disease Risk 6:34 – Story 5: High Altitude & Diabetes 7:57 – Story 6: Supplement Regulation Bill 9:16 – Weekly Summary 10:51 – Outro See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

What if the goal wasn't just to lose weight, but to achieve a balanced "weight health ecosystem"? In this episode, I speak with Ashley Koff about how ultra-processed foods, under-fueling, and disrupted hormones have shaped today's metabolic crisis—and why weight loss alone is the wrong goal. Ashley shares her deeply personal journey and her science-backed framework for understanding weight health, including a clear, honest conversation about GLP-1 medications and how to use them responsibly. Ashley Koff, RD, is the USA Today bestselling author of Your Best Shot (HarperOne) and founder of The Better Nutrition Program (BNP). With over twenty-five years of experience, Ashley's helped redefine how we approach sustainable, lasting weight health. In her new book, Your Best Shot, Ashley introduces weight-health hormones (GLP-1, GIP, CCK, PYY) and offers the first-ever system for assessing and optimizing these hormones, whether you're using GLP-1 medication or not. It's a game-changer for anyone who's felt stuck, blamed themselves, or been failed by traditional dieting. What you'll learn: (02:10) Why ultra-processed foods undermine satiety and metabolic health. (08:05) How dieting and under-fueling can damage digestion, hormones, and muscle. (13:40) What “weight health” means and why weight alone misses the real problem. (15:30) How GLP-1 and other incretin hormones regulate appetite, fat storage, bone, and metabolism. (17:45) Why enriched and ultra-processed foods leave the body under-resourced. (21:00) How GLP-1 medications work differently from the body's natural hormone signals. (24:10) Why fatigue, digestive issues, and muscle loss can happen on GLP-1s when dosing and nutrition aren't optimized. (30:20) Whether it's possible to come off GLP-1 medications and what sustainable success actually looks like. Love the podcast? Here's what to do: Subscribe to the podcast. Leave a review. Text a screenshot to me at 813-565-2627 and wait for a personal reply because your voice is so important to me. Want to listen to the show completely ad-free? Go to http://subscribetojj.com Click “TRY FREE” and start your ad-free journey today! When you're ready, enjoy the VIP experience for just $4.99 per month or $49.99 per year (save 17%!) Full show notes (including all links mentioned): https://jjvirgin.com/yourbestshot Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode covers: • Real Food Reset in U.S. Dietary Policy The new Dietary Guidelines for Americans 2025–2030 put real food back at the center of U.S. nutrition policy and take a direct swing at ultra processed foods, added sugar, and sugary drinks. Dave breaks down why this matters beyond personal dieting: these guidelines influence school meals, SNAP and WIC, federal feeding programs, and they shape what eventually shows up on labels and in public institutions. He also shares how biohackers can use this shift as leverage to push for better food environments in schools, workplaces, and hospitals. -Source: https://www.usda.gov/about-usda/news/press-releases/2026/01/07/kennedy-rollins-unveil-historic-reset-us-nutrition-policy-put-real-food-back-center-health • Drug Combo Extends Lifespan of Frail Old Mice by 73% A new aging study found that combining oxytocin with a compound called A5i extended the remaining lifespan of frail elderly male mice by 73%, while also improving function and tissue health. Dave explains why this is a big signal for the future of longevity medicine: stacking targeted interventions can outperform single compounds, especially when you start late in life. He also explains what to do with the idea right now: stop building random “everything stacks” and start thinking in phases, tracking outcomes, and waiting for real human combo data. -Source: https://www.futura-sciences.com/en/study-finds-drug-combo-could-slow-aging-and-increase-lifespan-by-73_23229/ • ChatGPT Health Turns Your Data Into a Health OS OpenAI launched ChatGPT Health, a dedicated health experience that lets you securely connect medical records and wellness apps like Apple Health and MyFitnessPal, so you can summarize visits, interpret labs, and prepare better questions for your doctor. Dave explains