WEBVTT 1 00:00:02.000 --> 00:00:06.120 Welcome to the Wellness Transcription Podcast. I'm your host, doctor Patrick Gurley. 2 00:00:06.400 --> 00:00:09.759 Are you guys ready to grow together in our understanding of all things health and 3 00:00:09.759 --> 00:00:13.800 wellness? If so, you found the right podcast for you. Each week, 4 00:00:13.839 --> 00:00:17.559 we will give you access to evidence, space, nutrition and lifestyle content 5 00:00:17.640 --> 00:00:20.760 that you can use to help improve the long term health and wellness goals for 6 00:00:20.800 --> 00:00:23.920 you in your entire family. You can find us on any of your favorite 7 00:00:23.920 --> 00:00:28.280 podcasting platforms, so please don't forget to like, subscribe and follow the show 8 00:00:28.320 --> 00:00:31.760 so you don't miss out on any of our weekly episodes or special guest interviews. 9 00:00:32.079 --> 00:00:36.799 Now let's get into today's episode. All right, guys, welcome to 10 00:00:36.840 --> 00:00:40.439 another episode of the Wellness Transcription Podcast. It's been a minute since we've had 11 00:00:40.439 --> 00:00:43.320 a show out and I apologize for that, but to make up for it, 12 00:00:43.679 --> 00:00:47.320 I have got a wonderful guest on who's a true expert in the field 13 00:00:47.359 --> 00:00:52.600 and not only a friend, but a true mentor of mine that took me 14 00:00:52.679 --> 00:00:56.920 under his wing during pharmacy school and really push me to kind of stay on 15 00:00:56.960 --> 00:01:00.880 the cutting edge of where science is going. So, without further a deal, 16 00:01:00.880 --> 00:01:03.840 I want to introduce you guys, doctor Ryan Yates, a true pioneer 17 00:01:03.879 --> 00:01:08.239 in the field and just a great all around guy. Ryan, thank you 18 00:01:08.280 --> 00:01:12.879 for coming on. I really appreciate it. Yeah, Patrick, thank you 19 00:01:14.000 --> 00:01:17.120 very much for having me. I've been looking forward to this. So, 20 00:01:17.200 --> 00:01:19.480 as you know, my background is was for many years as a professor, 21 00:01:19.959 --> 00:01:25.840 tenured full professor at the University of Tennessee College of Pharmacy, and in that 22 00:01:25.920 --> 00:01:30.519 where my research focused primarily in the area of inflammation, so animal models and 23 00:01:30.560 --> 00:01:34.840 discovery and traditional academic drug discovery. And then you know, before that, 24 00:01:34.959 --> 00:01:38.959 when I was in pharmacy school. So bys my background, I have a 25 00:01:38.959 --> 00:01:42.120 pharmacy degree and a PhD degree in clinical pharmacollege. Who always in pharmacy school, 26 00:01:42.120 --> 00:01:48.879 I had an opportunity to do a lot of pharmacogenetic research while working at 27 00:01:48.920 --> 00:01:55.719 Saint so they're a lot of interesting polymorphism and genotype screening, essay development and 28 00:01:56.200 --> 00:02:00.280 really enjoyed that. And then as I said, when I finished pharmacy school 29 00:02:00.280 --> 00:02:04.920 and then PhD and stayed on his faculty there at the University of Tennessee College 30 00:02:04.959 --> 00:02:09.680 of Pharmacy, and then in twenty nineteen I retired and moved my laboratory my 31 00:02:09.800 --> 00:02:15.520 research to the National Center for natural products research, where I do a lot 32 00:02:15.560 --> 00:02:21.080 of work with your esteem father, doctor Bill Gurley, and he and I 33 00:02:21.840 --> 00:02:25.800 Ronfay's one human clinical center there where we do a lot of human pharmacokinetic work 34 00:02:25.879 --> 00:02:34.120 focused on dietary supplements. It's a really hot area right now, understanding the 35 00:02:34.560 --> 00:02:39.080 pharmaco kinetics and oral dosage forms and all those pharmacy related things that pharma has 36 00:02:39.240 --> 00:02:43.400 dealt with for years, and as pharmacists we really hadn't thought much of the 37 00:02:43.479 --> 00:02:46.919 natural product world. But all that's changed the exciting time to be in the 38 00:02:46.000 --> 00:02:51.840 natural product space. And so about four or five years ago I got into, 39 00:02:52.199 --> 00:02:58.280 as you know, artificial intelligence and how artificial intelligence can be utilized in 40 00:02:58.439 --> 00:03:04.039 the discovery space. And for me, the transition, in addition to retiring 41 00:03:04.080 --> 00:03:09.719 from Tennessee, that transition was from a discovery really more from for a discovery's 42 00:03:09.719 --> 00:03:15.960 sake to discovery for a commercial application sake. So I've been doing a lot 43 00:03:15.000 --> 00:03:20.080 of work in the last five to ten years on translating a lot of the 44 00:03:20.159 --> 00:03:25.639 work that we're doing in the laboratory into commercially viable and science evidence based products. 45 00:03:25.639 --> 00:03:31.520 I think that's really where the interesting world of natural supplements is going, 46 00:03:31.680 --> 00:03:38.879 particularly with the Federal Trade Commission's recent meeting December of twenty two a statement about 47 00:03:38.919 --> 00:03:43.039 the requirement for if you're going to make a structural function claim for a dietary 48 00:03:43.199 --> 00:03:46.400 ingredient, you need to back with a randomized double bliples see well control trials. 49 00:03:46.400 --> 00:03:52.120 So it's a really exciting time in the natural product space. And so 50 00:03:52.240 --> 00:03:57.639 that's what I've been doing the last five or six years, applying artificial intelligence 51 00:03:57.879 --> 00:04:00.199 and doing discovery, particularly the diabetes you know, you know, I've talked 52 00:04:00.199 --> 00:04:05.439 a lot about what's come out of that and the supplement that my group has 53 00:04:05.479 --> 00:04:11.039 developed with commercialized just in the marketplace. Exciting time. We just got notice 54 00:04:11.159 --> 00:04:14.680 of allowance of our first patent a couple of weeks ago from the USPTO, 55 00:04:14.919 --> 00:04:18.079 the US Patent Trademark Office, so that's really exciting as well, and getting 56 00:04:18.519 --> 00:04:25.800 finishing up our first clinical trial with that product and getting ready to commence our 57 00:04:26.040 --> 00:04:28.920 second trial with that. So that sort of a little bit of background of 58 00:04:29.160 --> 00:04:32.639 what I do and where I've been in the last twenty to twenty five years 59 00:04:32.759 --> 00:04:38.120 in the space. I do think it's worth noting that, you know, 60 00:04:39.199 --> 00:04:45.399 I think sometimes in science and research, when we make discoveries that we hit 61 00:04:45.439 --> 00:04:47.879 a brick wall, especially when trying to translate things out of the laboratory, 62 00:04:48.519 --> 00:04:53.879 particularly natural product space. We can discover I'm being hypothetical here, you discover 63 00:04:53.920 --> 00:04:58.759 a cure for cancer, but it may be in a plant that doesn't commercial 64 00:04:58.759 --> 00:05:00.759 you know, it doesn't scale, and so you don't have the opportunity to 65 00:05:00.839 --> 00:05:03.759 really do that. We do some really interesting work a couple of years ago, 66 00:05:04.240 --> 00:05:10.480 and I'll continue that at some point with America's Caffeine, continue playing yopon, 67 00:05:10.959 --> 00:05:14.279 but ran into difficulty with the supply chain. So it started work with 68 00:05:14.360 --> 00:05:20.279 a really interesting group called agg Launch, nonprofit group out of Memphis, Tennessee, 69 00:05:20.720 --> 00:05:25.600 and so I'm doing some volunteer work with him. They're promoting specially crops 70 00:05:25.680 --> 00:05:30.199 and how we move away from this commodity based agriculture of focus over generative agriculture, 71 00:05:31.160 --> 00:05:35.759 and where that goes is making now discoveraging the laboratory and then being able 72 00:05:35.800 --> 00:05:41.040 to work with seal trial specialists to develop supply chains for that. That's sort 73 00:05:41.079 --> 00:05:44.720 of what what we look like in the future. So that's sort of broad 74 00:05:44.839 --> 00:05:48.959 spectrum of area and interest, and there's a lot of depth there as well. 75 00:05:49.120 --> 00:05:53.839 So you're kind of going to flip it back to you and say where 76 00:05:53.879 --> 00:05:56.639 would you like to die in? Where do you think whether user or your 77 00:05:56.680 --> 00:06:00.240 listeners would like to hear about. There's a lot to unpack there, and 78 00:06:00.240 --> 00:06:02.879 I feel like there's four or five different topics we could usually spend hours talking 79 00:06:02.920 --> 00:06:06.000 about there. I think what's what's interesting for me? And I'll just say 80 00:06:06.040 --> 00:06:10.519 this when you when you and you came to when I first really got to 81 00:06:10.600 --> 00:06:14.000 know you back in pharmacy school, when I was doing a coming up with 82 00:06:14.079 --> 00:06:20.199 the business plan idea for trying to translate wellness and genetic testing and all that 83 00:06:20.240 --> 00:06:26.480 stuff into a pharmacy type aspect. My dad I remember asking him and kind 84 00:06:26.519 --> 00:06:28.439 of saying, this is where I'm interested, this is what I want to 85 00:06:28.519 --> 00:06:30.639 try to do, and he was like, talk to Ryan. I was 86 00:06:30.720 --> 00:06:34.560 like, okay, I'll talk to Ryan. And then literally within a few 87 00:06:34.560 --> 00:06:39.000 minutes of talking to you, it's just you can tell there's just it's it's 88 00:06:39.439 --> 00:06:43.439 beyond what I would have ever thought a scope of someone like me would be 89 00:06:43.519 --> 00:06:47.079 in. I thought I'd just be a typical retail pharmacist doing retail pharmacy things. 90 00:06:48.160 --> 00:06:51.959 And then you've really encouraged me to kind of push the boundary there as 91 00:06:53.040 --> 00:06:57.800 far as where this field goes. I think the first part of your background, 92 00:06:58.000 --> 00:07:01.519 your extensive background, that is where I'd like to dive in first is 93 00:07:02.240 --> 00:07:06.759 is really just how I guess we sell a lot of supplements at our store, 94 00:07:08.000 --> 00:07:12.839 and I think there's a basic kind of assumption in the supplement field that 95 00:07:12.959 --> 00:07:16.000 there is all this research that's already been done. That's why these formulations look 96 00:07:16.040 --> 00:07:20.800 the way that they do. I don't ever really get questions that often in 97 00:07:23.560 --> 00:07:28.040 my day to day work with supplements about clinical trials and stuff that back up 98 00:07:28.040 --> 00:07:33.079 their evidence. People just assume that that's already done. So I guess let's 99 00:07:33.160 --> 00:07:38.040 just briefly touch on I can say briefly, but go into what it takes 100 00:07:38.079 --> 00:07:41.399 to kind of undergo a clinical trial for a dietary supplement. What are kind 101 00:07:41.399 --> 00:07:44.079 of some of the hoops that you have to jump through to get that type 102 00:07:44.120 --> 00:07:47.439 of study going? And then I guess my second question to that, which 103 00:07:47.519 --> 00:07:50.279 kind of bleeds into it, would be, you know, you talked about 104 00:07:50.279 --> 00:07:53.879 the product. I'm very familiar with the product that you guys have come up 105 00:07:53.920 --> 00:07:58.759 with. How where, why that product? Why did that start, what 106 00:07:59.600 --> 00:08:03.839 interest got you into pushing that product as opposed to the yap On Holly product 107 00:08:03.920 --> 00:08:07.319 that you mentioned that I'm also familiar with. So I guess just kind of 108 00:08:07.319 --> 00:08:11.000 give us an idea of how all that comes to be and then how you 109 00:08:11.160 --> 00:08:16.279 take that laboratory data and then translate it into a patent the thing the patient 110 00:08:16.360 --> 00:08:18.839 can be fully invested in and understand just all the science that went into it. 111 00:08:22.639 --> 00:08:24.600 Wow. So there's a lot there, and I'll try and take it 112 00:08:24.759 --> 00:08:28.639 in the sequence that you ask, which is the first is really sort of 113 00:08:28.680 --> 00:08:37.519 focusing on clinical trials and how that requirement is different than historical and by historical 114 00:08:37.600 --> 00:08:41.879 I mean over the last thirty years. As your listeners know, the regulations 115 00:08:41.960 --> 00:08:46.960 around dietary selfless. One of the one things that one of the things that 116 00:08:46.039 --> 00:08:54.240 makes me WinCE as a pharmacist, pharmacologist and natural product guy is when people 117 00:08:54.320 --> 00:08:56.919 say that supplements are not regulated. As you and I know, they are 118 00:08:58.039 --> 00:09:05.639 extremely regulated, and oftentimes it's on the enforcement side just due to sheer numbers 119 00:09:05.960 --> 00:09:11.039 and the number unfortunately bad actors in the space that makes it seem sometimes unregulated. 120 00:09:11.120 --> 00:09:16.600 But again, as you know, the regulations are laid out very clearly 121 00:09:16.919 --> 00:09:20.919 in the so called de Shay or the Dietary Something Health Education Act of nineteen 122 00:09:20.039 --> 00:09:24.720 ninety four. And when that came out, it defined a dietary something, 123 00:09:24.879 --> 00:09:31.360 a dietary ingredient, did define how these products should be manufactured under so called 124 00:09:31.480 --> 00:09:35.200 cGMP. There is a language that pharma lives big pharma lives by right in 125 00:09:35.320 --> 00:09:41.720 terms of just the rules and regulations around just producing something to be put into 126 00:09:41.759 --> 00:09:46.960 a bottle. And what lagged in the regulations was, well, what did 127 00:09:46.039 --> 00:09:54.039 you need to provide as far as evidence to substantiate your so called structure function 128 00:09:54.240 --> 00:09:58.120 claims? And that may be a new term for some of your listeners, 129 00:09:58.200 --> 00:10:01.879 but this concept of structure function and claim would be, for example, promotes 130 00:10:01.960 --> 00:10:11.440 healthy blooded And what you see is the reason people use language different than the 131 00:10:11.519 --> 00:10:15.919 pharmaceutical world is because, right, that's what that labels on there are your 132 00:10:15.960 --> 00:10:20.639 bottles, right, which is that this product is not proven to or allowed 133 00:10:20.720 --> 00:10:24.600 to be talked about in terms of diagnosed, treat, mitigate or prevent a 134 00:10:24.720 --> 00:10:30.039 disease. Those are so called disease claim. So where I'm going with that 135 00:10:30.240 --> 00:10:35.200 is when you start talking about how do I substantiate a structure function claim and 136 00:10:35.279 --> 00:10:43.159 a human clinical trial. It's unlike the typical pharmaceutical trial where Okay, my 137 00:10:43.399 --> 00:10:48.200 endpoint is lower in cholesterol for a statin and how that relates to law firm 138 00:10:48.320 --> 00:10:54.080 morbidity and more mortality, but more disease type claims. When you do a 139 00:10:54.480 --> 00:11:01.360 supplement human clinical trial, you have to be very clear and careful not to 140 00:11:01.519 --> 00:11:07.519 promote your product and interpret the results in the context of that treat mitigating prevent 141 00:11:07.679 --> 00:11:16.120 disease. And so you go back to your sort of definition in the d 142 00:11:16.200 --> 00:11:20.519 Shay Act of a structural function claim. What is it you're trying to modulate 143 00:11:20.879 --> 00:11:26.000 in the body, and how does that relate to a disease without directly linking 144 00:11:26.240 --> 00:11:31.360 because you're not doing a doing excuse me, a clinical trial under a so 145 00:11:31.519 --> 00:11:37.279 called new drug application or investigational new drug applicate right the traditional pharma path Now, 146 00:11:37.600 --> 00:11:43.320 I'll take a quick aside there because oftentimes even people expert in the field 147 00:11:43.480 --> 00:11:50.440 aren't aware that there's actually a provision, a pathway within the Food and Drug 148 00:11:50.440 --> 00:11:58.080 Administration to approve disease claims, treatment claims for botanicals and so called botanical drug 149 00:11:58.240 --> 00:12:05.240 approval rout And so there's been literally thousands of I and DS investigation new drugs 150 00:12:05.360 --> 00:12:11.559 for natural complex substances for the treatment of disease, but only a couple of 151 00:12:11.639 --> 00:12:16.519 products natural products have actually made it from the process into the marketplace. We 152 00:12:16.600 --> 00:12:20.000 can talk at length about why that is. I'd be a discussion for another 153 00:12:20.080 --> 00:12:24.639 day, but the bottom line is that's your typical disease claim. But back 154 00:12:24.720 --> 00:12:31.200 to the clinical trial side is let's say that you are, in my case, 155 00:12:31.799 --> 00:12:37.519 very interested in the liver. So why is a pharmacist, healthcare practitioner, 156 00:12:37.639 --> 00:12:41.639 resurgery a lot interested in the liver. Well, it's really interesting how 157 00:12:43.360 --> 00:12:52.440 the medical community, the medical education has become so compartmentalized, specialized that we 158 00:12:52.600 --> 00:12:58.080 lose sight that we're treating patients. And that hit me in the phase this 159 00:12:58.240 --> 00:13:03.399 past week when my wife is her mother another wads my mother in law. 160 00:13:05.159 --> 00:13:11.399 She was needing to have to be seen by a cardiologist, and so this 161 00:13:11.639 --> 00:13:15.279 was trying to get a cardiologist. Finally got a cardiologist and then oh, 162 00:13:15.440 --> 00:13:20.679 well this guy or gal is a Vowels cardiologist. You need somebody that's an 163 00:13:20.720 --> 00:13:26.679 atrial stib yeah, and so you need a specialist for a specialist for a 164 00:13:26.799 --> 00:13:31.000 specialists. Yeah, I think that's been. That's definitely tricky. You know, 165 00:13:31.080 --> 00:13:35.720 it's hard to just okay, you know PCP. Usually it used to 166 00:13:35.799 --> 00:13:39.320 just be a referral to a cardiologist. Cardiologist. Hey, this isn't a 167 00:13:39.399 --> 00:13:41.240 really crazy problem we got going on. Here's what we'll do now. Let's 168 00:13:41.320 --> 00:13:46.600 oh, I don't know anything about the abnormal rhythmia is to your point, 169 00:13:46.759 --> 00:13:50.320 let me forget you to this guy. Yeah, I can definitely see where 170 00:13:50.320 --> 00:13:52.120 the frustration and the bills then add up to on top of that. So 171 00:13:52.200 --> 00:13:58.159 that's I definitely share your sentiments there. Yeah, well I'm bringing it back 172 00:13:58.279 --> 00:14:03.440 to the liver. Is. If you're a cardiologist, it's all things hard, 173 00:14:03.480 --> 00:14:07.720 if your pulmonologist, it's all things lung and go on at length, 174 00:14:07.879 --> 00:14:13.679 right, But what we know is that through clinical research and basic research, 175 00:14:13.919 --> 00:14:20.200 there is oftentimes a common thread that runs through those different indoorgan disease states. 