奥兹匹克专家：奥兹匹克改变你的肠道菌群！人们正被过量使用奥兹匹克！微量用药救了我的命！——蒂娜·摩尔博士

2020年的时候，我根本没法活蹦乱跳。

I was not moving and shaking in 2020.

2021年，我只能平躺在沙发上动弹不得。

I was 2021, I was flat on my back on the couch.

我记得2021年底时在想，如果情况没有好转，我可能就要结束自己的生命了。

And I remember by the end of 2021 thinking, if this doesn't get better, I think I'm gonna kill myself.

真的，我再也承受不了了。

Like, I couldn't do it anymore.

那种程度的疼痛让我无法继续活下去。

Like, I just couldn't live with that level of pain.

我的脊柱正在融合，我能真切感受到。

And my spine was fusing, and I could feel it.

我不断试图告诉所有人情况不对劲。

And I kept trying to tell everyone something is wrong.

我的脊椎按摩师朋友们都很好，但他们只懂肌肉骨骼医学。

And my chiropractor friends were great, but they knew musculoskeletal musculoskeletal medicine.

我的自然疗法朋友们很棒，但他们只懂整体医学。

And my naturopathic friends were great, but they knew systemic medicine.

而我需要的是我自己。

And I I needed me.

我需要我的大脑来解决这个问题，就像需要一个两者都懂的人。

I needed my brain on the case, like someone who had both.

对吧？

Right?

我就是无法掌控局面。

And I just couldn't get on top of it.

最后，我不知道怎么或为什么，我有点陷入了那个故事里。

And then finally, I I don't know how or why I I went kind of into the story.

哦，我知道是怎么回事了。

Oh, I know what it was.

我爆发了银屑病。

I broke out with psoriasis.

我头皮上突然爆发了银屑病。

I broke out with psoriasis all over my scalp.

我当时就想，哦，原来是这么回事。

And I was like, oh, this is what this is.

这是银屑病关节炎，后来发现这是最痛苦的肌肉骨骼自身免疫疾病之一。

This is psoriatic arthritis, which turns out to be one of the most painful musculoskeletal autoimmune conditions you can have.

研究显示，在疼痛等级上它比类风湿性关节炎更严重。

It's worse than rheumatoid arthritis on the pain scale from what the studies show.

所以我想，好吧，既然知道问题所在，我能做些什么？

So I was like, okay, now that I know what I'm dealing with, what can I do?

于是我开始全力以赴，尝试所有我知道的方法：低剂量纳曲酮、外泌体治疗，你能想到的都试了。

So I started pulling out all the stops and all the things I knew to do, low dose naltrexone, exosomes, you name it.

我尝试了所有办法。

I was doing everything.

但效果并不持久——要么短暂见效后很快失效，要么根本压不住症状。

It really wasn't bringing it down or it would work for a minute and it would it would it would wear off.

于是我变得绝望起来，我有个播客节目，我的制作人建议我必须做一期关于Ozempic的节目。

And so I was getting desperate and my I have a podcast, and my podcast producer said, you gotta do an episode on Ozempic.

我当时想，我不喜欢谈论减肥话题。

And I was like, I don't I don't like talking about weight loss.

我真的不喜欢讨论减肥。

I really don't like talking about weight loss.

这个话题很容易触发人们的情绪反应，它涉及面广且充满微妙差异，远非人们想象的那么简单。

It people get so emotionally triggered, and it's a big topic, and it's nuanced, and it's not as simple as people wanna make it be.

在我的功能医学圈里，人们总想把它简单化——多运动、少吃点、服用这些补充剂，或者采用纯肉食疗法，问题就会消失。

And in my functional medicine world, people wanna make it so simplistic, just exercise more and eat less and take these supplements, and it'll go carnivore, and it'll all go away.

事实并非如此简单。

It's not that simple.

这里面有遗传因素。

There's genetic components.

还有大脑层面的因素。

There's brain components.

还有表观遗传因素。

There's epigenetic components.

这就像我不愿打开的潘多拉魔盒。

And it was like the Pandora's box I didn't wanna open.

所以最后，我想，好吧，行吧。

And so finally, was like, okay, fine.

我要开始研究这些了。

I'm gonna start researching these.

我当时坐着。

And I was sitting.

我仰面躺在沙发上。

I was laying on the couch on my back.

当时是2023年，但我还是需要频繁地躺着休息。

And it's twenty twenty three at this point, but I'm still having to take frequent breaks, right, on my back.

所以我锻炼完，还得躺上三个小时。

So I'd go exercise, and I'd have to lay down for three hours.

于是我开始用谷歌搜索，查了GLP-1和神经炎症，因为我总是从这里入手。

So I'm Googling, and I look up GLP one and neuroinflammation because I always start there.

我总是从疼痛、神经炎症和免疫激活开始研究。

I always start with pain, neuroinflammation, and immune activation.

我总想知道任何物质在这些方面有什么作用，因为这是我的专业领域。

I always wanna know what any substance does in those because that's my world.

对吧？

Right?

因为这就是我在临床实践中研究的内容。

Because that's what I did in clinical practice.

然后我搜索了这个。

And I Googled that.

当时我丈夫在厨房，我直接惊呼‘我的天哪’。

My husband's in the kitchen, and I was like, holy shit.

我把手机转过去说：‘快看这个。’

And I turned the phone around, and I was like, look at this.

他回答说，宝贝，我不懂这些。

And he's like, I don't know what that means, babe.

我当时就觉得，这和他们告诉我们的完全不一样。

And I was like, this is not what they're telling us.

因为那正是主流媒体和所有标题党新闻最猖獗的时候，什么妈妈服用Ozempic过量啦，人们会永久性胃瘫啦之类的。

Like, this is not what because that was at the height of mainstream media and all the clickbait headlines and, you know, mom is overdosing on Ozempic and people's stomachs are paralyzed forever.

于是我就开始，当然啦，查证所有这些说法。

And I was like so then I started, of course, looking at all that.

我就想：这些是真的吗？

Like, is that for real?

他们真的会永久性胃轻瘫吗？

Like, are they really getting gastroparesis forever?

不会。

No.

所以我开始深入研究所有数据，就这样开始了。

So I start going into all the data, and I just that was it.

这就像掉进了兔子洞。

It was like the rabbit hole.

那是2023年5月，自那以后我就深陷其中，被各种信息淹没。然后我开始在自己的播客节目里讨论这个话题，大家也纷纷给我发来各种资料。

And it that was May 2023, and I've been knee deep in it ever since, just consumed by any and all inform And then, of course, everybody start I started doing podcasts about it on my show, and everyone's sending me all the information.

数百人联系我，讲述他们健康发生的深刻变化——这些变化与减肥或糖尿病毫无关系。

And hundreds of people are reaching out to me, telling me these really profound stories and changes in their health that have nothing to do with weight loss or diabetes.

就这样，我被某种东西'咬住'了。

And so that was it.

你知道，我讨厌宣传。

I was like, I got I got bit by some kind of, well, you know, I don't like propaganda.

当我听到所有人都在说同样的话时，我就觉得不对劲。

I don't like when I hear everybody saying the same thing.

