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Get the clarity you need on the hottest topics in health and wellness with Second Opinion. Hosted by Rosemarie Beltz, this podcast brings you fresh perspectives from experts, innovators, and disruptors tackling life-changing issues. Each episode unpacks the latest research, debunks the hype, and delivers insights to help you make informed decisions. If you're ready for engaging, enlightening, and occasionally unexpected takes on health and wellness, tune in and discover your second opinion.
Steven - 00:00:04:
Welcome to Second Opinion. I'm Rosemarie, and if you've ever wanted a Second Opinion on some of the trending topics in health and wellness, you are in the right place. Each episode, I sit down with experts, innovators, and even a few disruptors to bring you fresh perspectives on the issues that could change your life, from age rejuvenation and brain health to the weight loss drug revolution and how to reinvent your career. Together, we'll dig into the latest research, question what's hype and what's real, and give you the insight you need to make your own choices about health and wellness. So if you're ready for a Second Opinion that's engaging, enlightening, and maybe even a little unexpected, let's get started. Today's guest is someone who has his finger on the pulse when it comes to chemistry, everything from precision health, custom supplements, to the growing field of peptides. And he's not your average pharmacist. Dr. Steven Hoffart is a doctor of pharmacy with a board certification in anti-aging medicine, founder of Magnolia Pharmacy. And I'm going to say this because I follow him. He's a bit of a trailblazer in functional and personalized medicine. His mission, to make health solutions more collaborative, effective, and personal through something he calls the triad, a powerful partnership between patient, physician, and pharmacy. Let's find out what he's helping, how he's helping people stay energized, age better, and optimize. And how he's helping them optimize their health right down to the cellular level. Steve, thank you so much for being here.
Rosemarie - 00:01:43:
Oh, thank you so much for having me, Rosemarie. Super, super excited to be here.
Steven - 00:01:47:
All right. So like I said, I follow you. All of your posts, they're tight, they're informative, and they're really easy to understand. And I think that's with the topic of what I'm going to get into in cellular health, but you as a pharmacist and the role of the pharmacy and the pharmacist in general, I sometimes think you guys are really underutilized and really misunderstood. So you opened up Magnolia Pharmacy over 20 years ago, and you took your traditional pharmacy, which a lot of people think of your pharmacy and dispensing meds, into a more holistic approach. If you could just describe, and for people who don't really understand what a compounding pharmacy is, and then what was that push into more precision-based care?
Rosemarie - 00:02:35:
Yeah, that's awesome. Yeah, pharmacy has really been awesome to me. And to be honest with you, as most healthcare professionals, my goal was to get out of school and help people. When I initially started pharmacy school, when I got into college, I wanted to be a heart surgeon, I'll just be honest. But part of me was like, I wasn't going to spend all of those years in school and I want to interact with patients. And so pharmacy was just that natural sense. I love the science. I love the biology, the chemistry. Pharmacy was that nice intersection where it gave me all those things. I could get in and out of school in a reasonable amount of time, get them with my family. And that's what happened. I'll be honest with you. I grew up with a mentor of mine who set me up for success. I went to work for him out of school and he kind of got me on this journey of the wellness side. But to be honest with you, he was actually doing a lot of the things that I'm preaching and teaching now 20 years later. He was doing it back many, many moons ago. And for most people I've learned on this wellness and health journey, it's either something personally that happens, or somebody that touches your life that happens. And you know, that's so key. So I opened up my own store, traditional pharmacy. Most people think pharmacists, I just put pills in bottles and that's what I went to school for. Obviously there's a lot more to it. And so I, one of the good things my mentor taught me into was doing something that's called a compounding pharmacy and what that has to do with traditional medicine. Now, whether it be an antibiotic, your heart medication, blood pressure medicine, those medicines are made in a vast amount in a large quantity for ends of thousands. And so it's like, this is what we do. And compounding is really unique. And I think this is where medicine's going. And it is a personalized approach to care. It's taking care in of one because no offense, your genetics is unique. Your, your lifestyle is unique. Your environment's unique. Your toxin exposure is unique. And all of those things go together to set you up for success and failure. And that's where compounding comes in. We have practitioners who see a patient. It's like, look, nothing's happened. Nothing's helped. What do we do? And they can reach out to us as a licensed pharmacist who's trained in compounding to come up with customized solutions. I mean, we're not making drugs on our own. We're taking a lot of times repurposing a drug that's currently been on the market, changing the dosage form, making it, you know, taking something that maybe was a shot. Now we can do as a sibling will drop. So it's customizing a medication for each patient. And really, that's kind of how my pharmacy got started and got me on this wellness journey. As I learned more about that, I realized this wellness side was the other piece. That's the other part of the puzzle, because with a lot of things we'll talk about, I'm sure there's just not one thing that fixes all these things. It's plugging a little hole, plugging a lot of little holes. And obviously, compounding is one of those things that can do that.
