The Detached podcast
Welcome to the podcast. This is a space where I get to vocalize my thoughts and dive deep into conversations with some truly remarkable individuals. It’s not about surface-level chit-chat—this is where we get into the real stuff. We talk about the things that matter: health, fitness, relationships, and the process of breaking free from the limitations we place on ourselves.
I don’t believe in small talk, because nothing meaningful ever comes from it. So, let's dig deep into the topics that can actually change your life. I want to bring you value, provoke your thinking, and help you see the world differently.
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Sophia
The Detached podcast
EP 97 : Dr. Nas - Beyond the Prescription: Rethinking What Wellness Really Means
What if everything you thought you knew about healthcare was just scratching the surface? Dr. Nas takes us on a remarkable journey from traditional medicine to functional wellness, revealing why conventional healthcare often falls short of truly optimizing health.
Growing up in a family of Iraqi immigrant doctors in the UK, Dr. Nas was destined for medicine from an early age. But it wasn't until he found himself staring out his rainy GP office window—funeral home on one side, discount supermarket on the other—that he realized he needed a drastic change. His move to the UAE opened doors to practicing functional medicine, an approach that examines how interconnected body systems influence overall health.
"Your hormones influence your immune system, your gut influences your hormones, your mental health influences everything else," Dr. Nas explains, highlighting why treating isolated symptoms often fails to address root causes. This comprehensive perspective has proven particularly valuable for patients suffering from unexplained symptoms that conventional medicine couldn't resolve, including the surge in mold-related illnesses following UAE flooding.
The conversation delves into cutting-edge topics including the proper use of GLP-1 medications like Ozempic (hint: it's not just about prescribing), the science behind peptide therapies for inflammation and recovery, and how stem cells actually work (no, they don't magically transform into new tissue). Dr. Nas debunks common misconceptions while providing practical insights on evaluating regenerative treatments: "If someone asked me for the sterility check of a peptide or the purity, I'd be able to provide it. Anyone who blocks it or refuses to give you that information—why would you trust the product?"
Perhaps most refreshingly, Dr. Nas reminds us that despite exciting advances in biohacking and regenerative medicine, the foundations remain surprisingly simple: "95% of longevity is eating right, exercising, sleeping, managing stress, and making sure your nutrients are topped up."
Ready to rethink your approach to health? This episode might just change how you view wellness forever.
If you want to check out Dr.Nas on instagram head over to the link below :
https://www.instagram.com/dr_nas_wellness?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==
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Thank you for listening.
Dr Nass, thanks for coming on the podcast today pleasure.
Speaker 2:Thank you for having me so how are you feeling today? Brilliant.
Speaker 1:I know we're saying brilliant. You just said you were on your holidays for quite some time, but you seem to get a little bit antsy when you're away from work. Yeah.
Speaker 2:I mean, it's just trying to get that work-life balance. I don't know, maybe work's becoming an obsession, uh, and hobby slash work. So yeah, I don't know, miss it. Never thought it'd be like that.
Speaker 1:so for everyone that have on the podcast generally, I go through like how did they get that position of wanting to be so passionate about their job? So where did that start?
Speaker 2:Well, you see, I don't think it was kind of one event and I think it's difficult to kind of date it to a particular time. But I mean, I was the classic kind of grew up in the UK kind of second generation immigrant family. Both parents were doctors. You kind of got out what you put in. It was a large focus on academia.
Speaker 1:So it was kind of out what you put in.
Speaker 2:It was a large focus on academia, so it was kind of, where's your parents from iraq? I was both parents from iraq and it was kind of like, you know, if you were academic enough you, you did medicine, basically uh, which you know in. In hindsight it's kind of like, well, at 17 and you choose a new place at university how are you meant to know what you want to do? But anyway, that that was it and I I wouldn't say at that point I had a particular passion for it was almost like a route that you sort of predestined for and then it was really, I think actually during university I was quite lucky because, uh, one of the professors I was uh studying with or working with or under uh was one of the lead researchers into creatine, and this was kind of towards the end of the 90s and yeah, just really started getting to sort of looking at nutrition and optimizing, you know, supplements and just learning things that you weren't taught in your traditional course and then later became a general practitioner, or family physician, as they call us here, and you just realize over time that the health model isn't set up to really keep people well and thriving and yeah, just kind of got a little bit disgruntled and kind of through.
Speaker 2:Also, at the same time, trying to optimize my own well-being, realized that there's got to be a different way of doing it and stumbled upon functional medicine. Again also realized that uk wasn't the place to kind of practice that kind of health provision and came to the land of opportunity which was the uae, which actually, interestingly, even at that time and this is 2015 no one really knew what functional medicine was. People spoke, I guess, about wellness and integrative health, but it was still considered pretty peripheral and it wasn't really a kind of someone you would go and kind of see as part of your health provision.
Speaker 1:But that's obviously changed in in recent years and I guess we can talk about that so to go back to the family roots, did you grow up in a strict household, then if doctors seemed like the pathway that you should go in your career I think it was pretty much kind of you know, if you had any inkling of going and doing something else.
Speaker 2:It's kind of like, well, what's the justification?
Speaker 2:yeah like, why? Why would you? And so, uh, strict in the sense that they were obviously trying to set us up for something, uh, you know, vocational and secure, and I guess that's the kind of immigrant, um, mentality. And you know, the beauty of medicine and health care is you'll always find your niche within the system, even within a subspecialty. You'll have two people doing completely different things. I mean, take me, for example I'm a family physician, but what I do is very different to say what 98% of family physicians do. So if you have a passion and an interest in something, you'll be able to carve it out.
Speaker 1:Being from Iraq and then being in the UK. Did you grow up with any struggles because of where you were from?