当所有人都朝一个方向跑，喊着'这是邪恶的'时，这让我很怀疑。

It makes me suspicious, you know, when everyone's running in one direction, screaming, this is evil.

他们都说这是有史以来最糟糕的东西。

This is this is this is, you know, the worst thing ever.

我当时想，我也不知道。

I was like, I don't know.

这种药物已经存在二十多年了。

This has been around for twenty some years.

不是司美格鲁肽，而是这类药物，这个药物家族。

Not semaglutide, but this version of medication, this family of medication.

所以我不确定。

And so I don't know.

我当时想，我才不信这套。

I was like, I'm not buying this.

我要找出真相。

I'm gonna find out what the truth is.

于是我联系了所有可能使用过它的医生。

And so I I called every doctor I knew that might use it.

我还联系了所有可能接触过它的药剂师。

I called every pharmacist I knew that might use it.

没有人观察到这些可怕的副作用。

Nobody was seeing any of these horrific side effects.

就像，你当时在媒体上看到的故事是什么来着？

Like, the stories you were seeing on the media currently what was that?

夏天吗？

Summer?

那确实到了，比如，2023年达到了顶峰。

That was really it it came to, like, full height, 2023.

我想那正是所有人对此疯狂的时候。

I think that was when everybody was losing their minds about it.

他们一开始讨论减肥，人们就对此疯狂了，我觉得这非常有趣。

The minute they started talking about weight loss, people started losing their minds about it, which I find very interesting.

而我查阅的文献与我所听到的完全不符。

And what I was finding in the literature was not at all adding up to what I was hearing.

然后还有所有这些令人震惊的其他益处。

And then there were all of these other benefits that were just mind blowing.

比如，在治疗和逆转1型糖尿病方面的益处，治疗和逆转神经认知障碍如帕金森病和阿尔茨海默症，对戒酒的有效性，那些患有酒精滥用综合症的人用它来戒酒。

You know, benefits on healing and reversing type one diabetes, healing and reversing neurocognitive conditions like Parkinson's and Alzheimer's, efficacy with alcohol cessation, people who were you know, alcohol abuse syndrome, using it for that.

还有那些携带HLA-B27基因型的人，这种基因容易导致脊柱关节炎，如银屑病关节炎、类风湿关节炎等病症，也显示出对这种病症的疗效。

People who also had the this type of HLA B twenty seven, it's a genetic propensity towards these spondyloarthritis, like psoriatic arthritis, rheumatoid arthritis, those kinds of things, having showing efficacy for that.

当我开始公开谈论这些时，我收到了许多人发来的信息，他们向我讲述自己的故事，成百上千的人分享他们的经历。

And as I started speaking out about it, I was getting messages back from people telling me their stories, hundreds and hundreds of people telling me their stories.

然后我看到了我的患者身上发生的变化。

And I and then seeing what was happening with my patients.

于是我开始根据不同原因、以不同剂量——非常微小的剂量——将它应用于我治疗的每个人，结果看到了人们身上发生的深刻变化。

So I started applying it to everyone I was treating for different reasons at different doses, very tiny doses, very little bits, and just seeing really profound changes in people.

但这与我们听到的情况并不一致。

And I it's not what we're hearing.

而且我认为标准模式下的使用方法对每个人来说也并非最理想的。

And I don't think that the way also that it's being done in the standard model is ideal for everyone.

我认为很多人用药剂量过高、速度过快，很多人实际上用药过量了，因为归根结底它是一种激素。

I think a lot of people are being dosed too high, too fast, and I think a lot of people are being overdosed because at the end of the day, it's a hormone.

它是一种肽信号激素。

It's a peptide signaling hormone.

因此，人们的剂量被迅速提高。

And so people are being cranked up on doses very quickly.

有一个16周的剂量递增方案，他们从这一剂量快速增加到那一剂量。

There's a a sixteen week escalation, and they go from this amount to this amount very quickly.

在这个过程中，许多人报告了严重的胃肠道副作用，这些都是真实存在的。

And in the journey, many people are reporting horrific gastrointestinal side effects, which are real.

但这并非肽本身的过错。

But it's not the peptide's fault.

归根结底它也是一种肽，这个我可以解释其含义。

It's the it's a peptide at the end of the day as well, which is I can explain what that is.

嗯。

Yeah.

如果你需要向一个10岁的孩子解释什么是ZENPEC，或者概述这种化合物

If you had to explain what a ZENPEC is or what go over your you know, this this compound is just to a 10 year old

是的。

Yeah.

好的。

Okay.

你会怎么解释它？

How would you explain it?

所以你吃的是氨基酸。

So you eat amino acids.

你摄入蛋白质，它会分解成氨基酸。

You eat protein, and it breaks down into amino acids.

对。

Yeah.

氨基酸通过肽键连接成链，形成肽。

And amino acids link up with peptide bonds into chains called peptides.

然后肽

And then peptides

会形成肽键。

will link peptide bond.

这不过是一种将两个氨基酸简单连接在一起的键。

It's just a simplistic bond that binds two amino acids together.

所以它很容易被不同的酶分解。

So it can be broken pretty readily with different enzymes.

而且这就在我体内。

And that's in my body.

肽键就在我体内。

The peptide bond is in my body.

是的。

Yeah.

所以你的体内存在所有这些酶，氨基酸会以非常简单的方式连接成不同的链。

So your body has all these enzymes present, and the amino acids link up very simplistically into different chains.

没错。

Yeah.

这些氨基酸链被称为肽。

And then those chains of amino acids are called peptides.

肽连接起来形成蛋白质，而你的身体就是由蛋白质构成的。

And peptides link up to form proteins, and your body is made of proteins.

你的整个身体都是。

Your whole body.

你所有的组织都由蛋白质组成。

All of your tissue is made out of proteins.

你的细胞受体也是由蛋白质构成的。

And your cellular receptors are made out of proteins.

一切都是由蛋白质构成的。

Everything's made out of proteins.

所以如果往回追溯，那些更小的版本是肽——抱歉，是氨基酸，而比肽更小的版本则是氨基酸。

So if you go backwards, those smaller versions are the amino acids I'm sorry, are peptides, and the smaller versions of that yet are the amino acids.

嗯。

Mhmm.

所以我们摄入蛋白质。

So we eat protein.

我们将其分解为氨基酸，再重新合成为更多蛋白质。

We break it down into amino acids, and we reconstruct it into more protein.

嗯。

Mhmm.

而肽就是这些氨基酸链，我们有各种不同类型的治疗性肽，它们会自行定位到需要发挥作用的地方。

And so peptides are these chains of amino acids that we've got all different types of therapeutic peptides, and they insert themselves where they need to go to do what they need to do.

嗯。

Mhmm.

归根结底就是这样。

So that's it at the end of the day.

那么ZEMPEC在其中是什么角色呢？

And what's so what's a ZEMPEC in that?

ZEMPEC是一种肽吗？

Is it ZEMPEC is a peptide?

它是一种肽。

It's a peptide.

它由我们肠道中的L细胞制造，这些细胞排列在从近端到远端的小肠中。

And it's made in our L cells of our gut, which line from the most proximal to the distal small intestine.

