The Peptide Podcast

• TB-4 vs TB-500 — Clearing Up the Confusion

  Today we’re tackling a question I hear all the time: What’s the difference between thymosin beta-4 and TB-500? These two names often get tossed around like they’re the same thing — but they’re not. I’ve touched on this before, but because it can get pretty confusing, I want to break it down in more depth today. And if you want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going. -> https://pepties.com/partners/ We’ll break down how each peptide works, the potential benefits and side effects we know about, what their half-lives look like, and why dosing often ends up being two to three times a week — even though technically you could dose daily at lower amounts.  I also want to note that we’ll talk specifically about subcutaneous use, since that’s how these peptides are most often used in practice. What is Thymosin beta-4 and TB-500?  Let’s start simple. Thymosin beta-4, or Tβ4, is the full-length natural peptide — it’s 43 amino acids long, and your body actually makes it. You’ll find it in platelets, white blood cells, and tissues all over the body. It helps with wound healing, new blood vessel growth, reducing inflammation, and keeping cells moving where they need to go. On the other hand, TB-500 is a synthetic (man-made) fragment of Tβ4 — basically, chemists figured out that a small part of the Tβ4 sequence, specifically the section that binds actin, or the 17-23 fragment, that seemed to carry a lot of the healing and regenerative activity.  The tricky part is, TB-500 isn’t always just that one fragment. Let me try to explain this very confusing concept.  Most of the time, when people say TB-500, they’re talking about the 17–23 fragment — the piece linked to actin binding and tissue repair. But full-length thymosin beta-4 can actually break down into several different active fragments, like Ac-SDKP, the 1-4 section, the 4-10 section, and even the 20–35 region — and each of those has its own unique effects on healing, inflammation, or fibrosis. Something we can discuss in another podcast.  The focus today will be on the full-length, naturally occurring 43-amino acid peptide and the common N-acetylated 17-23 fragment often referred to as TB-500. So think of it this way: Tβ4 is the whole book, TB-500 is one powerful chapter. How does thymosin beta-4 and TB-500 work? Both thymosin beta-4 and TB-500 are best known for their role in tissue repair and recovery — but the way they work isn’t identical. They both help guide cells to where they’re needed after an injury, a process called cell migration. They also help prevent or limit scar tissue, improve blood flow by encouraging angiogenesis — the growth of new blood vessels — and help settle down excessive inflammation so healing can happen. Where they start to differ is in their scope. The full-length thymosin beta-4 is like the master version. Because it’s the entire 43–amino acid chain, it has more binding sites and interacts with more pathways. That gives it a broader range of effects — it’s been studied not just for wound healing, but also for heart repair after a heart attack, corneal healing in eye injuries, nerve and brain protection after trauma, and even immune system modulation. TB-500, on the other hand, is a synthetic fragment that contains the ‘active core’ sequence responsible for actin binding. This means it still boosts cell migration and new blood vessel growth, which are huge for recovery, but it doesn’t have all the extra regulatory sections of the full Tβ4 molecule. Because of that, TB-500 tends to be seen as more targeted — very good at tissue and tendon repair, wound closure, and improving circulation, but without the same wide-ranging effects on the heart, brain, or immune system that you see with the complete Tβ4 peptide Half-Life and Dosing  Okay, let’s talk about half-life, because this confuses people all the time. Tβ4 has a short plasma half-life in humans — about one to two hours after IV dosing. That sounds super quick, right? But here’s the kicker: just because it clears from the blood doesn’t mean the effects are gone. Once it gets into tissues, it kicks off repair programs that can last for days. TB-500 hasn’t been studied as thoroughly in humans, so we don’t have published plasma half-life numbers you can point to. What we do know from animal and lab studies is that the fragment is also cleared pretty quickly, but the biological effects last much longer than the detectable levels in blood likeTβ4. That’s why protocols often use two or three injections per week rather than daily. Now, could you take either one every day? Technically, yes — especially at lower doses, and that’s actually been done in clinical research with the full-length thymosin beta-4. But in the peptide therapy world, particularly with TB-500 where we don’t have as much human data, most providers stick with two or three injections a week. It’s a sweet spot that keeps the benefits going, avoids overdoing it, and makes things easier and more affordable for patients. Let’s talk about subcutaneous dosing for TB-500 and Tβ4. Most of the time, these peptides are injected under the skin, usually in the abdomen or thigh. For TB-500, people commonly use 2–5 mg per injection, two to three times a week. The exact dose can really vary depending on what you’re using it for — tendon repair, muscle recovery, or general tissue healing. Tβ4, the full-length peptide, is similar, though sometimes the dose is a little lower because it has broader effects, including immune modulation. You might see protocols using 1–2 mg per injection, a couple times a week, or even lower daily doses for certain situations. BPC-157 is often called synergistic when used with (stacked with) peptides like TB-500 or Tβ4 because it enhances and complements their healing effects. TB-500 and Tβ4 mainly help with cell migration, tissue repair, and reducing fibrosis, which is great for muscles, tendons, and ligaments. BPC-157, on the other hand, is especially effective at protecting and repairing the gut, blood vessels, and connective tissue. When you use them together, you’re essentially covering multiple layers of healing: TB-500 or Tβ4 move cells to the injured area and support repair, while BPC-157 