176 00:14:20.639 --> 00:14:26.440 And so my research is focused on the liver as a contributor to chronic inflammatory 177 00:14:26.559 --> 00:14:33.480 diseases. And so to that end, my research looks at right evolving if 178 00:14:33.519 --> 00:14:37.919 you will, from or devolving back the way it used to be before farmer 179 00:14:39.039 --> 00:14:41.639 right, we had the reductious approach, right, Your typical you have a 180 00:14:41.799 --> 00:14:48.399 target and a small molecule in general that that modulates that target and gives an 181 00:14:48.799 --> 00:14:52.879 out an effect, right, a pharmacologic effect. But it's really that sort 182 00:14:52.879 --> 00:15:00.240 of reductionists. There's one pill, one drug for this particular disease, and 183 00:15:00.360 --> 00:15:05.879 it's evolving that to more of the systems pharmacology. That's one of the things 184 00:15:05.960 --> 00:15:11.639 that I wish I had more time to really talk about and educate people's concept 185 00:15:11.720 --> 00:15:18.960 of systems pharmacology. So my first sort of experience in this concept of systems 186 00:15:20.159 --> 00:15:26.159 systems thinking was in my first career, which was actually before my pharmacy career, 187 00:15:26.279 --> 00:15:30.879 when I was in the United States Navy and running nuclear reactors on submarines, 188 00:15:31.000 --> 00:15:33.879 and I was in charge of all the electronics on the submarine that were 189 00:15:33.919 --> 00:15:39.080 related to the nuclear reactor. And if you're at sea, if something broke, 190 00:15:39.279 --> 00:15:41.279 you had to break out the schematics and you had to figure out what 191 00:15:41.399 --> 00:15:46.799 was wrong with the sister, you know, this capacitor or whatever. And 192 00:15:46.840 --> 00:15:50.639 so I started I learned at a very young age how to think about the 193 00:15:50.919 --> 00:15:54.840 entire system as opposed to looks I'm only focused on this resistor or this capacitor, 194 00:15:56.320 --> 00:15:58.679 you know, as the analogy here is I'm only focused on this receptor 195 00:15:58.840 --> 00:16:04.320 or as transporter. You look at the body from a systems pharmacology standpoint, 196 00:16:04.639 --> 00:16:08.039 and so I think that's where artificial intelligence, not bringing it for a full 197 00:16:08.120 --> 00:16:14.519 circle, allows us to consider the body as a whole. So you see 198 00:16:14.559 --> 00:16:19.639 some really interesting work coming out now in the application of artificial intelligence, machine 199 00:16:19.759 --> 00:16:25.759 learning, et cetera that says, Okay, you tweak this particular receptor and 200 00:16:25.919 --> 00:16:30.639 you see this effect on the other side of the spectrum. And if you 201 00:16:30.879 --> 00:16:37.159 look at specifically, what I'm interested in where my research began six or seven 202 00:16:37.240 --> 00:16:42.840 years ago in this particular topic area and working with artificial intelligence, is how 203 00:16:44.039 --> 00:16:53.519 do we approach diabetes as a holistic systems pharmacology problem? And I say diabetes 204 00:16:53.600 --> 00:17:02.360 where diabetes is in my sort of mantra, is example of a chronic inflammatory 205 00:17:02.440 --> 00:17:06.880 disease. And oftentimes in my mind, I don't differentiate. I'm at the 206 00:17:06.960 --> 00:17:11.319 mechanistic level, right, molecular level. I don't differentiate between diabetes, metabolic 207 00:17:11.480 --> 00:17:15.200 syndrome, Alzheimer's, chronic card disease, these sorts of things because of those 208 00:17:15.240 --> 00:17:21.359 common elements that are linked back to the liver and so What my initial foray 209 00:17:21.440 --> 00:17:26.680 into artificial entailors told me is you need to understand polyunsaturated statty acid metabolism, 210 00:17:26.920 --> 00:17:32.200 right, your old omega three's and omega sixism. No, you know g 211 00:17:32.480 --> 00:17:37.759 diet p s of it, but you've got to understand in order to understand 212 00:17:37.880 --> 00:17:42.240 diabetes from a system's pharmacology approach, you need to start with polyunsaturated fatty as 213 00:17:42.440 --> 00:17:48.039 metabolism. That's where I was pointed with the artificial intelligence engine. I was 214 00:17:48.079 --> 00:17:52.920 working with fellow by the IMA wrong and Supermarprin guy who's in the tech office 215 00:17:52.960 --> 00:17:56.680 for Hewlett Packard Enterprise now continues to blaze trails in this area. In fact, 216 00:17:57.000 --> 00:18:00.359 he's got a one of the graduate students he funds at the University of 217 00:18:00.359 --> 00:18:08.039 South Carolina is developing an artificial intelligence based algorithm for food substitution for type two 218 00:18:08.119 --> 00:18:12.319 diabetics type one diabetics. That they're really fascinating topic as well. But so 219 00:18:12.720 --> 00:18:18.000 where this all came together through the omega threees is we see all this literature 220 00:18:18.640 --> 00:18:26.039 about how healthy health promoting omega threes, and we know your prototypicals right, 221 00:18:26.079 --> 00:18:30.480 your EPA, your DHA, right, those hardcore polyen satuated fatty assets that 222 00:18:30.519 --> 00:18:36.279 are in our officials are fatty fishes. We know their health promoting and study 223 00:18:36.359 --> 00:18:40.440 after study, it's equivalent, right, we give people, you know, 224 00:18:40.519 --> 00:18:44.480 look at fish intake, we look at their fishual intake. We look at 225 00:18:44.519 --> 00:18:49.240 polyen satuated fatty asset, metabolism, etc. And frustratingly, sometimes you'll see 226 00:18:49.240 --> 00:18:55.440 a connection to long term outcomes sometimes you want So that really got me started 227 00:18:55.480 --> 00:18:59.759 down as pat and says, Okay, we know omega threes are imported, 228 00:19:00.359 --> 00:19:06.000 but why is it that when we look at omega three levels there's no direct 229 00:19:06.079 --> 00:19:14.400 correlation between omega three levels and outcomes in disease states. So that started me 230 00:19:14.480 --> 00:19:18.960 thinking about sort of the systems pharmacology. Okay, yes, omega three's are 231 00:19:18.039 --> 00:19:25.319 absolutely a critical piece to the equation, but there are other things in The 232 00:19:25.400 --> 00:19:29.680 aha moment for me was three or four years ago when I read a paper 233 00:19:30.160 --> 00:19:37.119 that was looking at two basic elements and their relation to cognitive declinin and so 234 00:19:37.279 --> 00:19:41.480 of course they looked at you circulating omega three levels. Those with the highest 235 00:19:41.599 --> 00:19:48.920 quartile of circulating omega three levels should have a reduction if you will, in 236 00:19:48.000 --> 00:19:53.599 cognitive client but they didn't. We know that vitamin B twelve as a so 237 00:19:53.799 --> 00:20:00.119 called methyl donor. We know methyl donors are really important for various metabolic processes 238 00:20:00.279 --> 00:20:04.319 and brain health in particular. And so they looked at vitamin B twelve levels 239 00:20:04.559 --> 00:20:08.680 and said, okay, now the highest quartile of vitamin B twelve levels and 240 00:20:08.720 --> 00:20:14.960 these folks should correlate negatively with cognitive decline, meaning to higher the vitamin B 241 00:20:15.039 --> 00:20:18.440 twelve, the lower the decline rates. They didn't see a relationship. But 242 00:20:18.559 --> 00:20:22.440 then when they put the two together, meaning the highest quartile of the Mega 243 00:20:22.519 --> 00:20:29.160 three's the highest quartile of vitamin B twelve Bingo, that's when the association popped 244 00:20:29.200 --> 00:20:32.759 out. He says, yes, the MAGA three is important, Yes, 245 00:20:32.960 --> 00:20:37.240 vitamin B twelve is important, but they're important together in a system's pharmacology way. 246 00:20:37.799 --> 00:20:45.079 And so that started me down the pathway of developing a supplementation regimen that 247 00:20:45.640 --> 00:20:51.559 would focus there. Now, I took a slightly different tech and you can 248 00:20:51.680 --> 00:20:56.000 argue for various and Sunday reasons, whether it's from a sustainability standpoint or cost 249 00:20:56.160 --> 00:21:00.559 or whatever is right. Is there a different way to think about omega threes 250 00:21:02.039 --> 00:21:04.920 and how we promote omegas res in the body. Right, So instead of 251 00:21:06.079 --> 00:21:11.359 giving official supplement an EPA or a DHA, and the answer is yes, 252 00:21:11.039 --> 00:21:18.559 we absolutely can modify polyensaturated fatty acid metabolism, and by modify a mean influence 253 00:21:19.440 --> 00:21:26.200 polygensaturated fatty acid metabolism with dietary ingredients that actually promote omega three formation from omegas 254 00:21:26.240 --> 00:21:33.640 ree precursors at the expense of omegasix into the these like arachidonic acid right in 255 00:21:33.720 --> 00:21:37.400 his pharmacy school, right, arachodonic acid. Everybody things right, Cox two 256 00:21:37.480 --> 00:21:42.279 inflammation, right, everybody knows that arachodonic acid is I should say, as 257 00:21:42.279 --> 00:21:47.559 taught, arachodonic acid is associated with inflammation. But arachadonic acid, right, 258 00:21:47.559 --> 00:21:49.599 it's not too much of a good thing. Aracadonic acid is really good for 259 00:21:49.799 --> 00:21:53.880 us. But because of diet, because of genetics, because of various as 260 00:21:53.880 --> 00:21:57.880 sounded factors, that we get too much omega six. There's too much rachadonic 261 00:21:57.920 --> 00:22:03.640 acid relative to those omega three's EPA and dha. So how do we manipulate 262 00:22:03.880 --> 00:22:07.839 in a good way the body so that it produces more of those omega three 263 00:22:07.960 --> 00:22:14.400 is relative to those omega sixes. Said differently, more EPA and DHA relative 264 00:22:14.559 --> 00:22:18.160 to arachidonic acid. This is you know, and then ultimately relative to all 265 00:22:18.200 --> 00:22:22.599 the satty acids, whether their monolin saturated fat acids, saturated fatty acids in 266 00:22:22.640 --> 00:22:29.519 the body right in this so called ratio is the omega three index. So 267 00:22:29.680 --> 00:22:37.720 my research focused on sesame seed oil in particular ligman in sesame seed oil. 268 00:22:37.880 --> 00:22:45.319 This ligman is called sessimin, and sessimon is the ingredient if you will, 269 00:22:45.400 --> 00:22:52.440 and sesti seed oil that drives that preferential formation of epa and dha at the 270 00:22:52.559 --> 00:22:59.400 expense of arachodonic acid. And so you see sessiment promotes the omega three index. 271 00:22:59.759 --> 00:23:03.200 But get that's only the first piece of getting the omega threes to where 272 00:23:03.240 --> 00:23:07.720 they need to and so the next piece is, okay, how do we 273 00:23:07.000 --> 00:23:15.759 activate those omega three So there's for years we have thought about omega three's purely 274 00:23:15.920 --> 00:23:19.960 from an oral supplementation standpoint. Said differently, if we can get just getting 275 00:23:21.279 --> 00:23:26.359 a little more EPA and dha into the blood stream, then we can get 276 00:23:26.440 --> 00:23:30.000 those increases to where they need to go, so dha, for example, 277 00:23:30.039 --> 00:23:33.920 to the brain. But that's not the way the body works, and so 278 00:23:34.240 --> 00:23:37.480 well, if that's not the way the body works. Then how does the 279 00:23:37.559 --> 00:23:41.799 body work? Well, it's really simple, and that is the liver is 280 00:23:41.960 --> 00:23:47.680 responsible for taking those omega threes and other fatty acids, but particularly the omega 281 00:23:47.759 --> 00:23:52.880 threes and converting them into a storage form in the liver. Said differently, 282 00:23:53.319 --> 00:23:56.759 just because you have dhas floating around freely in your blood stream. Right, 283 00:23:56.759 --> 00:24:02.240 we talk about unbound fraction and some nightmares from talking about pharmacokinetics, which I 284 00:24:02.279 --> 00:24:03.440 talked for many years. Right, I'm down fraction. We talk about that. 285 00:24:04.119 --> 00:24:07.400 That is not what makes it into the moraine meaning of the DH form. 286 00:24:07.759 --> 00:24:11.680 It has to be in a transportable form of the way it gets there. 287 00:24:12.119 --> 00:24:18.640 It starts in this storage form. So I'm gonna throw out techie term 288 00:24:18.759 --> 00:24:25.319 here, right, nerdy term why sophoster ethanolamine so so called lpe SPCs, 289 00:24:25.400 --> 00:24:29.440 as well as phosphatidal ethanolamine. So what your liver does. It takes those 290 00:24:29.480 --> 00:24:33.839 omega three's and it stores them in the poster title ethanolamine form, so the 291 00:24:33.960 --> 00:24:38.119 so called PE form. Okay, and I call it the storage form because 292 00:24:38.279 --> 00:24:42.160 in order to activate. Now, think about you've got this storage form of 293 00:24:42.240 --> 00:24:48.359 p It's sitting there preloaded with these omega threes by your living and it's sort 294 00:24:48.400 --> 00:24:52.720 of stuck there in the absence of further conversion to the active. So here's 295 00:24:52.759 --> 00:24:56.680 a term that the listeners are much more familiar with. The are so called 296 00:24:56.720 --> 00:25:03.480 phosphatidal cholines or PCs that we convert our PE species. Those are megan freeze 297 00:25:03.519 --> 00:25:06.400 here. They are in the PE storage form. When they're converted to the 298 00:25:06.519 --> 00:25:11.559 PC form poster to coli form, that's when they increase their potential, their 299 00:25:11.640 --> 00:25:15.759 activation energy, if you will write our enzymology and our physics coming back, 300 00:25:15.920 --> 00:25:22.160 right, they're activated, and what's key to that activation, not surprisingly, 301 00:25:22.440 --> 00:25:26.480 is methyl vitamin B twelve. Right, many also have heard of batain, 302 00:25:26.640 --> 00:25:33.200 another supplement that's a natural right, and batain comes from our diet, the 303 00:25:33.319 --> 00:25:37.960 dietary ingredient called coline. Right, most of your listeners here coline, you 304 00:25:37.000 --> 00:25:41.720 think of cetal cooling exactly the same coline, right, dietor called it at 305 00:25:41.759 --> 00:25:48.240 least as cetocoline and coolinergic synaptic transmission exactly. But it's also converted to batain, 306 00:25:48.319 --> 00:25:52.920 which contributes that methyl donor pool. And so I'm gonna take a quick 307 00:25:52.079 --> 00:25:56.559 aside here on the methyl donor pool because just within the past week. And 308 00:25:56.640 --> 00:26:00.960 I sent this to you a couple of days ago. It's a fascinating paper 309 00:26:02.319 --> 00:26:07.440 that was just published that looks at this concept of aging and biological clocks and 310 00:26:07.880 --> 00:26:14.079 what really is the difference between our actual age and our biological age. And 311 00:26:14.240 --> 00:26:18.920 what's shown very clearly from this study it's published and it supports what's been done 312 00:26:18.960 --> 00:26:26.119 for the last twenty years and aging is that methylation status of our DNA is 313 00:26:26.400 --> 00:26:33.720 the biological clocks say that differently your methal donor status. The ability to methylate 314 00:26:33.799 --> 00:26:38.759 your DNA is directly related to your biologic age. As we age, that 315 00:26:38.960 --> 00:26:45.799 methylation decreases, either because they're in less methylation or the processes themselves that require 316 00:26:45.880 --> 00:26:52.759 methylation are starting to slow down. But the higher your methylation of specific sites 317 00:26:52.160 --> 00:26:56.960 within the DNA, and we will go into all at them in this podcast, 318 00:26:56.079 --> 00:27:02.079 but suffice to say, in regulatory region of the DNA, more mestilation, 319 00:27:03.039 --> 00:27:07.200 the more that you are able to slow down that aging process. Right, 320 00:27:07.279 --> 00:27:11.240 So that is the current thinking, and by current I mean within the 321 00:27:11.359 --> 00:27:17.079 last week of biological aging clocks. So how does this relate? So now 322 00:27:17.200 --> 00:27:21.519 you say, I'm sorry, So I just want to make an important point. 323 00:27:21.559 --> 00:27:23.079 So we do at my work, we do a lot of long term 324 00:27:23.119 --> 00:27:26.599 care patient management, so we have quite a few nursing homes that we deal 325 00:27:26.640 --> 00:27:30.759 with, and you see this combination pop up over and over again. So 326 00:27:30.960 --> 00:27:36.200 a lot of our patients that have dementia or whatever they're dealing with that's already 327 00:27:36.359 --> 00:27:38.960 well established. We're already at the point of cognitive decline. We're trying to 328 00:27:40.000 --> 00:27:41.720 slow it down. And I'm not kidding. Just about every one of those 329 00:27:41.759 --> 00:27:48.880 patients to a degree, is on some sort official will supplement quality unknown in 330 00:27:48.039 --> 00:27:52.839 some bordom, some form of B twelve. Now like they it's like they're 331 00:27:52.880 --> 00:27:56.039 making they're getting there, but they're not quite making the full connection. It's 332 00:27:56.079 --> 00:28:00.200 like, okay, we know these help, let's just give it to them 333 00:28:00.240 --> 00:28:03.880 and see what happens. When in reality, I think what's important to distinguish 334 00:28:03.960 --> 00:28:10.720 is having the idea of getting on top of it now, knowing how it 335 00:28:10.799 --> 00:28:15.880 works. As far as preventing cognitive decline, I think is really important because 336 00:28:15.880 --> 00:28:18.160 a lot of times you'll throw those on late after it's already established, and 337 00:28:18.240 --> 00:28:22.920 then just hoping it doesn't progress. But I think that's really cool. That's 338 00:28:22.960 --> 00:28:26.599 where my brain went, it's like, Okay, I've got all these patients 339 00:28:26.680 --> 00:28:29.960 on these things already and we're not really seeing improvement. Why is that. 340 00:28:30.559 --> 00:28:36.160 You've already answered that question. It's because we may not be methylating and properly, 341 00:28:36.400 --> 00:28:40.359 we may not be converting that storage form that we've that we're giving the 342 00:28:40.400 --> 00:28:45.920 patients and we're not facilitating that fospitual coaling build up. And then you know, 343 00:28:45.039 --> 00:28:48.599 you just if that doesn't work, the next thing you do is up 344 00:28:48.640 --> 00:28:52.559 to aceudocolonesteration inhibitor medications and just hopes that it doesn't get worse. Whereas, 345 00:28:53.319 --> 00:28:56.559 what you're telling it, or at least what I'm hearing, is that this 346 00:28:56.799 --> 00:29:02.119 is something that we should be focusing on im media to not even have to 347 00:29:02.200 --> 00:29:08.839 get to that point. So I say that as it's very interesting that all 348 00:29:08.920 --> 00:29:14.440 of that's finally starting to get teased out in what you're seeing in these papers. 349 00:29:15.920 --> 00:29:21.759 Yeah, so you set a couple of really interesting things that triggered responses 350 00:29:21.839 --> 00:29:25.640 from me. So first is upping the dose of the acelical master race inhibitor, 351 00:29:25.960 --> 00:29:29.440 and we know the downside of that is, well the upside and side, 352 00:29:29.799 --> 00:29:33.359 and so as you point out why we do that is because we don't 353 00:29:33.440 --> 00:29:38.519 have the acetal cooling right, which is degraded by these acetical master races floating 354 00:29:38.519 --> 00:29:42.079 around in the brain. So we need to enhance the acetal coaling. So 355 00:29:42.279 --> 00:29:48.200 that's what I'll call the last piece of the puzzle, where getting the omega 356 00:29:48.240 --> 00:29:56.119 three's right with assessment, getting the donors methyl donors right with vitamin B twelve, 357 00:29:56.960 --> 00:30:03.480 and it treat us another common natural sub dictor, suptmate, methyl sulfonal 358 00:30:03.559 --> 00:30:08.000 methane MSM. And so my lab was spent a number of years really promoting 359 00:30:08.240 --> 00:30:11.799 methyl sulfonal methane, and by promoting, I mean researching that as a methyl 360 00:30:11.839 --> 00:30:18.160 donor. And so where that relates to the biological clocks is one of my 361 00:30:18.240 --> 00:30:25.680 dear friends at the University of Arkansas Medical Sciences, Igor, excuse me, 362 00:30:26.240 --> 00:30:30.319 Igor. What he did was he showed that, yes, Run, that 363 00:30:30.440 --> 00:30:33.839 hypothesis is right. MSM methyl sulpontal methane is in fact a methyl donor. 364 00:30:34.119 --> 00:30:38.440 But he showed it in the context of DNA methylation. Right, So now 365 00:30:40.039 --> 00:30:45.319 MSM DNA methylation, biological clocks, you can start to see the connections there 366 00:30:45.359 --> 00:30:49.079 that doctor Koda Bush put together approved some of the hypotheses that we had, 367 00:30:49.640 --> 00:30:53.599 and so now you've got the methyl donors take care of and the ideas you're 368 00:30:53.680 --> 00:31:02.759 starting to activate your omegacreies in this fospitial cooling flood. But PHOSPHATITL cooline is 369 00:31:03.000 --> 00:31:07.880 degrading as we age because right we know it's a component of cell membranes, 370 00:31:07.960 --> 00:31:12.079 and cell membranes are undergoing constant attack from its lammatoid processes, so we're constantly 371 00:31:12.160 --> 00:31:18.440 having to replace phosphatial cooline. Well, if you're not replacing it with the 372 00:31:18.519 --> 00:31:21.880 foster to the lefthand alamine because you don't have the methyl dollars, right, 373 00:31:22.960 --> 00:31:25.880 one of the things that you can do is, as you said, well, 374 00:31:26.000 --> 00:31:30.359 let's look at maybe a cetocol mesturation hibbers from description or maybe an old 375 00:31:30.440 --> 00:31:37.559 prescription that is a dietary ingredient so called citycolin. So citicoline is a precursor 376 00:31:37.680 --> 00:31:44.599 for fostertial cooline. So the thinking and adding citicoline is to give you the 377 00:31:44.680 --> 00:31:49.960 ability from a different direction to restore or to increase phosphitlcoline levels and reduce some 378 00:31:51.079 --> 00:31:56.480 of that negative pressure on phosphitalcoline, which would then require chewing up the cooline 379 00:31:56.519 --> 00:32:02.720 precursors and reducing a cetocholine production, so you don't need that acetoceutocolinesterase inhibitor as 380 00:32:02.839 --> 00:32:07.039 much. And so that's the mix that we put together and patent it. 381 00:32:07.440 --> 00:32:13.039 So again the sessment for the omega threes, the methyl donor's MSM and the 382 00:32:13.200 --> 00:32:17.279 vitamin B twelve and then the city cooline adding that piece to really start to 383 00:32:17.559 --> 00:32:23.200 change phosphatidocoline metabolism and the liver so that we start to see all these other 384 00:32:23.359 --> 00:32:30.400 chronic diseases impacted it. And so the link I think is important for your 385 00:32:30.480 --> 00:32:37.880 listeners is let's look, let's focus back in on this relationship between the storage 386 00:32:37.920 --> 00:32:44.039 form PE and the active form PC of these omega threes. What study after 387 00:32:44.200 --> 00:32:50.119 study is showing it across all chronic diseases, whether it's Alzheimer's heart disease, 388 00:32:50.599 --> 00:32:54.240 even acute disease is sepsis for example, A already a sepsis and diabetes. 