Speaker 2:essentially, you know what, I was quite lucky in that sense and I didn't really, and I think a large part of that was actually and I do put that down to my friends they were quite forward thinking and they were very much about integrating us well. They didn't want us to be kind of different, whilst obviously, you know, we maintained a link to our kind of heritage. They very much wanted us to sort of get into sport and know, do what everyone else was doing. So I never really felt like there was any real difference or anything that particularly held me back.
Speaker 1:So there was no kids at school that felt like you were different or anything.
Speaker 2:Well, no, because I think we I mean I grew up well, I was in Cheshire, but the school was. The school was a private school in Manchester and it was very multicultural then. So a significant part of the school year was from Asia, or there was a big Muslim population, there was a big Jewish population and the discipline was quite a big part of the school. So there was zero tolerance for kind of that sort of uh thing. So it wasn't really present, to be honest so with the household.
Speaker 1:Did you have brothers and sisters growing up as well?
Speaker 2:yeah, so two brothers, older brother, younger brother and, uh, you guessed it, older brother ended up in medicine as well, I think by the time it came to my younger brother they kind of relaxed a little bit and he ended up going into law, which was obviously again another vocational degree, effectively. But I guess that's a general trend, isn't it? As the parents get more comfortable, both, I guess, in the kind of understanding of the system and, you know, wealth, and, yeah, they ease off. I mean, we see it with our, our own kids, you know you're, we're a lot more laid back with the, the youngest was there any competition amongst all you guys being in medicine then?
Speaker 2:because, like I can imagine, so uh yeah, I think not well, when I see the way that my kids compete not to that kind of level. But yeah, I mean there was always that benchmark. I don't think it was something that caused stress. I think I was of a personality where I obviously wanted to kind of do better, I guess, putting it on the table. I think my older brother was definitely more academic than I was, so I I think I almost felt like I had to work harder and I and I think also as a product of the circumstances, you know, there was a couple of other people in my school year. We were friendly but, you know, competitive, and so I think that kind of pushed me, um, but nothing that kind of scarred me. But I think you know, who knows, I mean maybe subconsciously, that's, probably there was competition there and that's, I guess, what drives me as well today so where did you work in the uk then?
Speaker 2:so in a traditional kind of well, once I'd kind of specialized into general practice. Uh, you just imagine you're kind of in a city place called oldham, north north of manchester, very deprived. Um, you're kind of usual bread and butter, acute sort of coughs and colds and infections, and then a lot of the kind of cardiometabolic stuff, obesity, type 2 diabetes, mental health, uh, and yeah, just wasn't for me what was it not for you like?
Speaker 2:what was the elements, the whole it, just the day-to-day stuff wasn't my passion in terms of you know how we were, how we were dealing with it, so I just didn't have the time, nor even the the training, to sit there and prevent people from developing cardiometabolic problems, never mind kind of reversing it. Um, yeah, I just, and I just think the kind of administrative tasks and hoops that you had to jump through and the kind of the cost savings that constantly kind of being run down you working in a public system just just wasn't something I was, I was interested in was there a pinnacle moment where you just thought you had enough?
Speaker 2:absolutely, yeah, I mean I was. I've told this story a few times. I wasn't. I mean, you know, dubai was and the uae was always on my radar because, uh, I had a few friends who'd come out years before and it was always something, you know, we would visit every year and I would pique my interest and I'd be like, right, I'd get home and I'd want to go there and just in terms of how the health system's set up here, it's not as easy for family physicians to get in, certainly back then, because it wasn't that kind of model of of care. So it was always on the radar. But it was, yeah, absolutely. It was a moment where I was just looking out of my window and my GP surgery was, as you can imagine, raining. I had a view on the left of the undertakers and there was an Aldi supermarket on the right and I just thought I cannot sit here for the next 30 years of my career and at that moment, then, how long did it take you to have that transition to Dubai?
Speaker 2:so I think it happened pretty soon after that. But that was just pure luck because I was looking before, um, and then just the opportunity came, came, came about to move to Abu Dhabi first and yeah, I was kind of lucky because the the owner of the clinic, or certainly the clinic they were setting up, wanted to almost he was a bit of a visionary that he wanted to change. The owner of the clinic, or certainly the clinic they were setting up, wanted to almost he was a bit of a visionary that he wanted to change the model of care.
Speaker 2:He wanted to move it from a us a system to, you know, having your family practitioner and then a regular doctor, and then you go off into the system through that family doctor and, uh, I think he was just probably a bit too soon, or the problem with the system being very heavily revenue focused. It was never a model that was going to work, so, but fortunately it got me out here and then, uh, you know, I took my next steps after that so what was the next steps from abu dhabi then?
Speaker 2:yeah. So I, you know, I got to abu dhabi when I arrived, actually very early on, realized that that kind of model of care wasn't going to work, but saw it as a foundation to start implementing what I saw as the next generation of healthcare that was based on the functional medicine approach but was bringing in genomics, you know, gut health testing. And it was at a time where no one I think there's probably one or two people regionally who were doing it, but that was more in in Dubai, certainly not in Abu Dhabi and straight away I could see the, the uptake from it. But we kind of deviated paths in terms of how we saw where where things were were. And I was just also fortunate that I met my current partner in DNA Health and it's funny how you just you meet people and you just know that you're going to complement each other really well and you know my strengths were his weaknesses and vice versa, because you know I'm sure we'll get into it.
Speaker 2:There's no way I could have built what we have now by by myself and and yeah, we've stuck to it and I think timing wise, I don't want to say it's luck, but I think it was a good time.
Speaker 2:Because if you want to say covid was a good thing, I don't think it was, but for our business it changed people's mentality and health seeking behavior and there's been a real sort of transformation in, I think, people realizing that the regular health system and the health insurance is just that it's an insurance for when you're sick or really ill, but it's not designed to keep you well, and so more and more people are investing in their health and coming to us to execute that.