helps stabilize blood flow, supports angiogenesis, and promotes stronger tissue remodeling. The result is often faster, more complete recovery than using either peptide alone — that’s why people talk about them as being synergistic. What Are the Benefits of Tβ4 and TB-500 So what are people actually using these peptides for? Tβ4 has a wide range of uses when it comes to healing and recovery. It’s been studied for soft tissue repair, chronic injuries, and general recovery, and in surgical settings, some researchers and surgeons have even used it intra-operatively to help tissues heal faster and reduce scar formation. It’s also been applied post-procedure to speed recovery and calm inflammation. On the musculoskeletal side, Tβ4 shows promise for tendon and muscle repair, helping reduce fibrosis, boost new blood vessel growth, and support regeneration of muscle and  tissue. Beyond that, it’s been explored for corneal injuries, dry eye, heart ischemia, neuroprotection, and inflammation control — making it a very versatile peptide with effects across multiple systems. TB-500 is popular for tendon and ligament repair, muscle recovery, post-surgical healing, and sometimes even athletic performance support. More on inflammation… Mast cells are immune cells that release chemicals like histamine when they get activated. This can cause redness, swelling, or itchiness — the classic signs of inflammation. But this isn’t all bad. Mast cell activation actually helps start the healing process by bringing other immune cells to the area and signaling the tissue to repair itself. In a controlled way, this early activation can help resolve inflammation faster because the tissue heals properly and swelling eventually goes down. This is also why full-length Tβ4 can sometimes cause more side effects than TB-500. Tβ4 interacts directly with mast cells and other parts of the immune system, so it can trigger more of these early inflammatory responses. TB-500, being a fragment, mostly focuses on tissue repair and cell movement, so it tends to cause fewer immune-related side effects. And speaking of well-tolerated, I want to talk about potential side effects next.  Side effects tend to be mild, but people have reported injection site irritation, redness, or mild swelling. People have also reported headache, fatigue, or a “flu-like” feeling in some users. What Are My Final Thoughts? Tβ4 is the natural, full-length peptide, and it has the broadest range of effects. There’s even some human trial data supporting it, especially for things like eye and wound healing. TB-500 is a shorter, synthetic fragment — it’s more targeted, easier to produce, and widely used in peptide therapy, but it doesn’t have as much human clinical data behind it. Both peptides leave the bloodstream quickly, but their effects last longer in the body. That’s why most people dose them two to three times a week with subcutaneous injections. That said, at lower doses, they can also be taken daily if needed. Thanks for listening to The Peptide Podcast. If today’s episode resonated, share it with a friend. Until next time, be well, and as always, have a happy, healthy week.    

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• Food Anxiety and GLP-1’s

  Today we’re diving into a topic that a lot of people struggle with quietly but don’t always feel comfortable talking about: food anxiety. And if you want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Maybe you’ve felt nervous about going to a party because you weren’t sure what kind of food would be there. Or maybe you’ve found yourself planning your entire day around what you’ll eat and how to control it. Perhaps you’ve even finished a meal only to have guilt set in right away. That’s what food anxiety looks like—and you are definitely not alone. Today we’re going to talk about what food anxiety actually is, why it shows up, what you can do to calm it, and even how some of the newest medications—things like GLP-1s and dual GIP/GLP-1s—may actually help by quieting some of the mental “food noise.” What is food anxiety? At its core, food anxiety is stress or fear around eating. And the thing is, it doesn’t look the same for everyone. For one person, it might show up as constantly worrying they’ll overeat. For another, it’s that lingering guilt after eating something they feel they “shouldn’t have.” And sometimes it’s more subtle than that—like a constant hum in the background of your mind where you’re thinking about food all day, even when you’re not hungry. I often describe it like having a radio station in your brain that’s tuned into “food talk.” Sometimes it’s background noise, sometimes it’s blaring, but either way, it’s draining. And over time, that stress around eating chips away at both your mental and physical health. Why does food anxiety happen? So why does this happen in the first place? A big part of it is the culture we live in. For decades, we’ve been bombarded with messages that carbs are bad, fat is bad, sugar is the enemy—and the list keeps changing. That constant labeling of food as “good” or “bad” teaches us to feel guilty when we eat the so-called wrong thing. For others, food anxiety starts when they get a medical diagnosis. If you’ve been told you have diabetes, heart disease, or that you need to lose weight for health reasons, suddenly every single bite can feel like a math problem. You’re not just eating—you’re calculating, you’re worrying, you’re second-guessing. And then there’s the way dieting itself messes with our natural signals. When we spend years restricting, counting, and controlling, we often lose touch with our body’s hunger and fullness cues. Instead of trusting how we feel, we rely on rigid rules. And when those rules get broken, the anxiety hits hard. And finally, we can’t ignore biology. Food, especially highly processed food, lights up reward pathways in the brain. For some people, those signals are incredibly strong—stronger than for others. That means more cravings, more urges, and unfortunately, more guilt when they give in. What can you do about food anxiety behaviorally? Now, here’s the good news. There are things you can do to reduce food anxiety, and you don’t need to overhaul your entire life to start seeing changes. One of the simplest but most powerful tools is mindful eating. And I know that phrase gets thrown around a lot. But at its heart, mindful eating just means slowing down.  