Steven - 00:05:10:
Right. Well, and I get it. It's all personal, right? Whether you're an athlete growing up or you're just trying to be your best self. And I'm with you, you know, kudos to the guy that you've, you know, your, your mentor back then. Right. It's like, I feel like juicy. I'm like, I was doing that then, but now all of a sudden everyone's talking about it. You know, it's like, oh, you know, I mean, that was, and I think too, if you're science minded, like if you're money minded, you know, you go into banking and you're really good at money. And those of us with science, we might not have a lot of money. We spent all this time in school, but we were really keen when it comes to the body, like what makes you tick. But then you took it another level. You actually went down the road of anti-aging medicine and you got boarded in that as well. So you zeroed in on that too.
Rosemarie - 00:05:52:
And that's exactly right. Because what I, what I really enjoyed was just having all the biochemistry and chemistry and science in my back pocket, and then going actually after school and going down this wellness penicillin in terms of I went to a group called A4M, which is the American Academy of Anti-Aging and Regenerative Medicine. And I went there and basically took all the things I knew as a pharmacist. And I think that's what kind of gives me a unique perspective compared to a lot of others. One, you and I both know, there are many social media influences out there and people on YouTube that unfortunately take a drug. And now they're the expert because they took it and lost 20 pounds. And I think part of that is... That scared me. And I'm like, you know what? I'm at a unique crossword where crossroad, where I understand the science. I understand traditional medicine because there is a place for traditional medicines. I want to make that super clear. You know what I mean? Like if you break your arm or you need acute care, cause you got an, you need an antibiotic. Like, like I'm glad I have the training in that, that I can handle it. But we're going down a road nowadays where people want to do something different and they realize like what we're doing is not working. And that's where the marriage of like the traditional training I have and the wellness functional piece. And it goes back to all the basics of the science. Like you said, back down to the cellular level, because that's where everything happened. That's where the magic happens. And if you can fix things there, it actually trickles back up in the system to create better health.
Steven - 00:07:10:
All right, since you mentioned that, the cellular, all of this, the mitochondria, they're really having their moment right now. It's everywhere. I don't know if it's because, well, like I said, I feel like we focused on that, but all of a sudden there's books, people are talking about it. They're talking all about the mitochondria. Could you go in, could you explain for people listening, like, let's go into the what, who, how, what, like, what are, if we can just break down the science so people can understand what this actually means and how it relates to aging?
Rosemarie - 00:07:46:
A hundred percent. So. Mitochondria is all the stuff that you did in biology in high school. And you're like, oh, I don't even care. You know what? If I don't pass this, I'm going to put it away. I'll never use it again. And then when you get to college and you get your basics that you have to take biology and chemistry, like, oh my God, here this shows up again. Why is this showing up? I can't wait to get this over. Let me make a good enough grade and pass the thing, pass my test. But to be honest with you, that's where it all starts. There was a reason for that. We just didn't realize it back then as far as that goes. And I think it's a combination of on the cellular level, if your mitochondria, which is the powerhouse of your cell, don't produce this little magic substance called ATP, which is basically like the gasoline of the fuel that runs the ship. You're going to die. And what's crazy is when we think of all the cells in our body, every cell in the body has mitochondria. And even more importantly, certain cells, like your brain, that's constantly having to work, your heart that never stops, your muscles that carry you throughout the day. They've got hundreds and thousands of mitochondria doing this process of respiration cellular and making this ATP. And if that doesn't work, we're not going to function. So keep in mind, if you have brain fog and you're tired, or you feel fatigued and run down, those are just a couple of things. Those are directly related to your body's ability and your mitochondria to produce this ATP, which is the fuel for the body. Unfortunately or fortunately, there are so many things we do nowadays that can radically affect how productive our mitochondria are. And like I told you, we realize how important they are. So the body's pretty smart. This is the part that I always find amazing is that it regulates these mitochondria, realizes in times of good metabolic health, it helps us make more. They work, they function better. But also too, when we get exposed to toxins or we live in inflammatory diet, we eat an inflammatory diet or we live in an inflamed environment or we have hormone dysregulation or our thyroid don't work as well or we have gut health issues. All of those things kind of poke holes and start causing insult to our mitochondria. Now, all of a sudden, they don't function as well. They don't make the ATP as well. And it's just like your car every day. If you drive your car every day and you don't take care of it, it's just not going to get you where you need to go as effectively and as fast every day. Mitochondria the same way. The body's pretty smart. It starts seeing the mitochondria that are getting struggling and having issues. And it starts, it'll actually do something called a mitophagy where it'll kill them off. But then it brings on new ones. And unfortunately, as we get older, even if we live the best life, that process gets a little more sluggish. It doesn't work as well, which is part of the aging process. So that's why doing all these things we can do to keep our mitochondria as healthy as possible is important. But it's not just about making ATP and the energy sources. It also has to do with the ability of. Our body, when we make energy, the ATP, it's just like everything else. When you burn gas in your car, we get energy out of it, but it produces certain chemicals. These mitochondria, when they make energy, they produce certain chemicals, which are called reactive oxygen species, which if the body don't have a good process of cleaning those up, can set us up for aging quicker. So it's a complicated process. I'm glad I'm not the one that invented it, but it's our process to kind of learn how to figure out how to harness it, make it be as efficient as it can so we age in a happy way with lots of energy, fully functional, and get through life and be healthy as we get older.