Speaker 1:So, when you were just mentioned about your partner, how do you define whether someone's a good person to partner with? Is it an intuition? Is it some research you did like? How, as an entrepreneur or as someone in the medical field who is looking to do exactly what you've done, what kind of advice would you give them?
Speaker 2:I think you know when I'm looking at it from my perspective and in the scenario I was in, I mean doctors. No matter how much they may think they are, they're not good business people exactly that's I.
Speaker 1:I see so many doctors partner with the wrong people, and it's, they're amazing at their craft.
Speaker 2:But then yeah, yeah they try and do it alone and I think that's a big ask and that's also coming from someone who I studied in an MBA and you know fine, the network was great at the time but it definitely did not equip me with particularly great skills to actually run a real business.
Speaker 2:It may help you, I think, in a corporate environment, but from my personal experience it didn't really help me in practice in kind of what we were doing in a small business at that time. But you know, what was it about my partner? I think I could just see that I hope it sounds really cheesy, just that kind of drive and glint in his eye. And you know, don't get me wrong he had a solid background as well. I mean, this was someone who was a banker at Goldman Sachs level, you know, m&a, family office and just everything he kind of touched seemed to work, combining it not just with intelligence, it was just a great strategist and just hard worker. And I think one of the lines that he used and he still uses today when he meets people is you know, I will run through walls, but I will just get stuff done.
Speaker 2:And to this day. I mean, how far are we in now? We met in 2017.
Speaker 2:You know, there's just some people who just have that combination where it's just like, whatever they'll do, they'll make it succeed, and just also that ability to figure things out. I mean, you hear it, I mean obvious examples. It's extreme, but kind of your Elon Musks of the world, just whatever they put their mind to, you know, they're just going to make it's going to blow up and okay, it's not to that same level, but it's just finding those people. Yeah, you know, maybe I'm not doing myself enough credit. I mean, I I saw the vision in terms of where I knew health care or thought health care was going and and ultimately just knew what good practice was, when people kind of just thought it was witchcraft and doubted it and stuck to it, which actually you know.
Speaker 2:You know I often reflect on this, coming from a background where my parents naturally again immigrant family doctors so risk averse for me to then, you know, not go and just work as a family physician in one of these regular like hospital brands which I actually had offers from, and to kind of just make that jump into a small business that was in negative equity and hardly any revenue. People thought it was mad. Certainly my parents did, but the way I looked at it was it was a completely measured risk and I backed it. I was investing, you know, in him. Uh, the vision and and just the. I knew that I could always just fall back and go and do what I was doing if all went to itself.
Speaker 1:Was there any day during the startup where you thought maybe this is gonna fail?
Speaker 2:all the time. Yeah, I mean. Everyone says that, don't they? I mean, they'd be lying if they didn't.
Speaker 1:Yeah, all the time how do you manage that?
Speaker 2:um, you know it's, it's I, I I think it's really hard to go from doing something that you're so passionate about that you know should succeed and will at some point succeed, to then going into something that you know you're not particularly that interesting and I just I thought just for me was soul destroying and I think also just seeing it as a you know failure just wasn't something that I'd experienced. I probably failed my driving test once, but aced pretty much any other exam, so it's kind of it wasn't a feeling that I was used to, so just just got a crack on and I think it's just wiring as as well and Coming back to that kind of competitiveness maybe, and being pushed in a private school and then medicine.
Speaker 1:You're trained.
Speaker 2:You've got resilience, you just get on with it. The night shifts that was at a time when you were doing night shifts you didn't have seniors in the hospital. There's people having cardiac arrests on the ward. You're being woken up at 3 am to deliver a baby. You do a C-section, you've watched one and you're basically bleeding it the next time. So there's that kind of around and I think that just builds up resilience when you talk about resilience.
Speaker 1:In those kind of moments, do you feel like medicine has made you become desensitized to certain situations?
Speaker 2:um, I mean desensitized to kind of, I guess, probably like death and you know if someone's limb was hanging off yeah, compared to your average person, but, um, not desensitized, I think, in any other way, because, again, a large part of our role is kind of compassion and the kind of soft skills that, uh, I think it's, in fact, it's probably the majority of what what we're doing.
Speaker 2:You know, if I'm looking at physicians that we're hiring now and assessing people and, you know, commenting on how good they are as a physician, I mean, it's almost a given that you should know the clinical stuff. Often you've got to develop that relationship. There's a huge amount of trust. People are kind of sitting with you and telling you things that they've often never told anyone else. It's probably the few occasions where they can come in and let their guard down, and just particularly now, with the health problems that we certainly deal with, it's, uh, you've got to be pretty with stone in terms of picking up cues again. Sometimes you only get if you have that sort of relationship how do you manage the?
Speaker 1:because it's kind of like counseling in some sense, because you're taking a lot off someone you know. If they're giving you a lot of information, how do you manage to place that in a box, away from your current lifestyle? Because sometimes I can imagine it.
Speaker 2:Probably you probably take it home with you uh, you see, I'm pretty good at compartmentalizing, so I wouldn't say that. Uh, there's many scenarios where I'm going home kind of reflecting and kind of stressing.
Speaker 2:So obviously I reflect, but not in a kind of stressed way yeah stuff goes wrong and you know, say, you know clive will call me out of hours and you know there's an issue. Yeah, of course I'm kind of on it and concerned about it that moment in time, but I'm not dwelling on on things in that in that sense that's good uh, in terms of how I sort of deal with the information when it's being imparted, it's a lot of.
Speaker 2:It comes down to just pattern kind of recognition and and, uh, the kind of skill that you develop over time when you've you've seen enough kind of cases and you kind of just know how to sort of uh, as you say, put things to a side, and not necessarily because you've kind of just leaving it and forgetting about it, but it may come in useful sort of later on. But you're right, because when often, when clients come in, they don't know how to impart the information, uh, they've got so many things that they need to tell you that have happened over, say, a 10-year timeline and it's just being regurgitated out, or you know they're nervous, or you know they're worried about forgetting certain information, so it's just complete the haphazard. You just kind of learn how to put it all together yeah, so functional medicine.
Speaker 1:Can you simplify that for the listener? What is functional medicine?
Speaker 2:yeah, and we get again. I get asked it all the time and I've probably spent the first 10 years not explaining it very well and we'll give it a go For me. I think it's just good medicine in that it's not a specific type of medicine, it's just more an approach whereby you're not just isolating systems. So if you look at the traditional health system, it's amazing. If you have a rare condition, you want a specialist who's seen that a thousand times and that's all they do, or a surgeon who does that operation a hundred times a year. You want to go to them for that.
Speaker 2:But if you look at a lot of the health problems that people suffer with today, your health doesn't act in individual systems. Your hormones influence your immune system, your gut influences your hormones, your mental health influences everything else and so, as the health system's gone down one route, these sorts of problems have been neglected. So functional medicine is an approach where you're looking at all of those systems together, taking a kind of history I mean, I guess a more detailed way and kind of linking it, ultimately linking it all together to give someone an outcome whereby you're optimizing their health, whether that's how they feel, or whether you're preventing a certain disease, or even reversing a disease. I wouldn't say there's a particular type of, you know, is it based on allopathic, is it based on, I think it's kind of combining the best of Western medicine with some, I guess, traditional Eastern practices as well?
Speaker 1:So have you seen any sort of increase in like gut health decreasing now in modern society, as, like we have a lot more convenience food, especially in dubai, you know, we look at so much food that's not, it's not grown locally, right? So, yeah, yeah, do you see this?
Speaker 2:yeah, and you know it kind of reflect on this a lot. I'm sure there is. I I guess the thing is as well over time, if you've been a practitioner in a certain area, even though we consider ourselves generalists you'll always have areas where you'll I guess the thing is as well, over time, if you've been a practitioner in a certain area, even though we consider ourselves generalists you'll always have areas where you'll become, sort of say, more known for and that's probably just more if you've had a number of cases. And I guess through word of mouth you start seeing more of these things. And gut health is probably one of those I see a lot of as well. As well, as you know, hormonal optimization is as well.
Speaker 2:Well, coming back to that point I made earlier, I mean, fine, they may come on, come in primarily presenting with symptomology from their gut, but actually you know you're still taking the same approach of, well, you know, are the hormones influencing this? You know, are they just stressed and their adrenals are also messing up their, you know, gut motility and production of digestive enzymes. So you can't again just look at things in isolation. But definitely more gut issues and yeah, I think, in large, a lot of that is to do with the change in nutrition. What are the things? I think? Environmental medicines becoming big. That still isn't on the radar of a lot of people, even a lot of integrative practitioners, just because it's just not as well understood. But I think, taking a prime example, so on the ground here, obviously you remember when we had the floods, don't know it's 18 months ago now that's, I would definitely say there's been a surge in people presenting with kind of mold related illnesses.
Speaker 2:And it's interesting because you know off. Originally you would come to that conclusion because you couldn't find anything else. I mean, we get this a lot. We're almost like a last resort like I need to go get my house.
Speaker 2:Well, let's see what we can get on to that. But uh, the the you know people often come in and say you are. The first thing they say is you're my last resort. And uh, you know, so they will have had every test under the sun and they've just got this whole array of kind of symptoms that just aren't explained by anything else. And then you start kind of thinking about other things and you screen them for mold and you see high levels of mold toxicity and then you start to question, well, is that just an incidental finding? But then you start to treat them and they get better. So you know, you'll never know everything.
Speaker 2:And that's, I think, where a lot of the passion and interest comes from, because it's amazing how you realize over time you'll always have black spots where you just you'll be unaware of your well, it's just the unknowns. And then you've got unknown, unknowns and it's kind of like, over time you, you start to just think, actually, maybe I should do this. You start to just think actually, maybe I should do this. Or you may just read a book of a practitioner who specializes, say, in toxins, and start to think about things differently. And you have to keep up to date because just things are evolving all the time and I mean, if you're looking at the whole of the human biology and health, it's limited, it's limitless yeah.
Speaker 1:So like, where would say the average listener now, like where do they even start when it comes to optimizing their health? What, what are? The cookie cutter approach here, because it is like it can be confusing for the practitioner. How does the general public get away with this?
Speaker 2:yeah, I think you know I probably made it sound more complicated than it actually is. I think, um, you know, I get asked all the time. You know, oh, you're a longevity clinic or you're a longevity physician and it's, and I think people automatically assume, oh well, that must be kind of stem cells and peptides, and you know exosomes and you know the kind of regenerative side of things, when actually no, I mean, 95 of longevity is eating, right, you know exercising, sleeping, managing stress, and then you know, making sure your nutrients are topped up. These other interventions, okay, they're gonna probably have some effect in unknown quantities, but unless you've got the foundations right, you're kind of probably wasting your time or money trying to kind of, you know, jump on a lot of these biohacks just as you said that there actually just come up with it, came up with an idea.
Speaker 1:It's a bit like dieting before. You know, people used to do keto. You know Dukin diet, no carb diet, whatever it was, but it's kind of very similar now in regenerative medicine. Now it's like people are trying to overcomplicate things rather than just the basics of like eating your meat, veg, but it's just that okay.
Speaker 2:More detailed approach to health uh, yeah, and I think there's two forces there. I think there's a lot of people don't actually understand the biology or the or the health systems and, uh, there's commercial interests at play as well.
Speaker 1:I mean, weight loss is another one yeah, that's something I wanted to ask you about today. So, glp1 drugs, right, what's your thoughts on this? Because I feel like I've I've lost 26 kilos right prior to the whole like into to this, and it was a long time ago, 10 years ago, um and when glp1 drugs came around, I was very much like no, you need to learn and how to lose weight and you go through the process and everything.
Speaker 1:But now I'm starting to see it full circle yeah so I'd like to know your views on this yeah, I can.
Speaker 2:I'll give you the short sort of answer because it has been a bit of a journey. I kind of went from writing them off also, or certainly not writing them off, but, um, being very specific in kind of who you used it with, and, and that was kind of your classic, extremely obese or with essentially insulin resistance or, you know, type 2 diabetes, um, and and but, and I think I think a large part of the problem is the, the way again, most people are being prescribed. It still isn't optimal and I think there are downsides to it, and you don't have to look very far, I mean, you just have to go to the studies that led to the FDA approval of some of these drugs.
Speaker 2:And look at the studies where they followed people after they stopped the injections and the vast majority of them regained the weight why do you think that?
Speaker 2:I think a couple of reasons. One is that they lost a lot of muscle mass so the naturally the metabolism is is slower and then also as well directly, because you're kind of in prolonged caloric restriction, you're getting other metabolic adjustments so you're kind of just in a far less healthy metabolic state afterwards. Plus, they haven't changed. A lot of them have changed their underlying habits. So if you're just going to go back to your same habits, then you're going to regain the weight, whereas I think if you're using glp1s as an adjunct to someone who's changing their underlying lifestyle habits and you're using GLP-1s as an adjunct to someone who's changing their underlying lifestyle habits and you're dosing in the right way.
Speaker 2:I like to cycle it, which is again different to probably how the majority of people are using it. We use minimum effective dose, so we're not escalating to the sorts of dosages that a lot of people are using it. We're tracking metrics like body composition. So there's there will be people who I feel lose too much muscle or don't have enough muscle to start with so we won't put them on it.
Speaker 2:So I think it's just like anything again in healthcare it's about not taking a one-size-fits-all approach and tailoring the use of those, those drugs, to the for the right people so let me just like create a little avatar.
Speaker 1:So, for an example, we have sally. She goes to the gym. She goes to the gym maybe five times a week. You know, lifts heavy, eats enough protein. She's an athlete, but she needs to lose a little bit of weight and she takes ozembic, for an example, so you're the lowest dose that she could take. Would that be beneficial for her to be taking that as an athlete?
Speaker 2:you see, um, I've also got to the point where it's actually uh, it's quite difficult to predict with a lot of these sorts of scenarios. So I I again, when I first started prescribing them, thought I was very clear about who they were and weren't going to work with. Again, over time, there's people where I thought this is never going to work and if anything is going to be harmful to you, and then you've kind of it's your last option.
Speaker 2:They've been crying for it for months or years even, and you know, will prescribe in a very measured way and they do incredibly well on it. And I just think that speaks to the fact that, when you know, if we look at weight loss as a whole, there's so many mechanisms in that black box between calories in, calories out, that we don't fully understand whether it's genetics, epigenetics, hormonal sort of mechanisms. Um, often these things you can't predict. Now it's it's risk management. So I'm being a little bit flippant.
Speaker 2:But if you, if, for example, there'll be a lot of athletes who are probably over training already over training, under eating, and maybe they're just not sleeping well as well, or they've got high amounts of emotional stress, they'd be scenarios where I'd be less keen to apply it. But I've been surprised again. I mean, there's been some people where they've had huge amounts of stress or they've not been sleeping very well, and then they, I see them a month later and they're like I've never felt more clear-headed. Um, I'm calmer, um, you know, my whatever they're referring to my inflammation has come down, I guess, the meaning, the puffiness and fluid retention, uh, so I'm open-minded.
Speaker 2:So, whilst again we're we're a lot more, I think, analytical in our approach yeah I'm not closed-minded and I'll never shut it down in people, uh, unless there's a clear kind of cut example where it definitely shouldn't be used. So someone is massively under muscled or there's an eating disorder or they're already only eating 500 calories a day. No, I'm not gonna. Yeah, but uh, I'm always willing to give it a try in most scenarios if we've exhausted other avenues.
Speaker 1:Have you come across any kind of um research out there now of the consequences for long-term use?
Speaker 2:Well, I think, if you look at it kind of in terms of how long they've been FDA approved for, I mean it's not, they've not really been around long enough.
Speaker 1:So that's what I was wondering Is there anything that you've got your hands on?
Speaker 2:No, not really. It's more. Just people are kind of looking at the mechanisms that it's impacting and then just kind of saying, oh, it's amazing for longevity, which I think you can't really necessarily make that jump yet. But I mean, all the spin you're seeing now is more the pharmaceutical industry trying to get it fda approved for other conditions, which I mean, isn't you know that doesn't surprise me that it helps with dementia or cardiovascular disease. I mean, this comes back to the functional medicine approach. We we know that insulin resistance and inflammation and being overweight, uh risk factors for these conditions, so naturally you're going to see improvements in the consequences yeah, these problems, um, has there been any kind of issues that you've seen that have come out of people using glp-1 drugs?
Speaker 1:have you seen, have you witnessed anything personally, any kind of issues that you've seen that have come out of people using glp1 drugs? Have you seen, have you witnessed anything personally, any kind of serious side effects or any, uh, horror stories, I think?
Speaker 2:it's more just, uh, some people who just almost kind of get stuck on it, and that's kind of whether that's physical and or psychological. I think the psychological part's the hardest. And I guess we see the same scenario in men who you put on TRT, testosterone therapy, and when they feel that good, it's very difficult for them to go back to kind of how they were before. You know, if it's in a scenario where you, you know be potentially need to cycle it, uh, it's the same with kind of weight loss. Once someone experiences being a certain oddy weight, even on occasions where, even if they're under muscle, they don't care. I mean, there's a huge element to where you know as long as you hit a certain point on the scale.
Speaker 2:Even if it's unhealthy, they don't care and they'll take it for the rest of their life.
Speaker 1:I nearly think, the GLP-1 industry. They need to work alongside a psychologist or someone who's going to mentally support them when they come off utilising these drugs. And it reminds me of like bodybuilding, essentially, where, like though, whilst you're stage lean, you need to have an end game plan to like mentally prepare yourself that you're not going to ever be that lean ever again. So it's like the coaching that comes after is actually more important than even the process. Well, actually, no, they're.
Speaker 2:They're both very, very important, because you should learn your behaviors and habits while you're on it yeah, well and and um, you know, I'll always say to people at the start it's not about weight loss, it's about fat loss and it's about sustained fat loss, and I think that's highlights a huge problem and that everyone is too short-termist in looking at the weight that they're losing. Um, well, so that that, whether that's a psychologist who helps them that, or I just think it's good doctor, doctoring, I mean, it can be any healthcare practitioner. But I mean, if you look sometimes at the way that some of these you know, typically endocrinologists are issuing it's almost like a conveyor belt prescription with no real attempt to address the underlying kind of root causes. And, yeah, fine, there'll be some success stories, but equally, there's going to be some people where, you know, two or three years down the line, they're going to be back to square one or, even worse, they're developing complications as a result of it.
Speaker 1:Are you ever disappointed with the healthcare system in terms of like making a quick buck over actually you know treating someone for long term?
Speaker 2:Yeah, I mean, that's the kind of given yeah. I mean that's just the market, I think internationally, it's not individual to a particular jurisdiction. I think it's particularly worse in the US, where I mean you can have two people presenting to the same hospital with the same problem, with different insurance policy or no insurance policy, and they're getting completely, they're charged completely different amounts policy or no insurance policy and they're getting completely.
Speaker 2:They're charged completely different amounts. Um, you know there's huge forces at play that are kind of dictating that and um, I guess we can only really try to just provide, uh, good care of the grassroots and hope that the health seeking behavior of people changes where they're demanding a different approach, which they are. But it's still pretty niche. You've got to really have changes on a bigger scale, at higher up, and I suppose in the US now the current head of the health system is trying to make those changes. But even then, I mean, there's only so much you can achieve in a four-year cycle.
Speaker 1:Yeah, absolutely so. To move on to a hot topic of peptide therapy, can you explain that?
Speaker 2:Yeah, so the huge, I guess, craze more so in the last, I think, five to 10 years, I think a combination of just people's focus since COVID, again on health and wellness, the availability of kind of podcasts and people taking an interest in wellness podcasts and it being spoken about, and then again availability particularly, I mean, regionally. We're lucky because we have favorable regulations for a lot of these regenerative practices. What are they? I mean they're the chains of amino acids that mimic kind of molecules, often signaling molecules in the body. I mean, two obvious examples that people will know about are just pharma-branded examples are insulin as a peptide, the GLP-1s that we've spoken of, other peptides that haven't necessarily been pharma branded but have effects, again, some also on body composition, others on immunity, hair and skin. The list kind of goes on and uh, people are seeing great uh results. Um and uh. Yes, the one of the hot topics right now so bp7 or bp157?
Speaker 1:yeah, is the one that I see often, so can you just unpack that?
Speaker 2:yeah. So there are a lot of people are using that as a kind of it's an anti-inflammatory peptide. So two common scenarios you see in a people who are just injured or, say, recovering from, uh say, surgery, post-op, or people who are hitting a certain age, or they have a level of training where they just need to recover quicker. So that's a nice little biohack that seems to, for a majority of people, get pretty instant and obvious results and how can one dose with?
Speaker 2:yes, it's two main avenues um, orally or uh subcutaneous injections, so small insulin like needles. I personally find that, again in terms of our experience, the oral stuff works generally better for gastrointestinal issues, but if I have someone with systemic kind of inflammation or the problems we were talking about, I would typically go more for the subcutaneous injections. So, for example, right now I have a tendonitis, I've got a tennis elbow, so I'm injecting BPC, I'm injecting it into the actual tendon.
Speaker 2:Again, anecdotally, I seem to get better results. You've got to do it with caution, obviously, but yeah, probably one of the most popular peptides prescribing if someone just, can someone just order that and inject themselves well.
Speaker 2:So that that's kind of again where one of the controversies is. I mean, a lot of people are they're going online and buying it and they'll be constituting it, so mixing it with a solution and then injecting. At the end of the day, I mean, you're injecting a effectively medicinal product and you're not always comparing apples with apples. I mean, you know where's this peptide come from? Yeah, uh, what's the purity, what's the stability? Uh, so we typically don't recommend that our peptides are certainly the ones that we're typically don't recommend that our peptides are certainly the ones that we're issuing and prescribing are from a compounding pharmacy. So it's regulated. We know that there are. Every batch is purity, sterility checked and the stable up to six months. So that's effectively what you're paying for ultimately, and that's a huge driver as to why people are going online, because there's a cost difference.
Speaker 2:Plus, also, we we have a certain portfolio of peptides that are licensed, as I alluded to earlier. There are hundreds, and so, until ones become licensed on the ground and regulated, there's there's a thirst and hunger for people going and wanting to to try them. I mean, the perfect example now coming back to glp1s, is the newer generation retatrutide, which is a you know, for those who haven't folded that closely you had a zempic, which is a blocks a single receptor, and then you have manjaro, which is to zepatide, which blocks two receptors, and then you now have retatrutide, which is currently in phase three trials and human trials, so it's still being trialed by the pharma industry can you explain that?
Speaker 2:yeah, so the what, the trial system or the actual mechanism of uh how it works, that's true time. Yeah, so it works on an additional receptor, glucagon, and the initial results from the pharma studies is that you get more rapid uh weight loss and there seems to be better preservation of muscle. But these are just so how does that happen?
Speaker 1:like, how's that?
Speaker 2:yeah, well, again, I don't. I don't think we fully understand the mechanisms yet conclusively so, uh, that's why it's a case of well, you've kind of you've got to hold your horses a little bit and be if you are using it. You've got to be very kind of measured in your approach, and it's certainly not something that I would prescribe. Um, I could help guide people, but I think people just have to understand again that there's a reason why there's trials and there's plenty of pharmaceutical drugs that have passed FDA approvals and turned out to you know, be withdrawn eventually, or you know side effects have occurred that weren't they weren't aware of, or even were suppressed.
Speaker 1:So to be jumping in and taking a compound that hasn't even gone through human trials yet, I think is, uh, pretty cavalier how does one manage the quality of what they're taking essentially here, especially in the uae like, because I nearly feel like all this regenerative medicine that's out there. It's difficult to feel like you can trust certain places.
Speaker 2:So yeah I think it comes down to. So part of it, I would say, is reputation of the, the clinic and the physician. But I mean, I wouldn't just stop at that. You, you, you have to kind of almost demand uh, where's the evidence for the kind of quality control? And you know, if the, if you know the, the trust isn't there, yeah, and and anyone who kind of blocks it or refuses to kind of give you that information, then why would you trust the product?
Speaker 2:if someone asked me for, you know, the sterility check of a peptide or the purity. I'd be able to provide it to them through the, the pharmacy. You know, if we're giving someone stem cells, they get a actual certificate of their stem cells telling them the volume, the viability, the sterility. So, uh yeah, you have to ask questions, which I think a lot of people struggle to do yeah and aren't, but you should never.
Speaker 2:As funny the amount of times that people say to me I was kind of worried or too scared to kind of ask or thought I would offend the doctor, or even what they've asked and they've been very dismissive. I just you know you shouldn't be working with that person. Yeah. It's a very simple rule. I mean, if the person you're working with can't give you simple explanations to your questions and provide you with what you need, they're probably not the person you should be working with I think that's great advice.
Speaker 1:So, uh, new cells. Can you explain that? Yeah, so this is a yeah yeah.
Speaker 2:So this is another area again and it's similar to the sort of peptides where there's some provisional studies showing that this subset of we call them mesenchymal stem cells so let's just call them stem cells for argument's sake. So the stem cells that people are traditionally using in regenerative medicine, some small scale studies showing that these MUSE cells have the potential for even greater regenerative effect, the potential for even greater regenerative effect. But we're talking very small studies in very specific circumstances.
Speaker 2:There isn't really any international guideline on best practice, on how to kind of produce these stem cells Plus regionally, there are regulations for products that you're using and it comes down to again the fact that who do you trust? There are going to be some places physicians or clinics where it's a competitive environment and their only competitive advantage is to try and offer a product where they feel there will be demand, regardless of whether the evidence is there or not. It doesn't mean I'm saying that they don't have a superior effect, but I can't tell you whether they're potentially going to have a detrimental effect. That's why we have kind of studies. So, yeah, it's probably a practice you'll see more of, but certainly regionally. It's not something that's uh, licensed or available.
Speaker 1:So what are some of the positive outcomes that you've seen with mu cells?
Speaker 2:well. So we don't. We don't. We don't use mu cells just by the simple fact that there isn't really international sort of guidelines or uh recommendations on how, how to apply them. There isn't, uh, you know, as practice in terms of how to produce them, so we don't use them. We're using traditional mesenchymal stem cells where we have got evidence to effects on longevity. What do we see? So we see improvements in a variety of different hallmarks of aging or just general well-being of the clients. So there are some people where they'll see improvements in energy, improvements in cardiorespiratory fitness, really sort of strange things like improved sleep quality or visual improvement. Uh, it's just.
Speaker 1:It's actually quite broad yeah, um, I'm just looking for something that's going to make me look like a baby well.
Speaker 2:So then, I guess, yeah, so well. Also, I think it's important at this point to highlight that I think there's a misconception as to how people think of stem cells and how they're working. I I think there's a lot of people where you know, let's take a knee problem, they'll, they'll inject, they'll get the knee injected with stem cells and they'll think that the stem cells themselves are converting to cartilage or bone or connective tissue whilst the stem cells have that ability to, they only have that ability if they're prompted or pushed under the right circumstances.
Speaker 2:That's not something, again, whereby uh, it's happening, you know, in a on a commercial level, it's happening experimentally in labs where my stem cells are being manipulated, but in terms of when it comes to regenerative practice, it's not something that is licensed to be, to be done.
Speaker 2:And and really the way the stem cell is working is that it's influencing the, ultimately the immune system. So, in very simple terms, it's reducing the kind of negative aspects of the immune system and attracting cells and non-cellular products to allow and facilitate regeneration. And there's a limit to what its capacity is. So, again, if you have bone on bone in a knee and you're getting pain as a result of that, the stem cell is probably not going to do a huge amount. So you have to be very clear when you're kind of counseling patients on this, because we're not talking about, you know, inexpensive products, and I guess that's a good rule in general. I mean, you have to manage. A lot of what we do is managing expectations and you have to be very clear, otherwise people are going to potentially end up disappointed you're not injecting magic into their body.
Speaker 2:No, contrary again to what they may think.
Speaker 1:So with anti-aging, is there any other kind of methods out there that you see in the future? That would be super beneficial.