It means actually tasting your food, noticing the textures, and checking in with how your body feels. When you slow down enough to notice satisfaction, you’re much more likely to stop eating when you’re comfortable instead of stuffed—and that takes a lot of the stress out of the meal. Another shift that helps tremendously is dropping the “good” and “bad” food labels. Health isn’t decided by one cookie, just like it isn’t guaranteed by one salad. What matters is your overall pattern, week by week, month by month. When you start to see food as neutral—as fuel, as enjoyment, as part of life—it loosens the grip of guilt and allows you to be more flexible. And speaking of flexibility, having a loose structure around meals can be calming. Instead of rigid dieting rules, like “I can never eat after 7 p.m.,” focus on balance. A meal that has some protein, some fiber, and a little healthy fat is naturally stabilizing. It helps keep blood sugar steady, which means fewer spikes and fewer crashes. And when your body feels stable, your brain feels calmer, too. It’s also worth paying attention to your personal triggers. For some people, weekly weigh-ins, keeping a food log, or using a nutrition app can be helpful. But for others, they actually fuel the anxiety. If you notice those things making you more stressed rather than less, it’s okay to step away from them. You can still eat intentionally without logging every single bite. And while we are on the subject of personal triggers like daily or weekly weigh-ins, I want to talk about this a bit more. It’s really important to remember, your body weight naturally fluctuates from day to day. Daily weight changes are completely normal and can happen for a bunch of reasons.  Your body might hold onto water from salty foods, hormones, or just changes in hydration. What you’ve eaten recently can also temporarily add weight, and when you eat carbohydrates, your muscles store them along with water, which can make the scale go up a bit. For women, hormonal changes during the menstrual cycle can cause water retention that shows on the scale as well. On top of all that, if you’ve been exercising more, you might be building muscle even while losing fat. Because muscle is denser than fat, the scale might not move—or could even go up slightly—while your body is actually getting leaner and stronger. Because of these normal variations, seeing a slightly higher number on the scale one day can feel discouraging—even if you’re making great progress. Instead of focusing on daily fluctuations, a better approach is to look at your net overall trend over a month. Tracking the weekly or monthly average gives you a more accurate picture of real progress and helps reduce stress or obsession with the number on the scale And lastly, support makes a big difference. Whether that’s working with a dietitian, talking with a therapist, or joining a group, sometimes having someone else in your corner makes it easier to change both your habits and the way you think about food. Where medications may help: GLP-1s and dual GIP/GLP-1s Now let’s shift gears for a moment, because in the past few years, there’s been an exciting development in how we treat weight and appetite. Medications like GLP-1 receptor agonists—semaglutide is one example—and the newer dual GIP/GLP-1 agonists, like tirzepatide, have been game changers. So what do they actually do? GLP-1s mimic a natural hormone your gut makes after you eat. That hormone tells your brain, “Hey, you’re full.” It also slows down how quickly food leaves your stomach and helps keep you fuller, longer. They also cause your pancreas to release insulin when there’s too much sugar from food in your bloodstream. This lowers your blood sugar and helps your cells use glucose (sugar from the food you’ve eaten). This is helpful because extra sugar your cells don’t use for energy is stored as fat, which is why high blood sugar can cause weight gain.  The dual GIP/GLP-1s do all of that, plus they act on another hormone called GIP, GIP improves how your body uses sugar AND fat (storing less of both by breaking them down to use for energy). Now, here’s where it gets fascinating for food anxiety. People who take these medications often report that the “food noise” in their head finally quiets down. Instead of thinking about food all day, the volume on that radio station turns way down. Meals feel more manageable. A normal portion actually feels satisfying. And for many, that overwhelming urge to snack or binge just isn’t there anymore. When your hunger cues are more predictable and less intense, you don’t feel like you’re constantly fighting your own body. That alone can dramatically reduce the anxiety around eating. And by calming the physical side—the cravings, the urges—it gives you more space to work on the mental and emotional side of eating without feeling like you’re swimming upstream. Of course, these medications aren’t a magic fix. They don’t erase years of learned guilt or change the culture we live in. But they can be powerful tools, especially when paired with mindful eating practices and professional support. My Final Thoughts If you take one thing away from this episode, let it be this: food anxiety is real. It’s not about weakness or lack of willpower. It’s shaped by culture, by biology, by personal history—and it can be incredibly challenging. But there are ways to reduce it. Slowing down and being more mindful at meals, letting go of the “good food versus bad food” mindset, building flexible eating habits, and getting support are all steps in the right direction. And for some, medications like GLP-1s or dual GIP/GLP-1s can make the process easier by quieting the biological noise that drives anxiety in the first place. Thanks for listening to The Peptide Podcast. If today’s episode resonated, share it with a friend and please remember you’re not alone. Many people struggle with food anxiety, and there is nothing wrong with reaching out for help—whether that’s behavioral support, medical treatment, or both. Until next time, be well, and as always, have a happy, healthy week.  