Steven - 00:11:05:
So at what age, I know it's kind of hard to say, it's a case-by-case basis. However, on average, when do you think we start experiencing the effect of, say, our cells not maybe working as efficiently?
Rosemarie - 00:11:23:
So, you know, it's funny you say that. I think the level that people have nowadays, I mean, I see this in some high school kids nowadays that are burning the candles at both ends and their parents are pushing them to do sports and debate. We can start to see that then because the stress and the diet and the lifestyle creates an environment, and I'm going to say of inflammation, and I'll probably say that a thousand things today. And inflammation is basically like putting poison on your mitochondria because it just doesn't allow the body to work as well. I would say, you know, if somebody's highly stressed out, it can happen at any time. The other part that we typically see is our males or females, and we're starting to see this earlier and earlier. Once you start going through hormonal changes as a female, your hormones play a dramatic impact on how well your mitochondria function. That's part of the problem as we get older and our hormone levels begin to drop. If we don't do things to correct those, we start seeing mitochondrial dysfunction. That's why you see a lot of ladies have brain fog and mood issues and fatigue and tiredness and weight gain. And I'm not saying, it's all mitochondria, but the root cause of is that's your metabolism. When you gain weight, you're basically, unfortunately, the metabolism just doesn't keep up for what's coming in, what's going out. And so it really could be at any age, and it is just so important as we get older, especially, and I'm going to say for women, when you're 35 and beyond, because that's when kind of hormone changes start to happen. And men, the same type thing in that age. You've got to start paying attention to these because if you wait till you're like 60 and want to start doing things to correct them, you're going to really struggle. It's a lot harder. It's a lot easier to fix things early on when they begin to break than when they're fully broken later and you try to correct things.
Steven - 00:12:57:
Right. Like you said, getting your car serviced every 3,000 miles versus just waiting for the oil to run out. And you were saying also, you made so many good points. One, CT surgery. Yeah. Talk about inflammation. I work in heart surgery. So yeah, I can talk all about stress and environment. But one day you wake up and you're thinking to yourself, it sounds like you're saying all these things are happening. It's this compound effect. And then one day you're like, oh, what the heck? That doesn't feel right. And all of a sudden everything starts kind of going awry with all these things. We think we're doing the right things, but it sounds like we're burning our, we're just like running ourself into the ground. So say if somebody wanted to do one thing. To improve their cellular health. You know, what would you say that could be? I know it's a complicated answer, but for people that are listening who maybe want to do that one thing today, like what could they do?
Rosemarie - 00:13:57:
I mean, it's pretty simple. It's change your diet. And it isn't even just what you eat. Like what you eat is the most important thing because, you know, there's so many things. We put inflammatory oils, high glycemic foods, especially sugar and all. I mean, those are honestly, those are poisons to the engine that is your mitochondria. But the other thing is too, it isn't, it's taking in way too many calories than what the body needs and never giving it a break. I mean, if you're constantly dumping in energy and you're not doing anything to burn it off or you're not burning off that energy or using that energy throughout the day, it poisons your mitochondria where they just don't work as well. The other piece of that is not even so much changing your diet, but changing how you eat. We've learned that if we go periods of not eating, i.e. If we do time-restricted eating or intermittent fasting, I mean, there's a million different terms you can talk about nowadays. But if we're not, you know, the old days, it was like eat 20 small meals and spread them out all throughout the day. So you eat from sunup to sundown and all this. But we're learning is, is if you give your body a break from eating and taking food in, and that means, maybe like you said, you get up, maybe you don't eat breakfast till 10 and you finish your meal by night. So you've got a good 12, 14, 16, 18 hours that you don't eat. You actually promote the body to be metabolically flexible, to be able to, and with that comes your mitochondria get more efficient to make ATP. And so I would say the biggest one thing people could do is how, is not only their diet, but how they eat. That is so, so important.
Steven - 00:15:19:
Okay. So say people start, you know, they change their diet. That's one of the things, you know, they're trying to move in the right direction and they want to test for this sort of thing. What I do like you mentioned about, I think it was in either one of your podcasts. I either listened to that or saw on one of your Instagrams that your approach, you talk about testing for disease versus testing for being healthy. And I thought, wow, that is a great way to look at it, even as someone who works in healthcare, who's also, we're all consumers of medicine, even though we work in healthcare, we're also trying to take care of ourselves too. And we have our own doctor that we, you know, so when you go to the doctors, what are some, you know, biomarkers or besides your labs, like some of the things that people could actually test outside from our say, our panel that we're usually given that will help us assess mitochondrial health.