389 00:32:54.359 --> 00:33:00.359 As you get to build up a P species relative to PC. So if 390 00:33:00.400 --> 00:33:04.440 you think through that, right, that makes sense in terms of the disease 391 00:33:04.519 --> 00:33:09.759 manifestation. If I build up the storage form of the omega trees at the 392 00:33:09.839 --> 00:33:15.119 expense of the active form meaning the PC species go down, then I can't 393 00:33:15.160 --> 00:33:19.640 deliver the active form ultimately to the tissues. So that's what you want to 394 00:33:19.680 --> 00:33:22.279 do, is you want to restart that process. But here's the good news. 395 00:33:22.599 --> 00:33:29.640 It's really a nutritional approach. So we know that there are a number 396 00:33:29.680 --> 00:33:31.680 of things, and you don't have talked about this at nauseam, there are 397 00:33:31.680 --> 00:33:36.319 a number of things that, for example, deplete our methyl donors. We 398 00:33:36.559 --> 00:33:42.240 know met form and is notorious for reducing Yeah, it's one of the vitamin 399 00:33:42.319 --> 00:33:45.480 B twelve is notorious. And then you also also got to think, like 400 00:33:45.799 --> 00:33:47.559 to the point I made earlier that a lot of these people are suppimitting with 401 00:33:47.599 --> 00:33:51.880 B twelve, they're not supplimenting with like a methylated version of B twelve. 402 00:33:52.359 --> 00:33:55.279 So yeah, it's your typical sianic abum and cheap everybody can get it. 403 00:33:57.039 --> 00:34:00.000 But whenever I reach for that, at least in the pays that I've talked 404 00:34:00.039 --> 00:34:04.759 to at length on this same process in the pharmacy, is yes, we 405 00:34:04.880 --> 00:34:07.559 need to be methylating as well. So let's take methylated forms of these things 406 00:34:07.960 --> 00:34:10.199 and also ask every one of these patients to come in, Hey, do 407 00:34:10.239 --> 00:34:15.239 you take any prescription medication? I may already know the answer to that question 408 00:34:15.320 --> 00:34:17.039 if they already fill with us. But you know a lot of times you're 409 00:34:17.039 --> 00:34:19.840 like, yeah, I take, you know, a statin. I take 410 00:34:21.039 --> 00:34:22.360 My doctor did say may whence he was a little bit high. So I 411 00:34:22.440 --> 00:34:24.199 take that, foreman. And I'm sitting here going, okay, you need 412 00:34:24.320 --> 00:34:29.000 you need a methylated B twelve and you need cookie ten, like just off 413 00:34:29.079 --> 00:34:32.559 the off the jump, because we're already dealing with depletion of certain of certain 414 00:34:32.599 --> 00:34:37.159 things just from the pharmaceutical side. So it's like you're just getting hit with 415 00:34:37.000 --> 00:34:39.519 negative after negative and you may not even realizing It's like, well, I'm 416 00:34:39.559 --> 00:34:43.039 taking meds and I know they have side effects, but I don't think it 417 00:34:43.119 --> 00:34:49.559 has those types of those types of implications. Yeah, and now we draw 418 00:34:49.599 --> 00:34:58.639 a straight line potentially potentially from vitamin B twelve depleting prescriptions, reduction and messal 419 00:34:58.719 --> 00:35:02.199 donor and ankle back to this concept of methylation and biological aging. It's not 420 00:35:02.360 --> 00:35:09.239 a great leap to say that some medications may actually be counteracting that methylation of 421 00:35:09.360 --> 00:35:13.039 DNA. Now that remains to be proven, sure, and so I'm not 422 00:35:13.119 --> 00:35:15.679 going to stand on the soap box. And that's what's happening. But there's 423 00:35:15.719 --> 00:35:20.159 certainly a correlation. There an interesting correlation that requires some hypotheses and texting. 424 00:35:20.599 --> 00:35:22.800 But it's it's not a it's it's not a leap, so to speak. 425 00:35:23.119 --> 00:35:28.159 I think the other interesting thing, particularly in a post COVID wood is, 426 00:35:29.000 --> 00:35:32.920 uh, you know, you've got these patients with brainfall all the time. 427 00:35:34.039 --> 00:35:43.719 That is often and that's often a feature of another interesting cardiology related malady known 428 00:35:43.840 --> 00:35:50.599 as postural orthostatic tactic cardia syndrome. But pots I'm not a cardiology pharmacist. 429 00:35:50.599 --> 00:35:52.760 I hope I said you did. You did, But we have we have 430 00:35:52.840 --> 00:35:57.639 a few patients that have come in with with a new diagnosis of that too, 431 00:35:57.800 --> 00:36:00.840 Like we're I'm seeing it's interesting all these terms you're you're it's like, 432 00:36:00.920 --> 00:36:04.880 okay, people, I used to not have an answer for it because people 433 00:36:04.960 --> 00:36:07.639 come in, you know, I got either they got COVID or how how 434 00:36:07.800 --> 00:36:10.760 have you? And they're like, man, I just it's been months and 435 00:36:10.840 --> 00:36:14.920 I can't. I'm just I get to about two pm and my brain is 436 00:36:15.000 --> 00:36:17.719 like just not working and it's like never felt like that before. And you 437 00:36:17.800 --> 00:36:22.559 know, I'm who's Who's who am I to say that that's not the case, 438 00:36:22.679 --> 00:36:24.119 because you know, let's be honest, if you live with the condition 439 00:36:24.199 --> 00:36:29.559 long enough, like you pretty much are the expert on how you feel and 440 00:36:29.639 --> 00:36:32.880 what's going on there. So it's important to key in on those things and 441 00:36:35.840 --> 00:36:38.000 pots. I've seen a handful of times which I had no idea what that 442 00:36:38.239 --> 00:36:42.519 was when I was in pharmacy school. It's relatively new term for me. 443 00:36:42.639 --> 00:36:45.639 But when you see it coming in your door over you know, every now 444 00:36:45.719 --> 00:36:49.360 and then, it's like, Okay, there's some something's going on, and 445 00:36:49.440 --> 00:36:52.440 then you know, your science brain kicks in and go, okay, you 446 00:36:52.519 --> 00:36:54.480 know, I've got all these things they're coming in for answers, So I've 447 00:36:54.519 --> 00:36:59.480 got to be able to give them something that's rooted in in science. And 448 00:36:59.559 --> 00:37:05.360 I think that's where your mentorship with me has helped significantly with helping my patients 449 00:37:05.400 --> 00:37:09.079 manage this stuff in a pharmacy setting, because who else are they going to 450 00:37:09.119 --> 00:37:15.400 go to that has these epic answers. Your typical PCP won't really be familiar 451 00:37:15.440 --> 00:37:19.119 with this process unless they're in it and they actively research it themselves. So 452 00:37:19.159 --> 00:37:22.840 it's a really important point you make there. I definitely see a lot of 453 00:37:24.320 --> 00:37:29.360 yeah, well, it's it's the science link and you make the right sort 454 00:37:29.400 --> 00:37:35.760 of direction there. Patrick Is. Let's use pots as an example where if 455 00:37:35.840 --> 00:37:44.039 you look at sort of the science behind what underlies pots. In the features 456 00:37:44.119 --> 00:37:47.800 of POTS, one of the interesting things is coming up is that there seemed 457 00:37:47.840 --> 00:37:54.119 to be antibodies against the specialized cells in the GI tract excuse me, our 458 00:37:54.159 --> 00:38:00.280 gas of paratal cells. And so those gas of parato cells are specialized cells 459 00:38:00.320 --> 00:38:04.559 which, among other things, they help absorb vitamin B twelve. So there's 460 00:38:04.599 --> 00:38:08.039 this thinking that this, for reason unknown, post COVID, you've got these 461 00:38:08.079 --> 00:38:14.400 antibodies attacking these vitamin B twelve uptake cells, and can that be contributing to 462 00:38:14.679 --> 00:38:17.639 what is known that there are vitamin B twelve deficiencies in these parts patients. 463 00:38:19.079 --> 00:38:22.480 I think another piece of that, in terms of sort of the autoimmune or 464 00:38:22.519 --> 00:38:28.400 the immune response post covid, as we talked about this is our adronergic receptors, 465 00:38:28.960 --> 00:38:34.000 and there are is depletion or attacking of our adenergic receptors. And you 466 00:38:34.119 --> 00:38:39.039 couple that with the inability to methylate, right, so making adrenaline epinf or 467 00:38:39.079 --> 00:38:43.480 nor epin f right, that going back to your medicinal chemistry, your pharmacology, 468 00:38:43.599 --> 00:38:49.360 and that's all methylation and so you see all these things point to methylation 469 00:38:50.719 --> 00:38:55.719 aging disease, but it's only one component of the systems pharmacology. So that's 470 00:38:55.760 --> 00:39:02.519 why it's so important to when you're talking supplementation to patients how they can think 471 00:39:02.559 --> 00:39:09.760 about it and in a more holistic way. And so as a pharmacist also 472 00:39:09.880 --> 00:39:16.639 think about sort of what's the cost ultimately to the patient. And you know, 473 00:39:16.880 --> 00:39:21.480 you're not discussed this last week. It says, Okay, how do 474 00:39:21.599 --> 00:39:27.800 you look at the cost of a multi ingredient supplement versus individual greets? Okay, 475 00:39:29.119 --> 00:39:30.639 patient with diabetes. Right, you got the methodistian. Okay, here's 476 00:39:30.639 --> 00:39:34.039 a vitim of the twelve years assessed me to see the le extract years. 477 00:39:34.119 --> 00:39:37.320 Right, you got all these bothers. Right, we've all seen the brown 478 00:39:37.400 --> 00:39:40.159 bag of the answer we had to go to and all that sort of thing. 479 00:39:42.679 --> 00:39:46.119 But if you can compact that, and by compact, I mean aggregate 480 00:39:46.239 --> 00:39:50.920 that into a single supplement, but do it in such a way there's a 481 00:39:51.119 --> 00:39:57.679 ration, sure, And I think that's what is why in the healthcare practitioner 482 00:39:57.760 --> 00:40:01.400 space, pharmacists included. Right, If you're not really a deep in this 483 00:40:01.559 --> 00:40:07.239 world is sort of this hit or misapproach and what we call ferry dusting, 484 00:40:07.360 --> 00:40:10.199 and so, yeah, what's the latest ingredient. Well, there it is 485 00:40:10.320 --> 00:40:13.880 on the label, but there's not enough in there too. It's like, 486 00:40:14.000 --> 00:40:17.000 given one microgram of your stating each day, there's a statin in there. 487 00:40:17.519 --> 00:40:20.800 Oh, but by the way, there's only one microgram of it, and 488 00:40:20.920 --> 00:40:24.119 so you see a lot of that. So those are the two biggest issues 489 00:40:24.280 --> 00:40:31.960 I have with formulators, particularly formulators who are not scientists, pharmacologist pharmacists. 490 00:40:32.000 --> 00:40:38.320 And let's face it that the vast majority of formulators in the natural product space 491 00:40:38.760 --> 00:40:45.239 are not science and certainly not pharmacologist. A lot of goodwoods out there. 492 00:40:45.800 --> 00:40:50.400 But you know, there's a reason why I don't find my own lawsuits if 493 00:40:50.400 --> 00:40:53.000 I'm suing somebody, Right, I'm not a lawyer, and so but I 494 00:40:53.119 --> 00:40:55.880 could do it, but you wouldn't want me to do it. So that's 495 00:40:55.880 --> 00:41:00.000 the other thing I cautioned, patience is right when you look at something that 496 00:41:00.199 --> 00:41:05.280 is quote science based and clinical base. And let's bring this back to your 497 00:41:05.280 --> 00:41:09.320 original point about clinical trials and sort of evidence base, right when you read 498 00:41:09.360 --> 00:41:14.079 a website I was reading this morning we're talking about continues to close monitoring and 499 00:41:14.480 --> 00:41:16.639 how how fascinating it is in the patients and in our study, in our 500 00:41:16.679 --> 00:41:21.679 study, and it's not public, meaning it's not peer of view. So 501 00:41:21.800 --> 00:41:27.360 that's just an extra level of evidence that the consumer of the practitioner can look 502 00:41:27.400 --> 00:41:29.480 at and say, Okay, at least this is peer of viewed. I 503 00:41:29.559 --> 00:41:34.519 can look at that and see what that clinical evidence is. And what we 504 00:41:34.639 --> 00:41:38.679 see sometimes in the diet supper world is that this supplement is clinically tested. 505 00:41:39.599 --> 00:41:45.079 And so there have been thousands of prescription medications over the years that have been 506 00:41:45.159 --> 00:41:51.280 clinically tested, but that doesn't mean they work. So it's language that we 507 00:41:51.360 --> 00:41:53.400 have to be real careful with as well. Right, Yeah, that's why 508 00:41:53.440 --> 00:42:00.239 it's important to have that study result there so that you can really vet what 509 00:42:00.360 --> 00:42:02.800 they mean by correct. Yeah, that's an important point you make, because 510 00:42:04.880 --> 00:42:07.480 you know someone that I'm very evidence spased, and that's kind of the whole 511 00:42:07.480 --> 00:42:09.800 point of the podcast. I was really trying to sift through a lot of 512 00:42:09.840 --> 00:42:14.159 that and I'm getting there. We'll get there breaking down some of this stuff. 513 00:42:14.199 --> 00:42:16.480 But yes, there's a big difference between Oh, there was a study 514 00:42:16.559 --> 00:42:20.039 that showed this and it's like, okay, well, can you explain what 515 00:42:20.119 --> 00:42:22.800 type of study it was. Can you explain what the outcomes were? You 516 00:42:22.880 --> 00:42:25.239 know, what were they in animals? Was it in humans? Like there's 517 00:42:25.280 --> 00:42:30.239 all these other questions that people just don't know to think about. Whereas yeah, 518 00:42:30.239 --> 00:42:34.280 I can say I tested it in my you know, in my lab, 519 00:42:34.480 --> 00:42:37.960 but if it didn't work, I'm not really helping anything. But yeah, 520 00:42:38.000 --> 00:42:42.880 I did test it, but I didn't there was nothing beneficial that came 521 00:42:42.920 --> 00:42:46.159 out of it. And again, yeah, I think when you have people, 522 00:42:47.000 --> 00:42:51.199 I think, let's let's just be honest. If there were more people 523 00:42:51.280 --> 00:42:54.840 like you doing these in the supplement field and everybody had your similar approach, 524 00:42:55.119 --> 00:42:58.880 we would have a lot less supplements on the market, but the ones that 525 00:42:58.920 --> 00:43:01.679 we would have would clearly we would be able to show, in Layman's term, 526 00:43:01.760 --> 00:43:06.559 is why it works and why it doesn't. And that's just yeah, 527 00:43:07.480 --> 00:43:10.480 because because going back to your like brown Bag, a point that you made 528 00:43:10.519 --> 00:43:15.519 earlier is like, yes, I could have a protocol that would help with 529 00:43:15.800 --> 00:43:19.760 you know what, say someone comes in with cholesterol issues as well as post 530 00:43:19.840 --> 00:43:23.440 COVID brain fog type stuff. Immediately, I know, based on our conversations 531 00:43:23.480 --> 00:43:25.960 over the years, like I know where to go. But if I wanted 532 00:43:27.000 --> 00:43:30.679 to get sesamia extract, if I wanted to get omega three's, if I 533 00:43:30.719 --> 00:43:32.639 wanted to get a beat a method to be complex up with that, and 534 00:43:32.679 --> 00:43:37.280 then I wanted a fosil toil chin on top of that and hit all the 535 00:43:37.320 --> 00:43:39.840 aspects. I've got seven supplements there that I'm trying to convince someone to take 536 00:43:40.239 --> 00:43:45.000 that. There's literature to back it up that you've shown me that works. 537 00:43:45.159 --> 00:43:47.480 But it's like, I don't want to pay two hundred dollars for all of 538 00:43:47.559 --> 00:43:52.360 these things every month because that doesn't make sense. So it's like, hey, 539 00:43:52.440 --> 00:43:55.239 but I have this one product that costs this much, it has all 540 00:43:55.320 --> 00:43:59.559 your bases covered. We're good to go. It's like, as a it's 541 00:43:59.599 --> 00:44:02.639 a win win because you're taking a minimalist approach, but you're also knowing that 542 00:44:02.800 --> 00:44:07.719 you there's no doubt that the clinical evidence is there as to why that formulation 543 00:44:07.840 --> 00:44:10.400 is the way that it is. And it's patented too. I mean, 544 00:44:10.480 --> 00:44:14.519 anybody could take a formula and add one thing to it and then say, 545 00:44:14.559 --> 00:44:16.920 oh, look, this is unique or proprietary to what we have going on. 546 00:44:17.559 --> 00:44:22.159 But you ask them a couple of questions as to well, what's where 547 00:44:22.320 --> 00:44:23.840 was your study published, Like you said, it was clinically tested, what 548 00:44:23.960 --> 00:44:27.719 were the outcomes? And it's like they'll start squirming, and it's like, 549 00:44:27.800 --> 00:44:30.800 okay, you know, but the lay person, you know, your average 550 00:44:30.800 --> 00:44:34.360 every day consumer, doesn't know to ask those types of questions, or if 551 00:44:34.400 --> 00:44:37.320 they did, who would you reach out to. So that's a very important 552 00:44:37.360 --> 00:44:43.199 point you make because a lot of times in the pharmacy world, I've seen 553 00:44:43.280 --> 00:44:46.280 it, you know, not necessarily said to me, but it's been hinted 554 00:44:46.320 --> 00:44:51.159 at that, like, oh, y'all just push medications, y'all, don't 555 00:44:51.199 --> 00:44:53.679 really try to get to the root cause of things, because you just want 556 00:44:53.719 --> 00:45:00.320 to prescribe a medication to treat a complication, and that's it. A so 557 00:45:00.519 --> 00:45:04.880 called you want a sick type approach, which I think is unfortunately kind of 558 00:45:05.159 --> 00:45:12.760 the the all too popular nowadays, especially on like social media and stuff, 559 00:45:12.760 --> 00:45:17.679 when it comes to anything pharmaceutical related. Whereas someone like you is a pharmacist 560 00:45:17.719 --> 00:45:22.039 by trade, knows all the absorption and like it, knows all the things 561 00:45:22.119 --> 00:45:27.800 to amplify and make perfect da dosage for him for a natural product, that's 562 00:45:27.840 --> 00:45:30.480 not your approach. I mean listening to you talk to this point, I 563 00:45:30.519 --> 00:45:35.079 mean that the listeners are gonna it's blatantly obvious that you care as to the 564 00:45:35.920 --> 00:45:38.400 whole, the whole mechanism and getting it to the what issue we have. 565 00:45:39.679 --> 00:45:45.079 Whereas you know, people just hear pharmacists and they think, oh, they 566 00:45:45.119 --> 00:45:46.559 just want to throw a pill at it. It's like, now we're really 567 00:45:46.639 --> 00:45:50.119 trying to I don't want you on medications, and if I can, if 568 00:45:50.159 --> 00:45:52.679 I can come up with a natural remedy to not have to even go down 569 00:45:52.719 --> 00:45:55.840 that route, that's what I'm gonna do. You know. We want what's 570 00:45:55.840 --> 00:46:00.280 best for our patients. So I think that's an important, important distinct should 571 00:46:00.360 --> 00:46:05.800 like to make because yes, we're pharmacists, but I think the true pharmacists 572 00:46:05.800 --> 00:46:07.519 that are really trying to push the boundaries of where the field's currently at, 573 00:46:07.599 --> 00:46:16.119 like yourself, have that everything's interwoven everyone's unique type of approach and mentality to 574 00:46:16.239 --> 00:46:21.039 things. So I think that's that's a thing that's really fascinated me with you 575 00:46:21.199 --> 00:46:24.360 got you and my dad and y'all's groups approach. It is just how you're 576 00:46:24.400 --> 00:46:30.480 able to take the science and really apply it and make it unique to where 577 00:46:30.519 --> 00:46:35.800 it's not just this cookie cutter type approach that really you're kind of not so 578 00:46:35.960 --> 00:46:42.159 sure if you had the clinical data to back it up. Yeah. Excellent 579 00:46:42.280 --> 00:46:46.159 description of the sort of the overview of the whole process, right, Patrick, 580 00:46:46.239 --> 00:46:51.360 And I think what is you know, I'll poke fund it myself as 581 00:46:51.400 --> 00:46:54.239 an inventor and scientist for you know, thirty years is I've come up with 582 00:46:54.840 --> 00:47:00.159 a lot of solutions to problems that don't exist, and so the focus now 583 00:47:00.280 --> 00:47:05.599 in my career is trying to come up with solutions to problems that do exist. 584 00:47:06.119 --> 00:47:08.920 So let's go back to I think it's very important for your listeners is 585 00:47:09.000 --> 00:47:15.599 to make that final connection to sort of the mechanism in the process to the 586 00:47:15.760 --> 00:47:22.840 disease related phenomenon. So let's go back to the phosphatidalpoline. Right. So 587 00:47:22.159 --> 00:47:27.119 we're taught in bio chemistry key component of cellular membranes, but now let's talk 588 00:47:27.119 --> 00:47:35.199 about phosphaticholine in the liver as a signaling molecule. Signaling molecule in the context 589 00:47:35.280 --> 00:47:45.760 of disease relevant endpoints. So slost fotidocolines are absolutely critical for constructing the vodal 590 00:47:45.920 --> 00:47:52.079 molecules that secrete triglycerides from our liver. Right, secreting triglycerides from our liver. 591 00:47:52.480 --> 00:47:53.440 Why do we want to do that? Because we want to get those 592 00:47:53.480 --> 00:47:57.559 fats I have the livers to them build up in the liver and cause fatty 593 00:47:57.599 --> 00:48:02.079 liver non alcoholic fatty liver disease or metabolical associated fatal liver disease, whatever we're 594 00:48:02.119 --> 00:48:13.360 calling it now. So the triglyceride lowering effect of phosphate cooline is is I 595 00:48:13.440 --> 00:48:17.400 think the other part of this is phosphate of choline right where it participates in 596 00:48:17.480 --> 00:48:22.559 this sort of lipid metabolism. It more familiar is as a result of its 597 00:48:22.880 --> 00:48:27.679 metabolism fosph to cooline, it's attacked by enzymes and our bloodstream. It is 598 00:48:27.760 --> 00:48:34.440 as able to increase our HDL. And so we've got to have phosphateicholines, 599 00:48:34.920 --> 00:48:39.960 not only phosphate of coolies, but those foster tocolines that are laden with the 600 00:48:40.039 --> 00:48:45.880 omegus rees. We have to have those in order to increase our HDL. 601 00:48:46.000 --> 00:48:51.000 It is part of increasing our HDL. So now we've got two disease relevant 602 00:48:51.199 --> 00:48:54.519 indpoints here. Right. If I've got good phosphate cooline levels and they're packed 603 00:48:54.559 --> 00:48:58.599 with the right ingredients and mega the reason in particular, I can increase my 604 00:48:58.719 --> 00:49:01.840 HDL, I can reduce triglycerides. And you know that's the other thing. 