肽专家：大药企正在向你隐瞒这种强效肽！——亚历克斯·泰特姆博士

为什么？

Why?

到底怎么了？

What's going on?

我觉得这其实是‘禁果效应’，因为之前被禁了。

So I think what we're seeing is the forbidden fruit effect because this was banned.

突然间大家就开始问：为啥要禁它？

And all of a sudden, oh, well, why'd they ban it?

要是没效果，他们怎么会禁呢？

Well, wouldn't have banned it if it weren't working, right?

而且现在TikTok和短视频传播得太快、太疯了。

And we're also seeing the effect of TikTok and short form content being spread very rapidly, very virally.

这种现象已经持续两年了，再加上政府高层、卫生与公共服务部还有RFK的最新推动。

And that's been going on for two years now, combined with new emphasis from administration leadership and HHS and RFK.

你见过肽类药物给患者带来最惊人的改变是什么？

What is the most incredible impact that you've seen peptides create in a patient?

天哪，我有个特别棒的故事要告诉你。

Oh my gosh, I have the best story for you.

我行医过程中最头疼的事之一，就是治那些代谢严重出问题的年轻男性不育。

So one of the most frustrating things about my practice is treating infertility in young men that have significant metabolic dysfunction.

这些小伙子精子数量低得可怜，对吧？

These are young men that have a low sperm count, right?

根本没法让伴侣怀孕，因为精子数量根本不够。

So they can't get pregnant because they just don't have the numbers to make it happen.

你看着他们，个个都严重肥胖，明白吧？

And you're looking at them, and they're morbidly obese, Okay?

胰岛素抵抗特别严重，

They have high insulin resistance,

对吧？

all right?

长期肥胖已经把他们的内分泌系统搞垮了。

And their endocrine system has been damaged by that obesity.

他们睾酮水平并不低，问题是大脑没给睾丸发出足够的刺激信号。

So they don't have low testosterone levels, and their brain is not making enough of the signals to stimulate their testicles.

我们现在是有药可以帮他们刺激信号、让睾丸多干活的，对吧？

Now, we have medications that we can use to help stimulate that, to make more of that signal stimulate testicles, right?

但真正折磨他们的、造成这一切的，根本不是什么化学失衡。

But really, what is eating at them, what is causing this, is not that chemical imbalance.

那个只是症状。

That's the symptom.

不是根源，明白吗？

It's not the problem, Okay?

光治症状，根本解决不了问题。

And treating symptoms doesn't really get you very far.

我以前带过的病人，不管我怎么讲道理、给资源，他们就是减不下来体重，精子数量也一直没起色。

And so I would have patients that I would take care of, and we would never see a significant improvement in their numbers because losing weight is really, really hard, regardless of all of the education and resources I try to give them.

但现在不一样了，有了GLP-1类多肽药，比如司美格鲁肽和替泽帕肽。

But now we have peptides in the form of GLP-one drugs like semaglutide and tirzepatide.

上周我接诊了一位患者，他通过使用替泽帕肽、锻炼和改善饮食，减掉了100磅，精子数量提升了十倍，现在已经回到正常范围了。

And I just saw a patient last week who increased his sperm count 10 times over and is now in a normal range because he's lost 100 pounds due to using tirzepatide, exercising, and improving his diet.

他整个人的生活都彻底改变了。

He has totally changed his life.

这一切都是从一种多肽开始的。

And that started with a peptide.

就是从一种多肽开始的。

It started with a peptide.

所以现在摆在你们面前的多肽种类可多了。

So we've got lots of peptides on the table in front of you.

对。

Yes.

我们一个个来详细讲。

We will go into them individually.

不过你能先给我大概说说，这些多肽在健康和生活的哪些方面能帮上忙吗？

But just can you give me a high level view of the types of areas in our health and life that these peptides can help with?

我们刚才谈到了不孕不育，没错。

So we've talked there about infertility Correct.

这是减重和改善代谢健康之后的连锁反应。

As a downstream consequence of the weight loss and fixing metabolic health.

那肽类物质还会影响身体的哪些其他方面呢？

What other parts of the body do peptides touch?

最好的理解方式是这样：

The best way to think about it is like this.

肽就像你手机上的一个应用程序。

So peptides are almost like an app on your phone.

想象一下，还没出现App的年代。

So imagine before we had apps.

我这年纪还记得到处登录网页做网上银行，那真是折磨人。

Like, I'm old enough to remember trying to log on and do my banking online before we had apps.

简直糟透了，对吧？

And gosh, it was so painful, right?

那时候虽然也能办事，但特别折腾，绕来绕去的。

Like, there were ways to accomplish things, but they were very inconvenient in a roundabout way.

现在手机上啥都能干，除了叠衣服，别的基本都能搞定，对吧？

And now all of a sudden, we have these apps on our phone that can do just about anything except fold your laundry, right?

当然也不是万能的。

There are some limits to it.

但从电子层面来说，真可以说是无所不能了。

But I mean, really, the sky's the limit from an electronic standpoint.

肽其实就跟这个一个道理。

And really, that's what peptides are.

比如，有些肽能帮你减重，像GLP-1这类药。

So the thing is, is that we have peptides that can help you lose weight, like the GLP-one drugs.

还有些肽能改善皮肤状态，比如GHK-Cu。

We have peptides that can improve skin quality, like GHK CU.

也有能修复肠道的肽，像BPC-157，对溃疡性结肠炎特别有效，现在FDA正准备开会对它做进一步评估。

We have peptides that can help heal your gut, like BPC-one hundred fifty seven, particularly effective in ulcerative colitis, which is something that's being investigated with the FDA's planned upcoming meeting on it.

我们还有能帮助改善睡眠、修复大脑中负责褪黑素分泌和调节昼夜节律的腺体的多肽。

We also have peptides that can help with sleep and with recovering the gland in your brain that's responsible for melatonin and regulating your sleep wake cycles.

所以问题不是多肽能做什么，

So the question isn't, you know, what can peptides do?

而是它们还有什么做不到的？

It's kind of, well, what can't they do?

如果现在还做不到，我们能不能研发出一种多肽来实现这个功能？

And if they can't do that yet, can we develop a peptide that can accomplish that task?

答案很可能是可以的。

And the answer is probably.

与此同时，虽然制药行业对这些多肽可能还有些抵触，但我们现在最关注的这些，已经和别的药企签了数十亿美元的协议，借助AI加速开发自己的多肽产品。

And simultaneously, while there may be resistance from pharmaceutical industry in these peptides, the ones that we're most interested right now, they have signed multibillion dollar deals with other pharmaceutical companies that are involved in peptide development aided by AI to try and fast track their own peptide products.