Rosemarie - 00:16:18:
Yeah, and that's a little tricky because there's not a lot of great markers of mitochondrial health directly because it's at the cellular level. But a lot of times you can look at the markers you can do that can affect mitochondrial health, i.e. Let's talk about a couple of those. So one would definitely be your fasting blood sugar, your fasting Insulin, and your hemoglobin A1c. We know when people have metabolic dysfunction, and that's this whole system where we have increased risk of, we have increased blood pressure, increased cholesterol, increased fasting blood sugars. All of that is poison to your mitochondria. So we want to make sure that we're checking our metabolic health in terms of our ability to handle, you know, we're not eating too many sugars, but then on top of it, we're not having Insulin resistance and prediabetes because all of that is a disaster. The next thing you can do in looking at is our inflammation markers. And that's like. I talk a lot about HSCRP. It's just a quick, easy one. Even most doctors won't question you. Like, they'll be like, why do you want that run? But if you explain, look, that's just a great marker of inflammation. And like we talked about is inflammation. If you're highly inflamed, I can almost guarantee you your mitochondria are dysfunctional. If you're run down, tired, fatigued, and you're not asking your doctor to do an HSCRP, be sure you do that because that can be a big difference. And the other thing is, and I'll give a couple others, but keep in mind too, sometimes it's not always going and checking these and what the lab may consider normal is not what's optimal because that's the other part that we have to keep in mind. Because unfortunately, you know, I hate to say it, a lot of things get lumped into what are called normals, but that's not, like you said, what's best for our health. So those are some of the things. Believe it or not, one of the markers that sometimes I like to look at that's a specific marker kind of for mitochondrial function that I can indicate, there's a marker not many people do it, but if you're struggling with thyroid, I recommend to do something called a reverse T3. And what it is, is when your body makes thyroid hormone, it makes something called T4, which is one of the main storage forms of the thyroid. And it kind of hangs out and does its thing over here. Well, as the body needs activity or your thyroid to start working, it converts that T4 to T3. So from an inactive form to an active form. Well, that's like the gas in your metabolism pathways. But sometimes when people have dysfunctional mitochondria, if you check their what's called a reverse T3 and it's high, that lots of times is a very good indication that you've got mitochondrial issues. So that would be another one that I think you could do. Probably going to have to ask your doctor because they're not going to run that on their own. But that's another one that I would like to look at that I think is definitely important.
Steven - 00:18:44:
No, I'm glad you brought that up because I'll just, you know, get personal. Like I, you know, as a woman, a midlife woman, I actually had a difficult time even finding a doctor. Like my doctor is fabulous, right? I actually fly to go see her. She's that good because I couldn't find. I had gone through a lot of doctors that would just basically say, this is a, I literally had someone say, this is a part of getting old. Like, what? I'm like, maybe you, lady, but not me. I've got a lot of work to do. I've got a lot of bills to pay and a lot that I need to do. That's not a good enough answer. So I call up my old doctor. I used to live in California and she's like, come see me, you know. But so I think the big part of this too is like you said, like you have to, when you said a doctor won't test for this, is finding a physician or someone like you, like somebody that's going to know or how to, you know, that's going to run these tests, but then also interpret them correctly. Because I've had lab work done and I don't know if anybody's listening or watching who's, and they get this lab work and they're like, it's either not really useful or not in a sense, it's like it's not telling the whole story or they're not even interpreting it correctly. I hate to say it.
Rosemarie - 00:20:02:
No, and you know that, and that's the problem. I think we run a lot of lab work to look for disastrous stuff. We don't want lab work to be preemptive and preventative and proactive. That's the problem, and that's what it's there for. So it's like, why wouldn't you do that? And you brought up a great point. It is so hard to find a doctor that does, I would say, personalized medicine, root cause medicine. And what I always make as a suggestion is two things. One, I'm not here to plug any organizations, but A4M and IFM have great websites where you can go find practitioners like myself that have been trained to do this, and you can find somebody in your area. So that's number one. The second thing is, and this is a shameless plug for compounding pharmacies, many of us that do this for a living have phenomenal relationships with practitioners in the area that are open to this type of medicine. Google compounding pharmacy in your area, and then go to them and ask them, hey, who is a functional medicine practitioner area that I can trust? And I can guarantee you there'll be a great resource to help you find a practitioner that does this type of medicine.
Steven - 00:21:04:
Yeah. And I do like that you brought up diet because my doctor too, I was like having some issues in case this helps anybody. But she said, you know what? She's like, you're making this, you're making these hormones. I think that maybe we need to put you on a probiotic. I just like her approach where she's, I know, she's a real nice balance of Eastern and Western. She's like, I don't think your body's converting the hormone to the form that it needs. You're making the hormone, you're not converting it. So your cells are utilizing it. So I just thought that that was interesting. But again, like you said, there's organizations that you can find these providers that will think outside the box and so forth, and they're worth every penny. And again, like you, I'm not here to like down anybody or it's just, it's to help you find what you need. That's basically was the premise of this and getting a Second Opinion. I'll plug that.
Rosemarie - 00:22:00:
No, and it's funny you say that. Because I always fear like, look, I'm a healthcare practitioner myself. And I know a lot of good pharmacists and a lot of bad pharmacists. I know a lot of good doctors and bad doctors. And sadly, when I went to pharmacy school, I wasn't taught any of this stuff. I was taught how to learn and educate myself how to understand all this now. But I didn't get this medical school. They're not taught this when you go as a nurse practitioner. And so I can't, I mean, I don't like that somebody would tell you, well, that's just part of getting older because it is, but that's fine. Well, but guess what? We can do this. That's what's important. And they just don't have the tools in their toolbox to handle the challenges that are out there because medicine's complicated right now and all this wellness stuff. So I agree with you. I get, I'm always scared. It's like, if your doctor doesn't do this, I don't want people to think I'm not down at doctors. Just sadly, they don't, they haven't been taught this stuff. So.