why this is a turning point for quantified self and protocol building: it reduces the friction of pulling data from five different places, and it makes pattern-finding accessible to nontechnical people. He also shares how to use it like a pro: clean inputs, smarter questions, and better doctor conversations. -Source: https://openai.com/index/introducing-chatgpt-health/ • Whole Milk Is Back in Schools The Whole Milk for Healthy Kids Act restores whole and reduced-fat milk options in schools, aligning school nutrition rules with the updated dietary guidelines that no longer treat full-fat dairy like a default villain. Dave breaks down why this matters for child healthspan: satiety and nutrient density drive behavior, learning, and metabolic stability. He also explains why this is a real-world policy experiment worth watching across school districts, and how it can open the door for bigger institutional upgrades like better protein and fewer ultra processed items. -Source: https://www.usda.gov/about-usda/news/press-releases/2026/01/14/whole-milk-back-president-trump-signs-whole-milk-healthy-kids-act • Tirzepatide Trial Targets Biological Age With Aging Clocks A registered clinical trial titled Tirzepatide to Slow Biological Aging is using multiple DNA methylation aging clocks as primary endpoints, along with functional metrics like grip strength and a 6-minute walk test. Dave explains why this is a big maturity step for longevity science: instead of assuming metabolic improvement equals slower aging, this study is measuring biological age directly, across multiple clocks, with performance outcomes. He also shares the practical lesson for biohackers: stop relying on one favorite metric and start thinking in panels, function, and durability of results. -Source: https://clinicaltrials.gov/study/NCT07220473 All source links provided for direct access to the original research and reporting. This episode is designed for biohackers, longevity seekers, and high-performance listeners who want practical strategies rooted in cutting-edge science. Host Dave Asprey translates emerging research into actionable upgrades for your biology, from metabolism and food policy to AI-driven tracking, institutional nutrition, and biological aging measurement. New episodes every Tuesday, Thursday, Friday, and Sunday. Keywords: Dietary Guidelines for Americans 2025-2030, real food policy reset, ultra processed foods policy, added sugar limits, sugary drinks guidelines, school lunch nutrition policy, SNAP WIC nutrition impact, USDA HHS dietary guidelines 2026, whole food protein guidelines, full fat dairy guidelines, oxytocin aging study, A5i lifespan extension, frail elderly mice lifespan 73 percent, combination longevity therapies, aging intervention synergy, staged longevity protocols, functional aging biomarkers, ChatGPT Health launch, OpenAI health records AI, Apple Health ChatGPT integration, MyFitnessPal ChatGPT integration, AI lab interpretation, AI doctor visit summary, quantified self AI tools, Whole Milk for Healthy Kids Act, whole milk back in schools, school dairy policy change, child satiety nutrition, school meal regulations USDA, tirzepatide biological aging trial, GLP-1 GIP longevity, epigenetic aging clocks trial, DNAmAge PhenoAge GrimAge DunedinPACE, grip strength aging endpoint, 6 minute walk aging endpoint, biological age measurement, longevity clinical trial endpoints, biohacking news update, longevity policy shifts, metabolic health upgrades Thank you to our sponsors! -BEYOND Conference 2026 | Register now at https://beyondconference.com/ -EMR-Tek | https://www.emr-tek.com/DAVE and use code DAVE for 40% off Resources: • Subscribe to my weekly newsletter: https://substack.daveasprey.com/welcome • Danger Coffee: https://dangercoffee.com/discount/dave15 • My Daily Supplements: SuppGrade Labs (15% Off) • Favorite Blue Light Blocking Glasses: TrueDark (15% Off) • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Upgrade Collective: https://www.ourupgradecollective.com • Upgrade Labs: https://upgradelabs.com • 40 Years of Zen: https://40yearsofzen.com Timestamps:0:00 - Intro0:19 - New Dietary Guidelines2:09 - Longevity Research Breakthrough3:41 - ChatGPT Health Launch5:10 - Whole Milk Returns to Schools6:29 - GLP-1 Aging Trial7:34 - Weekly Upgrade Protocol9:09 - OutroSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.