真有意思。

Interesting.

所以未来我们会看到越来越多这类产品，从药企那边源源不断地推向市场。

And so we are going to see exponentially more of these products come down the pipeline from pharmaceutical companies in the form of commercial products.

值得一提的是，今天有重大消息公布。

And it's worth saying that there was some significant news today.

没错。

Correct.

今天到底发生了什么？背后又在发生什么？

What happened today, but also what's going on?

顺便说一下，今天是4月15号。

And just for anyone that doesn't know, it's April 15.

对。

Yes.

今天FDA发了份公告，说七月他们会重新评估七种肽类物质，打算把它们从二类调回一类。

Today, we got a press release from the FDA saying that in July, they are going to consider seven peptides for removing from category two back to category one.

等于合法化了。

Legalizing them.

等于合法化了。

Legalizing them.

好的。

Okay.

这份名单里有几个重磅成分，比如BPC-157。

And some of the heavy hitters from that list include BPC -one hundred fifty seven.

就是我们之前聊过的那个，跟修复和损伤有关的。

Which is the one we talked about to do with repair and injury.

没错。

Absolutely.

好的。

Okay.

还有它的兄弟成分，TB-500，就是这边这个小瓶装的。

And then we have the brother to that, which is TB-five hundred, this vial over here.

它能促进受伤部位的血液流动。

This improves blood flow to an injured area.

你可以把它想象成派兵增援，把修复受损组织所需的细胞送到现场。

You could think of this as sending the soldiers, as sending the cells that are required for rebuilding that tissue matrix that was damaged by a tear or a cut.

明白吧？

All right?

除此之外，我们还在用一种叫KPV的东西。

On top of that, we're also getting something called KPV.

这儿可能没带，但这是另一种和血管生成、组织修复有关的多肽。

May not have it here, but that is another peptide that has been linked to angiogenesis and tissue repair.

我们还用MOTS C。

We're also getting MOTS C.

有些病人管它叫‘瓶装运动’。

And then, you know, some patients will call it exercise in a vial.

它能提升你的最大摄氧量和运动耐力，通过激活能量通路，让你体内产生更多ATP——也就是我们活动所需的能量。

It improves your VO two max and your exercise tolerance by up regulating the energy pathway, basically making more ATP, the energy that we all use to move, it makes more of that available.

好了。

All right.

我们还会用DSIP、上皮素和Cmax，这些都是影响认知功能的多肽。

We're also going to get DSIP, epithalon, and Cmax, which are all peptides that affect cognitive function.

所以像Cmax这种能提升思维能力的，真是个不错的选择。

So improving thinking, like Cmax, is a great option for that.

而DCIP和上皮素则都在调节睡眠和恢复方面有作用。

And then D CIP and epithalon both have roles in regulating sleep and recovery.

天哪。

Wow.

是啊。

Yeah.

真够离谱的。

Pretty wild.

而且我啊

And I've

得说一句，有些物质现在慢慢合法化了，但就算还没合法的，也有很多人偷偷在用。

gotta say, how does so some of them are are becoming legalized, but even the ones that aren't legal right now, a lot of people are taking them anyway.

没错。

Correct.

所以我想问，人们都是从哪儿弄到这些药的？

So my my question is, how are people getting them?

听我说。

Listen.

我不是想在这儿鼓吹非法药物。

I don't wanna promote illegal drugs here.

这事儿不是那个意思，我只是想知道到底发生了什么。

This is not that that kind of But I just want to know what's going on.

没错。

No.

这事儿其实特别值得聊聊，对吧？

This is well, this is important to talk about, right?

咱们得搞清楚，市场上到底在发生什么。

We have to understand, like, what's going on in the marketplace.

这些药在2023年被禁的那一刻，简直就像美国当年禁酒令一样。

The moment that these drugs were banned or these medications were banned in 2023, it was kind of like The United States experiment at banning alcohol.

结果并不好，对吧？

It didn't go very well, right?

突然之间，黑帮就冒出来了，到处都是无照经营的酒馆和非法酿酒作坊。

All of a sudden, you know, you know, the mob came around, and we started seeing unregulated saloons and unregulated alcohol production.

酒里还掺了各种害人的东西，根本没法喝。

And it was contaminated with all this stuff that you didn't want.

所以我们现在……

So we're

有人开始跨境购买了。

like People are traveling.

对，就是这样。

Yeah, exactly.

这根本不是个好主意，对吧？

It's just it's not a good idea, right?

结果一禁，灰色市场就趁虚而入了。

And so what happened is we banned these, and the gray market stepped in.

这些公司卖的肽类物质，标签上都写着‘仅供研究使用’，明白吧？

And so these are companies that will sell peptides that have on the label for research use only, all right?

他们的想法是，既然不是直接卖给人注射的，那就逃过了FDA的监管。

And the idea is that that takes them out of the FDA's jurisdiction because they're not selling it for people to inject into themselves out of the FDA's hands.

我就搞一管这‘神奇液体’，说是给大鼠用的，行吧？

I'm just creating a vial of this magical juice that you can use for your rat, Okay?

他们就是这么打马虎眼的。

That's the idea.

但谁都知道，根本不是这么回事。

We all know that's not what's really happening.

因为没人管质量，这就跟加油站卖的寿司一样。

But because there isn't any quality control, it's kind like getting gas station sushi.

嗯，你当然能吃，但你根本不知道那是不是真寿司，搞不好吃出问题来。

Like, yeah, you can do it, but you don't really know if it's sushi, and it may not end very well for you.

我不是说没人用‘仅供研究’的肽类真见效，但问题在于没标准，所以我才觉得，还是把它们重新纳入503A复合药房的监管里，对大家都好。

And so again, not saying that there aren't some, people who have gotten good results with, research use only, peptides, but again, it's not standardized, which is why I think moving this back into the five zero three a compounding world is the best thing for everyone.

这就是法律上的漏洞。

Which is the leg legal framework.

明白了。

Okay.

那肽类物质该怎么使用呢？

So how does one take a peptide?

这是个好问题。

That's a great question.

有意思的是，咱们之前说过，肽其实就是由氨基酸组成的。

So what's interesting is that, as we mentioned, you know, peptides are just made up of building blocks of amino acids.

如果你自己弄一杯蛋白粉，从乐高积木的角度看，它长啥样？

And, you know, if you were to go make yourself a protein shake, what is that going to look like from a LEGO standpoint?

就长这样。

It just looks like this.

手里抓一把乐高积木，对吧？

A handful of LEGOs in your hand, right?

全都是磨碎的。

All sort of ground up.

全都打成单个的小颗粒，对吧？

All ground up in individual pieces, right?