这些细胞在葡萄糖存在时会分泌GLP-1，

And it secrete these cells secrete GLP one in the presence of glucose, which

是

is

当我们摄入含糖食物或碳水化合物时，它们都会分解成葡萄糖。

sugar when we eat sugary foods or food well, all carbohydrates break down into glucose.

所以每当我们摄入葡萄糖时，实际上当一团食物通过肠道时，这种食物团的机制会触发这些细胞反应。

So whenever we eat glucose and they respond actually when a bolus of food so the mechanism of a blob of food going through our guts actually gets these cells to trigger.

然而，在我的临床实践和职业生涯中，我检测过数千人的肠道，人们的肠道状况一团糟。

However, I have tested thousands of people's guts in my clinical practice, in my clinical lifetime, and people's guts are a mess.

大多数人的消化功能都有问题。

Most people have compromised digestion.

因此我认为在很多情况下他们的L细胞并没有最佳运作。

So I don't think their L cells are working optimally in many cases.

我们还有文献资料，扎实的科学依据表明，那些患有肥胖症、二型糖尿病和脂肪肝等代谢综合征的人群，这些患者普遍存在GLP-1缺乏。

And we also have literature, good solid science to show that those who are suffering with obesity, type two diabetes, and fatty liver, that whole metabolic syndrome, you know, groupage, those folks are GLP one deficient.

所以我服用Zempec时，它实际上是在促使我的肠道——准确说是我的身体释放GLP-1吗？

So when I take a Zempec, it's causing my gut, basically, my body to release GLP one?

不是。

No.

它就是GLP-1本身。

It is the GLP one.

哦，它就是GLP-1啊。

Oh, it is the GLP one.

对。

Yep.

所以我们并没有促使肠道做任何事。

So we're not causing the gut to do anything.

我们是在模拟实际的肽。

We are mimicking the actual peptide.

啊，明白了。

Ah, okay.

所以它的原子结构与之相同。

So it's got the same sort of atomic structure as it do.

因此我的身体认为它就是GLP-1。

So my body thinks it's GLP one.

我想就功能而言它确实就是GLP-1。

I guess it is GLP one as far as things are concerned.

那这个GLP-1会对我产生什么作用呢？

And then the GLP one is doing what to me?

比如司美格鲁肽，它与我们体内分泌的GLP-1是生物同源的。

Well, so it's semaglutide, for instance, is bio identical to the GLP one that our body secretes.

所以本质相同，只是稍作了一些分子修饰。

So it's the same, except it's been tweaked with a little bit.

他们添加了一些脂质以延长半衰期。

They've added some lipids to it to make the half life longer.

所以它能持续更久。

So it lasts longer.

正常情况下，GLP-1会由我们的细胞分泌。

So normally, GLP one would be secreted from our cells.

它也会从我们的大脑中分泌，这一点我们稍后要详细讨论，因为正是这部分让我特别兴奋。

It's also secreted from our brain, which we got to get into because that's where I got really excited.

它由我们的身体分泌，并很快被分解。

It's secreted from our body, and it's broken down very quickly.

因此这些新型肠促胰岛素激素或肠促胰岛素肽的分解速度更慢。

And so these newer versions of these incretin hormones or incretin peptides are broken down at a slower pace.

好的。

Okay.

那么GLP-1具体有什么作用呢？

And then what does GLP one do?

它能实现各种奇妙的功能。

It does all kinds of cool things.

最显著且广为人知的作用是降低食欲。

So it most notably and what it's known for is to decrease appetite.

嗯。

Mhmm.

这一过程主要发生在大脑中枢。

And that happens centrally in the brain.

是的。

Yeah.

它会减缓胃蠕动。

It slows gastric motility.

通过减缓消化速度让你维持更长时间的饱腹感。

So it slows things down so you feel fuller for longer.

这是在较高剂量时产生的效果。

That's at higher doses.

这并不总是必然发生的。

That doesn't always need to happen.

而这正是它为人所知的特点。

And that is what it is known for.

它还会作用于胰腺细胞，促使它们在适当的时候分泌胰岛素。

And it also has induction of it it plays with the cells of your pancreas, and it gets them to secrete insulin at the right time.

大多数人随着年龄增长都会存在不同程度的胰岛素抵抗，这正是二型糖尿病的初期征兆。

And so most folks are walking around in some degree of insulin resistance as as they age, and that is the beginning glimmers of type two diabetes.

因此GLP-1类药物能改善这一状况。

And so GLP ones help that process.

它能增强细胞对胰岛素的敏感性，并在需要时促进胰岛素分泌。

It helps sensitize the cells to the insulin, and it helps secrete the insulin when needed.

当你在2023年遇到困难时

And when you were struggling in 2023

是的。

Yeah.

你开始服用Zempec（司美格鲁肽）这类品牌药物之一。

You started taking a Zempec, semaglutide, one of these brands.

是的。

Yeah.

它对你产生了什么影响？

What impact did it have on you?

我选择了复配版本，因为我认为初始剂量需要调整——让我们从头说起。

So I got a compounded version because I thought that the starting dose let's back up.

大多数人熟悉的品牌处方药是那些预充式小笔型注射器。

The brand name, the prescription that most people are familiar with are these little prefilled pens.

嗯。

Yeah.

而且这些笔型注射器只有特定剂量规格。

And the pens only come in certain doses.

你无法自行控制剂量。

You can't control the dosage.

你需要从他们提供的最低剂量开始，然后逐步增加。

You start at the lowest dose that they offer, and then you have to escalate from there.

如果你的医生比较开明，他们不会让你增加太多剂量。

Or if your doctor's cool, they won't make you escalate too much.

但无论如何，你不能低于起始剂量，而起始剂量是0.25毫克。

But either way, you don't get to go lower than the dose that it starts, and it starts at point two five milligrams.

我认为这个剂量太高了，尤其对我这样的人来说。

I thought that that was way too high, especially for someone like myself.

我的新陈代谢非常高效。

I'm very metabolically optimized.

我有良好的肌肉量。

I have good muscle mass.

我的骨密度非常好。

I have very good bone density.

我的体检报告看起来很棒。

I have my labs look beautiful.

我的激素水平处于最佳状态。

I'm hormonally optimized.

我正在接受生物同源激素替代治疗。

I'm on bioidentical hormone replacement.

我非常活跃。

I'm very active.

我经常锻炼。

I exercise often.

我的睡眠质量很好。

My sleep is good.

我当时在想，是否我们中有些人实际上存在轻微的GLP-1缺乏，不是因为肥胖、糖尿病和脂肪肝等问题。

And I thought my thinking was, I wonder if some of us are actually a little GLP one deficient from whether a life of not because we have obesity, diabetes, and fatty liver.

这些人缺乏GLP-1可能有不同原因。

There's different reasons why those folks would be deficient.

高水平的胰岛素本身实际上会导致一定程度的GLP-1缺乏。

Insulin at high levels itself will actually induce some GLP one deficiency.

它会降低GLP-1信号传导。

It'll it'll decrease GLP one signaling.

我在想，是否有些人天生如此，或者我们因慢性疾病等原因导致这种情况。

My thinking was, I wonder if folks are just genetically or maybe we got ourselves there through chronic illness, whatever it may be.