605 00:49:01.920 --> 00:49:06.880 We don't talk about triglycerides to HDL and their commentational ratio. We so been 606 00:49:06.960 --> 00:49:09.800 so much time talking about LDL. But I would encourage your listeners to really 607 00:49:10.079 --> 00:49:15.800 dive in and start to understand this concept of tricklyscride to HDL ratio. I 608 00:49:15.880 --> 00:49:20.679 think if you read the literature, you'll be fascinated where it is probably in 609 00:49:21.159 --> 00:49:24.960 my reading, the most relevant, one of the most relevant indicators of chronic 610 00:49:25.000 --> 00:49:30.400 disease, Heart disease, sattering for sure, those two ingredients. Yeah. 611 00:49:30.400 --> 00:49:32.719 I mean, if you just Google a put med search and you look up 612 00:49:32.760 --> 00:49:37.440 metabolic syndrome trigo sorry to HDL ratio. I mean, there's hundreds of papers 613 00:49:37.679 --> 00:49:40.159 that are all linking it. I mean, I was talking to one of 614 00:49:40.199 --> 00:49:45.000 my other our wellness director, Rodio, the other day, and I was 615 00:49:45.360 --> 00:49:50.320 she was very fascinated with metabolic syndrome. We have different approaches to certain aspects 616 00:49:50.360 --> 00:49:53.760 of that, but she's she's really gets kind of the biochemistry, and I 617 00:49:53.920 --> 00:49:57.440 was talking to her about that ratio and she's like, oh yeah, I 618 00:49:57.480 --> 00:50:00.480 mean that's one of the telltale things, super easy to calculate, you know, 619 00:50:00.559 --> 00:50:02.159 based off labs if we're dealing with it, and she goes, I 620 00:50:02.199 --> 00:50:07.039 see it all the time in my metabolic syndrome patients or patients with obesity or 621 00:50:07.320 --> 00:50:12.599 cholesterol issues. They go hand in hand, and you're exactly correct. I 622 00:50:12.679 --> 00:50:16.480 think that ratio and then like that Omega three to Omega six ratio I think 623 00:50:16.599 --> 00:50:21.440 is finally just now starting to get teased out in the literature, and as 624 00:50:21.480 --> 00:50:24.119 a person myself, that's where I start to really kind of look as well. 625 00:50:24.400 --> 00:50:27.480 So it's it's really cool that you bring that up, for sure, 626 00:50:27.480 --> 00:50:30.159 because it's definitely for the longest time, like even in pharmacy school, it's 627 00:50:30.159 --> 00:50:35.159 like fish oils, these types of things increase HDL and then someone like me, 628 00:50:35.239 --> 00:50:37.519 it's like, well, well, how is it do that? And 629 00:50:37.599 --> 00:50:42.000 they're like, it just does. That's what that's what the black box, 630 00:50:42.159 --> 00:50:45.480 right, Yeah, it just does. Like it's like yeah, it's like, 631 00:50:45.719 --> 00:50:49.199 yeah, cool, that makes sense. We know most of denovo cholesterol 632 00:50:49.239 --> 00:50:52.159 synthesis comes from the liver anyway, so it's not a you know, not 633 00:50:52.280 --> 00:50:55.960 a stretch to assume that it's something there, and it's finally cool and interesting 634 00:50:57.119 --> 00:51:00.559 to kind of tease out that mechanism. And I think you've done a good 635 00:51:00.599 --> 00:51:04.400 job of explaining that in Layman's terms, and it makes a whole lot of 636 00:51:04.440 --> 00:51:07.760 sense, Like there's so many implications for that mechanism and batty liver disease. 637 00:51:07.800 --> 00:51:10.000 When you were explaining you know, these storage forms, you may just load 638 00:51:10.079 --> 00:51:15.079 it up all the time, but it doesn't go anywhere, or if it 639 00:51:15.199 --> 00:51:17.519 does, you start seeing you know, triglyst ride of VLDL go up, 640 00:51:17.559 --> 00:51:21.360 it starts to shut it down that other pathway, and it's like, no, 641 00:51:21.480 --> 00:51:22.320 we want to make it go this way so we can get all the 642 00:51:22.360 --> 00:51:28.679 added benefits of excess phosphatial calling that you've talked about. So it's just it's 643 00:51:28.760 --> 00:51:30.960 really cool just to kind of finally have an answer to that question. Because 644 00:51:31.039 --> 00:51:36.719 every biology course or pharmacology course that I had, when this topic of omega 645 00:51:36.800 --> 00:51:39.599 threes comes up, it's like, well how, and then no one could 646 00:51:39.599 --> 00:51:43.559 ever really give a clear answer until yourself. So I think that's awesome. 647 00:51:44.480 --> 00:51:47.039 Yeah, yeah, it's really cool. And I think if you look at 648 00:51:47.039 --> 00:51:51.840 it sort of as a pike, the input would be the amina threes, 649 00:51:52.159 --> 00:51:55.039 and now we're talking about the outputs. The outputs are impacting HDL, are 650 00:51:55.119 --> 00:52:00.360 impacting triglyst rides. But let's sort of bring it full. So as a 651 00:52:00.440 --> 00:52:07.559 result of increasing HDL, omega three's and methyl donors increasing HDL, a side 652 00:52:07.639 --> 00:52:14.239 product of HDL production, interestingly enough, fascinating enough, is the actual transportable 653 00:52:14.440 --> 00:52:17.760 form of DHA. So, in other words, remember we sat over here 654 00:52:17.760 --> 00:52:22.119 on the left hand side of the pipeline where you have all this DHA floating 655 00:52:22.159 --> 00:52:24.000 around in the bloodstream and it's not able to make it into the brain when 656 00:52:24.039 --> 00:52:29.360 he goes to this pipeline and that last step where you form HDL, what 657 00:52:29.519 --> 00:52:35.119 comes out of that as a side sort of product is the brain's transportable form. 658 00:52:35.239 --> 00:52:38.440 So now I've got a form of DHA that when it passes through to 659 00:52:38.519 --> 00:52:44.519 the blood brain barrier, there's a transporter there that sits at the blood brain 660 00:52:44.639 --> 00:52:51.360 barrier that recognizes that transportable form of dha, not tree dha, the transportable 661 00:52:51.360 --> 00:52:55.679 form of DHA, and pulls DHA into the brain. So, now if 662 00:52:55.760 --> 00:53:00.960 you don't send DHA through that pipeline and reap package it into the transportable form, 663 00:53:01.239 --> 00:53:06.639 then you can take dha till you're blue in the face, right, 664 00:53:07.239 --> 00:53:10.920 and it's not going to do any good. But here's the downside is we 665 00:53:12.159 --> 00:53:15.639 know that too much of a good thing, anything is not good, that 666 00:53:15.800 --> 00:53:20.920 correct, and we know then when we get too much DHA, too much 667 00:53:20.960 --> 00:53:25.440 EPA in particular DHA. In some studies is shown that DHA is actually cardio 668 00:53:25.519 --> 00:53:34.599 toxin because it starts to replace other fatty acids and key membrane lipids in our 669 00:53:34.679 --> 00:53:39.480 monicondi, our energy producing organelles, and they don't work as efficiently. And 670 00:53:40.559 --> 00:53:45.880 you know it's because the DHA, because there's so much how it replaces these 671 00:53:45.000 --> 00:53:52.480 other key fatty acids. So that's the other reason why that sometimes as humans, 672 00:53:52.440 --> 00:53:54.760 right, we think we know how the body works, and we see 673 00:53:54.760 --> 00:53:58.039 an endpoint, Right, I've got to get DHA into the brace, So 674 00:53:58.119 --> 00:54:01.559 let's give more dha. But we don't get a body enough credit for it 675 00:54:01.960 --> 00:54:06.840 their regulated processes. And there's a reason why, Right, you can eat 676 00:54:07.320 --> 00:54:09.719 you know, fish once a week and still have plenty of DHA if you've 677 00:54:09.760 --> 00:54:15.960 got all the other dietary ingredients there to help your deliver do what it's supposed 678 00:54:16.000 --> 00:54:20.119 to do, right, which at the end of the day, I always 679 00:54:20.159 --> 00:54:25.639 remind myself these are dietary supplements. Let's go back to nineteen ninety four to 680 00:54:25.760 --> 00:54:31.360 shave. They're designed as nutritional supplements, meaning supplements to our diet. What 681 00:54:31.519 --> 00:54:37.039 are we not getting in our diet that we should be getting in our diet. 682 00:54:37.320 --> 00:54:40.880 And so that's the other thing to keep in mind is right from a 683 00:54:42.119 --> 00:54:46.159 pharmacist perspective, when you're talking with patients, and right, we're really good 684 00:54:46.239 --> 00:54:52.760 at patient, take this antibiotic with food, without food, or oftentimes we 685 00:54:52.760 --> 00:54:54.760 talk about with it because it's going to upset your stomach, but we don't 686 00:54:54.840 --> 00:54:58.719 think about supplements. Right, If you think about it in the context of 687 00:54:59.000 --> 00:55:01.719 their supplement to our food in our mill, then it rolls off the tongue. 688 00:55:01.920 --> 00:55:06.760 Be sure and take this with food, because it's a nutritional supplement. 689 00:55:07.159 --> 00:55:13.760 And what that means is that your body produces to physiologic process. It's the 690 00:55:13.880 --> 00:55:17.960 necessary chemistry to absorb all those things that are in these dietary supplements. And 691 00:55:19.079 --> 00:55:22.400 if you don't eat, then you don't have that secretion of these you know, 692 00:55:22.679 --> 00:55:27.880 Lessithans set of these solutlizing agents in the small testine and they just pass 693 00:55:28.039 --> 00:55:30.679 right through the GI track. So yeah, I would give that as a 694 00:55:30.760 --> 00:55:35.800 take home for your listeners today too, is I can't think of a single 695 00:55:35.960 --> 00:55:42.199 reason why you would give a nutritional supplement not in the context of extremely I've 696 00:55:42.239 --> 00:55:46.000 always open to being important. Yes, yes, that's extremely important. I 697 00:55:46.039 --> 00:55:51.239 always recommend and I always recommend any supplements with food and not just you know, 698 00:55:51.320 --> 00:55:53.079 yeah, if you take fifteen twenty supple. Iman know a lot of 699 00:55:53.079 --> 00:55:55.800 people that take a lot of stuff and if they take it on in stumm, 700 00:55:55.800 --> 00:55:59.119 it's like, I feel nauseous and terrible. It's like, just eat 701 00:55:59.159 --> 00:56:02.000 with it, you'll be good, and it's it's like and then you know, 702 00:56:02.079 --> 00:56:06.320 we haven't even gotten into the part that most of these extracts and large 703 00:56:06.400 --> 00:56:09.719 proprietary blends with all these ingredients just kind of thrown in, so to speak. 704 00:56:09.800 --> 00:56:12.559 Now, some of them may not just be thrown in. There might 705 00:56:12.559 --> 00:56:16.239 be a reason why they're all combined. Let's play both sides. But that 706 00:56:16.440 --> 00:56:22.360 dissolution profile of those certain extracts may not be very good, and you may 707 00:56:22.400 --> 00:56:25.599 be taking it and it's not getting absorbed, which is a whole other thing 708 00:56:25.679 --> 00:56:29.960 that I think is what farms to spring to the table is just especially you 709 00:56:30.039 --> 00:56:34.800 guys at the NCNPR, you are really good at going. My dad says 710 00:56:34.840 --> 00:56:36.679 this all the time. I'm my dad, what do you know about this 711 00:56:36.719 --> 00:56:37.719 supping? And I haven't heard of it before. It goes doesn't work, 712 00:56:37.719 --> 00:56:42.880 it doesn't matter, it doesn't get absorbed. And I'm just like okay, 713 00:56:43.199 --> 00:56:45.599 and he's like, yeah, I mean you could take you could take bottles 714 00:56:45.639 --> 00:56:49.079 of it. It's not get absorbed. And it's it's one thing that and 715 00:56:49.239 --> 00:56:52.159 that's if you tell that to a patient that's been on it for a long 716 00:56:52.199 --> 00:56:53.440 time, it's really frustrating. They're like, why didn't anyone tell me that. 717 00:56:53.480 --> 00:56:59.559 It's like, it's not very many people know, and they think, 718 00:56:59.599 --> 00:57:00.960 oh, it's natural source. Of course it's going to get those order. 719 00:57:00.960 --> 00:57:04.119 Why wouldn't it. It's like, you know, it's just not, That's 720 00:57:04.119 --> 00:57:07.760 not how chemistry works. It's just it's very important distinction. But yes, 721 00:57:08.039 --> 00:57:12.880 definitely eating with it. And again I tell people that all the time too, 722 00:57:12.960 --> 00:57:16.199 that supplements are meant to supplement a proper diet. So not only do 723 00:57:16.280 --> 00:57:19.559 we have you can take supplements to your blue in the face, and yes 724 00:57:19.639 --> 00:57:23.079 that some needles will improve, but again we've got to also facilitate that through 725 00:57:23.239 --> 00:57:30.320 that same those same principles through dietary management as well. Another point I'll make 726 00:57:30.440 --> 00:57:32.760 briefly because I just thought of this when we were talking about so you know, 727 00:57:32.840 --> 00:57:37.880 your product centers around sessament extract, which is from sesame seeds, which 728 00:57:37.960 --> 00:57:42.440 is there's a lot of there's kind of a push now and I'm not sure 729 00:57:42.480 --> 00:57:45.960 if you're super familiar with it, like the all seed oils or the cause 730 00:57:45.039 --> 00:57:50.239 of all the chronic problems. Now that narrative is starting to get pushed, 731 00:57:50.400 --> 00:57:53.239 and to a degree I can kind of get it. But sesame seed and 732 00:57:53.320 --> 00:57:58.239 all these different you know, seed oils, do you have large clinical benefit 733 00:57:58.280 --> 00:58:01.239 when you when you look into the research for them, especially if amounts are 734 00:58:01.280 --> 00:58:06.000 controlled, you're not overdoing it, just like anything else. So I think 735 00:58:06.519 --> 00:58:08.639 if the listeners get nothing out of it, if you're elling the anti seed 736 00:58:08.679 --> 00:58:15.559 oil type of train, I think I think Ryan's proved that the sessamon sesame 737 00:58:15.679 --> 00:58:17.960 seed oil part of that shouldn't be included at bare minimum. So I just 738 00:58:19.119 --> 00:58:22.119 I just want to make that quick point because as humans, we tend to 739 00:58:22.239 --> 00:58:27.679 fight, we tend to fall into these camps of things like, oh you 740 00:58:27.800 --> 00:58:30.760 know what, yes, this scary. This these seed oils, there's there's 741 00:58:30.239 --> 00:58:35.079 negative clinical benefits if overconsumed, So now they're all bad. It's like we 742 00:58:35.239 --> 00:58:37.599 take one thing and then we just go too far with it. Same thing 743 00:58:37.679 --> 00:58:40.519 with carbohydrates. It's like, oh, you know, yes, if you 744 00:58:40.599 --> 00:58:43.519 eat too many of them, and if you don't eat the right types, 745 00:58:43.559 --> 00:58:46.800 and we're not we're not really watching that a lot of people will go, 746 00:58:46.880 --> 00:58:50.320 Okay, all carbs are bad, you don't need any of them. So 747 00:58:50.480 --> 00:58:53.639 it's like when you talk to the actual scientists and people say, yes, 748 00:58:53.800 --> 00:58:59.679 balance and moderation is important. You got it. There's definitely truth to it. 749 00:59:00.280 --> 00:59:01.719 I don't think we're really going to get anywhere in the field of science 750 00:59:01.760 --> 00:59:07.639 if we all just take these if we all just hop into these camps where 751 00:59:07.679 --> 00:59:09.119 it's like an all or nothing type approach. If that makes sense. I 752 00:59:09.159 --> 00:59:13.039 don't know if you've been if you share any of those sentiments, but I 753 00:59:13.119 --> 00:59:15.559 just want to make that quick point because that's just what I was thinking about 754 00:59:15.559 --> 00:59:19.920 it when you were when you were talking about it. You know what I'm 755 00:59:19.920 --> 00:59:27.519 find fascinating about the seed oil is particularly sesame seed oil. I mean, 756 00:59:28.159 --> 00:59:31.960 it's been around since time and more in memorium, I think is the term 757 00:59:32.000 --> 00:59:37.280 I'm looking for. And the reason why it was so easy to transport is 758 00:59:37.320 --> 00:59:42.519 because of its high any oxidant activity, and so it was utilized for thousands 759 00:59:42.519 --> 00:59:47.079 of years. And so as a result of that, the listeners should know 760 00:59:47.559 --> 00:59:53.280 that there are a few people out there who interesting enough have sessame seed allergies, 761 00:59:53.760 --> 00:59:59.119 and so I think it's had been estimated there may be as much as 762 00:59:59.159 --> 01:00:04.599 a million people in the world that have assess me seed allergy. So we're 763 01:00:04.719 --> 01:00:07.920 very careful to put that on the ball, right. So it's it's like 764 01:00:07.039 --> 01:00:13.599 anything else. There is a generalization about health benefits, but you can always 765 01:00:13.679 --> 01:00:19.039 find a situation or scenario where it's not the right thing for a specific patient, 766 01:00:19.599 --> 01:00:23.039 and in that case you have to have alternatives for those individuals. But 767 01:00:23.599 --> 01:00:30.559 I think if you can come up with something that is generalizable for your patients 768 01:00:30.159 --> 01:00:35.880 on and gives them an option, right with both pharmacists. And there's a 769 01:00:36.039 --> 01:00:39.119 tremendous amount of benefit that comes from prescription medications, I would never say that 770 01:00:39.199 --> 01:00:44.159 there is no there's a tremendous amount of harm and misuse that comes from that 771 01:00:44.280 --> 01:00:46.760 as well, So we have to balance and our patients know that, and 772 01:00:46.880 --> 01:00:52.559 our patients want to be as natural as possible. And I think it's incumbent 773 01:00:52.679 --> 01:00:57.440 upon us as pharmacists to give them the education and the knowledge that we have 774 01:00:57.840 --> 01:01:00.119 around this topic and say, Okay, here is an option that you have. 775 01:01:00.960 --> 01:01:06.159 I'm never going to push something instead of a statin for example, I'm 776 01:01:06.159 --> 01:01:09.159 going to say, here is an option or a companion something that you know, 777 01:01:09.280 --> 01:01:13.639 you never want to get between an individual and his or her physician, 778 01:01:13.800 --> 01:01:16.960 right because they know the patient best, correct, But again, the patient 779 01:01:17.079 --> 01:01:21.840 at the end of the day knows themselves best, and so you give them 780 01:01:21.920 --> 01:01:25.079 the options to make the decision and informed decision. And I think at the 781 01:01:25.159 --> 01:01:28.679 end of the day, right, that's who we are as pharmacists. Our 782 01:01:28.760 --> 01:01:31.679 job is to inform the public, and we're the most accessible, you know, 783 01:01:31.760 --> 01:01:35.400 all those things that we've been told for years that we are, we 784 01:01:35.480 --> 01:01:38.360 are and that's why we have been one of the most trusted professions ever because 785 01:01:38.559 --> 01:01:43.840 we give information, but we don't typically have skin in the game, so 786 01:01:44.000 --> 01:01:45.960 to speak, and so it is a little bit concerning. And when you 787 01:01:46.000 --> 01:01:49.079 know you mentioned earlier, people say, oh, you just want to push 788 01:01:49.119 --> 01:01:54.039 the fill and if you're able to counter that with well you have options, 789 01:01:54.400 --> 01:01:58.920 and here are those other options, then you can make a much more compelling 790 01:01:59.039 --> 01:02:04.119 case. I think actually, for you're interested in treating the individuals in not 791 01:02:04.280 --> 01:02:08.519 selling them a prescription, and we won't even getting yeah, the costs of 792 01:02:08.559 --> 01:02:13.360 prescriptions and are you any make any money selling prescription? Oh dude, yeah, 793 01:02:13.519 --> 01:02:16.599 I mean I've told a few patients about that just in general, like, 794 01:02:16.639 --> 01:02:19.360 oh, yeah, I can't feel that, and they're like why. 795 01:02:19.440 --> 01:02:21.639 It's like, well, every time I do it, I lose money. 