关键是，你的肠胃本来就是设计来把吃下去的任何蛋白质都分解成这些小分子的。

Well, the thing is, is that your gut is designed to break up any sort of protein that you ingest orally into these little pieces.

所以如果你说，比如喝点TB500，你的身体根本分不清这和吃了一块鸡肉有什么区别。

And so if you were to say, I don't know, drink some of, you know, this TB five hundred, your body wouldn't be able to tell the difference between that and a piece of chicken.

因为它会把所有东西都拆得七零八落。

Because it would break it all apart.

也会全拆开。

Would break it all apart.

不过呢，也有几个特别的例外。

Now, are some very unique exceptions to that.

有一种BPC-157的形式，其实能在肠道里被吸收而不被破坏。

There's a form of BPC-one hundred fifty seven that actually is tolerated in the gut.

但总的来说，绝大多数这类物质都得通过注射使用，要么皮下注射，要么肌注。

But by and large, the overwhelming majority of these have to be injected either subcutaneously or into the muscle.

具体选哪种通常看个人喜好。

And that's usually a preference.

皮下注射就是打在肚子上吗？

Subcutaneous being my belly?

就是打在皮肤表层下面就行。

Just underneath the skin.

就像我跟患者说的那样，捏起一英寸皮肤，把药注射到皮下就行。

You know, as I tell patients, just pinch an inch, inject under the skin.

很多其他药物也是这么用的。

We do that for a lot of other medications as well.

那这个药就是这么用的吗？

Is that what this is?

对的。

Yeah.

这是处方用的Mounjaro笔。

So this is a prescription Mounjaro pen.

Mounjaro是替尔肽肽的商品名。

So Mounjaro is the brand name for tirzepatide.

明白吧？

Alright?

替尔肽肽现在是礼来公司最主流的GLP-1药物。

Tirzepatide being the leading GLP-one product right now from Lilly.

目前市面上，每毫克它带来的减重效果比其他任何药都强。

So this produces more weight loss per milligram than any other product that we've got out right now.

人们注射肽类药物，就是用这种方式吗？

Is this the mechanism in which people inject peptides?

有点不一样。

A little bit different.

有点不一样。

A little bit different.

这是一个自动注射笔。

Is an auto injector pen.

你只需要在右边调节剂量，然后捏起皮肤上的一小块，贴紧后它就会自动注射。

And so what you do is you're able to actually ratchet the dose there on the right side, and then you pinch an inch in your skin and then push it up against, and it'll auto deploy.

整个过程你什么都不用做。

And so there's nothing that you need to do.

不用学怎么抽药、怎么打针。

You don't have to learn how to drop medication and inject.

在家打肽类药物时，尤其是从只限研究用途的渠道买的，通常都是小瓶装的，得用针管抽出来，明白吗？

Whenever you're administering peptides at home, especially for patients that have obtained them from research use only markets, they usually come in just little vials that need to be drawn up with a needle, Okay?

好处是你可以自由调整剂量，对吧？

Now, the benefit of that is that you can do custom dosing, right?

但问题是，你得会算剂量、会配药。

But the drawback is that, well, you have to know how to calculate that and put it together.

这可能是我们桌上最争议的一点了。

This may be the most controversial thing we have on this table.

据药企估计，这可能是对他们整个商业模式最大的威胁。

And by pharma's estimate, it might be the most dangerous thing to their entire business model.

因为这玩意儿就是司美格鲁肽，跟你刚才那个笔里装的一模一样。

Because this is tirzepatide, the exact same thing that you had in that pen.

但这个是由一家高质量的503A配药房生产的。

But this is made by a high quality 503A compounding pharmacy.

现在这事儿这么有争议，是因为它灵活得多——你手里拿的这个剂量非常标准，每周打一次，是因为保险只报销这个频率。

And the reason why this is so controversial right now is because it offers an incredible amount of flexibility because what you have in your hand there is very standardized, and you administer it once a week because that's what's approved by insurance.

就是大家最近老在聊的那个Ozempic吧。

Is like the Ozempic thing everyone's been talking about.

没错。

Exactly.

但你把它想成是填色游戏就行了。

But think of that as paint by numbers, Okay?

这一块就该涂这个颜色。

This section is this color.

这一块是那种颜色。

This section is that color.

明白吧？

All right?

你可以把这想象成

Think of this as

你手里拿着的这个东西。

The thing you've got in your hand.

现在就是这样。

Right now.

对，就是这样。

Yeah, exactly.

一管替泽帕肽，能有无限种配比和剂量组合。

Just a vial of tirzepatide as having infinite permutations and dosing ability.

因为你可以用小针筒抽出来，做微量调整。

Because you can draw this up with a small syringe and do micro dosing.

所以别再每周只打一针大剂量了，很多人到周末就又饿得不行，体重又反弹回来。但用这种剂型，你完全可以把一周的量拆成几次小剂量，慢慢打，效果更好。

So instead of one large dose once a week, because what many patients will experience is they'll have a return of their hunger by the end of the week and they end up losing ground, you can actually, instead of doing a full dose once a week, you could do multiple mini doses throughout the week with this formulation and with this presentation of the medication.

明白吗？

All right?

但问题在于，正因如此，这种药才能由配药房来调配——他们能做出跟你手里这瓶类似的东西，但更灵活，对某些患者来说反而是更好的选择。

But the challenge is that that is the benefit that allows us to be compounded by compounding pharmacies because they are able to provide something that is similar to what's in your hand, but it offers more flexibility that may be the right choice for some patients.

这就是个性化用药，懂吧？

So personalization of medicine, Okay?

但问题是，你花再多钱，这钱也进不了礼来公司的口袋。

But the challenge is that if you spend however much money on this, you're not giving it to Lilly.

所以现在美国FDA对配药房展开了前所未有的打压，想彻底禁止他们生产这类药。可按现行法律，这种药又不是你手里那瓶的完全复制品，本该是合法的。

And so as a result, we have seen an unprecedented crackdown in The United States from the FDA in trying to shut down compounding pharmacies and prevent them from making these medications, even though that ability to customize the fact that this is not an exact copy of what's in your hand right now should protect it under current legislation.

但现在礼来和诺和诺德这两家GLP-1药物巨头施加了巨大压力，连FDA局长马蒂·马卡里都发推文疯狂打压配药房的GLP-1药物，比他整个任期内发的关于糖尿病和心脏病的推文加起来还多。

But there is now enough pressure from the powers that be and from lobbyists from both Lilly and Novo Nordisk that which are the two companies that make the GLP-one medications that we're seeing Marty Makary, the FDA commissioner, has now tweeted more about cracking down on compounded GLP-one medications than he's tweeted about diabetes or heart disease in his entire time in office.