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• Peptides for Perimenopause and Menopause Wellness

  Today we’re talking about something every woman deserves straight talk about—perimenopause and menopause and the many changes that happen as estrogen and progesterone begin to decline. If you want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Now, most of us have heard about hot flashes, but very few people explain what’s actually happening inside our bodies, why it’s happening, and what we can do to feel better. And yes, that includes some really interesting therapies like peptides. What is happening? Let’s start with the transition itself. Perimenopause is that phase leading up to menopause, which is officially defined as twelve months without a menstrual cycle. It usually starts in your 40s, though some women notice changes earlier. The reason it can feel like a rollercoaster is all about hormones.  Estrogen is our multitasker—keeping our bones strong, our skin glowing, our brains sharp, and even helping with vaginal lubrication. When estrogen dips, it’s not surprising that hot flashes, vaginal dryness, and mood swings start showing up.  Progesterone, on the other hand, is what I like to call our “chill hormone.” It helps us sleep and keeps our cycles balanced. When progesterone drops, insomnia, irritability, and mood swings can sneak in.  And let’s not forget testosterone, which fuels energy, muscle, and libido. As testosterone slowly declines, it’s no wonder sex drive can take a hit. When these three hormones are fluctuating or dropping during perimenopause, it can touch nearly every part of the body, making this phase feel intense and, at times, overwhelming. Brain fog Then there’s brain fog. You know, that feeling when you walk into a room and can’t remember why you’re there. Estrogen actually plays a big role in keeping our brain sharp by influencing neurotransmitters like acetylcholine, which manage memory and focus. When estrogen levels fall, those neurotransmitters aren’t as efficient, and poor sleep from night sweats can make brain fog even thicker.  What helps? Regular exercise, consistent sleep, omega-3s, and even brain-training games can make a difference. And peptides can play a role here too.  Nootropic peptides like Selank and Semax support neurotransmitter balance, helping with focus, memory, and mental clarity, while also helping the brain manage stress and fatigue. Weight gain Let’s talk about one of the biggest frustrations women bring up during perimenopause and menopause—weight gain. You may notice that even if you’re eating the same and moving your body the way you always have, the scale starts creeping up. This isn’t your imagination. As estrogen levels drop, metabolism slows down, muscle mass tends to decrease, and fat starts redistributing—especially around the belly. On top of that, poor sleep, more stress, and shifting insulin sensitivity can all make it harder to keep weight steady. The good news is there are ways to manage this. Resistance or strength training helps preserve and even rebuild muscle, which keeps your metabolism active. Prioritizing protein with every meal can support that muscle, too. Managing stress through mindfulness, yoga, or simply better boundaries can help with cortisol—the stress hormone that encourages belly fat storage. And paying attention to blood sugar balance, by choosing more whole foods and fewer processed carbs, can really make a difference. For some women, hormone therapy can provide extra support by improving sleep, mood, and metabolism, making it easier to maintain a healthy weight. And now, we also have GLP-1 agonists—like semaglutide—and even newer dual GIP/GLP-1 agonists, such as tirzepatide. These medications work by improving satiety, slowing digestion, balancing blood sugar, and supporting insulin sensitivity, all of which can make weight management during menopause more achievable. They’re not magic, but when combined with lifestyle changes, they can be powerful tools to help women feel more in control of their weight and overall health during this stage of life. Hair changes Hair changes are another big one. Estrogen helps keep hair thick, strong, and healthy by promoting follicle growth and prolonging the growth phase. When estrogen drops, hair can start thinning.  At the same time, shifts in androgen levels like testosterone and its potent form, DHT, can trigger hair growth in places we really don’t want it, like the chin or upper lip.  Collagen supplements, checking iron and vitamin D levels, stimulating the scalp, or even low-level laser therapy can all support healthier hair.  Peptides like GHK-Cu, a copper peptide, stimulate hair follicles by promoting cell growth, increasing blood supply, and supporting collagen production. Thymosin Beta-4, or TB-500, also helps by reducing inflammation and encouraging tissue repair, creating a better environment for hair growth. Skin changes As estrogen dips, natural moisture throughout the body also decreases. This can mean dry eyes, crepey or itchy skin, and new sensitivities popping up seemingly out of nowhere.  Support can be as simple as artificial tears, omega-3s to support tear production, gentle fragrance-free moisturizers, or running a humidifier at night.  