796 01:02:21.719 --> 01:02:24.280 It's like and they're like, what are you talking about? You? That's 797 01:02:24.320 --> 01:02:29.800 not how business works, Like exactly, it's how business works. And it's 798 01:02:29.840 --> 01:02:31.480 funny. I was, I was, but a forteous how pharmacy been. 799 01:02:31.639 --> 01:02:36.159 Yeah, it's just a it's a topic for another day, but I may 800 01:02:36.239 --> 01:02:38.960 I may do a mini episode on those, even though it's convoluted, but 801 01:02:39.079 --> 01:02:43.119 it's interesting enough. Like tomorrow, I'm doing an interview with another friend of 802 01:02:43.159 --> 01:02:47.280 mine who is heavily involved with Nimbus at the pharmacy. He's one of the 803 01:02:47.360 --> 01:02:51.639 co founders. It's doctor Richard Harris. He has a he's an m D. 804 01:02:52.280 --> 01:02:53.840 He also has his pharm d degree to, which makes him like super 805 01:02:53.920 --> 01:02:58.880 unique. And he tells me all the time about what he does when he 806 01:02:58.960 --> 01:03:02.639 meets with patients for life style managements. He'll go, Okay, I don't 807 01:03:02.800 --> 01:03:07.760 write prescriptions unless it's like the alarm bells are going off. He goes, 808 01:03:07.800 --> 01:03:10.440 But if I can look at the patient's labs and see that we may not 809 01:03:10.559 --> 01:03:14.760 be going in the right direction, I've got to have options for them. 810 01:03:14.960 --> 01:03:17.719 He goes, Now it maybe everything's lighting up red and not looking good. 811 01:03:17.760 --> 01:03:20.719 It's like, Okay, we need to do a statin and some stuff right 812 01:03:20.760 --> 01:03:23.480 now, or hey, we're kind of trend in there if we don't manage 813 01:03:23.519 --> 01:03:27.480 some of these things like this is these are the options we're going to have 814 01:03:27.679 --> 01:03:30.599 to take in the future, but for right now, here's here's three things 815 01:03:30.639 --> 01:03:35.400 you can do and stuff like that. So he's really pushing the boundary from 816 01:03:35.400 --> 01:03:39.679 a physician side of having options and when we're all on the same page, 817 01:03:39.880 --> 01:03:44.360 like as pharmacists to physicians to patient, if we're all on the same page 818 01:03:44.400 --> 01:03:49.400 and have the same approach, it's only going to be beneficial. I find 819 01:03:49.440 --> 01:03:54.599 it. I find it harder when and patients can can attest to this is 820 01:03:54.840 --> 01:03:59.280 they're like well, I'll have a conversation with one of them, for example, 821 01:03:59.360 --> 01:04:00.079 and they'll go, well, what you're telling me is not what my 822 01:04:00.119 --> 01:04:03.000 doctor said. But doctor didn't even spend a few, you know, much 823 01:04:03.079 --> 01:04:05.079 time with me. Let alone tell me that. It's like, yes, 824 01:04:05.239 --> 01:04:08.960 the doctor doesn't have time to do that as well. So let's not just 825 01:04:09.320 --> 01:04:12.719 assume that the doctor's not wanting to do their job is they don't have the 826 01:04:12.840 --> 01:04:16.440 time. So I think that's another benefit of having a pharmacist. If I 827 01:04:16.559 --> 01:04:20.800 know where their physicians at, then I can take that extra time throughout the 828 01:04:20.920 --> 01:04:26.400 day and help kind of facilitate that process moving forward to where we're all kind 829 01:04:26.440 --> 01:04:30.559 of moving in the same direction. I don't like to, like you said, 830 01:04:30.559 --> 01:04:33.159 I don't want to get in between the patient patient physician relationship. But 831 01:04:33.280 --> 01:04:36.800 if I know what that patient physician relationship is and I can help kind of 832 01:04:36.840 --> 01:04:41.519 elaborate on things they've already talked about, that's that's the most important role I 833 01:04:41.599 --> 01:04:46.880 think as pharmacist that we can provide because let's be honest, you don't see 834 01:04:47.000 --> 01:04:49.639 you may you know, if you're a relatively healthy individual, you may see 835 01:04:49.679 --> 01:04:54.920 your physician a couple of times a year for you know, let's say fifteen 836 01:04:55.000 --> 01:04:58.760 to thirty minutes, maybe longer, but in the scheme of things, you 837 01:04:58.840 --> 01:05:01.159 may come to see me at least once a month, hopefully if you're on 838 01:05:01.199 --> 01:05:04.159 a prescription or something like that, if you're taping supplements regularly. So it's 839 01:05:04.199 --> 01:05:06.760 like I can kind of get to know you, better understand what's going on 840 01:05:06.960 --> 01:05:14.239 outside of outside of a healthcare setting, and then help you facilitate getting good 841 01:05:14.320 --> 01:05:15.920 information good out there and have a plan of attacks so when you go back 842 01:05:15.960 --> 01:05:20.000 to the doctor's office that everything's looking right, and then you can say, 843 01:05:20.039 --> 01:05:23.280 hey, I you know, I've been doing what you said, and my 844 01:05:23.360 --> 01:05:26.519 pharmacists and are my other people that I see are We're all on the same 845 01:05:26.559 --> 01:05:30.079 page and it's only going to be beneficial for the patient at that point. 846 01:05:30.159 --> 01:05:32.880 So I think that's a really important point that you made for sure in that 847 01:05:33.000 --> 01:05:40.599 regard. So let's let's get into So you've already kind of we've clearly talked 848 01:05:40.639 --> 01:05:44.199 about the benefits for sesame and all that stuff. So I know you're one 849 01:05:44.239 --> 01:05:46.639 of your other fascinations and you talked about this in your your introduction. Is 850 01:05:48.199 --> 01:05:53.840 how you're interested in relating that to diabetes, So tell me more about granted 851 01:05:53.880 --> 01:05:56.639 I already know a lot of this, but tell me more for our listeners 852 01:05:56.679 --> 01:06:01.039 out there, how this applies more to diabetes and also where your kind of 853 01:06:01.119 --> 01:06:04.679 business ventures are going, if you can get into that on how this will 854 01:06:04.719 --> 01:06:09.079 help diabetics on like a national scale at some point, because I know that's 855 01:06:09.119 --> 01:06:13.920 kind of how you guys see this moving. So can you elaborate a little 856 01:06:13.920 --> 01:06:18.480 bit on that, and then also some because clearly you know all the cholesterol 857 01:06:18.599 --> 01:06:21.880 abnormalities and diabetes go hand in hand as well as all the liver stuff that 858 01:06:21.920 --> 01:06:26.760 we've already talked about, So feel free if you want to talk about that. 859 01:06:27.079 --> 01:06:30.280 I think our listeners would be really interested because there's a lot of patients 860 01:06:30.320 --> 01:06:31.719 out there that are pre diabetic it may not even know it, that are 861 01:06:31.800 --> 01:06:35.679 looking for these answers before they get that diagnosis if they're going down that track. 862 01:06:35.800 --> 01:06:44.679 So yeah, we'll start here. In terms of the pre diabetes it, 863 01:06:45.239 --> 01:06:54.000 there is extensive in I mean extensive research looking at liver metabolism foster to 864 01:06:54.039 --> 01:06:59.159 coli metabolism, and it's linked to conversion of pre diabetes to diabetes. And 865 01:06:59.239 --> 01:07:03.440 there's one mark or in particular and so called like selfosteral choline, which is 866 01:07:03.440 --> 01:07:12.760 a metabolized form of fospital kolide that is linked to a conversion of prediabetes to 867 01:07:12.840 --> 01:07:18.480 diabetes. So again there's direct linkage beyond the triaglycerride, the HDL, the 868 01:07:18.760 --> 01:07:25.800 forms of absorbable or penetrating DHA. Right, is these bio markers related to 869 01:07:25.920 --> 01:07:31.119 diabetes. So all that is to say that this foster decoline metabolism and the 870 01:07:31.400 --> 01:07:36.599 offshoot of that, the metabolites of that are related to diabetes. I think 871 01:07:38.119 --> 01:07:42.400 where I would go next is, you know, we talk about the triglycerides 872 01:07:42.679 --> 01:07:47.760 and what any healthcare practitioner that's paying attention to the literature, and I only 873 01:07:47.800 --> 01:07:51.400 say it that way because most are so swamped with just their day to day 874 01:07:51.480 --> 01:07:55.039 duties to see in their patients. Right, It's hard to keep up with 875 01:07:55.079 --> 01:07:58.280 the literature sometimes. But those that are able to keep up with the literature 876 01:07:58.280 --> 01:08:03.079 and habitime and energy are reading about fatty liver non alcoholic fatty liver disease. 877 01:08:03.159 --> 01:08:09.599 That's the scourge, and I think it gets lost sometimes though in the discussion 878 01:08:09.840 --> 01:08:16.439 of obesity and diabetes and again trying to put them into different buckets as opposed 879 01:08:16.479 --> 01:08:20.520 to try to look at them holistically and seeing how we can impact all those 880 01:08:20.600 --> 01:08:28.640 things in a more concerted fusion. And so I guess the greatest example that 881 01:08:29.079 --> 01:08:35.479 is this whole gop one receptor agonies in the context of obesity and sort of 882 01:08:36.800 --> 01:08:43.600 in my humble opinions that the train wreck waiting to happen, because what the 883 01:08:43.720 --> 01:08:48.359 patients aren't told is that as soon as they come off these agents, the 884 01:08:48.720 --> 01:08:56.560 clinical trials clearly show that you rebound severely in terms of right, it's just 885 01:08:56.720 --> 01:08:59.640 within a few months, and I forget the exact that we talked, but 886 01:09:00.199 --> 01:09:01.680 it's a few months, you're right back where you were. So I guess 887 01:09:01.680 --> 01:09:05.399 what going with that is. That is something that is a patient wants to 888 01:09:05.600 --> 01:09:11.159 commit a lifetime too. That's exactly what yours. Okay, if you're going 889 01:09:11.199 --> 01:09:14.119 out to GP one, if you want to use them to get you to 890 01:09:14.159 --> 01:09:16.760 a certain point, and actually you were the one and I really sort of 891 01:09:17.039 --> 01:09:19.600 got the thinking in this direction. If you want to use them to get 892 01:09:19.600 --> 01:09:24.560 to a weight, and how do you then sort of rethink what you eat 893 01:09:24.640 --> 01:09:27.760 and how you eat to keep you at a healthy weight. I think that 894 01:09:27.880 --> 01:09:30.800 could be a potential use for those to steal your words from last year. 895 01:09:30.880 --> 01:09:34.039 Yeah, exactly, I'm actually believing or not. Was before we started, 896 01:09:34.079 --> 01:09:38.479 I was working on a script for the next you know, a podcast episode 897 01:09:38.560 --> 01:09:40.760 is gonna do solo, and it was going to be basically everything you need 898 01:09:40.800 --> 01:09:45.279 to know about GLP ones. You know, not only from describing what they 899 01:09:45.319 --> 01:09:48.880 do pharmaceutically or in a pharmacology sense. But yes, that was the thing 900 01:09:48.920 --> 01:09:51.920 that was startling to me. And I think if I remember correctly from the 901 01:09:51.960 --> 01:09:56.119 trial, I remember the authors of it, but it was showing they studied 902 01:09:56.119 --> 01:09:59.199 these patients out for a year and I think by eighteen, by twelve months, 903 01:09:59.239 --> 01:10:02.000 they'd hit there whatever or what their weight goal was. And then I 904 01:10:02.079 --> 01:10:05.920 think it was within the year, I mean some within the year they had 905 01:10:05.920 --> 01:10:10.680 gained all their weight back quests some And you see that time and time again 906 01:10:10.680 --> 01:10:15.319 with just about any dietary intervention, whether that be like a fasting, whether 907 01:10:15.359 --> 01:10:18.560 that be like a keto diet again, all of it. It's about consistency. 908 01:10:19.119 --> 01:10:25.000 Now totally fine with I mean I totally. We dispense GLP ones all 909 01:10:25.039 --> 01:10:28.560 the time, I mean all the time, so I talk about them quite 910 01:10:28.600 --> 01:10:32.880 often with patients. But what I tell them is once we get where we 911 01:10:33.000 --> 01:10:38.119 need to if that's what helps you kind of facilitate doing things and helping with 912 01:10:38.239 --> 01:10:41.039 lifestyle patterns and stuff. So if you need to lose fifty pounds for you 913 01:10:41.119 --> 01:10:43.039 to be able to like feel like you have the energy to go to the 914 01:10:43.119 --> 01:10:46.359 gym consistently, fine, But what do we do when those medications stop? 915 01:10:47.279 --> 01:10:50.439 And that's the big thing is like if you just treat them as the medications 916 01:10:50.479 --> 01:10:54.760 going to fix all your problems, and then when you get off the medications, 917 01:10:54.840 --> 01:11:00.119 you've learned you don't know how to then keep that trend going. I 918 01:11:00.199 --> 01:11:03.399 think that's where people like us come into play. Is I think that's a 919 01:11:03.520 --> 01:11:09.000 very important piece of the puzzle that it's exactly in your word, it's a 920 01:11:09.039 --> 01:11:11.840 train wreck rating to happen, because then guess what when you if you gain 921 01:11:11.880 --> 01:11:15.600 all that weight back, what's all you know to do was I guess I 922 01:11:15.680 --> 01:11:19.119 got to go back on this medication again. And let's be honest, these 923 01:11:19.199 --> 01:11:24.840 medications are not cheap. I'll kind of be brief with this, but on 924 01:11:25.000 --> 01:11:28.520 average, let's say you walk into this pharmacy with the prescription for azempic, 925 01:11:28.720 --> 01:11:31.079 whether that beeper. Now, if it's for diabetes, it's different like insurances 926 01:11:31.199 --> 01:11:34.880 or more apt to cover something like that. Seeing copay is really low. 927 01:11:35.000 --> 01:11:39.720 I've seen some have no copays, but for weight loss, since it's now 928 01:11:39.800 --> 01:11:44.279 an FDA indication for that, insurance are still are still not willing to pay 929 01:11:45.479 --> 01:11:47.680 the cost of that on a monthly basis for everyone who wants weight loss, 930 01:11:47.680 --> 01:11:53.279 because that's pretty much everybody to a degree, So you're looking at paying I've 931 01:11:53.319 --> 01:11:59.880 seen with insurance coverage, I've seen copays five hundred dollars on average. Yeah, 932 01:12:00.119 --> 01:12:03.840 medication for cash is fifteen hundred bucks, so and that's per month. 933 01:12:04.439 --> 01:12:11.399 So again I imagine spending. Imagine being on a medication for six months, 934 01:12:11.399 --> 01:12:14.720 you're paying cash for it, So you're paying a thousand dollars a month for 935 01:12:14.880 --> 01:12:17.520 six months. At six thousand dollars, you've gotten where you want to and 936 01:12:17.600 --> 01:12:21.399 then literally six to eight months later and a year later, you're back to 937 01:12:21.439 --> 01:12:26.319 square one and you've got to do that process all over again. And I 938 01:12:26.359 --> 01:12:29.359 don't know about you, but that's very discouraging as a patient. And I'm 939 01:12:29.399 --> 01:12:31.199 just like thanking I just every time I walk out the door. Nowadays, 940 01:12:31.319 --> 01:12:34.199 it life's expensive, and it's just like, why does it cost so much 941 01:12:35.000 --> 01:12:40.920 to lose weight, and it's like it's not the right approach. These medications 942 01:12:40.960 --> 01:12:44.560 are fantastic in my opinion, for helping get that process going and make it 943 01:12:44.680 --> 01:12:46.439 easier for patients. But again, we've got to be waiting at the finish 944 01:12:46.520 --> 01:12:49.119 line to go, Okay, we're here, we need to stay here. 945 01:12:49.600 --> 01:12:53.600 We don't need to go back to square one. So I think that's a 946 01:12:53.680 --> 01:13:00.239 really important point. I'm glad you brought that up. Yeah, And I 947 01:13:00.359 --> 01:13:06.239 think it's important for the listeners to to understand that sometimes we can be pedantic 948 01:13:06.600 --> 01:13:12.880 and meaning professorial to patience. And by that I mean, look, you 949 01:13:12.960 --> 01:13:15.560 need to eat right and you need to exercise, and if you eat right, 950 01:13:16.039 --> 01:13:19.840 then this whole obesi thing will go away. That's simply not the case 951 01:13:20.560 --> 01:13:25.079 we know. In fact, I was just reading an article the other day 952 01:13:25.119 --> 01:13:29.520 by the guy who discovered left many years ago, and he was talking about 953 01:13:30.600 --> 01:13:33.039 that. Yes, at the end of the day, you can't get past 954 01:13:33.159 --> 01:13:38.920 the basic input output right let you put into your body and how you get 955 01:13:39.039 --> 01:13:42.800 rid of that and metabolize right, has it is a factor in obesity, 956 01:13:43.079 --> 01:13:46.119 but there is a mental part of the diabetes. Excuse me, the obesity 957 01:13:46.239 --> 01:13:49.319 as well, Right, Why am I eating what I'm eating? Why can't 958 01:13:49.359 --> 01:13:54.960 I feel satiated? And that's where these g op one receptor agon is come 959 01:13:55.079 --> 01:13:59.520 in, is giving you that satiety feeling so that you eat less. So 960 01:14:00.039 --> 01:14:03.600 it's sort of coming at it from the mental side, but the manifestation is 961 01:14:03.720 --> 01:14:08.920 that you eat less, and that's that's why you ultimately end up losing weight. 962 01:14:09.560 --> 01:14:13.479 And so I think sometimes it's it's important for patients to understand that these 963 01:14:13.600 --> 01:14:17.520 medications aren't doing something not fat burners. They're not going in and changing your 964 01:14:17.560 --> 01:14:24.239 metabolism and making somehow some superhuman fat burner, right, which is what we 965 01:14:24.439 --> 01:14:30.319 want through a pill. It's it's changing your sort of mental approach to eating, 966 01:14:30.920 --> 01:14:38.239 but using pharmacology. And if we think about that from a just a 967 01:14:38.399 --> 01:14:44.439 normal physiologic process is right the way and I won't go into details, here's 968 01:14:44.479 --> 01:14:48.439 too much to unpack here, but the way we are supposed to eat actually 969 01:14:48.640 --> 01:14:53.439 promote gop one level so many it does this the right thing, right, 970 01:14:53.479 --> 01:14:56.560 So the more processed foods, the pure sugar, these sorts of things that 971 01:14:56.680 --> 01:15:00.560 we eat, the more our gop one levels are adoxically they're reduced. And 972 01:15:00.680 --> 01:15:06.000 so it's like this is vicious cycle. Is the modern Western diet pushes gop 973 01:15:06.119 --> 01:15:10.479 one levels down and tells us we're not full, so we have to eat 974 01:15:10.520 --> 01:15:15.479 more, and it just get snowballs out of control. And so it's important 975 01:15:15.560 --> 01:15:23.640 to really control that caloric intake. And again not for this podcast, but 976 01:15:23.720 --> 01:15:29.119 hopefully for another there's some really interesting technologies and concepts out there right now. 977 01:15:29.239 --> 01:15:31.800 One in particular, as we've all many of us have heard of this concept 978 01:15:31.880 --> 01:15:36.960 of low glacemic index, and the way it's presented is that you know, 979 01:15:38.159 --> 01:15:45.199 you eat certain foods that are the glucose and glucose precursors are absorbed more slowly, 980 01:15:45.279 --> 01:15:49.119 so that's why you don't have the peaks. But the narrative now is 981 01:15:49.399 --> 01:15:55.600 much like a sustained release formulation we give patients. It's absorbed more slowly, 982 01:15:55.720 --> 01:15:59.439 but you still deliver the same dose. And so that's the narrative now in 983 01:15:59.600 --> 01:16:03.479 the low blas semic index world, is that yes, you slow absorption, 984 01:16:03.600 --> 01:16:09.319 but you still deliver the same amount of calories. And my research and my 985 01:16:09.600 --> 01:16:13.560 reading says that doesn't have to be the case. That's a component of its 986 01:16:13.600 --> 01:16:19.880 slowing it. But there's a whole other fascinating area in research and development, 987 01:16:20.239 --> 01:16:25.920 where now you have the potential emphasis on potential, and there's data to back 988 01:16:25.960 --> 01:16:31.199 it up, the potential to eat what you're used to eating, because we're 989 01:16:31.199 --> 01:16:35.000 all human and we're going to we like things we like and not derive the 990 01:16:35.079 --> 01:16:40.600 same calore. Again, taken other words, you can potentially take a white 991 01:16:40.640 --> 01:16:42.680 bread row. You know, people, I love bread too, well, 992 01:16:42.720 --> 01:16:47.039 eat that same piece of bread, right, and then absorb a lot for 993 01:16:47.079 --> 01:16:53.479 your calories from that same piece of bread without impacting the organ elleptics and soil. 994 01:16:53.520 --> 01:16:57.000 The fancy way of saying it just tastes and feels the same way. 995 01:16:57.960 --> 01:17:03.079 And so as that concept evolves, now we have it changes the conversation. 996 01:17:03.640 --> 01:17:09.600 Now from a science perspective and from a development perspective, we get to meet 997 01:17:09.680 --> 01:17:14.079 the patients halfway and saying, Okay, you like this food, well, 998 01:17:14.359 --> 01:17:17.640 have you considered a low gus semic index version of that food? Folks? 999 01:17:17.880 --> 01:17:24.520 That's possible today, and we just have to figure out how to make that 1000 01:17:25.239 --> 01:17:30.479 market and understanding and educate so that we can start building products in more products 1001 01:17:30.479 --> 01:17:31.840 than that are in it. And you alluded to it earlier. That's one 1002 01:17:31.880 --> 01:17:36.319 of the most fascinating projects that I'm working on right now commercial projects is bringing 1003 01:17:36.439 --> 01:17:44.239 technologies like that to consumer awareness so that they understand that they have options besides 1004 01:17:44.840 --> 01:17:47.199 gop one receptor agones. And I'll stop there because I don't want to take 1005 01:17:47.239 --> 01:17:51.000 us to me. You're fine. It's a very import two things it's important 1006 01:17:51.079 --> 01:17:56.119 is that's one part of the equation. You know, people in the attrution 1007 01:17:56.159 --> 01:18:00.279 space tright don't really focus on It's like, for example, I don't like 1008 01:18:00.439 --> 01:18:03.920 the advice to eat less moved more on a basic principle principle, Yes, 1009 01:18:04.000 --> 01:18:08.520 that's true, you have to eat less and move more to not to lose 1010 01:18:08.560 --> 01:18:12.439 weight. That's true. However, that doesn't really facilitate any like action. 