为了确认我有没有理解错，我复述一遍，你听听看对不对。

And just so I understand, I want to play this back to you to make sure I understand.

好的。

Sure.

我左手拿的是替泽帕肽。

In my hand here, I have Trizepatide on the left.

对。

Yep.

这是礼来公司生产的，他们申请了专利，靠这个赚大钱。

And this is made by Lilly, which is a corporate company who's patented it so they can make lots of money from it.

没错。

Correct.

我右手拿的也是替泽帕肽。

In my right hand, I have trizepatide.

加了烟酰胺的替泽帕肽。

Trizepatide with niacinamide.

含烟酰胺的。

With niacinamide.

对。

Yep.

这个没法申请专利。

And this is not patentable.

所以礼来公司对您手里这种配方中的替尔泊肽分子拥有专利。

So Lilly has a patent on the tirzepatide molecule in that formulation in your hand.

明白吧？

Okay?

如果有人侵犯了专利，可以在美国法院起诉。

And if anyone violates a patent, that can be pursued in US court.

是的。

Yeah.

专利法，对吧？

Patent law, right?

但有意思的是，礼来和诺和诺德都知道，你右手拿的这个不一样。

But what's interesting is that Lilly and Novo Nordisk know that that's different in your right hand.

看起来根本不一样。

It doesn't look the same.

给药方式也能不一样。

You can dose it differently.

他们心里清楚，要是真打官司，又花钱又耗时间。

And they know that if they were going to fight that in court, it would cost a lot of money and take a lot of time.

那你猜啥更省事？

So you know what's a lot easier?

直接给FDA的朋友打个电话，让他帮着压一压对手，不就完事了。

Calling your friend at the FDA and getting him to step on the competition so you don't have to.

那这执法的费用谁来出？

And then who's paying for that enforcement?

可不是药企请的律师掏钱。

It's not the lawyers that the pharma company is paying for.

是纳税人用税款给FDA买单。

It's the taxpayer paying for the FDA through taxes.

你这意思好像是说，这种用法其实更好，因为剂量可以更灵活地调整。

And you seem to imply that this was actually better because you could take it in a more flexible dose.

想吃多少就吃多少，随便你。

You could take a little bit, a lot.

想什么时候吃就什么时候吃，不像这个，一周才一次。

You can take it when you want, whereas this is once a week.

那到底哪种更好呢？

Well, what is better?

我很多病人其实更喜欢这个，因为灵活嘛。

So I like this option for many of my patients because it's flexible.

这种方案对大多数病人来说都挺合适的。

So that is something that works for most patients.

不过话说回来，这个对病人来说也特别管用，

But then again, this works great for patients,

没错。

too.

但你真正需要的是一个能提供多种选择的体系，让医生能为每个病人选最合适的方案。

But what you want is you want an ecosystem where you have choice so you can make the right choice for the right patient.

很多病人用这个效果特别好。

For a lot of patients, they're going to do exceedingly well on this.

这背后有大量数据支持。

And there is so much data to support that.

但我也有不少病人，一打大剂量的Mounjaro或者GLP-1MEN就特别难受。

But I also have a lot of patients who get really ill after they do a large dose of Mounjaro or of GLP-1MEN.

如果我们把单次大剂量拆成一周内几次小剂量，就能避开这些副作用。

And if we take that same dose and we just cut it into multiple doses within a week, we can avoid those side effects.

所以你跟我说过，我们面前这些多肽能改善皮肤、减脂、增肌、提升精力，还能缓解慢性病。

So you've told me that these peptides we have on the table in front of us can improve your skin, weight loss, muscle, energy, chronic illnesses.

你还提到了对认知功能的好处。

You talked about the cognitive upsides.

你讲这些的时候，真的特别有热情。

And you talk about it very passionately.

是的

Yeah.

所以有人可能会问，你本人应该也在用一些肽类吧？

So one should ask you, presumably you're taking some peptides.

对，我在用。

I am.

没错。

Yeah.

你都在用哪些？

Which ones do you take?

我现在用的唯一一种肽，就是小剂量的替泽帕肽。

So I will tell you that as of right now, the only peptide I'm taking is a small dose of tirzepatide.

就是我们刚才说的那一种。

Which is the one we were just talking about.

对。

Yeah.

因为

Because

几个月前，我体重快到二百四十磅了，那时候我正在练力量举。

back a couple couple of months ago, I was probably close to about two forty or so, and I was into powerlifting.

我到现在还是在练。

You know, I still am.

能硬拉五百磅是挺牛的，但爬楼梯就吃力了，走两三层就喘不上气。

But, you know, it's really great to be able to deadlift 500 pounds, but then stairs become really hard when you're trying to walk up.

我当时就想，唉，这事儿有点麻烦。

And you're like, I don't know.

我更想要的是，爬个两三层楼，都不用停下来歇口气。

I kind of like, being able to not take a break after two or three flights of stairs.

所以我就想，行吧。

And so I was like, okay, all right.

长寿对我来说是头等大事。

Longevity is a priority of mine.

我想先瘦一点。

I'm going to slim down a little bit.

就先试试看吧。

Like, let me just try this for a little bit.

结果我发现，这东西效果特别强，而且剂量很低，身体完全扛得住。

And what I found is that it is incredibly potent and at a very low dose, very, very tolerable.

那你为啥不试试其他的？

Why didn't you take some of the others?

说实话，现在我根本没法合法搞到那些东西。

Honestly, because right now, there is not a legal framework for me to obtain them.

而且说实话，我想给我的病人做个榜样。

And the truth is, is that I want to be an example for my patients.

所以我才出来奔走，希望咱们能重新合法、安全地用上这些肽类药物。

And that's why I'm out here advocating that we get access to these peptides in a legal, safe way again.

明白吧？

Alright?

因为这对每个人来说都是最好的选择。

And because it's it's the best thing for everyone.

如果它们合法了，你会考虑哪些？

If they were legal, which ones might you consider?

天哪。

Oh, man.

我跟你说啊。

I will tell you this.

比如说吧，我不清楚你多大了，史蒂文，但我今年33。

As some like, I I don't know how old you are, Steven, but I'm 33.

33？

33?

祝你长寿啊。

God bless you.

我跟你说实话。

I will tell you.

过了35岁，真的太难熬了。

Once you get over 35, man, that is brutal.

你懂的吧？

Alright?

我睡觉姿势不对，脖子一扭，就得戴个支具，一戴就是俩礼拜。

I sleep on my neck in a wrong way, and I need like a freaking brace for like two weeks.