Steven - 00:22:46:
Exactly. Exactly. And a lot of them don't have the time because they're so pressed to see 40 patients a day. So you do have to really go outside on your own and usually seek this more boutique type of care, which is a whole other topic about costs and things like that. But I'm going to move into supplements because that's one thing we can control. We're going to go to supplements. So I find supplements, okay, clearly, just some quick numbers, things that a lot of us know. This is not a new topic, and there's information all over the place. It's a $200 billion industry globally, almost $100 billion in the US, and it's growing at a rate at almost 8%. And it's really this push. People want to feel better. They have all these supplements on their shelves, but then they don't feel good still, right? So I know people who have a tackle box full of supplements and still feel lousy. So where do many people go wrong in this area? Where are they going wrong and some remedies for that.
Rosemarie - 00:23:51:
I mean, honestly, if you think you're going to take a supplement for XYZ but not work on all these other things, like I said before, it's one piece of the puzzle, but it can be a huge piece of the puzzle in the sense that one. It's all about getting quality. I mean, that's the other part that's scary. We talked about there's influences out there that don't know a lot. There's also a lot of supplements out there that there's not much regulation on. Sadly, in the world we live in, supplements, even though I live in a highly regulated world of pharmacy, the supplement industry, there is no regulation. And you've got to make sure wherever you're buying supplements from, Amazon or you name it nowadays, you want to make sure you're getting stuff that's third-party tested. And it isn't even so much to say, let's say you get magnesium glycinate 500 milligram capsule. It isn't even so much that that's what's in that product, because who knows if it is or who knows if it isn't, but even more so the fillers and all the other stuff in there. Does it have toxins in it? Has it got heavy metals in it? Was it a poor grade of something? Is the capsule or the tablet it is in, is it going to dissolve? Well, that's why you have to buy from somebody that's done their homework. That's why I feel like as a pharmacist, I know a lot about this because I want the supplements that I carry and I promote to be made in the quality of every prescription drug that's behind me. We can talk about the. Good and bad of regulatory agencies that have three letters. But what I'm going to say is, is that this, that's the one thing that does go well with prescription drugs. If your prescription drug on the shelf, say it's. Lisinopril 10 milligrams in our country, as long as it's purchased, right? We know that as a lisinopril 10 milligram tablet back there, that's a blood pressure med supplements just because it says my magnesium glycinate 500 milligram, and it's setting out on the pharmacy shelf, or you ordered a line. Does it really mean it has to have that? Unless you know that manufacturer. Who it's purchased from, who it's made follows all that. So that's the one thing I think people go wrong is maybe the quality. And then the other thing is too, there's some interactions with supplements that I think people just start throwing this on and that on. And there's some interactions that I think you can maximize benefit. Um, the other thing that happens too, I think people forget is, is that a lot of people take prescription medications. And unfortunately there's some thoughts of the 50% of the side effects related to prescription medications are actually drug nutrient depletions, which means I take a prescription medication. And it depletes one of my substances. Like I'll use, I'll use a controversial class of drugs. It's like statins for cholesterol, right? And going back to mitochondrial health. So that's one class of drug, the jury's still out. And I'll tell you, I think there's maybe a few cases you would use a statin, but I'm not a big fan. I'd rather take supplements and lifestyle to control cholesterol, but. The original manufacturer that made a statin actually got that drug approved and has a patent not only on the statin, but to put CoQ10 in it because they knew at that time it depletes CoQ10. We talked about mitochondria. One of the very first supplements that I'll tell you have to be on if you've got mitochondria issues, you've got to be on CoQ10. So it's no wonder that people who take statins, if they don't supplement with CoQ10, they're going to have tiredness and fatigue issues because the drug is depleting it. So that's the other part is there's certain nutrients and vitamins we need to put back in the body. That's important. So, I mean, those are just some of the things about that can go wrong. But that's why you have to get your education about what supplements to take. I think sometimes people, and I'm probably guilty of it myself, but I've added over time, take way too many supplements. To me, start simple. If you've got an issue, take one or two supplements. See how you do. If it doesn't work, add another one and then kind of go from there. But I think that's important. But yeah, the supplement world is kind of crazy right now. You can scroll through your social feeds and it's supplement after supplement after supplement. So it's kind of nuts.
Steven - 00:27:26:
So you brought up a really interesting point. I find that I didn't realize that they were more or less formulating a statin with CoQ10. That's pretty wild to me.
Rosemarie - 00:27:36:
Yeah, they had a patent on it. It never came to market. But the manufacturer knew that was a problem. And I mean, a lot of people now know statins to plead CoQ10. But early on, nobody knew that. That was kind of a secret. And so the point is, is like anybody on a statin should be taking CoQ10. You need to be taking it as you get older anyway. But that's exactly right. The manufacturer of that drug knew that was a problem, but they never did anything. But they did hold the patent on it.