1011 01:18:13.039 --> 01:18:16.119 It doesn't really give anyone tips or advice. You're also not talking about the 1012 01:18:16.159 --> 01:18:21.399 whole concept of food reward and how you know, humans act and feel after 1013 01:18:21.479 --> 01:18:29.039 they eat certain foods. So yes, eating more less processed foods and stuff, 1014 01:18:29.039 --> 01:18:30.600 it's gonna beneficial. However, you know, sometimes if you want to 1015 01:18:30.720 --> 01:18:34.439 enjoy something, there's a food reward aspect to eating foods that may not necessarily 1016 01:18:34.479 --> 01:18:39.760 be the healthiest for you. So there's all these different factors at play, 1017 01:18:40.399 --> 01:18:45.079 and I think it's it's fascinating. Another cool thing you mentioned about the low 1018 01:18:45.119 --> 01:18:48.199 glycemic index stuff is I would be interested from a nutritional side, and a 1019 01:18:48.239 --> 01:18:54.399 lot of dieticians will understand what I'm talking about here, is I wonder how 1020 01:18:54.520 --> 01:18:57.680 that technology, especially with the food types that you're talking about. By the 1021 01:18:57.720 --> 01:19:00.000 way, I got some. I finally got my delivery the other day. 1022 01:19:00.079 --> 01:19:02.279 So we're going to try it tonight with our with our meal tonight that I 1023 01:19:02.319 --> 01:19:06.560 cook for my wife and to see how she likes it. But I'll be 1024 01:19:06.640 --> 01:19:10.640 interesting, just can't wait it. It'd be interesting to see what the effect, 1025 01:19:10.720 --> 01:19:13.199 like the thermic effect of those foods would be, because, like you 1026 01:19:13.239 --> 01:19:16.159 know, it does take calories and energy to break down certain foods, but 1027 01:19:16.239 --> 01:19:19.520 if we're not absorbing as much of those calories to the beginning, that's going 1028 01:19:19.560 --> 01:19:24.079 to have an interesting impact I think on the whole thermic effect of breaking all 1029 01:19:24.079 --> 01:19:28.800 that stuff down would be. There's your body had certain foods high and fat 1030 01:19:28.920 --> 01:19:31.279 have the lowest thermic effect of food, so like it just takes less energy 1031 01:19:31.319 --> 01:19:34.000 to break those down. Glucose is second, and then I think protein it 1032 01:19:34.039 --> 01:19:38.119 actually takes a good bit of caloric energy and demand from the body just to 1033 01:19:38.239 --> 01:19:42.560 break those proteins down. So it'd be interesting to see with these types of 1034 01:19:42.600 --> 01:19:45.960 formulations of these low glycemic index foods and how they have an impact on that 1035 01:19:45.000 --> 01:19:49.880 because there's really not from an energy balanced perspective, there's really not anything you 1036 01:19:50.000 --> 01:19:54.680 can do too, or at least that I'm aware of, to really increase 1037 01:19:54.840 --> 01:20:00.319 the amount of caloric energy needed to break down the foods that you eat because 1038 01:20:00.319 --> 01:20:03.520 it's a minimal part of the whole energy balance equation. I'm just there could 1039 01:20:03.760 --> 01:20:06.920 there may not be any connection there whatsoever. It's just that's an interesting thought 1040 01:20:08.000 --> 01:20:11.960 that I had, especially with knowing the more intricate details that we're not going 1041 01:20:12.039 --> 01:20:15.319 to get into about these products and why they work. But yeah, I 1042 01:20:15.399 --> 01:20:18.600 think that's fantastic is being able to have a food that may have the full 1043 01:20:18.640 --> 01:20:23.840 amount of carbohydrates on the label, but you're only absorbing you know, fifty 1044 01:20:23.920 --> 01:20:28.159 percent of those calories. Because that's where the impact on your blood sugar is 1045 01:20:28.159 --> 01:20:29.960 going to be. I think that's going to be going to be huge in 1046 01:20:30.039 --> 01:20:33.520 that space. So yeah, and I want to I want to point out 1047 01:20:33.560 --> 01:20:38.039 your listious this is not hypothetically correct. In other words, their data sets, 1048 01:20:38.119 --> 01:20:40.079 right, I mean I have a data set in my hands, human 1049 01:20:40.159 --> 01:20:43.399 data set, clinical, try right, powered, appropriate, et cetera, 1050 01:20:43.520 --> 01:20:48.439 that shows that this is in fact today, And so you diabetics and others 1051 01:20:48.520 --> 01:20:54.479 that are interested in their glucose and particularly they're glucose variation, which I'll come 1052 01:20:54.479 --> 01:20:58.680 back to a minute. In a minute, that's here today, what's not 1053 01:20:58.920 --> 01:21:01.279 here today? So let's tell your listeners three to seven years into the future. 1054 01:21:01.800 --> 01:21:04.359 Okay, why do I say three to seven years into the future, 1055 01:21:04.680 --> 01:21:11.920 Because when we talk about blood glucose, we automatically think right first, especially 1056 01:21:11.960 --> 01:21:14.479 those of us have been around a while, our fingersticks, and we get 1057 01:21:14.640 --> 01:21:19.239 a moment in time a blood glucost level. Now that's evolved with the continuous 1058 01:21:19.279 --> 01:21:24.840 glucose monitors. I won't advertise for anybody in particular on your show here, 1059 01:21:24.920 --> 01:21:28.920 but or on your podcast, we'll just say continuous glucose monitors that are available 1060 01:21:28.960 --> 01:21:34.520 for type two and type one diabetics. The concept there is twofold, right, 1061 01:21:34.600 --> 01:21:39.079 and it's all pharmaco kinetics. It's if you're a pharmacist, right, 1062 01:21:39.159 --> 01:21:45.000 think about this as glucose pharmaco kinetics. It's about cmax right, our peak 1063 01:21:45.039 --> 01:21:49.399 glucose concentration. But it's also that peak to trollh ratio, that variability that 1064 01:21:49.479 --> 01:21:55.760 we experience throughout the day. And so where we are today, we can't 1065 01:21:55.840 --> 01:22:00.800 talk about glucost variability because we don't have a ready read out unless you're wearing 1066 01:22:00.840 --> 01:22:05.880 a continuous glucose monitor and you know someone who can interpret the data that's coming 1067 01:22:05.920 --> 01:22:11.079 into your app, right, so is very limited. We don't have the 1068 01:22:11.199 --> 01:22:15.920 ability to interpret that data. And so that's not a good way to say 1069 01:22:15.960 --> 01:22:20.800 that we don't have the routine ability to interpret that data and it's not routinely 1070 01:22:20.880 --> 01:22:28.000 available. Right where when and where is it going to be likely available to 1071 01:22:28.319 --> 01:22:31.479 the average health conscious person? Right, it's right here on our risk. 1072 01:22:32.319 --> 01:22:38.600 So in March, in March, Apple came out with they had just made 1073 01:22:38.640 --> 01:22:43.479 a major breakthrough in continuous glucose monitoring. I didn't know that, Okay, 1074 01:22:43.640 --> 01:22:47.119 so now they're able to do absolutely was in March of this year, right. 1075 01:22:47.640 --> 01:22:50.920 But the biggest problem, and they didn't say this, this is behind 1076 01:22:51.039 --> 01:22:55.600 sort of discussion scene, but my understanding I should say it that way is 1077 01:22:55.680 --> 01:23:00.960 the one of the biggest hurdles is that the battery power is when you're doing 1078 01:23:00.000 --> 01:23:04.039 a continuous gluecost monitoring, you choose up battery power really quickly. So that's 1079 01:23:04.039 --> 01:23:08.359 the problem because we're already our Apple Watch is right, doesn't get us at 1080 01:23:08.399 --> 01:23:11.880 twenty four hours to begin with this eighteen hours best. But where I'm going 1081 01:23:12.000 --> 01:23:15.119 with this is right, when I said, let's look take your listeners three 1082 01:23:15.199 --> 01:23:18.399 to seven years in the future, Apple said, right, and I believe. 1083 01:23:18.399 --> 01:23:21.399 Then I'll tell you why I believe in a minute. It's why celbet 1084 01:23:21.560 --> 01:23:28.119 is is that they will have continuous gluecoast monitoring capabilities on the Apple Watch within 1085 01:23:28.239 --> 01:23:32.000 three to seven years. Well, and so now in this world, as 1086 01:23:32.119 --> 01:23:38.119 early as three years from now, you're going to have diabetics, healthy individuals, 1087 01:23:38.239 --> 01:23:42.800 whatever. They're going to be able to show you Patrick, they're glucose 1088 01:23:42.960 --> 01:23:46.359 and rehability, and studies have already shown. Right, what's most important, 1089 01:23:46.439 --> 01:23:51.279 it's that so called coalfiicient of variation around your glucost variation. So remember your 1090 01:23:51.319 --> 01:23:55.640 stats class, right, fear of your levels. Here's your average level, 1091 01:23:55.800 --> 01:23:58.960 right, you're mean, and here's your standard deviation. So you take those 1092 01:23:59.079 --> 01:24:02.520 numbers and come up with cootefficient variation standard deviation INVIDABER the mean. You keep 1093 01:24:02.600 --> 01:24:09.159 that below thirty six and that is going to keep you in an a one 1094 01:24:09.239 --> 01:24:14.399 seeding range. That is, I hate to stake you worth normal, but 1095 01:24:14.600 --> 01:24:20.319 certainly outside an or inside of normal. Okay. And so that is available 1096 01:24:20.880 --> 01:24:26.640 now but not widespread. But again, in as little as three years, 1097 01:24:27.600 --> 01:24:30.439 we have potentially that ability, if not sooner. Now, what's interesting about 1098 01:24:30.439 --> 01:24:34.199 three to seven years? Because I was reading the Apple announcement, I was 1099 01:24:34.239 --> 01:24:40.520 asking myself, that's an odd thing. When you're developed continuous glucose monitoring devices 1100 01:24:40.600 --> 01:24:45.880 has to be SDA approved, so they are quote medical devices, and so 1101 01:24:45.479 --> 01:24:49.399 me the curious guy, right, that sounds odd three to seven years. 1102 01:24:49.640 --> 01:24:53.640 It's a medical device, So why do I do that? Go Google? 1103 01:24:53.960 --> 01:24:58.079 Right, what's the average time to approve a medical device? Three to three 1104 01:24:58.119 --> 01:25:02.319 to seven years? Three? Now, I'm not a rocket size, right, 1105 01:25:02.319 --> 01:25:05.840 I'm only a pharmaceutical scide this, But that's pretty darn compelling then. 1106 01:25:06.239 --> 01:25:14.720 So now imagine three to five years in the future where some will call him 1107 01:25:14.760 --> 01:25:16.560 influencer, you name whomever you would like to. Again, I'm not gonna 1108 01:25:16.640 --> 01:25:20.720 show for anybody on your show here, but you kind of said my gluecoast 1109 01:25:20.760 --> 01:25:25.560 variability is thirty two, and it's because of right, And then I feel 1110 01:25:25.600 --> 01:25:28.800 like, oh well, what's my number, And now you're going to have 1111 01:25:28.840 --> 01:25:31.199 an appeah and and now people are going to start saying, okay, you 1112 01:25:31.279 --> 01:25:34.159 know, like tonight, if you had a continued to glucose motor when you 1113 01:25:34.239 --> 01:25:39.760 guys use this glow glacemic index pasta, if you had day to to prove 1114 01:25:40.479 --> 01:25:45.479 that it reduces your peak and overall gluecoast variability, that's all you need packing 1115 01:25:46.199 --> 01:25:53.119 And this is not magic. So one of my interested parties, and we'll 1116 01:25:53.159 --> 01:25:59.000 call him an investor in this technology of low glacemic index idea, he did 1117 01:25:59.079 --> 01:26:02.119 that right, So he's a hip too diabetic. He did his finger stick 1118 01:26:02.239 --> 01:26:09.159 and he showed it absolutely. It bay his blood glucose barely moved relative to 1119 01:26:09.279 --> 01:26:14.600 what he would expect from eating a postdial and so he was convinced from that. 1120 01:26:15.000 --> 01:26:17.399 And that's only that's only a snap snapshot right right again, back to 1121 01:26:17.439 --> 01:26:21.760 the glucost pharmacole kinetics CEMAX. Okay, that's important, but the variability to 1122 01:26:21.800 --> 01:26:26.640 pique the trough is even more critical. We're getting there. I think it's 1123 01:26:26.680 --> 01:26:30.239 important too. And I'll go on this little side because there are some people 1124 01:26:30.520 --> 01:26:34.800 on social media and stuff that do have continuous glucoset monitors, and they're in 1125 01:26:34.880 --> 01:26:40.600 a situation financially where they can afford one, and they may not necessarily. 1126 01:26:40.760 --> 01:26:43.960 I'm still I don't know how to feel about this, to be honest, 1127 01:26:44.439 --> 01:26:48.199 because a lot of these people that are promoting you know, continuous glucost motors, 1128 01:26:48.279 --> 01:26:51.800 especially on social media, they are not diabetic at all. So they're 1129 01:26:51.840 --> 01:26:57.319 just completely healthy, normal individuals that don't have issues with blotcher control and their 1130 01:26:57.399 --> 01:27:00.279 thing making videos. Oh look, I ate you know Chipotle today, I'm 1131 01:27:00.319 --> 01:27:02.880 wearing my glucose monitor. Look at how big the spike was. It's like, 1132 01:27:02.960 --> 01:27:05.720 well, I'm sitting there watching the video, going, well, that 1133 01:27:05.760 --> 01:27:10.199 big spike doesn't scare me. You're a completely normal, healthy individual, and 1134 01:27:10.279 --> 01:27:13.720 it went up and down and we're good to go. Like it. People. 1135 01:27:13.760 --> 01:27:17.399 I've seen people take like a snapshot and a healthy individual and then kind 1136 01:27:17.439 --> 01:27:21.479 of promote it in a way that makes people scared of any type of glucose 1137 01:27:21.520 --> 01:27:28.279 elevation whatsoever. So if I'm a diabetic, walk can it? Can I 1138 01:27:28.319 --> 01:27:31.119 stop you here? Though? Can Can I stop you there? And I 1139 01:27:31.359 --> 01:27:34.439 hear you loud and clear, I would ask you to think about it this 1140 01:27:34.560 --> 01:27:38.319 way and not the way the influencers thinking about it right now, I'm not 1141 01:27:38.399 --> 01:27:43.600 agreeing with them at all. Right, I'm saying that let's stink through this 1142 01:27:43.720 --> 01:27:50.239 procesess. We eat processed foods our blood glucose reaches cmax due to fast absorption 1143 01:27:50.399 --> 01:27:56.119 and complete absorption. There's those calories of glucose molecules, right, So what's 1144 01:27:56.159 --> 01:28:00.319 the body's response. We get a spike in insulin because we had a spike 1145 01:28:00.399 --> 01:28:03.920 in blood sugar, and we know in pharmacology that that is spike spike. 1146 01:28:04.079 --> 01:28:09.920 Right, It's like turning up and down the volume on your radio right over 1147 01:28:10.000 --> 01:28:12.359 a day or two, Not a big deal. You do that over the 1148 01:28:12.439 --> 01:28:15.359 course of a lot, Yeah, exactly. Then that's when you start wearing 1149 01:28:15.399 --> 01:28:19.640 out that pancrease. You start wearing out those instoreceptors. And so that's what 1150 01:28:19.880 --> 01:28:26.680 I'm interested to see Patrick, to follow the research. At what point does 1151 01:28:26.760 --> 01:28:31.840 it become important to understand peak to trough ratios? Is it only important in 1152 01:28:31.920 --> 01:28:35.800 your controlling blood sugar in a type point or type two diabetic or does that 1153 01:28:35.880 --> 01:28:41.159 include pre pre diabetics or does it include you know, a ten year old 1154 01:28:41.199 --> 01:28:44.079 athlete. I don't know the answer to the correct Yeah, and that's that's 1155 01:28:44.119 --> 01:28:47.359 the point she's going to tell us. Yeah, I think that's an important 1156 01:28:47.399 --> 01:28:54.000 point. I to interrupt you, but yes, like there's I'm not in 1157 01:28:54.079 --> 01:28:56.680 that camp of like, if you're not diabetic, you don't need these these 1158 01:28:56.920 --> 01:28:59.680 this equipment. If you want to, if you want to pay cash for 1159 01:28:59.760 --> 01:29:01.319 one, and you want and you have the ability and means to do that, 1160 01:29:01.359 --> 01:29:04.720 I think it's fine. The more information the better, but we do 1161 01:29:04.880 --> 01:29:09.079 have to be careful with where like we've already touched on this, you know, 1162 01:29:09.159 --> 01:29:13.600 where you've said multiple times, we're not there yet. So having someone 1163 01:29:13.640 --> 01:29:15.800 who may not necessarily know how to interpret the data that they're seeing on their 1164 01:29:15.840 --> 01:29:20.600 app going hey, I ate this food and it went up this high, 1165 01:29:20.720 --> 01:29:26.920 not knowing what the ranges really mean in its context, and saying it went 1166 01:29:27.000 --> 01:29:30.159 up this high, you shouldn't eat this, because then you're then you're facilitating 1167 01:29:30.239 --> 01:29:32.520 people to just start cutting out foods that they may not necessarily have issues with. 1168 01:29:33.880 --> 01:29:36.720 That's where I was going with with that, because I think, like 1169 01:29:36.880 --> 01:29:41.920 you said, we're not there yet, and again, most people that are 1170 01:29:42.000 --> 01:29:47.239 doing that, the average everyday person doesn't quite understand glucose pharmacology or glucosse pharmacokinetics 1171 01:29:47.279 --> 01:29:50.000 and how that works, which I don't blame them. They don't They don't 1172 01:29:50.039 --> 01:29:55.720 need to know that. But I had no idea well that Apple was working 1173 01:29:55.760 --> 01:29:58.319 on that. I think that that'd be That would be one of the reasons 1174 01:29:58.359 --> 01:30:00.760 why I went back. Why I go back to an app watch just because 1175 01:30:00.800 --> 01:30:02.600 that'd be cool from a science for a science perspective, to get the data 1176 01:30:02.720 --> 01:30:09.279 like I have a whoop and I use it more for fitness and sleep tracking 1177 01:30:09.359 --> 01:30:13.760 than I do anything else. But one of the big reasons I got rid 1178 01:30:13.800 --> 01:30:15.319 of my Apple Watch because I used to have an Apple Watch for forever, 1179 01:30:15.479 --> 01:30:17.520 was I felt like I had to buy a new one every year, which 1180 01:30:17.560 --> 01:30:23.600 is just about any Apple product, and I hated having a charge it overnight 1181 01:30:24.560 --> 01:30:26.800 all the like, if I wore it all day, I'd have to charge 1182 01:30:26.840 --> 01:30:30.319 it for quite some time overnight and I couldn't check my sleep with it. 1183 01:30:30.399 --> 01:30:32.359 So I was just getting tired of with the of the battery going out. 1184 01:30:33.119 --> 01:30:36.159 So when you were saying the Apple was thinking about doing continuous glitcost Maria, 1185 01:30:36.159 --> 01:30:39.279 I'm like, they're gonna have to have like just an Apple Watch it just 1186 01:30:39.359 --> 01:30:42.680 as that function on it. If they want the battery life to not be 1187 01:30:42.800 --> 01:30:45.279 an issue. But that's cool, that's really fascinating. Yeah, But I 1188 01:30:45.359 --> 01:30:49.960 mean, right, so let's go back thirty years to my when I did 1189 01:30:50.039 --> 01:30:59.039 pharmacochy netting research and developing essays and right really working on converting that to the 1190 01:30:59.159 --> 01:31:02.760 real time respects that we could really use that from a clinical diagnostic and treatments 1191 01:31:03.039 --> 01:31:09.199 perspective. The reason why it took a number of years, it still requires 1192 01:31:09.239 --> 01:31:14.560 a lot of sort of work is to your earlier point about the interpretation piece, 1193 01:31:14.960 --> 01:31:17.239 the FDA very quickly stepped in. It says, these are medical devices. 1194 01:31:17.359 --> 01:31:24.039 They need the results need to be interpreted by a medical professional because there's 1195 01:31:24.239 --> 01:31:29.119 all sorts of potential for a farm dyta flies to the bluecoast monitors to your 1196 01:31:29.159 --> 01:31:31.520 earlier point, Right, That's why I think one of the reasons, maybe 1197 01:31:31.560 --> 01:31:36.600 the primary reason, speculation that the SDA considers the medical devices to your point, 1198 01:31:36.680 --> 01:31:42.000 so that people don't come out like your next you know you, whoever 1199 01:31:42.000 --> 01:31:45.279 the next influencer is and starts talking about continuous glucoset monitors and interpreting results. 