像我这种经常去健身房、拼命锻炼的人，身体各种小毛病都慢慢攒出来了。

And so as someone who spends a lot of time in the gym, you know, working out, like you start to accumulate all these little aches and pains.

就说我的右肩膀吧，特别娇气。

And so the idea of, for example, I have a very finicky right shoulder.

要是没热身就直接上大重量卧推，一不小心就拉伤，起码一个月别想练了。

If I try to do a really heavy bench and I haven't warmed up, I can tweak this and it takes me out of the fight for at least a month.

明白吧？

Okay?

所以我只能改练别的。

And I have to do other things.

过去两年里，好几次我都恨不得能有BPC和TB500，好让这种恢复快一点。

You know, I would have killed at various points in time over the past two years to have had BPC and TB five hundred to hopefully speed that sort of healing.

明白吧？

All right?

还有啊，我严重有玫瑰痤疮。

Also, for example, I suffer from really bad rosacea.

动不动就发作。

It flares constantly.

那是什么？

What's that?

就是脸上老泛红，懂吧？

So just redness of the face, Okay?

搞得我看起来像被太阳晒脱皮了。

That it makes me look like I'm sunburned.

结果有次我周二去办公室，下属一看就惊了：‘你这周去院子里干活了？’

And then I come in, in the office on like a Tuesday, and then my staff's like, oh my gosh, you go out in the yard and do some work this week?

我就说，这不过是我的脸而已。

I'm like, it's just my face.

比如，很多人用GHK-CU后都反馈效果不错。

For example, that's something that a lot of people have reported benefits from GHKCU from.

所以，这又是另一种可能对我这种人有帮助的化合物、多肽。

So again, another compound, another peptide that could be beneficial for a patient like myself.

那肌肉增长呢？增肌这方面怎么样？

What about muscle mass and gaining muscle?

对。

Yeah.

其实这说法是个常见的误解，社交媒体上总有人这么吹。

So that is an interesting misnomer because that has been a common selling point you'll see on social media.

但目前来看，唯一可能跟这个沾边的多肽，就只有我手里这个——IGF-1LR3。

But as of right now, the only peptide that you might construe that way would be this guy right here in my hand, IGF-1LR3.

明白吧？

Okay?

IGF-1LR3其实就是IGF-1的长效版，而IGF-1是生长激素的下游作用产物。

Now IGF-1LR3 is basically the longer lasting version of IGF-one, which is the downstream effect of growth hormone.

你肯定听过一些健美爱好者用生长激素来增肌减脂吧。

I'm sure you've heard of bodybuilders taking growth hormone to increase size and lose fat.

剂量大的时候，它确实能帮人增加一点肌肉。

In higher doses, it can help contribute to muscle mass.

明白吧？

All right?

但说实话，真想大幅增肌，靠这个根本行不通。

But truthfully, if you're trying to gain significant muscle mass, this is not the way to do it.

所以目前来说，多肽本身是没法让你独立长出大量肌肉的。

And so right now, one of the things that peptides can't do for you is independently put on significant amounts of lean mass.

你还是得去健身房。

Still You have to go to

的。

the gym.

你还是得去健身房，信不信由你。

You still have to go to the gym, believe it or not.

你猜怎么着。

And guess

好了，这期播客到此结束。

Well, that's end of the podcast.

是的。

Yeah.

我跟你说啊。

I tell you.

但让我特别惊讶的是，我有那么多病人以为，只要打点睾酮，肌肉就能自己长出来。

But something that blows my mind is that I have so many patients that think that they can just take testosterone and just put on muscle naturally.

根本不是这么回事。

And it doesn't work that way.

可能有点儿小变化，但你还是得有训练刺激。

You might get a tiny little bit, but you still have to have stimulus.

你还是得去健身房。

You still have to get in the gym.

该花的功夫一点都不能少。

You still have to put the work in.

所以我跟病人说，我可不是替代私人教练的。

And so I tell patients that I am not a replacement for a personal trainer.

我是你的医生。

I'm your doctor.

你还需要找个私人教练。

You also need your personal trainer.

而且你们大多数人，真得找个营养师。

And most of you need a nutritionist, man.

我很幸运，能和社区里一些很棒的人合作，一起帮病人搞定这些事。

And so I'm lucky to work with some great people in the community who partner with me on that.

但说真的，想让人过上最优质的生活，那真是得全方位使劲儿。

But, you know, it's a it's a full court press when you're trying to get people to, you know, live the highest quality of life.

那像胰岛素抵抗这类代谢紊乱和疾病呢？

What about some of these metabolic disorders and diseases in terms of, like, insulin Yeah.

胰岛素抵抗？

Resistance?

咱们的观众和留言区里，很多人都特别关心胰岛素的问题。

People on the Diaries here, the audience, are very interested to learn about insulin.

我经常在评论区和数据里看到这一点。

I see that a lot in the comment section and a lot of the data.

是的，确实如此。

Yeah.

那如果有人血糖控制不好、胰岛素水平有问题，这些多肽能帮上什么忙？

So how can if someone's struggling with their insulin levels or their, you know, their glucose response, how does these peptides help?

说实话，目前最有效的多肽就是GLP-1类药物。

Honestly, the best peptides for that right now are the GLP-one drugs.

毫无疑问。

Okay, hands down.

因为你这是在延缓胃排空，所以你吃下去的那顿饭吸收得更慢，血糖就不会突然飙升。

Because what you're doing is you are slowing gastric emptying, and so you have a slower absorption of that bolus of food that you've eaten, so your glucose doesn't spike.

这样一来，胰岛素敏感性就会明显提升。

And so as a result, that increases insulin sensitivity significantly.

不过呢，你得搞清楚，不同肽类用途不一样，别用错了。

Now, again, you have to be careful about what peptide you're using for what.

很多能促进生长激素和IGF-1的肽，反而会让血液里的葡萄糖升高。

A lot of these peptides that boost growth hormone and boost, let's say, IGF-one, those can actually increase serum glucose.

如果你本来就想改善胰岛素敏感性，那这种效果可就适得其反了。

And that may not be what you want if you are someone that is trying to work on your insulin sensitivity.

这些肽有没有做成乳膏或者口服药片之类的形式啊？

And do any of these peptides come as like creams or as pills or anything like that?

网上你随便一搜，啥都能找到。

If you look online, you can probably find a version of everything.

但要说真正正规的制剂，皮肤用的乳膏里最典型的就是GHK-CU了。

But if we're talking about actual legitimate formulations, the best example of a topical cream is going to be GHKCU.

这挺有意思的，因为这种铜三肽会随着年龄增长，体内的表达和浓度逐渐下降。

And this is interesting because this is a copper tripeptide that has been found to decrease in expression and concentration as we age.