Peptides like Epitalon reduce oxidative stress, support collagen production, and promote cellular repair, which can improve skin elasticity. BPC-157 helps reduce inflammation and supports healing, making the skin less reactive and more comfortable. Bladder issues And then there are those bladder surprises. Ever sneeze, laugh, or cough and suddenly wonder if you should’ve packed a spare pair of underwear? Dropping estrogen weakens the pelvic floor and thins the bladder lining, which can make those little “oops” moments more common.  Kegel exercises, pelvic floor physical therapy, vaginal estrogen creams, and avoiding bladder irritants like coffee or alcohol can help.  Peptides like BPC-157 support tissue healing in the bladder and pelvic area, and KPV may help calm irritation in urinary tissues. Mood changes Mood changes are another challenge. Shifts in estrogen, progesterone, and serotonin can trigger anxiety, irritability, or low mood seemingly overnight.  Things like therapy, mindfulness, regular exercise, and making sure you get enough vitamin D and magnesium can really help.  Peptides give an extra boost too. Selank is a gentle anti-anxiety peptide that won’t make you drowsy, DSIP (Delta Sleep-Inducing Peptide) helps improve deep sleep, naturally stabilizing mood, and Semax works on dopamine pathways to lift energy, focus, and motivation when you need it most. Sex drive Finally, let’s talk about something we don’t discuss enough: libido. Vaginal dryness, fatigue, and shifting hormones can all make desire dip, and this is very much physiological, not just in your head.  Lubricants, vaginal moisturizers, hormone replacement therapy, and open communication with your partner can all help.  Peptides like PT-141 (bremelanotide), work on melanocortin receptors in the brain to boost sexual desire. It’s an on-demand injection, usually taken a few hours before intimacy, and many women feel it helps restore that spark that seemed long gone, though side effects can include flushing or nausea. So here’s the big takeaway: menopause is much more than hot flashes. It’s brain, body, skin, mood, and sexual function all shifting at once. But you don’t have to just “tough it out.” From lifestyle shifts to targeted peptides, there are tools to help you feel like yourself again. And the most important thing to remember is that you are not alone. Every chin hair, every laugh-leak, every brain fog moment—you’ve got millions of women nodding right along with you. Thanks for listening to The Peptide Podcast. If today’s episode resonated, share it with a friend—because if she’s in her 40s or 50s, she’s probably going through the same changes and wondering if she’s the only one. And if you want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Until next time, be well, and as always, have a happy, healthy week.      

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• MythBusting GLP-1s: TRUTH About Weight Loss Medications

  Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Today, we’re diving into one of the most talked-about topics in health and weight loss right now: GLP-1 medications like semaglutide and the newer dual GIP/GLP-1s like tirzepatide. You’ve probably seen the headlines, scrolled past a few TikToks, or heard a friend mention it — but with all that noise comes a lot of confusion, half-truths, and flat-out myths. Today we’re breaking it all down. What’s real? What’s hype? And what do you actually need to know if you're using these medications — or thinking about it? Let’s separate science from scare tactics and get to the truth, one myth at a time. Myth #1: GLP-1s Cause Dangerous Muscle Loss The claim:  “GLP-1s cause massive muscle loss.” Truth: This is an overstatement. Some loss of lean mass is normal with any kind of weight loss — whether it’s through diet, medication, or surgery. What studies show is that with medications like semaglutide (Wegovy) and tirzepatide (Zepbound), about 20–25% of the total weight lost comes from lean mass, and the rest is fat — which is exactly what we’re targeting in obesity treatment. That 20–25% figure isn’t unique to these meds; it’s actually pretty typical in weight loss without focused resistance training or optimized protein intake. You may also hear “You’ll lose all your muscle and become frail on GLP-1s.” Truth: You won’t “lose all your muscle.” In fact, muscle loss is preventable by maintaining adequate protein intake, resistance training, and managing weight loss pace. Furthermore, many patients gain strength and mobility as excess weight comes off. And lastly, my favorite myth is “You can’t preserve muscle on GLP-1s.” Truth: That’s completely false — muscle loss isn’t inevitable on GLP-1s if you take the right approach. You can absolutely preserve muscle by making a few intentional choices: aim for enough protein each day (a good goal is around 0.8 grams per pound of body weight), include some strength or resistance training a couple times a week, and avoid losing weight too quickly. These simple steps go a long way in protecting your lean mass while still getting all the benefits of weight loss. One study on semaglutide showed that people lost an average of about 15% of their body weight, and only around 3–4% of that was lean mass. So if someone drops 30 pounds, maybe 6 to 8 of those pounds might be lean mass—not ideal, but definitely not disastrous either, and very manageable with the right lifestyle habits.  