Steven - 00:28:01:
Okay, that's pretty cool. So I was going to ask this more towards the end of the conversation, but it's coming up organically. Again, not to down, I'll say at the FDA, I'll say it because I know a lot of people that I don't really want to talk. This is not a political show. It's supposed to be health, but politics are affecting our health. Do you think all of a sudden the FDA was like, there's the supplement world, you're over there. Now all of a sudden they want a hand in it. They're like, wait a second. It seems like they're kind of meddling a little bit. Are they not? I don't know. This is just from my other doctor, like doctor friends, anybody in the wellness industry, anybody with a med spa, who are physicians, PAs and so forth. It seems like the FDA is starting to kind of crack down and they want to control some things. Do you think that is, and maybe this Pat, and again, I don't want to speculate, but. What is the push all of a sudden for them? Is it a money? Is it a safety? They'll say, is it safety or is it money? I don't know. I'm curious now why that drug never went, they never followed through with that. I didn't know that. That's pretty interesting.
Rosemarie - 00:29:12:
Yeah, I mean, it's kind of interesting. Be real careful what I say.
Steven - 00:29:16:
I know.
Rosemarie - 00:29:17:
Because I live in a highly regulated industry where they could walk in any day. And I don't mean, they serve a good purpose for the purposes that they serve. But I would definitely say there is definitely a heavier hand in regulatory agencies getting more involved. Like compounding pharmacies, like yes, it's the FDA is very much involved in that because the pharmacy compounding world, and you all know like with GLP-1s right now, like that is a big thing because it was the FDA is the one that ultimately put the bulletin out just recently and said, hey, okay, the shortage is over. Now compounders can no longer make these GLP-1s, which I had right before I got on this podcast, I had somebody in the store panicking, like, what am I going to do? I can't afford the others. But I would say the FDA's hand, there's a place for them. But I think you're right. I've got a lot of, I've got some physician friends that are worried because some of the FDA now is coming into, physician offices looking at some of these compounded drugs that they're using in the offices. And it's definitely a challenge. I think they serve a role. I think some of that you may see change over the coming years, just kind of with our current administration, good or bad. But I think What's the word? I think there are bad actors. Like that's the one thing I want to say. Like I'm uber conscientious. I'm very advocacy promoting. I'm in Washington, D.C.. Multiple times a year. I'm in my own state of Texas. I'm in Austin. Because the point is, is I want to protect my profession. I want to protect my patients. I want to make sure that they have access to the things they need to set themselves up for success. I know one of the things we may talk about a little bit later is something like peptides, for instance. But I'm going to go back and say that that's like there is so much gray area. And there's people that are willing to get in that gray area and operate in that. Like I'm a very morally and ethically person. Like there's a lot of things. Like I didn't even compound GLP-1s because I kind of thought that was still a little gray area. But a lot of my compound buddies did, and that's fine. And I think we look on it in hindsight. The FDA is like, hey, it was perfectly fine. There was a shortage. But I would say. The fear, whether it be practitioners, whether it be pharmacists, of... That if the FDA is going to come in and cause problems, that's a fact. I think there's a lot of fear though with patients too, because they may hear, i.e. The compounds we do. None of the compounds we do are FDA approved medications. They're approved for other things, but a lot of things get repurposed. Sometimes patients hear that thing, oh, it's not FDA approved. I can't use that. Hormone replacement, things like that. So there's just a lot of confusion that we kind of need to put a bubble on to try to kind of rein stuff back in and create some common language so that we all understand the rules that we're playing with. So I kind of hope that answers your question.
Steven - 00:31:51:
No, it does. And I do want to get into peptides for sure. But I do want to bring up too, you brought up a really good point that maybe people do understand or don't, but how many drugs are really used off-label anyways in so many experimental, right? They're not intended for, say, oncology, but they're being used. Or they're not intended. Well, oncology is probably the biggest area, right? But it's like how many drugs, you know, your last-ditch effort that you're looking for some kind of remedy that they're trying. So a lot of them, right? Anybody listening or, you know, you go for treatment, they'll say, hey, it's usually used for this, but we're going to use it for this. And it's a doctor prescribing it.
Rosemarie - 00:32:28:
Yeah, and like there's two, well, look at GLP-1s. Like they were originally approved for diabetes. It wasn't weight loss, but oh my gosh, while we're already clinical trials, these people are losing 15, 20% of their body weight. So, i.e., then they push the FDA and get the approval for that. I'll give you an example of something in the compound world that we use that is a game changer for patients. It's something called Low Dose Naltrexone. Now, Naltrexone is a drug that was used to reverse narcotic overdoses and help with addiction potential in terms of alcohol at like 100, 200, 300 milligrams. What we've learned at really low doses, like between three to five milligrams, it actually is a powerful, powerful anti-inflammatory that works for all type of inflammation conditions. And I didn't say it. Inflammation is the driver of disease. Autoimmune conditions, chronic gastrointestinal things, that is a great example of something used off-label. But I mean, I've probably got 10,000 patients that take that with great success. So if we weren't using these things off-label, patients wouldn't have access to the things that they need.
Steven - 00:33:27:
Yeah. Well, and you brought up all great things like the microdosing. So with supplements, whether it's microdosing, taking a tablet, injection, which is microdosing, I guess, what would you say the bottom line for people to take away with when they're thinking about delivery method of any supplement? And then we'll move on to peptides. Is there anything that they need to think of? What's right for them? How do you direct people through that process?