但只要把它涂在皮肤上，效果就非常好。

But when it is applied topically, it's highly effective Topically.

涂在皮肤上。

Topically.

所以，往脸上抹点这种面霜，真的能显著改善皮肤质量。

So putting on a cream on your face, all right, has been found to be extremely beneficial in regenerating the quality of skin.

比如提亮肤色，增加胶原蛋白和弹性蛋白——这些正是让我们脸部紧致、保持年轻的关键成分，很多人花大价钱做激光项目，就是为了这些效果。

So complexion, all right, increasing the amount of collagen and elastin, the things that we need to keep our faces taught and youthful, the things that people will pay lots of money to go get lasered to get improvements.

当然，这不能完全替代激光治疗，但你可能想不到，这种外用的GHK-CU现在就能买到，因为它和注射剂的监管方式完全不同。

Not that it's a replacement for that, but that's a topical form that believe it or not, you could go out and buy today because topical GHK CU is regulated very differently than the injectable form.

贵不贵？

Is it expensive?

一般都挺贵的。

Usually.

我小时候真觉得那些抗衰老面霜都是忽悠人的。

Growing up, I thought these anti aging creams were bullshit.

你刚才说这玩意儿真能改善衰老迹象？

You were telling me that this has actually been associated with improving signs of aging.

我跟你说啊。

I will tell you this.

我上大学、读医学院那会儿，可是最不信这套的。

When I was going through college and medical school, I was the biggest skeptic.

那时候市面上那些健康养生的宣传，我一个字都不信。

I did not believe any of the health or wellness claims that we saw coming out at the time.

那时候满天飞的都是阿特金斯饮食啊、这个那个的，简直让人眼花缭乱。

And again, that was at a time where we were getting bombarded with stuff about Atkins diet and this, that, or the other.

可后来，病人一个个回来跟我说，他们用了这些产品后真有变化。

But then all of a sudden, you start having patients come back to you, and they're testifying as the benefits they've seen from these things.

我才开始认真去查背后的生化原理。

You start to actually look at the biochemistry behind them.

你会觉得，这背后其实有很多科学依据。

You're like, there's a lot of science backing this up.

这可不是什么玄乎的东西。

This isn't just mumbo jumbo.

所以你可能不信，但确实有些面霜能减缓衰老过程，至少在皮肤外观上是管用的。

And so believe it or not, yeah, there are creams that can slow the process of aging, at least from a visual standpoint when it comes to your skin.

我还没找到任何能让我像二十出头那样精力充沛的东西，但我正在努力。

I have yet to figure out anything that makes me as energetic as I was in my early twenties, but I'm working on it.

对。

Mhmm.

对。

Mhmm.

说到精力和认知力，如果我想做个更棒的播客主，是的。

But on that point of energy and cognition, if I wanted to become a better podcaster Yeah.

有时候我就坐在这儿想。

And, you know, I sit here sometimes.

有时候一天录两期，那我就得在这儿坐上八个小时。

Sometimes we do two in a day, which means I might sit here for eight hours.

我们偶尔也试过一天录三期，那真叫一个累人。

Once we do I think a couple of times, we've done three in a day That's brutal.

整整十二个小时都在录音。

Which is twelve hours of recording.

是啊。

Yeah.

但如果我想提升认知表现，你有什么建议吗？

But But what would you recommend if I was trying to improve my cognitive performance?

作为医生，我得保住我的执照，所以不能直接推荐。

So again, as a physician who likes keeping my license, I wouldn't say necessarily recommend.

不过，如果我们看看这些药物是怎么被使用的，尤其是可能在今年七月重新合法化的那种——鼻喷的Cmax。

But I would say if we're looking at how these medications have been used and potentially one that may be legal again coming this July, pending what the FDA says, intranasal Cmax.

这药其实最早是很多年前在俄罗斯研究出来的。

And this was one that was originally studied actually in Russia many years ago.

他们发现，这种由七个氨基酸组成的肽类物质，在脑外伤或急性损伤后使用，能让患者恢复得更快。

And what they found is that this seven amino acid peptide, when it was administered after a TBI, so a traumatic brain injury, all right, or acute injury, that patients tended to bounce back faster.

而且他们还观察到，它对中风后的康复也有改善作用。

Also, they saw evidence of it improving outcomes after stroke.

它似乎还能上调那些有助于提升认知、帮助大脑连接句子和信息片段的因子。

And it also seems to upregulate the same sort of factors that help with cognition and with connecting sentences and bits of data in your brain.

有趣的是，它还能通过鼻腔给药，因为能透过黏膜直接到达作用部位。

And so it's also one of the interestingly enough, one of the ones that is available intranasally because it goes through the mucous membranes and gets right where you need it.

所以，等它重新上市时，这个化合物真的非常值得期待。

And so that's going to be a really, really fascinating compound to see back on the market.

到那时，我们就能获得更多关于它在广泛人群中的疗效数据了。

And then we can actually get more data regarding efficacy across a wide population.

这真有意思。

So interesting.

你是说，直接往鼻子里喷？

And you sniff that through your nose?

就像用鼻喷减充血剂那样闻一下，对吧？

Sniff it like you would for any nasal decongestant, right?

比如你有过敏或者类似的情况。

If you have allergies or something like that.

还有像你这样经常出差的人。

Also, for someone like yourself, you travel a lot.

总在不同时区之间来回穿梭。

You're going in between different time zones.

一天到晚要应付各种杂七杂八的事儿。

You're balancing multiple obligations at different odd times of the day.

我都不敢想你生物钟得乱成啥样了，老兄。

I shudder to think what your circadian rhythm looks like, my friend.

不过，我们正好有一些别的成分能帮上这个忙。

But that is what we have some of these other compounds that are going to be available for.

比如说D-CIP，它已经被证实能帮助调节生物钟。

So if we look at D CIP, Okay, that has been shown to be helpful with regulating your circadian rhythm.

明白吧？

All right?

这个药预计今年七月左右就能重新获批了。

That is one of the ones that's going to be approved hopefully here soon again in July.

对吧？

Right?

另外，像CELENC这种东西，能在你睡觉前一小时帮你放松下来。

And then, you know, on top of that, you've got, you know, things like CELENC, which is another one that can help calm you as you're going to sleep about an hour ahead of time.

还能帮你促进那种深度的德尔塔脑波，让你真正休息的时候恢复得更好。

And again, help those deep delta brain waves that are so restorative whenever you actually are resting.

这些药要是合法了，我们上哪儿买？

Where will we be able to buy these when and if they are legalized?

就是说……

So from

在美国，得凭医生开的处方，找503A认证的药房配制。

503A compounders here in The United States with a prescription from a physician.

所以还是需要处方吗？

So you still need a prescription?

还是得有处方。

Still need a prescription.

没错。

Correct.

要是人人都天天给自己打针，那世界得多疯狂啊。

Could be quite a crazy world when everybody seem is gonna be injecting themselves every day.

我的意思是，现在像Zempek这种药，我身边好多朋友都已经在用了。

I mean, we're already getting to that point now with the Zempek where I've got loads of people in my my friendship group that are Yeah.

他们确实都在用。

And they're yeah.

而且状态都挺好。

And they're doing great.

是啊。

Yeah.

他们状态特别好。

They're doing great.

他们状态特别好。

They're doing great.

我喜欢GLP-1这类药的一点就是，它让打针这件事不再有污名了。

And that's what I like about the advent of these GLP-1s is they're removing the stigma of a needle.

我看看我那些用过的朋友。

And I look at some of my friends who have been on it.

我都快认不出他们了。

I can't recognize them.

他们看起来棒极了。

They look awesome.

你担心他们会有啥问题吗？

Are you concerned with any of them?

我身边有好几个朋友，我其实有点担心。

I've got a couple of friends in my circle where I'm a little bit concerned.

我都不确定该不该担心，但当你看到认识的人突然间变化这么大，真的挺让人不安的。

I don't even know if I should be concerned, but it's just when you see someone you know change so dramatically, so quickly Yeah.

我觉得我们骨子里有种原始的本能，一看到这种情况就会想：天啊，出问题了。

I think there's something in us which something prehistoric in us which goes, oh my god, there's a problem.

对。

Yeah.

我真正担心的是GLP-1药物导致的快速减重。

One thing I am concerned about is the rapid weight loss with GLP-one medications.

因为当你陷入这么极端的热量缺口时，身体就会进入分解状态，开始消耗组织。

Because the problem is that when you go into such a radical caloric deficit, your body goes into catabolism, which is breaking down tissue.

你当然希望分解的是脂肪，对吧？

And you want to break down fat, right?

但身体可没那么讲究。

But your body isn't that judicious.

它会连肌肉一起拆了。

It's going to break down muscle.

肌肉是我们身上代谢最重要的组织。

And muscle is the most metabolically important tissue that any of us have.

所以如果你想真正改善胰岛素敏感性，就得保住肌肉。

And so if you really want to optimize your insulin sensitivity, well, you need to maintain your muscle.

目前来说，能和抗阻训练一起有效保住肌肉的，也就只有睾酮了。

And right now, really the only compounds that we have that are really good at preserving muscle with resistance training is testosterone, right?

但对想怀孕的男性患者来说，这显然不合适，因为睾酮会抑制男性生育能力。

But that isn't going to be a good option for our male patients that want to get pregnant because testosterone turns off fertility in men.

明白吧？

All right?

对女性患者来说，这也不是个好选择。

It's also not a great idea for our female patients, all right?

根据年龄不同，有些老年女性确实会用睾酮替代疗法。

Depending on their age, Testosterone, TRT is a thing in older women.

更年期的事儿咱们就不展开说了。

Menopausal won't go into that.

但说实话，睾酮并不是每个人的最佳选择。

But truthfully, testosterone is not the right answer for everybody.

很快我们就会看到一种比多肽更复杂的生物制剂登场，那就是单克隆抗体，它们专门设计用来抑制分解肌肉的酶。

And so what we are going to see come down the pipe very soon is kind of the older brother of peptides, the more complex form biologics called monoclonal antibodies that are specifically designed to inhibit the enzymes that break down muscle.

这些药物专门被称为肌抑素抑制剂。

So these are specifically called myostatin inhibitors.

目前有三种正在研发中。

There are three that are coming down the pipeline.

其中一种叫比马格兰单抗，由礼来公司研发。

There is one called Bimagramab, which is owned by Lilly.

它会像花生酱裹果酱一样，结合到肌抑素的搭档——激活素上。

That is going to bind to the peanut butter to myostatin's jelly, which is called Activan.

另外还有巴雷托单抗和特罗沃单抗，这两种药由另一家药企开发，目标是在大幅减少热量摄入的情况下依然保持肌肉。

And then you have Baretosmab and Trovogumab, which are two other compounds owned by a different pharmaceutical company that are all designed to maintain muscle even in a significant caloric deficit.

这下可越来越有意思了。

This is getting interesting now.

是的

Yeah.

对

Yeah.

所以你的意思是，我可以先打一种药来减脂，再打另一种药来保持肌肉？

So you're telling me I'm going to be able to inject myself with a Zempec to lose the fat And then inject myself with something else to keep the muscle.

这太疯狂了。

It's wild.

简直不可思议。

It's wild.

说实话，我知道你作为接受方，最头疼的就是这事儿太复杂了。

And and I'll tell you, you know, one of the hardest things that I'm sure you've heard being on the receiving end of this is just the complexity of it.

有太多因素在同时变动，想搞明白、平衡好真的不容易。

And there are so many levers that are moving at once and trying to get your head around it and balance it all.

这需要细致的判断，还得跟懂行的医生好好聊聊。

Like, it requires nuance and it requires a thoughtful discussion with your doctor who is well educated on them.

其中一个难题就是，目前医疗界对这些产品普遍缺乏深入的了解。

And that's one of the challenges is that there isn't broad, great education on these products right now in the medical space.

所以我特别想推动这件事，让我的同行们都能更好地理解这些技术，不再害怕它们。

And so that's something that I'm very passionate about is improving education across my colleagues so that they're not afraid of these anymore.

那对于现在听你说话、觉得‘管他呢’的人，你怎么回应？

What do you say to people that are listening to this now who go, fuck it now.

你为什么不干脆多吃点蔬菜、去健身房，做个普通人，不就完事了？

Why don't you just eat your greens and go to the gym and just be more human, and you'll be fine?

我超喜欢这句话。

I love that.

多吃蔬菜、去健身，我也超爱。

I love eating your greens and going to the gym.

但现实是，美国的情况没那么简单，具体数据要看你参考哪个统计。

But the unfortunate reality is that here in The United States, it depends on what database you look at.

肥胖率估计在百分之四十到百分之七十之间。

But obesity rates are estimated to be forty percent to seventy percent.

明白吧？

Okay?

这得看你用哪个BMI标准了，对吧？

Whether you depending on what BMI cutoff you're using, okay?

BMI虽然不完美，但目前也只能这样了。

BMI is not perfect, but it is what it is.

问题是，光靠吃青菜和去健身房，咱们整个社会根本解决不了问题。

And so the thing is, is that, well, eating greens and going to the gym are not working for us as a society.