The truth is, while some lean mass loss is expected with any type of weight loss, research shows that most of the weight lost on GLP-1s is actually fat, not muscle. For example, in the STEP 1 trial, about 80% of the weight lost on semaglutide came from fat, and only about 20% from lean tissue (as we mentioned earlier).  The SURMOUNT-1 trial with tirzepatide showed similar results—significant fat loss with relatively preserved muscle, especially when paired with resistance training. And that’s important, because preserving muscle during weight loss helps protect metabolism, strength, and overall health. With good nutrition and movement, GLP-1s can lead to healthier body composition—not just a lower number on the scale. Okay, moving along to the next myth … Myth #2: GLP-1s Can Cause Blindness The truth: This myth stems from concerns about diabetic retinopathy worsening, which is tied to how quickly blood sugar drops, not to the drug itself. In the SUSTAIN-6 trial (Marso et al., NEJM, 2016), a small subset of patients with pre-existing advanced diabetic retinopathy saw transient worsening—but only in those with rapid improvements in A1c. No increased rates of blindness or new-onset retinopathy have been found in non-diabetic patients using GLP-1s for weight loss. The bottom line is that those without advanced diabetic eye disease, there’s no increased risk of blindness. Patients with diabetic retinopathy should be monitored closely—but this is about glycemic management, not a direct effect of the medication. Myth #3: GLP-1s Cause Kidney or Liver Damage The truth: This is false. In fact, GLP-1 agonists may protect kidney and liver function—especially in patients with diabetes or fatty liver disease. The most recent notable study showing kidney‑protective effects of a GLP‑1 receptor agonist is the FLOW trial, which evaluated semaglutide in people with type 2 diabetes and chronic kidney disease (CKD). This double‑blind, randomized, placebo‑controlled trial included 3,533 participants followed for a median of 3.4 years and found that semaglutide reduced the risk of major kidney‑related events—including kidney failure, substantial eGFR decline, and death from renal or cardiovascular causes—by 24% compared to placebo. A 2025 meta-analysis of multiple randomized controlled trials (11 studies, 85,373 participants) concluded that GLP‑1 receptor agonists reduced the risk of composite kidney failure outcomes by 18%, kidney failure by 16%, and all‑cause death by 12%. And let’s not forget the SMART trial, involving obese patients with kidney disease but without diabetes, found that semaglutide protected kidney function in this non‑diabetic, CKD‑affected population.  When it comes to the liver, there's actually growing evidence they’re actually helping reverse non-alcoholic fatty liver disease (NAFLD). The STEP 1 MRI substudy and SURPASS-3 MRI substudy have shown people on these medications can reduce liver fat by 30 to even 50% and in some cases, completely resolve liver inflammation — that more serious form called NASH, where fat is combined with inflammation and early scarring. The LEAN trial found that nearly 60% of people taking semaglutide had resolution of NASH, without worsening their liver scarring. That’s huge. And even better, we’re seeing these effects even in people who don’t have diabetes. Just losing weight helps fatty liver, but these meds seem to do more than that — they actually target inflammation and fat storage in the liver itself.. The bottom line is GLP-1s are not nephrotoxic or hepatotoxic. In fact, they may be organ-protective—especially for people with underlying metabolic issues. Myth #4: These Drugs Lead to Bone Loss The claim: “You’ll get osteoporosis from losing too much weight!” The truth: While extreme weight loss can affect bone density, GLP-1s themselves do not cause bone loss, and may even have neutral or protective effects on bone. A 2022 study in Bone found no significant change in BMD (bone mineral density) in adults treated with semaglutide for obesity. While the SUSTAIN and PIONEER programs found no increased risk of fractures in semaglutide-treated patients versus placebo. Truly, concerns about bone loss are more relevant in extreme calorie restriction or eating disorders—not evidence-based GLP-1 treatment with appropriate nutrition. Myth #5: Everyone Gets Gastroparesis The claim: “These medications paralyze your stomach” The truth: GLP-1s slow gastric emptying, which is part of how they work—making you feel full longer. But this is dose-dependent and typically reversible. A 2023 FDA safety review found that true gastroparesis is extremely rare and resolves when the drug is stopped. Reality check: Nausea, early satiety, and mild bloating are common but manageable side effects. True, lasting gastroparesis is not typical, especially when doses are titrated gradually. Myth #6: GLP-1s Make Your Hair Fall Out The claim: “You’ll lose a ton of hair—just like with crash diets” The truth: Hair shedding is not directly caused by GLP-1 medications. Instead, it’s often a temporary, non-scarring condition called telogen effluvium, which can happen with any rapid weight loss, regardless of the method. A 2023 analysis from the American Academy of Dermatology emphasized that telogen effluvium is common with surgical or medical weight loss, especially if patients lose more than 10% of their body weight within a few months. In clinical trials like STEP and SURMOUNT, hair loss was not listed as a common side effect, but patient-reported data show it occurs occasionally—likely tied to nutritional stress, not the drug itself. So why does hair loss happen? We’ve talked about this before, but I don’t want to leave this important information out.  