1200 01:31:45.359 --> 01:31:50.000 Right, we need to have that in the context of what's the ratio or 1201 01:31:50.159 --> 01:31:56.600 what's the ray, etc. So I think that will be useful, but 1202 01:31:57.399 --> 01:32:00.520 it once it makes it to the Apple Watch or the fitbit or the whoop 1203 01:32:00.560 --> 01:32:04.159 band you know my daughter logan as a whoop band or something like that awareable 1204 01:32:04.239 --> 01:32:11.319 that's called it a wearable, then then it becomes even more important for healthcare 1205 01:32:11.399 --> 01:32:16.439 practitioners to be aware of its potential and how their patients are using I say 1206 01:32:16.479 --> 01:32:19.960 patients because they may not right, if you've got some twenty three year old 1207 01:32:21.359 --> 01:32:25.039 young man or young woman doing it, they're not a patient, right, 1208 01:32:25.079 --> 01:32:28.680 They're doing it because of what they see on TikTok. So there's the potential 1209 01:32:28.800 --> 01:32:31.000 form. Yeah, I think that's a very important. I'm by no means 1210 01:32:31.359 --> 01:32:34.880 anti any of these devices, but I think it's important to have to just 1211 01:32:36.159 --> 01:32:41.520 understand what you're trying to understand with them. What is the data showing you, 1212 01:32:41.920 --> 01:32:45.640 How does that relate to physiology? What changes you can make? Because 1213 01:32:45.720 --> 01:32:48.159 let's be honest, that's another key thing, especially with diabetes management in an 1214 01:32:48.159 --> 01:32:51.720 ambulatory care setting. When I was in pharmacy school, I went on to 1215 01:32:51.800 --> 01:32:57.199 do quite a few of those for clinical rotations, and that was the hardest 1216 01:32:57.239 --> 01:33:00.760 part was someone who would come in and we would see improvement in their A 1217 01:33:00.880 --> 01:33:03.920 one C. For example, I'll give you a one we had. There's 1218 01:33:03.920 --> 01:33:08.159 a patient who had a nearly diagnosed Type two diabetic who had an A one 1219 01:33:08.239 --> 01:33:11.039 C. I want to say it was like eleven or twelve way up there, 1220 01:33:11.880 --> 01:33:15.760 and we started doing we started doing lifestyle interventions with her. We did 1221 01:33:15.880 --> 01:33:19.560 basic like teaching her just the fundamental basics of the nutrition that she wasn't aware 1222 01:33:19.600 --> 01:33:25.800 of and just just trying simple things. The next she came back in I 1223 01:33:25.880 --> 01:33:28.880 think in three months when we went and checked her A one C again because 1224 01:33:28.880 --> 01:33:30.479 you want to wait a while before you do it is sure you check your 1225 01:33:30.560 --> 01:33:33.239 A one C. You don't want to check that all the time. And 1226 01:33:33.680 --> 01:33:38.760 it went down to like eight. So we're like, okay, we're getting 1227 01:33:38.800 --> 01:33:41.880 there where it went from eleven or twelve to eight, So what are you 1228 01:33:42.000 --> 01:33:44.880 doing like And we would ask her, hey, did you check your what 1229 01:33:44.960 --> 01:33:47.239 are your blood glucause checks? And she goes, oh, I just haven't 1230 01:33:47.279 --> 01:33:53.239 really been logging them. And we're like, okay, why because it would 1231 01:33:53.239 --> 01:33:55.880 be nice to see because clearly you're doing something right. It's not like we're 1232 01:33:55.880 --> 01:33:58.760 going in the wrong direction. And I'm chastising that person or going, hey, 1233 01:33:58.800 --> 01:34:00.720 what's happening. She was just like, I hate pricking my finger. 1234 01:34:00.920 --> 01:34:03.000 She goes, it gets annoying. It doesn't hurt that bad, it's just 1235 01:34:03.079 --> 01:34:06.840 annoying having to do it all the time. And if you try, I've 1236 01:34:06.880 --> 01:34:11.359 done this myself, Like if just from purely experimental perspective, it's like, 1237 01:34:11.359 --> 01:34:14.279 I want to know what these people, what my patients are, what's it 1238 01:34:14.399 --> 01:34:17.880 like? So if I wanted to map out, you know, my response 1239 01:34:17.960 --> 01:34:21.960 is to food before two hours after throughout the day, I'm having to prick 1240 01:34:23.079 --> 01:34:27.800 my finger eight ten times and it hurt, it's annoying, it's sore, 1241 01:34:28.000 --> 01:34:30.199 and then I have to go, Okay, it was okay, let's see 1242 01:34:30.239 --> 01:34:33.319 it was this, this response should be around here at this time. Okay, 1243 01:34:33.399 --> 01:34:36.720 cool, and you map it out. It is tedious, Like and 1244 01:34:36.800 --> 01:34:40.640 I'm a I'm a healthcare professional and know I'm know what I'm doing. I'm 1245 01:34:40.680 --> 01:34:46.199 like, this is frustratingly annoying. But Patrick, Patrick, you just made 1246 01:34:46.319 --> 01:34:49.880 the case, I think indirectly for where I was trying to take you into 1247 01:34:49.920 --> 01:34:55.800 the future. If you're a pharmacy practitioner, right then he's going to have 1248 01:34:56.000 --> 01:35:00.159 to be interpretation of that data that's readily available, and you've got to understand, 1249 01:35:00.279 --> 01:35:04.760 I think that's a perfect opportunity for the pharmacist and you know, an 1250 01:35:04.800 --> 01:35:12.399 independent pharmacy or ambilatory care facility setting or whatever to really step in and take 1251 01:35:12.720 --> 01:35:15.199 control of that piece of day, to work with that patient, work with 1252 01:35:15.279 --> 01:35:19.720 that patient and his or her physician right to manage them. But that is 1253 01:35:20.399 --> 01:35:26.079 again, if you think about it's just it's beautiful if you think about it 1254 01:35:26.159 --> 01:35:30.479 from a pharmacist descript and that's why I use gluecost pharmaco kinetics. There's nobody 1255 01:35:30.000 --> 01:35:38.159 more qualified to monitor glucost variation than a train from literally mean so there's a 1256 01:35:38.319 --> 01:35:44.600 really cool opportunity for people who want to expand their scope of practice. And 1257 01:35:44.680 --> 01:35:46.479 now I'm back on you know, now I'm back at UT I'm lecturing to 1258 01:35:46.600 --> 01:35:50.920 my pharmacy students right about opportunity and how you practice out you know, above 1259 01:35:51.000 --> 01:35:55.359 your license. So and by let me, I'm as I said that wrong, 1260 01:35:55.439 --> 01:36:00.119 but you know what I mean, expanding both of your licensy. We 1261 01:36:00.199 --> 01:36:01.239 get told that all the time. And you know, when I was a 1262 01:36:01.319 --> 01:36:03.720 lowly P one student, it was just like, oh, what does that 1263 01:36:03.880 --> 01:36:06.199 mean, how am I going to expand upon for like blah blah blah. 1264 01:36:06.479 --> 01:36:11.279 And then I remember talking to you the first interaction we had. I was, 1265 01:36:11.479 --> 01:36:14.520 where was I. I was in Memphis at the time, I think, 1266 01:36:15.239 --> 01:36:16.600 and I was I was on a trip or something. You were out 1267 01:36:16.600 --> 01:36:19.960 of town and no, we actually know. I remember meeting you in person. 1268 01:36:20.039 --> 01:36:24.840 We had lunch together. I forget where it was. Oh man, 1269 01:36:24.920 --> 01:36:30.319 where was that? We're eating outside? It was like kind of a anyway, 1270 01:36:30.319 --> 01:36:33.119 I can't remember the exact spot, but do you know what? You 1271 01:36:33.159 --> 01:36:35.520 know what I'm talking about though, Like that first meeting where I met you, 1272 01:36:35.600 --> 01:36:41.199 I tried to the restaurant's not relevant, but I remember listening to and 1273 01:36:41.279 --> 01:36:45.279 I'm like, Okay, I get what. I get what pushing the boundaries 1274 01:36:45.319 --> 01:36:49.479 of pharmacy means now. And then I mean, I the implications are even 1275 01:36:50.039 --> 01:36:56.000 even with especially with the telehealth market that we have now and those platforms and 1276 01:36:56.079 --> 01:36:59.600 the brilliance of the Internet is like you could have those on a platform, 1277 01:37:00.319 --> 01:37:05.439 especially with where we're at with Nimbus and stuff like that platform of having you 1278 01:37:05.520 --> 01:37:10.319 know, scheduling a simple twenty minute Google meeting too with a pharmacist or a 1279 01:37:10.439 --> 01:37:15.520 physician that knows you to then go over those continuous glucose monitor results with you 1280 01:37:15.760 --> 01:37:21.159 and understand what's happening. I think that's yeah, that's there's definite major implications. 1281 01:37:21.439 --> 01:37:25.640 We need to put that education. We need to put that education program 1282 01:37:25.720 --> 01:37:31.239 together for pharmacists and related nutrition related that that is such a critical need. 1283 01:37:31.359 --> 01:37:35.000 And again, when you put it in the context of you've got a three 1284 01:37:35.079 --> 01:37:40.520 to seven year head start, you've got a focus group now type two diabetics, 1285 01:37:40.560 --> 01:37:44.920 Type one diabetics, right yet, you can really get your seat wet 1286 01:37:45.279 --> 01:37:50.840 because the avalanche is coming. It really is right in a good way. 1287 01:37:53.640 --> 01:37:58.680 It's a really cool practice opportunity. I see. I think I've told the 1288 01:37:58.800 --> 01:38:02.079 podcast listeners a story with my background before. Maybe I haven't, but I 1289 01:38:03.960 --> 01:38:09.079 that was one thing we were was P one or P two student right before 1290 01:38:09.079 --> 01:38:13.359 I decided to start my masters and nutrition too. Was one of our professors 1291 01:38:13.479 --> 01:38:15.000 was saying, hey, like, you need to be able to not only 1292 01:38:15.000 --> 01:38:18.119 answer pharmacy questions, you need to be able to answer nutrition questions too, 1293 01:38:18.159 --> 01:38:20.640 and be able to like you know, relate all that to what they've got 1294 01:38:20.680 --> 01:38:26.199 going on. And everyone else just kind of brushed it off and was everyone 1295 01:38:26.279 --> 01:38:30.119 else kind of brushed it off and was like, Okay, you know whatever. 1296 01:38:30.119 --> 01:38:33.920 And I'm sitting there going, that's terrifying what you just said, because 1297 01:38:34.039 --> 01:38:36.359 I don't know anything, Like I know, yeah, I'm and I was 1298 01:38:36.399 --> 01:38:41.000 a student athlete, like I do know about protein goals and importance of eating 1299 01:38:41.079 --> 01:38:46.039 enough energy that kind of stuff. However, as we've exhausted my knowledge to 1300 01:38:46.119 --> 01:38:49.279 this point and I'm like, you know what, I'm gonna have to get 1301 01:38:49.359 --> 01:38:51.319 more educated on this. So I was like, you know, I'll just 1302 01:38:51.439 --> 01:38:55.439 reach out to one of my dad's good friends happened to be the dean of 1303 01:38:55.479 --> 01:38:59.800 the College of Nutrition and Dietetics, and I was talking with him, got 1304 01:38:59.880 --> 01:39:02.439 in to that program. And one of the few things that I found out 1305 01:39:02.600 --> 01:39:08.359 really quickly, and a lot of the my advisors and doctor Hakick would attest 1306 01:39:08.439 --> 01:39:11.880 to this. He goes, Paedrick, we wish we have more pharmacy students, 1307 01:39:12.960 --> 01:39:15.840 and I go, well, why, Like I was the only one 1308 01:39:15.880 --> 01:39:19.039 that had ever done it at ums anyway that was a pharmacy student and did 1309 01:39:19.079 --> 01:39:23.399 this at the same time, not to toot my own horn, but they 1310 01:39:23.439 --> 01:39:29.520 were they were like, you answer questions to our clinical nutrition situations from a 1311 01:39:29.560 --> 01:39:32.159 perspective that none of our dietetic students do. And I'm like, what do 1312 01:39:32.239 --> 01:39:34.880 you mean? I already knew the answer, but I like, I'll try 1313 01:39:34.920 --> 01:39:38.000 to get them to get out there. They're like, the way you guys 1314 01:39:38.119 --> 01:39:43.199 understand the pharmacokinetics and like the absorption and stuff like that, They're like, 1315 01:39:43.359 --> 01:39:45.239 we don't. We're not, that's not in our wheelhouse to a degree, 1316 01:39:45.319 --> 01:39:48.640 but we know it is. It is. But having that perspective and relating 1317 01:39:48.720 --> 01:39:56.720 it that those pharmacy drug principles of all of that too, nutrition is it 1318 01:39:57.239 --> 01:40:02.720 is very unique because they essentially worked way. So again, it's interesting and 1319 01:40:02.800 --> 01:40:06.560 fascinating that you bring that point up, because that way of thinking, if 1320 01:40:06.600 --> 01:40:09.920 we can apply it to medications, I mean, why wouldn't it work the 1321 01:40:09.920 --> 01:40:15.000 same way from a nutrition perspective. So I think it's I think it's encouraging. 1322 01:40:15.039 --> 01:40:18.079 And I'm not saying that every pharmacist has to go get a nutrition degree. 1323 01:40:18.119 --> 01:40:25.800 It's not what I'm saying, but it definitely it brings another skill set 1324 01:40:25.920 --> 01:40:30.640 to practice. So I think I'm all for trying to tease that out and 1325 01:40:30.760 --> 01:40:35.560 how we can develop some sort of training, certification or whatever programs where a 1326 01:40:35.600 --> 01:40:41.039 pharmacist can understand what they're looking at, especially if within three to seven years 1327 01:40:41.199 --> 01:40:45.399 someone's going to do it. Someone's gonna have to do it. Yeah. 1328 01:40:45.760 --> 01:40:51.359 Well, so in my pharmacy school days many years ago, and the buds 1329 01:40:51.520 --> 01:40:57.159 term was therapeutic drug TDM. TDM was everything right, it's mine and mine 1330 01:40:57.239 --> 01:41:00.840 run. And so that's where I go with this is this is just therapeutic 1331 01:41:00.880 --> 01:41:08.079 drug monitoring applied to the folks. And now you don't have to go through 1332 01:41:08.239 --> 01:41:11.239 a lab and take to those activity sorts of things, you know. Yeah, 1333 01:41:11.920 --> 01:41:15.319 yeah, yeah, theraputic drug monitoring for sure. I mean that's still 1334 01:41:15.359 --> 01:41:17.800 a term that we hear a lot in pharmacy school too. I haven't been 1335 01:41:17.840 --> 01:41:20.359 out that long, only a few years, but that was something that they 1336 01:41:20.399 --> 01:41:27.359 were really trying to push. And I find that the lay public and my 1337 01:41:27.479 --> 01:41:30.439 patients that come in there, you know, they're not coming in asking me 1338 01:41:30.600 --> 01:41:34.840 like foundational groundbreaking principles and nutritional A lot of it's pretty simple stuff. They 1339 01:41:34.920 --> 01:41:38.239 just want to know what to do that, what works, what has evidence 1340 01:41:38.279 --> 01:41:43.359 behind it, because a lot of people with certain biases may interpret clinical data 1341 01:41:43.439 --> 01:41:48.199 differently to fit whatever nutritional approach they prefer, which is fine, but my 1342 01:41:48.399 --> 01:41:53.520 big thing is consistency and what I can work with the patient to get to 1343 01:41:53.600 --> 01:41:56.199 where they do it consistently they don't, it's where they don't feel like they 1344 01:41:56.239 --> 01:42:00.399 have to do a lot of work because dieting, I think I don't really 1345 01:42:00.399 --> 01:42:02.880 even like the term diet because that applies that it's like a short term kind 1346 01:42:02.920 --> 01:42:08.199 of thing, Whereas I like lifestyle interventions because that's just part of what you 1347 01:42:08.279 --> 01:42:16.119 do at that point. However, I think it's really important as a as 1348 01:42:16.199 --> 01:42:23.520 a pharmacist too, with the interactions that I have with patients and the clinical 1349 01:42:23.640 --> 01:42:28.319 questions that I get on a daily basis is there's definitely a need for that. 1350 01:42:28.520 --> 01:42:31.199 And again you don't have to be go into all the fancy science terms 1351 01:42:31.359 --> 01:42:35.800 that you know, make everything kind of a little bit complicated. But knowing 1352 01:42:35.880 --> 01:42:39.479 how to take that data and just make it simple for people, I think 1353 01:42:39.520 --> 01:42:42.880 it is going to be the key, key factor because you know you can 1354 01:42:43.840 --> 01:42:45.600 you can have that technology and if Apple has I mean, if Apple puts 1355 01:42:45.640 --> 01:42:49.760 that out for or when they put that out if for their fitness wearables, 1356 01:42:49.840 --> 01:42:54.920 people are going to have questions and someone's gotta someone's going to have to to 1357 01:42:55.119 --> 01:43:00.479 stand there when the floodgates open, so to speak. And armacy is a 1358 01:43:00.479 --> 01:43:03.000 perfect too, whether you're whether you're in a pharmacy, whether you're an ambulatory 1359 01:43:03.119 --> 01:43:08.680 care setting, whether you're in lifetime sitness where I work out. People are 1360 01:43:08.720 --> 01:43:14.920 going to have questions because it's going to be saturated. I see it because 1361 01:43:15.000 --> 01:43:17.560 it has so many health implications. Now the science is evolving, and I 1362 01:43:17.640 --> 01:43:25.079 see evolving. There's a tremendous amount of literature on glucose variation and diabetes, 1363 01:43:25.159 --> 01:43:27.399 both type two, type one set up. So there's I don't mean to 1364 01:43:27.479 --> 01:43:30.880 imply that this is at the research level. We're well beyond that. I 1365 01:43:30.960 --> 01:43:33.840 mean, we've been working on this for twenty years, and so that's why 1366 01:43:33.880 --> 01:43:39.680 I think it's just really it's a technology problem now. But once that technology 1367 01:43:39.800 --> 01:43:43.119 problem is solved, it may have been solved. We're just waiting for the 1368 01:43:43.159 --> 01:43:48.359 approval speculation. But we'll see be there, just ready and waiting for your 1369 01:43:48.399 --> 01:43:55.479 patients and individuals that you're just curious about health related health and wellness. You 1370 01:43:55.560 --> 01:44:00.000 ask earlier or right of it. You know this earlier generations, right, 1371 01:44:00.119 --> 01:44:04.520 we're thinking more preventive, whereas the older generations are so brought up in a 1372 01:44:04.600 --> 01:44:11.560 treatment medical environment, right, So this is in dovetails with that sort of 1373 01:44:11.760 --> 01:44:15.760 preventive, preventive holistic health and well as sort of approach. So who knows 1374 01:44:16.239 --> 01:44:21.840 where this is going to go, But if I'm well, I think it's 1375 01:44:24.319 --> 01:44:27.960 it is and it's finally you know, And I see it too from another 1376 01:44:28.359 --> 01:44:31.760 another angle, is that like it's finally going to help provide answers to questions 1377 01:44:31.800 --> 01:44:36.039 that just about every one of these patients has because right now, I mean, 1378 01:44:38.520 --> 01:44:42.520 yes, you know, understanding what foods and how they impact your blood 1379 01:44:42.560 --> 01:44:45.960 sugar is extremely important. And again I think it's also also will help patients 1380 01:44:46.000 --> 01:44:50.439 from a different perspective because I deal with insurance companies all the time with prescriptions. 1381 01:44:50.479 --> 01:44:57.520 It's like, okay, yes you could then with this continuous glucose monitoring 1382 01:44:57.560 --> 01:45:01.680 and a diabetic patient if you let's say you do just basic labs and they 1383 01:45:01.720 --> 01:45:05.359 don't look that much different. Now I see the trends, you know, 1384 01:45:05.479 --> 01:45:10.720 if you interpret labs in a different way, it's not oh these are you 1385 01:45:10.800 --> 01:45:13.640 know, fine, No, they're trending on the lower end, or they're 1386 01:45:13.640 --> 01:45:15.640 trending in a positive way, but they may not necessarily on paper, look 1387 01:45:15.720 --> 01:45:19.880 that much different. But then you can extrapolate and bring in that glucose data 1388 01:45:19.920 --> 01:45:23.960 and go and look, here's their average. Like you could take that clinical 1389 01:45:24.079 --> 01:45:29.000 data you're getting from that wearable and go look from from three months ago to 1390 01:45:29.159 --> 01:45:33.000 now, we have seen this change in their in their glucose numbers, and 1391 01:45:33.119 --> 01:45:36.199 that could then facilitate like, hey, we're getting better, this treatment's working. 1392 01:45:36.720 --> 01:45:43.520 Like there's there's other it ties in IT, ties in another piece of 1393 01:45:43.560 --> 01:45:46.359 the puzzle that I help that helps that clinical data. So like for example, 1394 01:45:46.439 --> 01:45:49.680 said just looking at A one C like I always like seeing, okay, 1395 01:45:49.720 --> 01:45:53.560 well what was their fasting insulin? Well they're fasting insulin improved. It's 1396 01:45:53.600 --> 01:45:57.279 like, okay, great, that's what we want. We want less insulent 1397 01:45:57.319 --> 01:46:00.399 equals less insulin resistance to a degree. So we need to look at that. 1398 01:46:00.479 --> 01:46:02.399 We need to look at what the A ONEC is. We need to 1399 01:46:02.439 --> 01:46:06.119 look at you know, you can even get into fractionated HVA one C two, 1400 01:46:06.239 --> 01:46:10.800 but that's neither here nor there. But you take that puzzle. Let's 1401 01:46:10.800 --> 01:46:15.840 say you're A ONC went from six to five point five. Now, that's 1402 01:46:15.880 --> 01:46:19.720 great, you're no longer pre diabetic at that point. It's but someone may 1403 01:46:19.760 --> 01:46:23.359 say, well, that's only a half of a point. You know, 1404 01:46:23.760 --> 01:46:28.279 that's only point five improvement. But you can then show them go, yeah, 1405 01:46:28.319 --> 01:46:30.279 that may not look like a big difference to you, but look at 1406 01:46:30.319 --> 01:46:32.760 the trends and your glucose numbers of that continuously. Look how it changed like 1407 01:46:32.880 --> 01:46:36.840 this. It's a different frameshift. And then you have the patient not feeling 1408 01:46:36.920 --> 01:46:44.800 discouraged about that small incremental improvement you're seeing. You're seeing that that small improvement 1409 01:46:45.000 --> 01:46:47.840 looks bigger now because of that other improvement that you otherwise wouldn't have had. 1410 01:46:48.840 --> 01:46:54.000 So it reinforces that you're doing the right thing. You're not anxious about it, 1411 01:46:54.039 --> 01:46:58.319 you're not frustrated that you've been working this hard and you've only seen a 1412 01:46:58.359 --> 01:47:02.279 little bit of an improvement, because let's let's let's be honest. If you're 1413 01:47:02.279 --> 01:47:05.680 anything like me, you know you're you're kind of tough on yourself being a 1414 01:47:05.720 --> 01:47:10.880 former athlete. It's like you want to see those big improvements and payoffs and 1415 01:47:10.920 --> 01:47:14.920 you feel good when they happen. But especially with labs and health and wellness, 1416 01:47:15.920 --> 01:47:19.079 those little improvements add up significantly, and it's a it's a mindset. 