我们甚至可以说，现在根本没什么真正的食物了。

And we could talk about how we don't have real food anymore.

到处都是食物荒漠。

We have food deserts.

满大街都是热量爆表却没啥营养的垃圾食品。

We have this calorically dense but nutritionally poor food.

作为医生，我最揪心的是，病人一进门，我就知道他们已经严重肥胖了。

I'll tell you, the most disturbing thing I see as a surgeon is I'll see a patient come in the door, and they're morbidly obese.

他们体型很大，但我还得给他们做手术。

They're a large individual, but I have do surgery on them.

他们的结缔组织，就是那种由蛋白质构成、把身体撑起来的结构，薄得跟纸一样，因为他们吃进去了海量的热量，长的全是脂肪，可饮食里却一点蛋白质都没有。

But the connective tissue, the stuff that's made up of protein that makes them them, that literally holds them together, is paper paper thin because they're eating an incredible amount of calories, they're gaining fat, but they don't have any protein in their diet.

这事儿一点都不稀奇。

And that's not something that's rare.

我每天都能见到这种情况。

I see that on a daily basis.

我们平时聊这个，总从那些热衷健康、搞生化黑客的人的角度出发。

And so the truth is that we're talking about this from the angle of biohackers and people that are super engaged in our health.

但说实话，这技术将来能帮到的，是整个普通人群，最终希望能避免那些正把医疗系统压垮的严重疾病。

But the truth is that this is going to be able to be used to help our population at large and ultimately, hopefully, avoid a lot of the terrible disease states that we're seeing overwhelm the medical system right now.

现在肽类产业规模有多大？

How big is the peptide industry right now?

如果我们

If we

你看看目前四大主流大语言模型公司，那些巨头们的收入，估计在580亿到620亿美元之间，但今年光是司美格鲁肽和替泽帕肽这两款药的收入，就要超过550亿美元了。

look at the top four large language models companies, all right, so all the heavy hitters and how much revenue they're generating, it's estimated to be between $58,000,000,000 up to maybe $62,000,000,000 Yet the income and the revenue from just semaglutide and tirzepatide alone is going to be over $55,000,000,000 this year.

所以现在，光是算上已经投入市场的肽类药物，还没算上科研领域或者仅限研究使用的那些，也没算上那些由配药房生产的肽，我们现在的收入规模已经快跟人工智能行业持平了。

And so what we have is peptides without even considering all of this happening in the research space or the research use only space, without even considering the peptides that we'll see come from compounding pharmacies, we're already approaching parity with what we're seeing in AI as far as revenue goes.

这说明市场对它的需求有多旺盛。

That is the demand that we're seeing in the marketplace.

我运营着好几家公司，每家都有自己的销售团队。

I run multiple companies that have multiple sales teams.

作为创始人，经常让人头疼的一件事就是：你根本搞不清销售到底卡在哪儿了。

And one of the things as a founder of a company that's often confusing is you find it hard to figure out where sales are.

大概十年前，我就开始在以前的公司用Pipedrive，现在我旗下的媒体公司steven.com，所有销售团队也都全面换成了Pipedrive，就是这个原因。

So about ten years ago, I started using Pipedrive in my former company, and it's also the reason why I switched over all of my commercial teams in my current media company called steven.com to use Pipedrive as well.

他们不只是赞助这个节目，更重要的是，多年来它一直是我们扩大销售引擎最有效的工具。

Not only do they sponsor this show, but they've been an incredibly effective way of scaling our sales engine over the years.

Pipedrive是个简单好用的智能客户管理系统，核心功能就是把整个销售流程都清晰地呈现在一个仪表盘上。

Pipedrive is an easy to use intelligent CRM, and at its very core, it makes your sales process visible through one dashboard.

一个可视化的销售流程，展示每一个潜在客户所处的阶段，接下来该做什么，全部实时更新，毫无延迟。

A visual pipeline showing every deal, what stage it's in, what needs to happen next, and it's all in real time with no delay.

当然，它不会帮你自动成交，但它能把复杂的事情变得一目了然。

It doesn't magically close the deal for you, of course, but it does replace complexity with clarity.

如果你想加入已经使用Pipedrive的十万多家公司，可以通过我的链接免费试用30天，不用绑信用卡。

If you want to join over 100,000 companies already using Pipedrive, you can use my link for a thirty day free trial with no credit card payment.

去 pipedrive.com/ceo 开始体验吧。

Head to pipedrive.com/ceo to get started.

就是 pipedrive.com/ceo。

That's pipedrive.com/ceo.

咱们那儿见。

I'll see you over there.

当你的病人来找你，Alex医生，他们最常问你关于多肽的问题是什么？

When your patients come and see you, Doctor Alex, what are they asking you most frequently as it relates to peptides?

你被问得最多的前三一个问题是什么？

What are like the top three questions you get asked the most?

我最常被问到的就是：我该用哪种肽？

The first thing I get asked is what peptides do I need?

然后我就盯着他们看。

And then I just look at them.

我就问：你到底哪儿不舒服？

I'm like, well, what's your problem?

你知道吧？

You know?

你哪儿觉得不对劲？

Like, what's bothering you?

那他们怎么说？

And what do they say?

他们一来就开始聊能量、性欲，诸如此类的问题。

You know, and then they'll come in and they'll start talking about energy, sex drive, that sort of things.

我就说：行啊，要是就这问题，那咱先查查你的睾酮水平，兄弟。

And I'm like, okay, if that's it, well, we need to check your testosterone levels, brother.

明白吧？

Okay?

所以别一上来就找什么肽了，对吧？

So instead of looking for peptides, right?

你不会走进家得宝或者劳氏，就问：我需要什么工具吧？

You know, you don't walk into a Home Depot or a Lowe's, you know, like, tools do I need?

你肯定会问：你到底想干嘛？

And you're like, what are you trying to do?

对吧？

Right?

然后你跟店员说：我想做个这个。

And then you start to talk to someone there like, well, I'm trying to build this.

哦，这样啊。

Okay.

那你就得买把锯子、螺丝刀，还有这个。

You need a saw, you need a screwdriver, you need this.

而这些工具里，有些可能就是肽类。

And some of those tools might be peptides.

没错。

All right.

但有些可能是激素。

But some of them may be hormones.

有些问题其实靠饮食和运动就能解决。

You know, some of it may be diet and exercise.

所以肽类只是我们能用的另一种工具而已。

And so peptides are just another type of tool that we can use.

不过医生啊，我们都想走捷径。

We all want a shortcut though, doctors.

谁都希望有个快速变好的办法。

We all want a quick way to to be better.

是啊。

Yeah.