Dr. Craig Koniver: Peptide & Hormone Therapies for Health, Performance & Longevity

Added: Oct 8, 2024

The Rise of Peptide Therapies in Performance Medicine

Dr. Koniver begins by discussing the peptide therapies, which are increasingly recognized for their potential to enhance both mental and physical health. Peptides, which are small proteins composed of amino acids, are naturally produced by the body, but only a select few are utilized for therapeutic purposes.

One of the most notable peptide therapies highlighted by Dr. Koniver is GLP-1 agonists, such as semaglutide. Initially approved for managing type 2 diabetes, these medications have gained attention for their side effect of promoting weight loss, leading to their off-label use for obesity. The rapid increase in prescriptions has sparked a debate regarding their efficacy versus concerns about dependency and high costs.

Dr. Koniver emphasizes that while lifestyle changes, including diet and exercise, are essential, these medications can significantly aid individuals struggling with weight management. He notes that weight loss often leads to improvements in overall well-being, including cognitive function and reduced inflammation levels.

Addressing Muscle Loss with GLP-1 Agonists

A critical concern associated with GLP-1 agonists is muscle loss, which can occur when weight is lost too quickly. Dr. Koniver suggests that this issue can be mitigated through resistance training and careful dosage management. He advocates for a microdosing approach to promote gradual weight loss, which helps preserve lean body mass. His clinical observations indicate that a controlled weight loss strategy can prevent muscle loss, enhancing the overall effectiveness of the treatment.

BPC-157: Healing and Recovery

Another peptide discussed is BPC-157, known for its anti-inflammatory properties and potential to aid in injury recovery. Although clinical research on humans is limited, Dr. Koniver shares his clinical experiences, noting its effectiveness in reducing inflammation and promoting healing in various conditions, including post-viral symptoms and musculoskeletal injuries. BPC-157 can be administered orally or through injection, with the latter often yielding better systemic effects. Interestingly, Dr. Koniver mentions that injecting BPC-157 can provide benefits even for injuries located far from the injection site, suggesting a systemic healing effect.

Regulatory Challenges and Sourcing Peptides

Dr. Koniver addresses the recent FDA restrictions on BPC-157 and other peptides, which have been categorized as no longer allowable for compounding pharmacies. This has raised concerns about sourcing clean and effective peptides, as many individuals may turn to gray and black market sources that do not adhere to safety standards. He emphasizes the importance of obtaining peptides from reputable compounding pharmacies, which are regulated to ensure the purity and safety of their products. The dangers of using unregulated sources, including potential contamination with harmful substances, are significant concerns.

Anabolic Steroids and Testosterone Therapies

The conversation also touches on anabolic steroids and testosterone therapies. Dr. Koniver notes that while testosterone can be beneficial for certain individuals, particularly older adults, there is a growing trend of younger males using synthetic testosterone without medical supervision. This can lead to significant health issues, including infertility. He stresses the importance of working with knowledgeable physicians to navigate these therapies safely and effectively.

Growth Hormone Secretagogues: Enhancing Vitality

Dr. Koniver discusses growth hormone secretagogues, particularly ipamorelin and GHRP-6, which stimulate the release of the body’s own growth hormone rather than providing exogenous growth hormone. Ipamorelin is preferred for its minimal side effects and effectiveness in improving sleep quality and overall vitality without significantly increasing appetite. In contrast, GHRP-6 can stimulate appetite, which may not be desirable for everyone.

He also mentions other growth hormone secretagogues, including tesamorelin and sermorelin. Tesamorelin is noted for its effectiveness in reducing visceral fat, particularly in patients with lipodystrophy. Dr. Koniver explains that these peptides can be stacked together for enhanced effects, allowing for a single injection that combines multiple benefits, optimizing results such as fat loss and improved recovery.

The Role of Coenzyme Q10 in Health

Coenzyme Q10 (CoQ10) is another compound discussed by Dr. Koniver, who takes it daily for its benefits on mitochondrial health. He explains that mitochondria play a crucial role in energy production, and CoQ10 supports this process by facilitating electron transport within the mitochondria. Maintaining mitochondrial function is essential for overall health and energy levels, and CoQ10 is safe at high doses, making it particularly beneficial for individuals experiencing migraines.

Building Trust in the Medical Profession

Dr. Koniver reflects on the importance of trust in the medical profession, especially in light of the pandemic. Many patients have lost faith in traditional medical practices, making effective communication and personalized care essential for rebuilding that trust. He emphasizes that many prescriptions are written off-label, which can lead to confusion and mistrust among patients. Advocating for a holistic approach to health, he believes in empowering patients with the tools and knowledge to take charge of their health.

MK-677: Appetite Stimulation and Caution

MK-677, also known as ibutamoren, is highlighted as an orally bioavailable growth hormone secretagogue that stimulates appetite, similar to GHRP-6. While it can be beneficial for certain individuals, particularly older adults struggling to gain muscle mass, it may also lead to increased cortisol and prolactin levels, which can be undesirable for many. Dr. Koniver shares a personal anecdote about his experience with MK-677, noting that it significantly increased his appetite, especially when taken before bed, which disrupted his sleep.

Hexarelin and Dosing Considerations

Hexarelin is presented as another growth hormone secretagogue that does not stimulate appetite. Dr. Koniver describes it as providing clean energy and enhancing endurance, making it suitable for athletes. He typically prescribes a dosage of 100 micrograms, taken in the morning, and notes that it can be compounded with CJC 1295, although the latter has been removed from the FDA-approved list.