Hair follicles are sensitive to internal stress. Rapid changes in caloric intake, nutrient levels (like iron, zinc, and biotin), or hormone balance can push hairs into the shedding phase. This is a delayed effect, often showing up 2–3 months after weight loss begins, and it typically resolves within 6–12 months. What helps is slower, sustained weight loss, prioritizing protein intake, supplementing iron, zinc, and biotin if deficient, and avoiding very low-calorie diets and over-restriction. Myth #6: GLP-1s Cause Dehydration It’s a common myth that GLP-1 medications cause dehydration — but that’s not exactly true. The medication itself doesn’t directly dehydrate you. What can happen is that some people experience nausea, vomiting, or a reduced appetite early on, which can lead to drinking less water without realizing it. That’s where the dehydration risk comes in. A good general rule for staying hydrated is to aim for half your body weight in ounces of water per day. So, for example, if you weigh 160 pounds, try to drink around 80 ounces daily — more if you're active or live in a hot climate. Electrolytes can also be really helpful, especially if you’re feeling tired, dizzy, or crampy. I like LMNT packets — they’re a clean option with no sugar and a good balance of sodium, magnesium, and potassium. The sodium in LMNT packets helps keep you hydrated by pulling water into your cells and helping your body retain the fluids it needs to function properly. Just one a day can make a big difference in how you feel. Myth #7: You Have to Stay on GLP-1s Forever or You’ll Gain All the Weight Back The claim: “As soon as you stop taking it, all the weight comes back” The truth: Yes—some weight regain is likely after stopping GLP-1 medications. But that doesn’t mean they’re ineffective or that you’re doomed to rebound completely. The same pattern happens after any type of weight loss intervention, whether it’s a diet, surgery, or medication. The STEP 4 trial (Wilding et al., 2022) showed that participants who stopped semaglutide after 20 weeks regained an average of 6% of their weight loss over the next year. But it’s important to note that they still weighed less than at baseline—and many continued to experience improvements in blood pressure, cholesterol, and insulin sensitivity. Similarly, in SURMOUNT-4, patients who stopped tirzepatide also regained weight, but less than they lost. So why does this weight gain happen? I feel like the answer to this is obvious, but I’ve found that it’s not.  GLP-1s change your appetite and hunger cues. Once the medication is stopped, your body’s baseline hunger signals return—and often with increased intensity, due to metabolic adaptation. But this isn’t unique to GLP-1s. The same thing happens after crash diets, keto, intermittent fasting, or bariatric surgery if long-term changes aren’t made. The real issue isn’t the drug—it’s the lack of a plan after the drug. To help make results sustainable, we need to use the medication as a tool, not a crutch. We should use it to help us lose weight and understand our hunger cues, while transitioning to a whole foods, protein based diet coupled with resistance training to help preserve and build muscle.  Just remember, if you're coming off a GLP-1 and want to keep the momentum going, the key is to approach it thoughtfully. Tapering slowly under medical supervision can help your body adjust and reduce the chances of weight regain. At the same time, this is a great moment to double down on the habits that helped you feel your best while on the medication. Think ongoing support—like working with a health coach, joining a support group, or even doing behavioral therapy—to help reinforce those long-term lifestyle changes. It’s not just about what you stop; it’s about what you keep doing that matters most. You don’t necessarily have to stay on GLP-1s forever—but if you stop without a plan, some weight regain is very likely. Think of them like glasses: they help you see clearly while you build the habits to eventually navigate without them. For some, that may mean staying on a lower maintenance dose long-term—just like with blood pressure or cholesterol meds. What are my final thoughts? I want to be clear—GLP-1s aren’t magic. But they are powerful tools when paired with education, support, and smart lifestyle changes.  Myths like ‘you’ll go blind,’ ‘you’ll lose all your hair,’ or ‘you’ll be stuck on these meds forever’ aren’t just misleading and downright false—they discourage people from getting real help.  So if you’re thinking about these medications, get informed, ask the hard questions, and make your decision based on science—not fear. Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Until next time, be well, and as always, have a happy, healthy week.