Rosemarie - 00:33:55:
Yeah. So, I mean, a lot of times when we look at what supplements and things that are needed, I mean, you really got to take a complete picture of the patient. And that's a little bit of a challenge nowadays. A lot of people try to do a lot of this on their own and figure it out. So I would say, you know, you really want to try to work with a practitioner. It could be your local pharmacy. I mean, for that matters, there's a lot of pharmacists like myself that are trained in this. Go in and ask. That's the part that like me as a pharmacist, I'll be a little braggadocious. We are the only healthcare professional. You can walk in, you don't need an appointment. You can walk up the counter and say, hey, can I get a pharmacist to help me with that? Try to walk into your doctor's office or your physical therapist, or, I mean, it just doesn't happen that way. That's what makes pharmacy unique. So I'm here to preserve my profession. But with that said, I mean, like I'll give you an example. Like there's a lot of just not quality made supplements, but if somebody has got gastrointestinal issues, you have to keep in mind that, hey, maybe it's best if we don't give them a supplement in a capsule or a tablet, especially tablets, because those are even harder to dissolve. Because the first thing that has to happen for that supplement to work, it has to get in your gastrointestinal track and be absorbed. But let's say you've got, I mean, who doesn't have GI issues out there nowadays, right? So you take some kind of product in your gut and it doesn't dissolve and it doesn't work well. Then you might as well just take that bottle, take that pill out, throw it in your trash, put the lid back on because that's kind of what you're doing. I hate to say it. So we've got to look at things like that. Sometimes using powder forms of supplements is a good choice just because we avoid that product where it has to break down and dissolve. Sometimes, like some of your B vitamins, as we get older, we don't absorb them as well. Going sublingual, using a sublingual route for vitamin D. I see so many patients low in vitamin D and they take crazy doses, but they don't get the blood levels because they got poor gut health. And so doing sublingual. So it's really kind of looking at the individual. It goes back to that personalized approach, looking at the individual and try to find a way that they can get the supplements, taking a good quality supplement, taking the right dose, doing your monitoring because like he said, taking the wrong supplements and the wrong quantities and the wrong amounts has consequences too. So you really can't ignore that either.
Steven - 00:35:54:
Yeah. Well, and then you brought up a lot of really good points. And I'm going to ask one question before we go into peptides, because I know a lot of people are very interested in peptides right now. The green powders, you know, the green ORAC powders and things, I actually been taking that for probably since early 2000. And I know a lot of people, that was introduced to me very long time ago. But I just saw something and it was really interesting. I'm like, wow, I never thought of that. There's so many great green powders on the market, right? I guess they're, I don't know. I've been taking them, whether they're great. Maybe I should watch what I say. I don't know if they're great, but they're from very reputable, like there's from pretty, you'll, you see them a lot, right? You'll see like the brands, again, don't want to mention any names, but it got me thinking, you see these, these green superfood powders and you'll see like literally like hundreds of ingredients in the back, barley, you know, wheatgrass, blah, blah. I mean, all kinds of things. And then, and then I was watching someone and I thought, I was like, well, that's true. Are we even able to absorb all these things? Like you brought up gut health and these green powders. Again, if you're taking them and you're getting good results, I'm just curious, like as somebody who invests, like these are expensive. I'm thinking, well, maybe this isn't. Is this even worth it? I use that to down my other, you know, my other supplements. I'll chase it with some green powder. What are your thoughts on that?
Rosemarie - 00:37:26:
What if I told you as a pharmacist, I kind of have the exact same question. I think if it's a quality product, it's organic, it doesn't have a lot of pesticides, it's tested for heavy metals and stuff. I don't think it's a bad thing because unfortunately, just most people aren't eating their fruits and vegetables. And that's the whole point of eating a plant-based diet. And once again, that's another discussion for another day. I think fruits and vegetables are key because they have many phytonutrients that feed our gut bacteria that promote good, healthy metabolism in your mitochondria. All of those type things. So I think there's a place for them, especially if you're not eating your fruits and vegetables, like no doubt about it. My thing is when you see these and there's a plethora of them, there's two things that I think is important. One is as long as it's a good quality product, I think there's a lot of antioxidants in there. I think they provide a lot of benefit because I'll tell you, we do a lot of cellular nutrient testing of patients. And some of the best cellular nutrient results that I get that's looking at the intracellular amount of vitamins and minerals are patients who are taking these products. So I will say. I think there's value in that. The problem is you can't turn it on the back and say this has this much vitamin C or vitamin E or magnesium, calcium. So that's my only challenge. You really don't know what you're getting. You want a quality product. My other concern is, and I heard you mention juicing, which kind of makes me cringe a little, not in a bad sense. I'm not against it, but I am. You want to be careful because we want to make sure the carbohydrate load of some of these products I've seen gets a little high. To me, if you're going to. Grind and grind up like vegetables, lettuces and kales and Brussels sprouts or whatever you're going to type vegetables. I don't have a problem. There's not much of a glycemic issue there. The problem is, is that some of these things you've got blended up fruits and no offense, like I am all for fruits, especially if you're active and that kind of stuff. But if you, if you blend up your fruit, you take a fruit, in my opinion, that is lower glycemic, like an Apple or something like that, and you blend it, it makes it super high glycemic. It almost turns it into candy, which you're going to get a blood sugar spike. And that's my only kind of fear about that. So as long as it, it's a good quality product, very pure and doesn't have a big carbohydrate load to it. I think those products really as an add on, why not?