Speaker 2:A product that we're bringing over very soon, in the next couple of months, is plasmapheresis, which is, again, I think, the best way of describing it. It's kind of dialysis for healthy people. So you're effectively cleaning the plasma, so you're reducing a lot of the inflammatory cytokines or components in the blood that are leading to kind of chronic inflammation, poor healing, poor cellular function, reducing toxins levels, and I think this ties into kind of what I was saying earlier on. I think people are going to start to realize more and more the environmental, environmental toxins and medicine and and consequently inflammation, are huge contributors to aging and disease, and that's where something like this will come in so is there any other things that are impacting essentially our, our aging right now, especially here in the uae?
Speaker 1:I see like obviously the air quality so bad here, essentially like we were ranked number one, I think, is poor air quality, and I think it's summertime anyway. Um, do you think aside from uv exposure as well? Um, yeah, it has to be.
Speaker 2:I I think again though it's difficult to kind of measure, yeah, um, because I just think this it comes to the fact that there's just so many variables that it's difficult to kind of allocate a causal link. A lot of this will be more sort of observational type studies. There's no doubt that it is. I don't think that there's particularly anything that's more individual to hear. Yeah, I guess the air quality isn't as good as certain places, and you know, do I see evidence of that on the ground? Again, I can't. I'm not saying this in a necessarily a mathematical or analytical way, but definitely. I mean we see a lot of respiratory issues, particularly in younger kids, but that's not, you know, I can't quote you sort of uh study to show that so with technology increasing so much in AI, what's your thoughts with doctors using AI and do you think there's?
Speaker 1:I'm getting worried to the point of like doctors potentially having clients and patients on a conveyor belt and using chat, GPT and maybe overlooking mistakes. Let's say what's your views on this?
Speaker 2:I I think it's uh, listen, I think we're seeing it get to a a very competent level and I think, um, I I can't remember what I saw a headline the other day, or it was, predicting that you know, it's going to surpass human intelligence. I think in the next, maybe 10 I think it's already passed a fast.
Speaker 2:But yeah, it's a fast rate, yeah right so then, uh, I think it's, it's the same with any specialty, I mean. Ultimately, I mean, certainly, what I've learned, and I guess what most people are realizing, is that it comes down to more the fact that it's about how you're prompting it, um, so I think, rather than you know seeing it as necessarily a replacement, which I think you're highlighting as a concern, and it is because this there's still, I think, variables that the you know, something like chat, gbt, can't account for, um, but I mean, is it, is it, uh, a useful sort of adjunct or or or something that may improve or facilitate better practice? And medicine is no different to any other industry. So, um, I don't see how it won't, I mean, I I think the most obvious example is you look at radiology. I mean, radiology is still pretty primitive when you think about it you're still using a human eye to look over.
Speaker 2:You know what are getting more, you know better quality, but still imperfect images. So you've got an imperfect image that may not capture something and then you've got human error interpreting it. I mean already other studies that exist that's showing that machines can do it better. So straight away, that's a specialty where I see almost becoming kind of obsolete. Yeah. When it comes to, I think, the more patient-facing specialties I don't see. I mean, maybe you know Star Trek, 100 years, will be eliminated.
Speaker 2:But I don't see that happening in the next few decades, because I just think that there's certain prompts and cues and soft skills that machines and AI won't be able to replicate. But it's scary, I mean, isn't it how you know, if well-prompted, the level of what it can potentially come out with? But I mean, yeah, you shouldn't be used blindly. I mean it's like anything. It's kind of you've got to still really you've got to still understand what you're looking at, whether that's medicine or something else. Take a lawyer, for example. I mean a lawyer, yeah, I mean it can draft contracts very well. But you know, the difference between a good lawyer and a bad lawyer is the good lawyers are going to review it and make adjustments or, in the first place, it's prompt it properly.
Speaker 2:I mean, the one thing that I can't understand how they're managing it is in universities now yeah I've got no idea how they are assessing people that's a good point uh, so, so I think actually the thing that worries me more is just education, uh, as a whole really good point to make.
Speaker 1:That's something I'm gonna reflect, because this is the detached podcast. I have one last question to ask you what would you detach yourself that's limiting you today?
Speaker 2:um, yeah, I think often, sometimes and it may, you know, interestingly tie into kind of what you were trying to get out of me earlier on, and it's probably something that I hadn't thought of that you know, you ultimately go ask yourself what is kind of driving you, and is it? Is it your passion and kind of interest, or is it more? Are you trying to prove something to someone else, or are you just being kind of competitive and trying to achieve something?
Speaker 2:uh, for the for the sake of it, I think I'm fortunate that I am doing something that I'm genuinely kind of interested in and passionate about, and I think we're lucky that we live somewhere where I wouldn't say that there's a work-life balance at this stage of the company. But we, we live in a place where, you know, when you have family, you know, you're not as worried about doing a 18 hour day as, say, you know, if I was back in the UK and the weather was terrible and there isn't anything for my kids to kind of go and do, um, and and maybe you just kind of, you know, get caught up in the sort of uh rat race and not kind of consider you know these things in your life but um, no.
Speaker 1:I think it's more just doing things on my own timeline and for myself and for my own interest, rather than for other people yeah, I think when you're so passionate, sometimes it's like are you passionate because you just really care about something, or are you running from an insecurity to develop?
Speaker 2:yeah, as well yeah, and is you know? Yeah, exactly, is it. Is it okay? Maybe is my brothers were clever. Do I have to keep working and prove myself and achieve something that's greater? I probably would say that that is true if it was something that I genuinely wasn't interested in, but I think I'm quite lucky that I'm in a sector that, even for non-medics, it's dinner table conversation. It's hugely topical at the moment and I think you'd have to be living under a rock not to have some interest in some aspect of it.
Speaker 1:So I'm just riding that wave well, thank you so much for being on the podcast today thank you, I loved it.