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• Beyond Blood Sugar: Metformin’s Surprising Promise

  Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Today we’re switching gears a bit to talk about a medication rather than a peptide — metformin. If you’re someone who’s interested in peptides for metabolic health or inflammation, you’ve probably heard metformin mentioned alongside them. It’s been around for decades as a diabetes medication, but recently it’s gaining attention for its potential benefits beyond blood sugar, including longevity, inflammation, and neuroprotection — even in people who don't have diabetes. Let’s get into it. Metformin and Longevity Can metformin really help us live longer? One of the biggest sparks came from a 2014 study published in Diabetes, Obesity and Metabolism, where researchers found that diabetics on metformin actually lived longer than non-diabetics not taking the medication.  The authors suggested that metformin may offer protective benefits beyond glucose control, possibly by reducing oxidative stress and slowing cellular aging. This inspired the launch of the TAME trial—short for Targeting Aging with Metformin—which is designed to test whether metformin can delay the onset of age-related diseases like cancer, cardiovascular disease, and cognitive decline. While results are still pending, it’s the first large-scale effort to study aging as a treatable condition, not just a process. Inflammation and Immunometabolism Next up: inflammation. Chronic low-grade inflammation is at the root of so many health issues—heart disease, dementia, even depression. Metformin appears to blunt systemic inflammation by activating AMPK. Think of AMPK as a metabolic master switch that lowers inflammatory signaling. A 2021 review published in Pharmacological Research found that metformin can inhibit NF-κB, a major pathway that drives inflammation. It also helped lower levels of CRP—a protein made by the liver that rises when there’s inflammation from things like infection, injury, or chronic disease—and IL-6, another immune system protein commonly elevated in chronic inflammatory conditions. Because of these anti-inflammatory effects, researchers have been exploring metformin’s potential in conditions beyond diabetes, including autoimmune diseases, multiple sclerosis (MS), PCOS, and even COVID—where it’s been linked to lower mortality in patients with diabetes. Brain Health and Neuroprotection What about the brain? Can metformin help protect against cognitive decline? There’s some promising data here too. A 2017 study in Aging Cell found that metformin improved neurogenesis in the hippocampus of aged mice—basically, helping old brains grow new neurons. In 2019 a cohort study in JAMA Network reported that people with type 2 diabetes taking metformin had a lower risk of developing dementia compared to those not taking it. Mechanisms may include reduced insulin resistance in the brain, less oxidative stress, and—again—AMPK activation, which promotes mitochondrial health and energy production. Still, human trials are mixed, and more controlled research is needed before we can call it a “smart drug.” Lower Cancer Risk So, here’s an interesting one—can metformin actually lower the risk of cancer? Well, the short answer is: maybe. People with diabetes tend to have a higher risk of developing certain types of cancer, so part of metformin’s benefit could just come from better managing blood sugar and insulin levels. But what’s really exciting is that researchers think metformin might do even more than that. There’s evidence suggesting it could have direct effects on cancer cells—like slowing down their growth or making the environment less friendly for tumors. Some studies have found lower rates of cancers like breast, colon, and prostate in people taking metformin. Now, this isn’t a magic bullet or anything, but it’s a promising area of research that’s getting a lot of attention. So metformin might be pulling double duty: managing diabetes and potentially helping reduce cancer risk through other mechanisms we’re still learning about. Metabolic Health for Non-Diabetics Now here’s where it gets controversial—should healthy people without diabetes be taking metformin? Some researchers argue yes, especially for people with metabolic syndrome, prediabetes, or high inflammation. Metformin improves insulin sensitivity, reduces liver glucose production, and may even support modest weight loss. That said, there are tradeoffs. Metformin can cause stomach-related side effects (e.g., nausea, gas, heartburn, and diarrhea) and vitamin B12 deficiency (which may lead to nerve damage). It can also cause extreme fatigue.  Metformin may sometimes cause sexual side effects, like erectile dysfunction in men. Some studies suggest it might lower testosterone, which we know is important for male sexual health. But interestingly, other research points to metformin actually improving blood flow to the penis, which could help with erectile issues. So, it’s a bit of a mixed picture—and it really depends on the individual. And although rare, it can cause lactic acidosis (a life threatening condition where lactic acid builds up in the blood) in older adults, people with advanced kidney disease, or those who drink excessive amounts of alcohol. So it’s not a free pass.  So what are my final thoughts and who should you take metformin for longevity? Metformin isn’t a one-size-fits-all solution, and it’s definitely not something to start just because you heard about it on a podcast. We still need more research—especially in people without diabetes—to really understand who benefits most. But it might make sense for some people, like those with prediabetes, PCOS, metabolic syndrome, or even older adults looking to support healthy aging.  As always, it’s something to talk through with your healthcare provider.  The science is exciting, but it’s all about finding what makes sense for you. Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  Until next time, be well, and as always, have a happy, healthy week.

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