Steven - 00:39:32:
Thanks. It makes me feel good. Because like you, it's like all balance. It's everything, right? It's like, you want to do this, a smoothie, a juice, but you're also doing all these other things to keep your blood sugar stabilized. So, okay, good. Well, thank you for that. So, I'll continue my subscription to one of my many. But it's like, I feel good. So, there you go. Okay. So, peptides, because that's really why we're here. That's where I really want to get to. But, you know, but all this stuff, you know, clearly leads up to it. They're now having their moment, depending on where you get your health information, kind of where, you know, say the green powders were like in hormones 20 years ago. Now it's peptides. Can you talk a little bit about, again, they're every right. We're seeing them in lotions. We're seeing them in vitamins. You're seeing them in tablets. Can you talk about exactly what they are, how the who, what, why, and all that good stuff as well and aging and when you should take them? I know that's a loaded, but I'm going to give you the floor.
Rosemarie - 00:40:34:
Yeah, I'll try my best. That's a loaded topic right now. And especially for me as a compounding pharmacy, I don't compound with any. The FDA is very strict about that, even though there are compounders out there doing them. But let's kind of keep it simple. So all a peptide is, it's a certain group of amino acids. So if you look at protein, it's made up of amino acids. That's the building block. Well, peptides are just a shortened fraction of a longer group of amino acids, as far as that goes. Keep in mind, peptides aren't new. Insulin's a peptide. Some of glutide's a peptide. These are all peptides. And so it's one of those type things. It's not like they're something new that we haven't ever seen. Even something like glutathione, which is a very simple molecule, it is a sequence of amino acids. That's all it is. So peptides aren't new. I think the body, I heard, I think I was listening to a podcast the other day. The body has maybe 100 to 300,000 different peptides that it makes. And these are signalers. They cut on and cut off pathways. Think of it like the light switch or the doorbell. It's like a flip. And a lot of times these peptides get cleared really quick. So you put them in and they do their thing. And then they go away. The problem or the good thing is, is that with a lot of this stuff, there's not much regulation in this world. I think people or practitioners like myself that know about peptides, I've recommended some. You can go online now and order like BPC-157 in an over-the-counter product. We already talked about supplements and how, I don't know how much regulation there are on some of those. Now imagine going and picking a peptide, something that the body makes and just starting to use it. What does it do? How does it work? Because. These peptides affect a lot of things. And what I've learned about the peptides, and I've been to some modules and been educated on them. It isn't so much the one, it's very important, the peptide you pick, but it's very important the dose you take. It's very important the way it's given. It's very important the regimen. Some of these ones that are used, i.e. One of the, like one of the big things is how do I increase my growth hormone? So there's several of these peptides that are really good in terms of helping with growth hormone. But I've also learned though, is that if you overuse them and don't dose them right, it can have a negative effect. So we have to be super careful. I think. I think peptides have a place and I think they're going to become more and more popular. The problem is there's just not much regulation. Some of the anti-aging functional medicine groups I do, they'll do a whole weekend on peptides, how to use them, how to dose them, how to monitor. And I think it's great. The problem is many of my doctor friends, they don't have places to go order these because what happens is you'll have a compounding pharmacy pop up selling all these peptides. And then what happens is, is the FDA goes in and says, hey, because technically speaking, we cannot compound with peptides. It's not allowed. Okay, pharmacies are doing it. So then all of a sudden some pharmacy gets into it. But I'm hoping they're sourcing them from good places because like keep in mind, everything that I use as a compounder, I have to get the raw ingredient in or what's called an API, active pharmaceutical ingredient. I get it in and that's what I use to compound. All of those, I've got to vet to make sure they're quality because whether you want stuff made in the USA or not, like 99.9% of all the stuff that we actually maybe use to make stuff here, it comes from companies overseas. And a lot of these are FDA registered chemical suppliers, but there's a lot of loopholes in that too. And with all that said. So if I'm making a peptide in a compound, which I don't. I've got to make sure that's a quality product because I want to make sure if I say it's, this is what it is, that's what it is. But there's not really good vetting of sources for some of the peptides. I think that's a challenge. And the FDA, a lot of times that these pharmacies get popular, they get big, they start advertising, hey, we do peptides, send us, you know, send your prescriptions to me. Next thing you know, FDA comes in and says, hey, you can't be doing that. It gets shut down. And then somebody else pops up and does it. So I'm seeing this happen. I think the good thing is I think there's some change right now to say, hey, maybe we should look at peptides because they are very powerful. I mean, in terms of healing the gut, healing torn muscles and ligaments, sleep, hormone regulation, growth hormone regulation, skin effects, like you said, the derm type part, what they do, fixing gut issues. There are so many things these peptide do. They are powerful. They do magical things, but they have to be done right. The problem right now is just trying to find quality sourcing because like even myself, I had like a L. