On Call with Dr. Mary Talley Bowden
Dr. Terri DeNeui, DNP, APRN, ACNP-BC, founder of Evexias [https://www.evexias.com] and a leading expert in peptide and hormone therapies, discusses regulatory challenges with peptides and the importance of clinical supervision. Insulin and GLP-1 agonists are peptides with an established role in medicine. Now we are seeing broader applications of peptides used for inflammation, autoimmune conditions, muscle preservation, sleep, and tissue repair. The FDA’s 2022 decision to remove several peptides from the compounding safety list disrupted access for patients and clinicians. This shift pushed many toward gray-market sources, often labeled “research only,” raising serious safety concerns regarding purity, potency, and sourcing. Recent enforcement actions have shut down non-compliant suppliers shipping across state lines. DeNeui emphasizes that reputable compounding pharmacies adhering to FDA-inspected facilities and good manufacturing practices remain viable in certain states, but patients should avoid unverified online vendors. Underground products lack proper testing and clinician oversight, posing risks of contamination or inconsistent dosing. Growth hormone-stimulating peptides like CJC-1295 and ipamorelin attract teenagers via social media for muscle building and performance. DeNeui strongly cautions against this. Healthy adolescents with normal growth and puberty do not need them; exogenous interference can disrupt natural hormone balance, potentially stunting growth, elevating prolactin (causing gynecomastia), or causing pituitary issues. These compounds are better suited for age-related sarcopenia, injury recovery (e.g., Lisfranc fractures under medical supervision), or immune support in adults via peptides like Thymosin Alpha-1 and BPC-157. Proper cycling and clinician guidance are essential, as peptides act briefly and require tailored protocols. GLP-1 medications demonstrate strong efficacy for obesity and type 2 diabetes but demand careful management. Compounded versions are more affordable and allow micro-dosing to minimize side effects, though muscle loss remains a concern—up to 40% of weight lost can be lean mass without adequate protein and monitoring. Adverse events, including rare severe cases like pancreatitis, underscore the need for baseline assessments and experienced providers. DeNeui favors starting with semaglutide or tirzepatide from trusted sources. Hormone replacement, particularly subcutaneous bioidentical pellets (estrogen and testosterone), offers sustained release for three to six months. Unlike synthetic options such as Premarin (derived from mare urine), bioidentical or biosimilar hormones more closely mimic the body’s molecules. Pellet hormone therapy, used since the 1930s, supports mood, libido, energy, muscle maintenance, and overall quality of life, especially as testosterone declines in women post-childbearing. Progesterone is typically taken orally and necessary when taking estrogen to protect the uterus. Individual dosing accounts for age, activity, and hormone levels; side effects like unwanted hair growth are manageable. Urine metabolite testing (e.g., DUTCH) and GI mapping provide deeper insights into hormone processing and gut health, which influences conditions like PCOS, endometriosis, and fibroids. Both peptides and hormones offer powerful tools when used responsibly under trained clinicians. They are not shortcuts for lifestyle deficits but complements to nutrition, sleep, exercise, and stress management. As regulation evolves and research advances, prioritizing safety, evidence, and personalized care will maximize benefits while minimizing risks. Professional guidance remains non-negotiable for these potent therapies. Follow Terri DeNeui on X [https://x.com/DrTerriDeNeui] and learn more with her book “Hormone Havoc [https://a.co/d/0ixk47fM].” Get full access to Dangerous Misinformation at drbowden.substack.com/subscribe [https://drbowden.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4]
41 episodios
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