我在想是否存在轻微的缺乏。

I wonder if there's a little bit of a deficiency.

如果我像补充激素一样补充这种肽会怎样？

What if I supplement this peptide like I would a hormone?

我的做法是给予人们达到有利生理影响所需的最低剂量，然后设定上限。

Which the way I do that is I give people the lowest dose necessary to achieve a physiologic impact that's favorable, and then I cap it.

所以如果你需要一点甲状腺素，标准模式会让你服用——你知道的，算法显示你有甲状腺功能减退，所以我们会给你这个剂量和这种特定药物。

So if you need a little bit of thyroid, the standard model would have you take Well, you know, the algorithm says you have hypothyroidism, so we're going give you this much and we're going to give you this exact drug.

在我的理念中，我们会根据需要定制复合药物。

In my world, we compound what we need.

也许你需要更多的T3而非T4。

Maybe you need a little more t three than t four.

也许你需要一个非常小的剂量。

Maybe you need a tiny dose.

也许我们会逐渐增加剂量，直到你开始出现轻微症状，然后我们会说，哦，让我们稍微减少一点。

Maybe we titrate you up until you start getting a little symptomatic, and we're like, oh, let's back it down a little.

所以我的想法是以这种方式使用它。

So my thinking was to use it that way.

于是我询问了所有认识的人，你们是否将其用于除抑制食欲、减肥或糖尿病以外的其他用途？

So I asked everyone I knew, are you using this for anything other than appetite suppression or weight loss or diabetes?

他们都说没有。

And they all said no.

实际上没有人这么做。

Nobody really was.

至少我的同事中没有人这样做。

None of my colleagues were anyway.

而且他们都是从我认为仍然过高的剂量开始的。

And they were all starting at a dose that I still thought was too high.

于是我从极小剂量开始尝试。

So I started myself at a tiny little dose.

我最初感受到的效果是大脑变得清晰。

And my first impact was brain clarity.

短短几天内，我的思维就变得清明起来。

Within days, my brain cleared.

这种感觉甚至难以用语言形容。

I can't even explain it.

脑雾症状确实已经开始出现了。

Brain fog was definitely starting to happen.

我认为这与银屑病关节炎有关，也可能是新冠后遗症。

I think it was the psoriatic arthritis, and I think it was the I think it was post COVID.

要知道，我们的大脑都因此受到了不小的冲击。

You know, I think our brains all got hit pretty hard by that.

我觉得这还与长期压力有关，也可能是更年期导致的。

And I think it was chronic stress, and I think it was menopause.

我当时的状态就像是，表面是个高效能的女强人，实际上却连工作都完成不了。

And I was sort of in this I'm a high functioning kind of boss babe, and I couldn't get my work done.

我的团队都快疯了，因为我总记不清交代过他们什么。

And my team was going crazy because I couldn't remember what I told them.

他们打电话来问，说'这个我们已经做过了'。

And, you know, they're calling me, and they're like, we already did this.

'这个对话我们已经进行过了'。

We already had this conversation.

'你到底怎么回事？'

What is wrong with you?

所以我就想，真是见鬼了。

So I was like, damn it.

这样下去不行。

This isn't gonna work for me.

我不能一边这样浑浑噩噩，一边还想经营好所有企业。

I can't be rolling the way I'm rolling and trying to run all my businesses and have brain fog like this.

这是我注意到的第一件事，就是思维变得清晰了。

So that was the first thing I noticed, was clarity of thought.

脑雾消失了。

Brain fog went away.

焦虑感立即下降，我甚至都没意识到自己之前有焦虑。

Anxiety immediately dropped, which I didn't even realize I had.

一种平静感笼罩了我，这感觉太美妙了。

It's just a calmness took over me, which was so amazing.

两周内，我的疼痛感就显著减轻了，非常显著。

And within two weeks, my pain was down significantly, significantly.

我注意到身体各部位又开始活动和发出声响了。

And what I noticed was everything was starting to move and pop again.

我的活动能力正在恢复。

So I was getting mobility back.

到第二周时，我又想运动了。

And by week two, I wanted to move again.

这个曾经只想完成锻炼、做完工作就躺下的我，已经不再那样了。

So this version of me that just wanted to, like, go do my workout, go do my work, and then lay down on my back, I wasn't that doing that anymore.

我立刻重新报名了普拉提课程，发现自己又开始在家里转呼啦圈跳舞了。

And I immediately, like, signed back up for Pilates, and I found myself dancing in hula hooping around the house again.

我发现自己变得活跃多了。

And I found myself just being much more active.

慢慢地但确实地，那种破坏性的状态逐渐消失了。

And slowly but surely, the destruction sort of fell away.

因为过去几年我一直在经历相当严重的免疫系统破坏过程，现在差不多一年了，这种状态正逐渐但确实地消退。

Because I had been in a pretty destructive immune process for a couple years there, and it just has it's taken me I think it's been almost a year now, and it's just slowly but surely dropped away.

我还注意到体重减轻了一些，过去几年我确实增重了不少。

I also noticed a little bit of weight loss, which I had gained some weight over the past couple years.

我想这是长期压力导致的。

I think it was chronic stress.

我的新陈代谢受到了严重影响。

I was doing a number on my metabolism.

要知道，当你到了50岁这个坎，事情就变得艰难了。

And, you know, you hit that 50 year old mark and things get tough.

所以我减掉了一些体重。

So I had some weight loss fall away.

我很快又恢复到了我的战斗体重。

I got right back down to my fight and weight.

我现在几乎和201年开始这一切时的体型一样。

I'm, like, literally the size I was in 2019 going into all of this.

于是我很快开始推荐别人使用，也得到了非常相似的效果。

And so I quickly started putting people on it and very similar responses.

他们都有点小肚腩，但没人是为了减肥才用的。

All of them had a little bit of fluff, but nobody was on it for weight loss.

每个人都减掉了一点体重，很快就恢复到了理想体重。

Everyone had a little bit of weight, fell right off, got back down to a good weight.

我特别担心我妈妈，因为我不想让她再次消瘦下去。

My mom, was particularly concerned about because I didn't want her to waste away again.

我不想让她呕吐。

I didn't want her vomiting.

我不希望她出现任何胃肠道症状。

I didn't want her having any gastrointestinal symptoms.

我希望所有这些症状都能消失。

I wanted all of those to resolve.

如果操作得当，它能将你的肠道微生物群转变为更有利的微生物群。

It shifts your gut microbiome to a more favorable microbiome if you do it right.

我们确实掌握了相关数据。

And so and we have the data on that.

所以我对她非常缓慢且谨慎。

So I was very slow and cautious with her.

我不希望她流失任何肌肉量。

I don't want her losing any muscle mass.

而每个人都产生了这些深远的影响。

And everybody just had these profound impacts.

我女儿的皮肤，囊肿性痤疮。

My daughter's skin, cystic acne.

我是说，长达十年的严重囊肿性痤疮，让她整个青春期都过得不开心，甚至因此产生过自杀念头。

I mean, a decade of severe cystic acne, the point where she did not enjoy her teenage years, and she was suicidal from it.

整整几年时间，她都躲在头发后面不敢见人。

I mean, just hiding behind her hair for for years.

我记得她坚持三周后我再见到她时，她的皮肤就像瓷器一样光滑。

Her skin I remember seeing her after three weeks on it, and I was like, your skin is porcelain.

发生了什么？

What happened?

她所有的多囊卵巢综合症症状都逆转了。

All of her PCOS symptoms reversed.

我丈夫不再想喝酒了。

My husband didn't want to drink anymore.

这人可是出了名的酒鬼。

The guy is a known alcoholic.

他好像对酒精完全不感兴趣了。

He was, like, not interested in alcohol.

他的血压也恢复正常了。

His blood pressure regulated out.

我是说，所有这些小变化开始出现，我也在病人身上看到了类似的效果。

I mean, just all of these little things started happening, and I started seeing similar effects in my patients.

与此同时，我在社交媒体上分享这些经历，并在播客中讨论，人们纷纷发消息告诉我这些深刻的故事。

And then I, at the same time, I was posting about it and talking about it on my podcast, and people were messaging me, telling me these profound stories.

他们说，我本来是为了减肥/代谢功能障碍/二型糖尿病才尝试的，但没想到还发生了这么多其他变化。

They were like, I went on it for weight loss or I went on it for metabolic dysfunction or type two diabetes, but here's all the other things that started happening.

后来有人开始告诉我他们因为这个怀孕了。

And then people started telling me they were getting pregnant on it.

要知道，这些人原本不孕不育，经历了好几轮失败的试管婴儿治疗，突然就出现了这些奇迹般的故事。

And, you know, when they had been infertile and gone through rounds of IVF that were not working and just all of these amazing stories.

所以当然，我必须继续研究这个现象，收集更多相关信息。

And so, of course, I keep I have to research that and do more information on that.

而我一直以来都在慢慢解开这个谜团。

And it's just been I've just been unwinding.

我觉得我正在揭开一个未被讲述的故事。

I I feel like I'm unwinding a story that isn't being told.

那么这个故事是什么呢？

So what is that story?

总结来说，你逐渐相信的这个未被讲述的故事是什么？

To summarize, what is that story that's not being told that you've come to believe?

这些肽具有治愈作用。

These peptides are healing.

它们具有抗炎性和再生性。

They are anti inflammatory, and they are regenerative.

而且对我们的免疫系统有着深远的积极影响。

And they have a profound impact on our immune system in a positive way.

它们不仅仅是掩盖导致2型糖尿病的胰岛素抵抗和代谢功能障碍。

And they don't just cover up and mask the insulin resistance and the metabolic dysfunction that leads to type two diabetes.

它们确实能治愈它。

They actually heal it.

你是怎么知道的？

How'd you know that?

嗯，有趣的是，随着今年时间的推移，越来越多的研究结果出炉，我们开始看到这一点。

Well, interestingly, as this year has gone on, more and more studies have come out, and we're starting to see it.

我关于此的许多假设开始通过优质的临床数据和良好的研究显现出来。

So many of the hypotheses I had about it are starting to show themselves in good clinical data, in good studies.

我在我的病人身上看到了效果，也在自己身上见证了这一点。

And I've seen it with my patients, and I've seen it with myself.

所以我现在能够停用它了。

So I am now able to go off of it.

起初，我只能停用很短时间，然后我的牛皮癣就会复发。

At first, I could only go off of it for a short amount of time, and my psoriasis would come back.

那是最初的症状。

That was the first symptoms.

我的皮肤问题会开始出现，通常是在发际线周围，有些轻微瘙痒。

I would start getting skin issues, and I usually get it around my scalp line, little itchies.

这些症状会在7到10天内复发。

That would come back within seven to ten days.

现在我能坚持一个月不复发，且完全没有症状。

I am now able to go a month without it and absolutely no symptoms.

一旦开始出现脑雾或轻微疼痛，我就会重新开始治疗。

And the second I start to get brain fog or a little bit of pain, I go back on.

我像调节其他激素一样周期性地使用它。

I cycle it like I would any other hormone.

不知道你们是否邀请过讨论激素的嘉宾，但周期性使用效果最佳，因为受体会达到饱和。

I don't know if you've had any guests on talking about hormones, but they're done best when you cycle them because receptors get saturated.

当你用激素使受体饱和一段时间后，细胞就会停止响应。

And when you saturate a receptor with a hormone or after a while, the cell will stop listening.

所以你不应该持续让细胞或身体处于激素的过度刺激中。

And so you don't want to just keep flooding a cell or a body with a hormone.

你需要暂停使用，让那些受体重新活跃起来。

You want to take it away and let those receptors pop back up.

因此我认为，如果以正确且优雅的方式——一种合理、临床合理的方式——来操作，我们实际上可以开始治愈这些如此猖獗的慢性生活方式疾病。

And so I think done correctly and done in an elegant way that's just reasonable, clinically reasonable, I think that we can actually start to heal some of these chronic lifestyle diseases that are so rampant.

这让我不禁思考，我们是否可能越来越少地需要那些像糖果一样被随意分发的常见药物。

And it makes me wonder if we would need less and less and less of the common pharmaceuticals that are being handed out like candy.

那些终身服用的药物。

The lifelong pharmaceuticals.

人们开始服用他汀类药物或降压药时，没人提出异议。

People go on statin drugs or they go on blood pressure medications, and no one says boo.

他们需要终身服用。

They're on it for life.

‘哦，这是给你治疗二型糖尿病的二甲双胍。’

Oh, here's your metformin for your type two diabetes.

‘你需要终身服用。’

You're on it for life.

我认为如果操作得当，再加上这些物质在大脑中诱导的神经再生过程，它们确实能促进神经元再生。

I think done correctly and also the neuro regenerative process that these induce in the brain, they actually regenerate neurons.

神经可塑性是指当你重复做某件事足够多次时，大脑会将其固化为本能反应。

Neuroplasticity is this concept where when the brain when you do something enough, your brain will hardwire into that.

因此无论是好习惯还是坏习惯，只要你持续去做；或是任何思维模式，比如长期抑郁、长期消极——你懂的，你明白我的意思。

And so any habit, good or bad, that you consistently do or any thought process you consistently have, if you're chronically depressed or chronically negative or you're, you know I mean, you know this.

你一直在自我优化、不断成长，努力变得更好。

You're you're self optimizing yourself all the time and growing and trying to grow and be better.

你正在重塑大脑并固化这些神经回路。

You're plasticizing your brain and hardwiring that circuitry.

所以这对你来说会越来越容易，你也会持续追求知识。

So it's getting easier for you and you continue to seek knowledge.

这些肽类物质不仅为人们提供了一个机会窗口，让他们重获掌控权——因为大脑中的某些机制和多巴胺通路正在让人们重新掌握主导权。

These peptides offer people a window of opportunity of not only giving them the onus of control back, because there are some mechanisms in the brain and the dopaminergic pathways that are giving people the they're back in the driver's seat.

他们重新掌控了自己的行为。

They're back in control of what they're doing.

但它同时也在诱发这种神经可塑性。

But it's also inducing this neuroplasticity.

因此，如果他们在用药期间能真正实施积极的生活方式习惯，这些习惯就会被固化到他们的大脑中。

So if they are to implement really positive lifestyle habits during the period of time that they're on it, they will hardwire that into their brain.

这就像为某人打开了一扇彻底改变生活的机会之窗。

So it's like opening a window of opportunity for somebody to completely change their life.

你刚才提到的一些研究确实支持了你的论点，即Zenpek不仅仅是一种减肥药，还具有这些再生特性和治疗特性。

You mentioned some studies there that have really supported your thesis that a Zenpek is more than just a weight loss drug, and that it has these other sort of regenerative properties and these healing properties.

具体有哪些研究？

What are some of the studies?

你面前带了些资料过来。

You've got some some things in front of you there that you brought with you.

在你看来，有哪些研究特别突出了这一点？

What are some of these studies that highlight this in your view?

嗯，有一项特别的研究——虽然我没记下具体标题——他们分析了市面上所有GLP-1激动剂的数据，包括我提到的不同版本。

Well, so there's one study in particular that I don't have the title of it written down, where they looked at all of the data on all of the GLP one agonists that are out there, the different versions that I mentioned.

他们回顾了所有研究，并逐一对每个系统进行了分析。

And they went back through all of the studies, and they looked at it system by system by system.

我已将相关链接提供给你们团队。

And I gave your team a link to that.

他们的发现是，从头到脚——从大脑神经再生和抗炎作用，到心血管组织的改善。

And what they found is, I mean, going from tip to toe, neuro regeneration and anti inflammation in the brain, they showed improvements in cardiovascular tissue.

我们刚在2023年发布了一项名为SELECT试验的研究。

We just had a study come out at the 2023 called the SELECT trial.

这是一项重大研究。

Was a big one.

是的，这项研究由诺和诺德赞助，他们是司美格鲁肽的制造商，或者我应该说，是诺和泰的制造商。

Yes, it was sponsored by Novo Nordisk, who's the manufacturer of semaglutide, of of I should say, of Ozempic.

所以人们会说，哦，别相信那些研究。

And so people say, oh, don't believe those studies.

这是一项设计严谨的研究。

It was a well done study.

该研究针对四十多岁超重但未患二型糖尿病的人群，结果显示严重心血管事件减少了20%。

It looked at individuals in their forties who were overweight but did not have type two diabetes, and it showed a twenty percent reduction in severe cardiovascular events.

包括中风、心脏病发作等。

So stroke and heart attack and and others.

结果公布后有人反驳说，诺和诺德公司主导的研究不足为信，认为这只是体重减轻带来的效果。

And so then people argued once that came out and said, oh, well, foof, you know, Novo Nordisk did it, and that would happen if people lost weight anyway.

对吧？

Right?

体重下降确实会改善心血管疾病。

You'd you'd have improvements in cardiovascular disease.

但研究团队重新分析数据后发现，这些益处与体重减轻无关。

Well, they just looked at the data again and realized that those benefits were independent of weight loss.

无论受试者是否减重，其心血管结局均有显著改善——目前没有任何其他疗法能做到这点。

Whether people lost weight or not, they still had significant improvement in cardiovascular outcomes, which there's just nothing we don't have anything out there that does that.

我还发现数据显示，若干预及时，一型糖尿病患者的胰腺组织和β细胞能够再生。

I found data showing regeneration of pancreatic tissue, beta cells in type one diabetics if given early enough.

1型糖尿病是一种自身免疫性疾病，患者的胰腺会被免疫系统破坏，这与2型糖尿病不同。

So if a person is type one diabetes is an autoimmune condition where the pancreas becomes destroyed by the immune system, it's different than type two.

我们目前没有任何方法能帮助这类患者。

We don't have anything to help those people.

过去它被称为青少年糖尿病，而2型糖尿病则被称为成人发病型糖尿病。

It used to be called juvenile diabetes, and then type two was adult onset.

但现在很多很多儿童也患上了2型糖尿病，所以这个分类变得很混乱。

But now kids, many, many children are dealing with type two, so it's a big mishmash.

但这是两种完全不同的病理过程。

But they're very two different processes.

它们甚至不该用相同的疾病名称。

They shouldn't even have the same name.

总之，早期干预可以逆转胰腺损伤，使患者无需使用胰岛素，并实现胰腺组织的修复。

Anyway, done early, reversal of that pancreatic damage to the point where people didn't need to go on insulin and were able to have pancreatic healing.

除了干细胞疗法外，我们目前没有任何其他手段能做到这一点。

We don't have anything that does that except stem cells.

他们在2023年不得不中止了流动试验，因为这是一项针对慢性肾脏疾病的研究。

They, at the 2023, they had to stop the flow trial because this was a chronic kidney disease trial.

他们不得不中止试验，因为从伦理角度必须让对照组也能获得这种物质，它的疗效实在太显著了。

They had to stop it because the control group they needed to be able to ethically give the control group the substance because it was so effective.

它在逆转慢性肾病和肾衰竭方面效果如此显著，以至于必须让对照组也能接受治疗，而不能任由他们的肾脏继续受损。

It was so effective at reversing chronic kidney disease and kidney failure that they needed to be able to offer it to the control group ethically and not let them continue on their journey of kidney damage.

所以我们手头有这些零散的研究数据，他们还做了一些小规模研究，比如针对肌肉组织的实验。

So we've got this mishmash of studies, and then they've done little studies here and there looking at muscle, for instance.

它对肌肉组织具有再生作用。

It's regenerative to muscle.

它对骨骼具有再生作用。

It's regenerative to bone.

它对我们的关节具有再生作用。

It's regenerative to our joints.

其中部分研究是在小鼠身上进行的。

Some of this is in mice.

其中一些是在人类身上进行的。

Some of it's in humans.

它对睾丸以及精子生成和活力具有再生作用。

It's regenerative to the testes and to sperm production and motility.

当你说对肌肉有再生作用时，人们讨论Zempeg时最担心的问题之一就是会流失大量肌肉。

When you say regenerative to, say, muscle, when when people talk about a Zempeg, of the big concerns is that you lose a lot of muscle.

没错。

Right.

这不是事实。

It's not true.

我的意思是，这确实是事实。

I mean, it is true.

让我重新表述一下。

Should let me let me let me rephrase that.

任何导致严重热量限制的饮食干预或减肥手术都会造成约20%至35%的肌肉量——或者说瘦体重的流失。

Any dietary intervention or bariatric surgery that induces a severe caloric restriction will lead to about 20 to 35% muscle mass, or I should say lean mass loss.

所以这需要稍微细致一点的讨论。

So this is a little bit of a nuanced conversation.

如果你让某人进入自我饥饿模式，他们会失去20%到35%的瘦体重。

If you basically put somebody into a self starvation mode, they will lose 20 to 35% of their lean mass.

瘦体重是指你体内所有的软组织。

Lean mass is all the soft tissue in your body.

这包括肌腱、韧带、大脑等，他们把这些都归为一类。

So that could be your tendons and your ligaments and your brain, and they they clump it all into one.

他们看着这些数据，就认为全是肌肉。

And they're looking at that and saying it's all muscle.

肌肉只是其中的一部分。

Muscle's a percentage of that.

肌肉并不等同于你的全部瘦体重。

Muscle isn't all of your lean mass.

对吧？

Right?

因此，我认为这让那些研究显得不太可靠。

And so that kind of makes the thing the the studies look bad there, I think.

他们未考虑的另一点是，代谢功能障碍导致的病态肌肉会与脂肪形成大理石纹。

The other thing that they don't consider in that is pathologic muscle due to metabolic dysfunction will be marbled with fat.

这是什么意思？

What does that mean?

抱歉。

Sorry.

嗯，就像人造鹅肝。

Well, it's like a faux gras.

当你诱导动物产生代谢功能障碍时——养牛场常对牛这么做，对鹅也是如此以使其肝脏肥厚——最终肌肉中会出现脂肪浸润。

When you induce metabolic dysfunction in an animal, which is what they do in feedlots for cows often, and they do it to geese to get their liver fatty, you will end up with this fatty infiltrate in the muscle.

于是肌肉从原本优美、条纹状、线条分明的美丽形态变成了脂肪斑驳的状态。

So the muscle goes from being this lovely, striated, linear, beautiful pattern to marbled with with fat.

嗯。

Mhmm.

这种脂肪浸润对肌肉极具病理危害，会使肌肉本身进入胰岛素抵抗状态。

And that fatty infiltrate becomes very pathologic to the muscle, and it puts the muscle itself into an insulin resistant state.

所以一旦肌肉出现大理石纹样变，对肌肉来说就像是鸡生蛋蛋生鸡的恶性循环。

So once the marbling occurs in the muscle, it's sort of a chicken and egg downhill situation for the muscle.

我坚信（几十年来一直在宣扬这个观点），一旦这个过程开始（通常始于大腿），你可能看过那些横截面对比图——比如这位80岁铁人三项选手的肌肉纹理依然清晰优美。

And I do believe very strongly, and I've been preaching this for decades, that once that process starts, and it most often starts in the thighs, you've probably seen the pictures of the cross section of, like, this is an 80 year old triathlete, and his muscle looks really beautiful and linear.

而普通80岁老人的肌肉则布满脂肪纹，骨质流失严重，外层脂肪层也更厚。

And then here's, you know, the average 80 year old, and it's really marbled, and the bone loss is significant, and the fatty layer on the outside is thicker.

但那张照片最关键的是肌肉的大理石纹样变。

But what's most important in that photo is the marbling of the muscle.

我们不需要布满脂肪纹的肌肉。

We don't want marbled muscle.

那是终结的开始。

That's the beginning of the end.

在这种代谢功能障碍状态下，你最终还会出现脂肪肝和脂肪胰，这条下坡路将导致二型糖尿病的发生。

You also end up with fatty liver, and you end up with fatty pancreas when you're in this metabolic dysfunction state, this downhill journey that culminates in type two diabetes.

因此，当代谢健康改善时——无论是通过饮食干预、生活方式调整还是力量训练等方式——最先发生的变化之一就是脂肪浸润开始溶解。

And so one of the first things that happens when metabolic health improves, whether this is through dietary interventions, lifestyle strength training, you name it, is that fatty infiltrate starts to dissolve.

这些GLP-1受体激动剂会促进脂肪溶解的过程。

These GLP one agonists induce that process of the fat dissolving.

所以我认为这就是他们测量到的瘦体重减少的部分原因。

And so I think that's part of the lean mass loss that they're measuring.

他们只是将其记录为瘦体重减少。

They're just measuring it as lean mass loss.

但我们同时也在减小肌肉尺寸，因为脂肪浸润开始自我燃烧消耗。

But we're also decreasing muscle size because we're having the fatty infiltrate start to burn itself up.

研究还显示GLP-1类药物能通过血管新生改善肌肉灌注，从而增加血管供应，使更多氨基酸可供肌肉利用。

GLP-1s have also been shown to perfuse the muscle with angiogenesis so we get a vascular supply so that more amino acids are available to the muscle.

当研究人员观察老年人肌肉并给予GLP-1受体激动剂后，由于获得更好的血液供应并能吸收饮食中的蛋白质氨基酸，他们的肌肉变得更健康且病理性降低。

So when they looked at aging muscle in a human and they gave them GLP-one agonist, their muscle became healthier and less pathologic because it started to actually get better blood supply and be infused with the amino acids they were eating in the form of protein.

此外还有相关通路会受到影响，从而促进肌肉蛋白质合成。

So it's and then there's pathways that are impacted as well that are inducing muscle protein synthesis.

因此GLP-1实际上会促进肌肉蛋白质合成。

So GLP-one's actually induce muscle protein synthesis.

它们不会导致肌肉萎缩。

They don't cause muscle wasting.

是热量限制导致了这种消耗。

It's the caloric restriction that's causing the wasting.

而且他们的测量方式有些偏差。

And they're measuring it somewhat aberrantly.

这样讲得通吗？

Does that make sense?

这就是我想在这里阐述的观点。

That's that's the story I'm trying to weave here.

嗯。

Yeah.

那么如果我正在服用GLP-1激动剂（比如司美格鲁肽或ZENPEC），该如何避免热量限制呢？

So but how how do I how can I avoid the caloric restriction if I'm taking the GLP one agonist, something like semaglutide or ZENPEC?

不要将剂量调得过高。

You don't dose it too high.

这样就不会完全抑制食欲。

So you don't crush the appetite.

整个目标是让人们保持在仍有食欲的剂量水平。

So the whole goal is to keep people at a dose where they still have an appetite.

不必用它来彻底压制食欲。

You don't have to crush their appetite with it.

传统给药方式是快速增加剂量，结果严重破坏了人们的食欲。

The way it's being dosed traditionally is they're ramping it up really fast, and they're just devastating people's appetite with it.

于是人们从饥饿状态直接变成什么都不想吃，结果就真的不吃了。

And so people go from hungry and starving to I don't wanna eat anything, and so they don't.

然后他们往往会吃更不健康的食物——抱歉。

And then they often will eat less healthy version I'm sorry.

他们会减少摄入量，但吃的仍是劣质饮食。

They'll eat less volume of a poor app of a poor diet.

因此他们会继续吃垃圾食品，只是吃得少了些。

So they will continue to eat junk food, only less of it.

他们会继续吃那些习惯了的劣质食物，只是分量减少了。

They will continue to eat the crappy foods they're used to eating, only less of it.

我听约翰·哈里在你的节目里谈到过这个，他写了一本很棒的书，那本《神奇药丸》。

And I've heard Johan Hari on your show talk about this, and he a beautiful book that he wrote, his magic pill book.

他谈到过这一点。

He talks about that.

他发现自己在用药五、六个月后，仍然吃着同样的垃圾食品。

He found himself about five or six months in, and he was still just eating the same crap.

他只是吃得少了些。

He was just eating less of it.

无论使用何种剂量，使用者都必须竭尽全力保护肌肉。

And what needs to happen when anybody's on this at any dose is they need to be protecting their muscle with all their might.

他们需要进行力量训练，并优先保证蛋白质的摄入量。

They need to be strength training, and they need to be prioritizing their protein macros.

这两点是绝对不容妥协的。

Like, those are the two nonnegotiables.

我认为医生并不总是强调这一点，而患者也往往未能遵守。

I don't think doctors are always talking about that, and I don't think patients are compliant with that.

但如果我开始微量用药，我获得的回报会不会减少呢？

If I start microdosing, though, you know, won't I see less of the reward?

虽然成本降低了，但难道我不会同时获得更少的回报吗？也就是你描述的那些积极效果？

I see less of the cost, but I when I will I not also get less of the reward, the the positive upsides that you've described?

不会的——前提是你同时做好其他生活方式调整。

Not if you're doing all the other lifestyle things.

就像我说的，这开启了一个机会窗口——人们会感觉更能掌控自己，因为药物对大脑的影响能让人更好地控制自己的选择、思维过程甚至强迫行为。

So like I said, it opens this window of opportunity where people feel much more in control because there's impacts on the brain that allow people to be much more in control of their choices and of their thought processes and of their even of their obsessions.

它的作用机制非常有趣。

It's very interesting how it works.

因此人们能够做出更好的选择。

And so people are able to make better choices.

我认为借助这个机遇窗口并引入这些生活方式干预措施，他们会更容易接受这些改变。

And I think given that window of opportunity and introducing these lifestyle interventions, they're gonna be much more open to it.

所以我们让他们开始锻炼。

So we get them exercising.

我们让他们改善饮食。

We get them eating better.

我们让他们完成所有该做的事。

We get them doing all the things.

你知道，我们让他们优化睡眠质量。

You know, we get them optimizing their sleep.

我们让他们散步、冥想并缓解压力。

We get them going on walks and meditating and mitigating their stress.

所有这些都将改善他们的代谢健康。

All of those things are going to improve their metabolic health.

所以这是个双管齐下的方法。

So it's a two pronged approach.

而且我们不必加大剂量。

And we don't have to crank the dose.

我们可以缓慢而温和地进行。

We can do this slow and low.

有些人可能需要更多，有些人可能需要更少。

And some people may need more, and some people may need less.

但关键在于传统做法——就像你拿到处方后直接离开诊所，没有任何咨询或支持——这正是我认为人们陷入可怕绝望深渊的原因。

But the point is is the way it's being done traditionally, where it's like you get your script, and you walk out of your office, and you don't get any counseling, you don't get any support, this is where people are falling into, I believe, the terrible pits of despair.

这就是我们发现问题的地方。

So this is where the we're seeing the problems.

我们可以采用不同的方式，即对患者采取全面综合的治疗方法。

And it can be done differently where we're doing a holistic comprehensive approach with a patient.

我读到林赛·王2024年的一项研究，发现服用Zempec的糖尿病患者比使用胰岛素的患者患肠癌的几率低50%。

I was reading a 2024 study by Lindsey Wang that found diabetic patients taking a Zempec were fifty percent less likely to develop bowel cancer compared to those on insulin.

这对Ozempic在预防癌症方面的作用说明了什么？突出了哪些意义？

What does this say and highlight about Ozempic's role in staving off cancer?

嗯，这项研究很有趣，因为胰岛素具有促生长作用。

Well, that's an interesting study because insulin is pro grow.

胰岛素也是一种信号肽激素，与GLP-1非常相似。

So insulin is also a signaling peptide hormone, very much like GLP-one.

当你给人注射胰岛素时，它确实会促进生长。

And it is pro grow when you give it to someone.

因此我认为，使用胰岛素的人可能本质上更容易患癌症。

So someone being on insulin, I believe, will inherently potentially make them more vulnerable to cancer.

我不想说得太绝对，因为不想吓到所有人——毕竟有很多人都在使用胰岛素。

I don't want to say certainly because I don't want to scare everybody because there's a lot of people out there on insulin.

但它确实是一种促生长激素。

But it is a pro grow hormone.

这种促生长特性体现在运动后胰岛素会激增，这其实很棒。

Now it's pro grow in that we get surges of it after we work out, which is awesome.

这正是我们需要的。

We want that.

对吧？

Right?

我们想要那种合成代谢反应。

We want that anabolic response.

但对于那些不锻炼、没有正确利用胰岛素、因胰岛素抵抗而体内胰岛素水平已经很高、现在又因胰腺功能衰竭而需要注射胰岛素的普通人来说，情况就糟糕了。

But in your average person who's not working out and who's not really using their insulin the way they need to, who they're already swimming in it due to insulin resistance, now they're taking insulin because their pancreas is pooped out, that's a mess.

那就像一锅我们不希望体内滋长的东西混在一起。

That's a soup of of things we don't necessarily want happening growing in the body.

所以这项研究比较了胰岛素与GLP-1类药物

And so that study looked at insulin versus GLP ones.

这并不完全公平，因为对照组设置不够严谨

It's not entirely fair because it's not a it's not a true control group.

嗯

Mhmm.

但还有其他尚未公布的数据集显示，这类药物可能对降低癌症风险有显著、积极的效果

But they there are other data sets coming out that haven't been published yet showing really good, really hopeful and positive impacts on potentially reducing cancer risk.

它们是相关性而非因果性的。

And they're correlative, not causative.

所以我们不能断言这些药物直接降低了癌症发生率。

So we can't put our finger on it and say these these these reduce cancer.

但他们研究了超过一百万服用司美格鲁肽的2型糖尿病患者，发现相比未使用GLP-1类药物的患者，肥胖相关癌症有显著减少。

But they looked at, you know, over a million people that were type two diabetics that were on semaglutide, and they found a significant reduction in different types of cancer that are obesity related in comparison to the folks who were not taking GLP-1s.

这些包括最凶险的癌症类型——卵巢癌、胰腺癌、结肠癌等，你知道，这些癌症的预后往往不乐观。

And those were the ovarian the cancers you don't want, the ovarian, the pancreatic, the colon, the types of cancers that are you know, you don't come back from readily.

因此这发现非常令人振奋。

And so that's very exciting.

这个研究尚未引起广泛关注，且数据非常新颖。

It's not getting a lot of play, and it's really, really new information.

我很期待继续观察后续发展。

So I'm excited just to watch it.

但这结果完全合理，因为这类药物同时作用于免疫细胞。

But it makes sense to me because these sit on your immune cells as well.

我们的全身都分布有GLP-1受体。

There's GLP-one receptors throughout our entire body.

这就是为什么它能在全身产生效果。

That's why we're getting the impacts throughout the entire body.

我认为它对个体整体免疫环境的影响很可能具有抗癌作用。

And I think that the impact that it's having on the overall immunologic milieu of an individual is potentially very anticancer.

我是说，你提到的那个研究，我之前对Ozempic和GLP-1类药物完全不了解。

I mean, that study that you cited there, I knew nothing about Ozempic and GLP ones, really.

但即便以我这种，你知道，简单的思维来看，我也会觉得有道理。

But in my even in my sort of, you know, chimp brain, I go, yeah.

因为如果他们减重，患癌几率就会降低。

Because if they lose weight, they're less likely to get cancer.

对。

Right.

不。

No.