1417 01:47:19.479 --> 01:47:23.479 You know, a patient may think, hey, how'd your week go? 1418 01:47:23.760 --> 01:47:25.920 And you could go, yeah, I struggle this week. I maybe eight 1419 01:47:26.000 --> 01:47:29.159 some things I shouldn't have and you can tell they're kind of a little bit 1420 01:47:29.239 --> 01:47:31.159 upset with themselves. And then you go, well, your numbers look great, 1421 01:47:31.239 --> 01:47:35.239 and then look at these values, like from a practitioner perspective, you 1422 01:47:35.279 --> 01:47:39.840 can then reinforce that there actually are doing good and they are making progress. 1423 01:47:39.960 --> 01:47:45.720 So I think that's going to be interesting. Yeah, but he gets back 1424 01:47:45.760 --> 01:47:53.000 to the mentality part as well, is we assume certain foods cause our blood 1425 01:47:53.039 --> 01:47:57.840 sugar to spike that just because they're sort of this food. But then when 1426 01:47:57.920 --> 01:48:01.039 you consume them, and they're many examples, do you realize they don't for 1427 01:48:01.159 --> 01:48:04.239 various to Sunday reasons. So then it starts to open up things that you 1428 01:48:04.319 --> 01:48:08.640 thought you couldn't have that you could have because now you're not worried about bloodsher 1429 01:48:08.800 --> 01:48:14.479 right. So it's sex behavior and food choices. And I think that's key 1430 01:48:14.680 --> 01:48:18.279 from a nutrition standpoint, is if in the study show this very clearly wearing 1431 01:48:18.399 --> 01:48:24.520 continuous glucose monitors sex food choices, because to your point, you can see 1432 01:48:24.640 --> 01:48:29.000 you know that a continuous diet they cause a spike after spike after spike, 1433 01:48:29.079 --> 01:48:33.319 it's not good for you. So if you're truly interested in reversing those trends, 1434 01:48:33.560 --> 01:48:39.000 then you're going to start look seeking out those foods that are similar but 1435 01:48:39.119 --> 01:48:42.800 don't give you or right but still give you that sort of food. Or 1436 01:48:43.119 --> 01:48:46.880 to your other point with your with the low gipost we're talking about earlier, 1437 01:48:47.039 --> 01:48:51.560 and you expand that product line into something like let's say you know, a 1438 01:48:51.680 --> 01:48:55.640 cake mix or something like that, to whereas you know, you know, 1439 01:48:55.720 --> 01:48:59.279 a normal piece of cake that was made normally, did this to my blood 1440 01:48:59.359 --> 01:49:01.239 sugar, but I'm eating the same thing. It's very similar, mouth feel, 1441 01:49:01.359 --> 01:49:05.399 very similar, taste, flavor profile like there's all that there, but 1442 01:49:05.560 --> 01:49:09.560 it doesn't do that same effect to your blood sugar. So then you're able 1443 01:49:09.640 --> 01:49:13.960 to when you do have those types of craybas we're all human. When you 1444 01:49:14.000 --> 01:49:16.640 do have those things and you want to reach for those foods, is you 1445 01:49:16.720 --> 01:49:19.960 have another option that's not to where you don't feel like you can have to 1446 01:49:20.039 --> 01:49:23.960 completely avoid that type of food for forever. Like I know a lot of 1447 01:49:23.960 --> 01:49:26.840 people that say, you know what, I love bread, I love passa, 1448 01:49:26.920 --> 01:49:29.359 but and I know I probably shouldn't need a bunch of it, but 1449 01:49:29.479 --> 01:49:30.920 I enjoy it. It's like, no, it's fine if you want to 1450 01:49:31.079 --> 01:49:33.279 enjoy it. But like if you, if you're one of those people that 1451 01:49:33.319 --> 01:49:36.960 likes the aposta all the time, why not have why not have a pasta 1452 01:49:38.079 --> 01:49:43.239 option that we know don't that we know won't affect you negatively as far as 1453 01:49:45.479 --> 01:49:50.359 it's impact on your blood sugar over time. So I think that the implications 1454 01:49:50.439 --> 01:49:54.760 for that, I think you are really are really going to be interesting to 1455 01:49:54.760 --> 01:49:57.399 see how they tease out. And I'm excited to know that you're you and 1456 01:49:57.640 --> 01:50:01.479 y'all's group are on are on that, and I'm excited to be involved with 1457 01:50:01.560 --> 01:50:05.479 it too because it's just super cool. Yeah. I mean again, I 1458 01:50:05.760 --> 01:50:11.760 just want to re emphasize to your to your listeners, if there today and 1459 01:50:13.920 --> 01:50:18.920 without going into a rabbit hole, we don't consumer education. Isn't there enough 1460 01:50:19.119 --> 01:50:24.439 for big groups to pick it up because there's not a market, But but 1461 01:50:24.560 --> 01:50:29.199 there's a good on swell that has started. And I think to your point, 1462 01:50:29.359 --> 01:50:32.079 if you get more people educated and you give them the ability to understand 1463 01:50:32.399 --> 01:50:35.880 why is it important? Why do I care? Once you get up, 1464 01:50:35.920 --> 01:50:40.800 why do I care? Then the awareness is you're going to hit that adoption 1465 01:50:40.880 --> 01:50:44.920 curve, right, that linear portion log linear portion, that adoption curve, 1466 01:50:44.960 --> 01:50:46.560 and then you're really going to see a take off, right, So you 1467 01:50:46.680 --> 01:50:53.920 just gotta That's my encouragement to any pharmacists looking to branch out or starting out 1468 01:50:54.239 --> 01:50:59.560 isn't don't think of diabetes as a dead end. So really it's it's really 1469 01:50:59.600 --> 01:51:03.600 going to be an amazing opportunity if you sort of look into the future and 1470 01:51:03.720 --> 01:51:08.239 see where those opportunities. Yeah, yeah, I couldn't. I couldn't agree 1471 01:51:08.279 --> 01:51:15.000 with you more there, you know, Yeah, it's finally it's it's interesting, 1472 01:51:15.079 --> 01:51:15.760 and I have to it's gonna take me a minute to kind of get 1473 01:51:15.760 --> 01:51:18.800 my head around that because for the longest time it's you know, you knew 1474 01:51:18.800 --> 01:51:24.439 that. It's it's a very similar feel to like ten years ago. I 1475 01:51:24.479 --> 01:51:28.079 would have never thought that I would have readily, easily, readily, at 1476 01:51:28.199 --> 01:51:31.920 ready access to my genetic profile to a degree. I'm a whole genome mapped 1477 01:51:31.960 --> 01:51:34.800 out, but like for one hundred bucks or two hundred dollars, I can 1478 01:51:34.840 --> 01:51:39.640 get a test done that that tells me just some cool, interesting things I 1479 01:51:39.680 --> 01:51:43.880 didn't know before. I would have never thought that technology would have been available 1480 01:51:43.920 --> 01:51:47.319 ten years ago, you know, or let alone be affordable. So and 1481 01:51:47.479 --> 01:51:51.479 right now with continuous glucose monitors, I mean you know, des comms, 1482 01:51:51.520 --> 01:51:56.560 stuff like that. I mean, they're not cheap still, and then the 1483 01:51:56.840 --> 01:52:00.439 ones that are cheaper, the sensors don't last for very on, maybe a 1484 01:52:00.439 --> 01:52:02.279 couple of weeks. I mean they're good and effective, but again, some 1485 01:52:02.439 --> 01:52:05.319 of them aren't continuously reading it. You have to kind of scan it every 1486 01:52:05.520 --> 01:52:11.720 every so often. So there are options, but I think it's gonna be 1487 01:52:12.079 --> 01:52:15.319 I think it's gonna be really interesting, especially from a pharmacist perspective on how 1488 01:52:15.359 --> 01:52:19.479 do we then take that data that is now readily available and use that to 1489 01:52:20.119 --> 01:52:28.000 then facilitate improvement from a clinical side, because that's a task that I think 1490 01:52:28.119 --> 01:52:31.199 is right for pharmacists to do, not because you know, I always want 1491 01:52:31.239 --> 01:52:36.880 to see pharmacists do more and succeed, but it takes the burden of that 1492 01:52:38.119 --> 01:52:42.680 off of a position in the nurses because to do that right and to look 1493 01:52:42.720 --> 01:52:46.680 at those trends over time take time, and they've got more important things to 1494 01:52:46.760 --> 01:52:51.199 do as far as diagnosing and doing all the lab testing and things that they 1495 01:52:51.279 --> 01:52:56.239 do, and there to where hey, I know your We've got you on 1496 01:52:56.359 --> 01:52:59.119 this. You know, we know what's your results are. Go talk to 1497 01:52:59.159 --> 01:53:01.720 the pharmacists. He knows how to interpret that data. We're all on the 1498 01:53:01.720 --> 01:53:05.960 same page, so I think we're I think it'll really help us expand upon 1499 01:53:08.319 --> 01:53:11.560 interprofessional practice too, to where we can all kind of be on the same 1500 01:53:11.600 --> 01:53:15.359 page, because I know for a lot of folks they feel like every provider 1501 01:53:15.399 --> 01:53:18.880 they go to to a degree is telling them something different. And I think 1502 01:53:18.920 --> 01:53:24.960 that's a big problem in and of itself. But Ryan, Uh, we're 1503 01:53:25.039 --> 01:53:29.399 approaching the two hour mark, which for you and me is not not anything 1504 01:53:29.560 --> 01:53:32.720 unfamiliar. I don't want to to take up any more of your Sunday either. 1505 01:53:33.600 --> 01:53:38.279 I know you've got a lot going on. I guess real quick, 1506 01:53:38.359 --> 01:53:43.119 if there was not on anything we've touched on, what other thing? Are 1507 01:53:43.119 --> 01:53:46.720 there any other things you've got working on right now that that that you're excited 1508 01:53:46.800 --> 01:53:48.840 for that you I mean, I'm not asking for you to go into like 1509 01:53:48.920 --> 01:53:55.520 any great detail, but in addition to the sessiment and the lower GI impact 1510 01:53:55.560 --> 01:53:59.319 foods things like that, are there any other things you're working on currently that 1511 01:54:00.560 --> 01:54:04.720 that you're also excited about? Before we wrap things up. Yeah. My 1512 01:54:05.000 --> 01:54:10.800 two big projects right now are this low blastemic in addition to the the what 1513 01:54:10.920 --> 01:54:14.600 I'll call the mighty liver supplement if I can link it to a disease. 1514 01:54:15.119 --> 01:54:17.279 In addition is this low glastemic index. I see, this is a revolution 1515 01:54:17.359 --> 01:54:19.760 and I want to being part of that. So that's a big push through 1516 01:54:19.800 --> 01:54:24.880 me right now. I think. The other thing is it maintaining sort of 1517 01:54:24.960 --> 01:54:30.840 overlap between nutrition and dietary supplementation. Is this concept of nutrient density and where 1518 01:54:31.119 --> 01:54:36.960 our agricultural practices need to change in the coming years, and the technology around 1519 01:54:38.000 --> 01:54:43.039 looking at nutrient density is changing as well. So there is a prototype device 1520 01:54:43.479 --> 01:54:48.119 where it makes possible in the future you to walk into your Kroger or your 1521 01:54:48.359 --> 01:54:54.880 grocery store and pick up to squash. Right, here's this one yellow squatsh 1522 01:54:55.079 --> 01:54:58.239 here's another yellow squatch and boom, look at the nutrient density of those two. 1523 01:54:58.359 --> 01:55:01.760 I start to make selection based upon nutrient density, right, And so 1524 01:55:01.920 --> 01:55:08.760 that's that's really fascinated is how do we get specially crops to think more in 1525 01:55:08.840 --> 01:55:14.880 the regenerative agriculture soil health. But the goal there is again nutrient density. 1526 01:55:14.960 --> 01:55:20.960 And the example I give very quickly is that we've gotten so good at fertilizer 1527 01:55:21.359 --> 01:55:27.319 and creating growth. But what that's still But now I'm oh, so I'm 1528 01:55:27.399 --> 01:55:30.079 being hyperbolic here. But now I've got a corn stalk. It's got two 1529 01:55:30.119 --> 01:55:33.039 ears of corn. It's in the same ground, and now I'm making grows, 1530 01:55:33.039 --> 01:55:36.000 so they increase four stalks, you know, four ears of corn, 1531 01:55:36.159 --> 01:55:41.159 Right, those four ears of corn in Toto still can say the same nutrients 1532 01:55:41.239 --> 01:55:43.920 that the two ears of corn did. It's the same ground. So now 1533 01:55:44.039 --> 01:55:47.680 you have the nutrient density of the corn on the cob that you're eating. 1534 01:55:48.079 --> 01:55:53.079 That's the hypothetical sort of scenario. We are right, just because we can 1535 01:55:53.760 --> 01:55:58.840 increase our yields doesn't mean it's the same thing in terms of nutrient density. 1536 01:55:59.039 --> 01:56:01.680 And in fact, they can't be, right, It literally cannot be because 1537 01:56:01.800 --> 01:56:05.039 it's more than just adding fertilizer to the soil. Right, it's so many 1538 01:56:05.159 --> 01:56:09.520 vitamins and minerals, et cetera, and so nutrient density. I guess it 1539 01:56:09.800 --> 01:56:13.520 is the other thing I'm really interested in, and how that ties back agricultural's 1540 01:56:13.560 --> 01:56:18.640 practices, particularly in especially crop food space. Yeah, that's that's that's awesome. 1541 01:56:18.760 --> 01:56:24.119 I've always been really fascinated into regenerative agriculture and farming and stuff too, 1542 01:56:24.159 --> 01:56:27.640 because it's one of those things you just can't ignore at this point. But 1543 01:56:27.880 --> 01:56:30.000 one of the biggest things that I see is like, man, how do 1544 01:56:30.079 --> 01:56:31.479 you see that's awesome on a local level. How do you make it? 1545 01:56:31.760 --> 01:56:36.279 You know? How do you expand upon that which is neither which is coming? 1546 01:56:36.319 --> 01:56:41.800 I'm sure, but that's fascinating, and I'm you know, I've thought 1547 01:56:41.800 --> 01:56:44.359 about it, but never really at that detail of like, yeah, you 1548 01:56:44.399 --> 01:56:46.560 know, if we're genetically modifying these things. I'm not a big anti GMO 1549 01:56:46.640 --> 01:56:51.000 person. I think that's fine as far as like volume of food and providing 1550 01:56:51.079 --> 01:56:55.319 people access to food and stuff like that. However, to your point, 1551 01:56:55.840 --> 01:56:59.840 if I take corn and I've modified it to be to where I don't have 1552 01:56:59.880 --> 01:57:02.880 to really worried about the weeds and things like that, but I've also made 1553 01:57:02.920 --> 01:57:06.600 it to where now we're doubling the yield of said crop, You're and no 1554 01:57:06.720 --> 01:57:11.399 one's talking about how do we how do we increase the nutrient density in the 1555 01:57:11.479 --> 01:57:15.319 soils, etc. So I never really made that link of oh, well, 1556 01:57:15.479 --> 01:57:18.039 yeah, we up the we made they can grow a lot more wheat 1557 01:57:18.159 --> 01:57:24.239 or a lot more corn. However that soil, you're just increasing the demand 1558 01:57:25.600 --> 01:57:28.399 of the soil and then then next thing, you know, it's not yielding 1559 01:57:28.439 --> 01:57:30.520 those crops anymore. That we're yielding four years of corn, and now you 1560 01:57:30.600 --> 01:57:33.880 have to go somewhere else and buy up more land and then you just repeat 1561 01:57:33.880 --> 01:57:38.720 the process over and over again. So that's fascinating to me as well. 1562 01:57:38.800 --> 01:57:43.279 I'm interested to pick your brain more on that in another episode or just another 1563 01:57:43.319 --> 01:57:45.920 conversation that we have, you know, just as friends. But man, 1564 01:57:46.079 --> 01:57:51.720 I really appreciate you you being on here. I you know, I I 1565 01:57:51.840 --> 01:57:57.399 can't thank you enough just from a friend mentor pushing me to kind of do 1566 01:57:57.520 --> 01:58:00.159 better as a pharmacist too. Man, I can't. I can't thank you 1567 01:58:00.319 --> 01:58:05.000 enough. It's super it's super cool to be well connected to people who are 1568 01:58:05.000 --> 01:58:11.000 really pushing the boundaries who in their fields. I think it's it's just I 1569 01:58:11.079 --> 01:58:16.079 think it's awesome. And the super humble guy, well, I appreciate well, 1570 01:58:16.079 --> 01:58:19.159 I appreciated Patrick An I'm gonna pay it forward kind of guy, right, 1571 01:58:19.199 --> 01:58:23.239 And that's what I tell anybody I talked to, Uh, you know, 1572 01:58:23.399 --> 01:58:26.840 and I'm honored to be considered a mentor. But I would tell people 1573 01:58:27.000 --> 01:58:29.840 that say they paid forward, right, make sure that those folks right, 1574 01:58:30.079 --> 01:58:34.720 tell everybody you can to read as much study and learn this stuff and get 1575 01:58:34.800 --> 01:58:40.079 involved. You know, you and I've talked about this guy, Jay Phipps 1576 01:58:40.199 --> 01:58:43.760 right here, a former classmate of mind or actually I think he was one 1577 01:58:43.840 --> 01:58:45.840 year behind me a pharmacy school. With the things he's doing in the field 1578 01:58:45.920 --> 01:58:49.560 of pharmacy and independent pharmacy in West Tennessee, you know, we need more 1579 01:58:49.640 --> 01:58:53.399 people, and they're out there said, but we need even more people like 1580 01:58:53.600 --> 01:58:58.399 Jay Phipps and like yourself and what y'all are doing at Nimbus to really push 1581 01:58:58.479 --> 01:59:02.399 those boundaries. Because right now, in one respect, right, So, 1582 01:59:02.479 --> 01:59:08.119 when I went to pharmacy school, if the mantra was you need to be 1583 01:59:08.159 --> 01:59:11.479 getting out of pharmacy, because this report just came out and said the pharmacy 1584 01:59:11.520 --> 01:59:15.119 professional was done the jobs going away. And when we finished pharmacy school and 1585 01:59:15.159 --> 01:59:20.159 my wife finished their residencies and the pharmacy went through the biggest explosion in salaries 1586 01:59:20.279 --> 01:59:24.680 in the history of pharmacy, right, So completely opposite. So anything you're 1587 01:59:24.760 --> 01:59:29.680 hearing now about pharmacy's probably alved and still the same. I heard that. 1588 01:59:29.760 --> 01:59:32.079 Okay, I'm not being heard same thing in pharmacy school when I got in, 1589 01:59:32.239 --> 01:59:34.319 when I got accepted, even from my dad, he in and I 1590 01:59:34.399 --> 01:59:38.840 was like, oh yeah, he goes one of my prescas who was yeah, 1591 01:59:38.880 --> 01:59:41.399 I guys, it's the pharmacy builds saturated. There's a lot of pharmacy 1592 01:59:41.439 --> 01:59:44.079 schools, not many jobs right now. You are going to really struggle getting 1593 01:59:44.119 --> 01:59:46.479 out. I'm like, that was what I heard p one year. And 1594 01:59:46.479 --> 01:59:50.680 then when I graduated, COVID hit and then it was just everything changed and 1595 01:59:50.760 --> 01:59:56.720 now there's a demand, a significant demand for pharmacists and pharmacy students. So 1596 01:59:56.840 --> 02:00:02.279 it's like it went full circle in four years. So well so as a 1597 02:00:02.319 --> 02:00:06.199 guy who's seen that over thirty year period, I told every single class I 1598 02:00:06.319 --> 02:00:12.600 ever talked, there will always be a shortage of good. That's correct. 1599 02:00:12.960 --> 02:00:16.840 Yep, that's correct. Never forget that when you're getting you to our profession. 1600 02:00:17.159 --> 02:00:21.560 If you want to become the best pharmacy she can be, you'll always 1601 02:00:21.600 --> 02:00:26.920 find a job. There'll never be a right. That's awesome. Never, 1602 02:00:28.119 --> 02:00:30.239 Ryan, I don't want to take up too much more of your time. 1603 02:00:30.279 --> 02:00:31.800 It's been a long it's been a long Sunday. If you're a busy man, 1604 02:00:32.960 --> 02:00:35.680 tell everybody in your family. I said, hello, give him my 1605 02:00:35.720 --> 02:00:38.920 best, keep my dad in line. I tell you that all the time. 1606 02:00:39.119 --> 02:00:42.640 That's not an easy task, but someone's got to do it. I 1607 02:00:42.760 --> 02:00:45.880 was gonna say, but hey, you're better than me. I live far 1608 02:00:45.960 --> 02:00:48.079 I live too far away now, But Ryan, I appreciate you being on. 1609 02:00:48.239 --> 02:00:51.159 This won't be the only time I plan on having you back, just 1610 02:00:51.279 --> 02:00:56.600 whenever you want. Just let me know. I'm really excited to see where 1611 02:00:56.640 --> 02:00:59.600 all this goes, and I'm excited that you will. You know, are 1612 02:00:59.640 --> 02:01:01.800 allowing me the opportunity to get involved with you too. I haven't really gotten 1613 02:01:01.800 --> 02:01:05.079 a chance to thank you for that, but I'm really excited to see where 1614 02:01:05.119 --> 02:01:10.560 this goes, and I appreciate your time. Sure, Patrick ahead, thanks 1615 02:01:10.560 --> 02:01:15.760 for having me. Thank you guys for listening to today's episode of The Weldness 1616 02:01:15.800 --> 02:01:17.960 Transcription Podcast. If you wanted to continue to support the show, please do 1617 02:01:18.119 --> 02:01:21.199 us a huge favor and like, follow, and leave us a five star 1618 02:01:21.279 --> 02:01:26.720 review on any of your favorite podcasting platforms. Your support and feedback me in 1619 02:01:26.800 --> 02:01:29.159 the world to us, and it also helps us to continue to bring you, 1620 02:01:29.239 --> 02:01:32.159 guys, high quality content moving forward. You can follow us on Instagram 1621 02:01:32.199 --> 02:01:35.039 at the Weldness Transcription Podcast. That way, you can stay up to date 1622 02:01:35.119 --> 02:01:40.359 on all of our upcoming content and special guest interviews. As always, be 1623 02:01:40.520 --> 02:01:41.600 well, thank godless,