Methylated B Vitamins and Cardiovascular Health

The discussion shifts to methylated B vitamins, particularly concerning the MTHFR gene mutation, which affects the body’s ability to process folate and B12. Elevated homocysteine levels, a marker for cardiovascular risk, can be mitigated by taking methylated forms of these vitamins. Dr. Koniver recommends methyl B12, methyl folate, and trimethylglycine as effective supplements to lower homocysteine levels and improve metabolic function. He suggests that individuals should consider taking these vitamins in the morning, but they can also be beneficial if taken later in the day to combat afternoon slumps.

Peptides for Sleep: Pinealon and Epitalon

Dr. Koniver discusses the use of peptides like Pinealon and Epitalon for improving sleep quality, particularly REM sleep. Pinealon, a small peptide, has shown remarkable effects in increasing REM sleep duration and enhancing overall sleep quality. He notes that it may stimulate the pineal gland, responsible for melatonin production. The combination of Pinealon with glycine is highlighted as particularly effective, with glycine serving as an inhibitory neurotransmitter that helps calm the nervous system.

Glycine and Liver Detoxification

Glycine is discussed as a beneficial amino acid for liver detoxification and sleep enhancement. Dr. Koniver recommends a dosage of 3,000 to 5,000 milligrams at bedtime, which can be increased to 10 grams for those who do not notice effects at lower doses. Glycine aids in phase 2 liver detoxification, helping the body process and eliminate toxins more effectively. Supporting liver function is crucial in a world filled with environmental toxins.

GLP-1 and Compounding Pharmacies

The conversation touches on GLP-1 agonists, which are FDA-approved for weight management and metabolic health. Dr. Koniver expresses concern that pharmaceutical companies may restrict access to compounded versions of these peptides, which are often more affordable. He explains that compounding pharmacies can provide personalized dosages and formulations that are not available through traditional pharmaceutical channels. The potential for increased costs and reduced access to these therapies is a significant concern for patients seeking effective treatments.

Stem Cell Therapy and PRP

The podcast also touches on the potential of stem cell therapy and platelet-rich plasma (PRP) in regenerative medicine. These therapies harness the body’s natural healing processes to promote recovery in various conditions, particularly musculoskeletal injuries. However, the specifics of their mechanisms and efficacy are still under investigation.

Thymosin Alpha-1 and Brain Health

Thymosin Alpha-1 is highlighted as a peptide with significant immune-modulating properties. It has been used to manage autoimmune diseases by downregulating the immune response and has shown promise in treating post-viral syndromes, including long COVID. The typical dosage mentioned is 5,000 micrograms per day, often administered intravenously. Cerebrolysin, another compound discussed, is noted for its use in brain health, particularly in post-stroke recovery and traumatic brain injury, although it can cause mood shifts in some patients.

Methylene Blue and Cognitive Function

Methylene blue is introduced as a compound that has gained attention for its cognitive-enhancing effects. It improves mitochondrial function by binding to cytochrome C oxidase, enhancing oxygen utilization in the body. Methylene blue can also act as a mild MAOI (monoamine oxidase inhibitor), potentially increasing serotonin levels. The typical oral dosage is around 10 milligrams, and it can turn urine blue, indicating its absorption and utilization.

NAD Infusion and Nutritional Deficiencies

Dr. Koniver shares his clinical experiences with NAD (Nicotinamide Adenine Dinucleotide) infusions, particularly in the context of COVID-19. He notes that NAD infusions can lead to rapid improvements in symptoms, with patients often feeling significantly better after treatment. The typical loading dose is 750 milligrams, administered intravenously over a short period. He also discusses NMN (Nicotinamide Mononucleotide) and NR (Nicotinamide Riboside) supplements, which are precursors to NAD. While NMN is preferred over NR for its efficacy, both are seen as beneficial for supporting mitochondrial function and overall health.

PT-141 and Libido Enhancement

PT-141 (Bremelanotide) is discussed as a peptide used to enhance libido in both men and women. It works through a neurogenic mechanism rather than just increasing blood flow, making it effective for conditions like erectile dysfunction. However, it has a narrow therapeutic window, and excessive dosing can lead to nausea, a common side effect. The brand name Vyleesi is mentioned as a commercial product derived from PT-141, specifically for female sexual dysfunction.

Regulatory Landscape and Pharmaceutical Influence

The podcast delves into the regulatory landscape surrounding peptides and other compounds. Dr. Koniver expresses concern over the FDA's recent actions to remove certain peptides from the market, suggesting that while there may be good intentions behind these decisions, they often overreach. Many beneficial peptides are being restricted, potentially to pave the way for pharmaceutical companies to develop proprietary versions that can be sold at high profit margins. This raises questions about the balance between safety, accessibility, and the influence of the pharmaceutical industry on healthcare practices.

The Power of Positivity and Mindset

In a segment focused on mindset, Dr. Koniver emphasizes the profound impact that a positive outlook can have on overall well-being. He explains how thoughts and beliefs shape reality, suggesting that cultivating positivity can lead to better health outcomes. Negative self-talk can lead to stress and anxiety, adversely affecting physical health. By reframing negative thoughts and replacing them with positive affirmations, individuals can foster a healthier mental state. He also highlights the role of gratitude in promoting positivity, encouraging practices such as keeping a gratitude journal.