October 7, 2024 • 2hr 29min
Dr. Craig Koniver: Peptide & Hormone Therapies for Health, Performance & Longevity
Huberman Lab
Key Takeaways
- Peptides are chains of amino acids (40 or fewer) that can have powerful effects on health and performance when used therapeutically
- GLP-1 agonists like semaglutide (Ozempic) and tirzepatide are effective for weight loss but may cause muscle loss if not combined with resistance training
- BPC-157 is a potent anti-inflammatory peptide that can aid recovery and healing, especially for tendons and ligaments
- Growth hormone secretagogues like ipamorelin, tesamorelin and hexarelin can improve sleep, recovery, and body composition when used properly
- NAD+ infusions or injections can have profound effects on energy, cognition, and overall health according to Dr. Koniver's clinical experience
- Methylene blue may enhance mitochondrial function and cognitive performance when used at appropriate doses
- Working with a knowledgeable physician is crucial for safe and effective use of peptides and other advanced therapies
- The FDA has recently banned several peptides from being compounded, limiting access to previously available treatments
- Maintaining a positive mindset is one of the most powerful ways to impact overall health and wellbeing
Introduction
In this episode, Dr. Andrew Huberman interviews Dr. Craig Koniver, a board-certified physician with extensive experience in using peptides and other advanced therapies to optimize health and performance. They discuss the science behind various peptides, their potential benefits and risks, proper dosing and administration, and Dr. Koniver's clinical observations from treating thousands of patients.
The conversation covers popular peptides like BPC-157 and growth hormone secretagogues, as well as other compounds like NAD+ and methylene blue. They also explore broader topics like working with compounding pharmacies, recent FDA regulations on peptides, and the importance of mindset in health.
Topics Discussed
What Are Peptides and How Are They Used? (7:40)
- Peptides are chains of 40 or fewer amino acids
- The body naturally produces around 300,000 peptides
- Therapeutically, about 150 peptides are currently being used
- Peptides can have powerful effects on various biological processes
GLP-1 Agonists for Weight Loss (9:37)
- Semaglutide (Ozempic) and tirzepatide are highly effective for weight loss
- Originally developed for diabetes, now widely used for obesity
- Microdosing these peptides can reduce side effects and muscle loss
- Dr. Koniver: "If I can help people lose weight first...they're now excited. I met with a client yesterday here in Los Angeles, and she literally looked at me and said, you've changed my life."
BPC-157: A Potent Anti-Inflammatory Peptide (18:43)
- BPC-157 is highly anti-inflammatory and aids in recovery
- Effective for reducing joint pain, stiffness, and inflammation
- Can be injected subcutaneously for systemic effects
- Dosage has increased over time from 500mcg to 5000mcg daily
- Often used in a protocol of 5 days on, 2 days off
Sourcing Peptides and Working with Physicians (28:43)
- Importance of working with a knowledgeable physician for peptide therapies
- Risks of obtaining peptides from unregulated sources
- Compounding pharmacies are regulated and can ensure purity
- Dr. Koniver: "Having a physician who's knowledgeable to me is super helpful. The challenge for people is they don't know where to get the right information."
Growth Hormone Secretagogues (46:35)
- Peptides like ipamorelin, GHRP-6, and tesamorelin can stimulate growth hormone release
- Can improve sleep, recovery, and body composition
- Different peptides have varying "flavors" of effects
- Typical dosage is 100mcg before bed, without carbohydrates for 2 hours prior
- Dr. Koniver often stacks multiple peptides for synergistic effects
Coenzyme Q10 and Mitochondrial Health (1:01:54)
- CoQ10 supports mitochondrial function at cytochrome 3
- Dr. Koniver recommends 200mg daily, taken in the morning
- Can be safely used at doses up to 2400mg per day
- May help with migraines and overall energy production
The Importance of Trust in Healthcare (1:05:16)
- Many patients don't trust or follow their doctor's recommendations
- Building trust and educating patients is crucial
- Dr. Koniver emphasizes helping patients feel better first
- Patients need to value themselves to make positive health changes
Peptides for Sleep: Pinealon and Epitalon (1:24:47)
- Pinealon can significantly increase REM sleep
- May help regenerate pinealocytes in the pineal gland
- Often combined with glycine for enhanced effects
- Epitalon (now banned by FDA) was used for circadian rhythm and DNA repair
Glycine for Sleep and Detoxification (1:31:03)
- Glycine is an inhibitory neurotransmitter that can improve sleep
- Supports phase 2 liver detoxification
- Typical dosage starts at 3-5 grams before bed, can increase to 10 grams
- Dr. Koniver: "Glycine is one of the best [for liver detoxification]."
NAD+ Infusions and Supplements (1:50:20)
- NAD+ infusions can have profound effects on energy and cognition
- Dr. Koniver uses a protocol of 750mg IV infusions
- Maintenance dose is typically once per month
- Subcutaneous injections of 100mg can be used between infusions
- NMN or NR supplements may provide some benefits orally
- Dr. Koniver: "If I had to pick one thing for people engaging in, NAD would be it."
Methylene Blue for Cognitive Enhancement (1:44:17)
- Methylene blue can support mitochondrial function
- Typical dose is 10mg taken orally in the morning
- May improve cognitive function and energy levels
- Can turn urine blue/green for up to 24 hours
FDA Regulation of Peptides (2:10:57)
- The FDA has recently banned several peptides from being compounded
- This limits access to previously available treatments
- Pharmaceutical companies may be developing patented versions
- Dr. Koniver believes the motivations are likely mixed
The Power of Positive Thinking (2:20:17)
- Dr. Koniver emphasizes the profound impact of mindset on health
- Positivity can override many other factors in wellbeing
- Helping patients find their purpose is a key part of his practice
- Dr. Koniver: "No good has ever come from a negative thought."
Conclusion
This wide-ranging conversation between Dr. Huberman and Dr. Koniver provides a comprehensive overview of the current state of peptide therapies and other advanced approaches to optimizing health and performance. While many of these treatments show promise, it's clear that working with a knowledgeable physician is crucial for safety and efficacy.
The discussion also highlights the complex landscape of medical regulation, with recent FDA actions limiting access to certain peptides even as pharmaceutical companies develop patented versions. Despite these challenges, Dr. Koniver remains optimistic about the potential for personalized, proactive approaches to healthcare that empower patients to take control of their wellbeing.
Ultimately, both doctors emphasize that while advanced therapies can be powerful tools, foundational factors like mindset, lifestyle, and finding one's purpose are equally if not more important for achieving optimal health and fulfillment.
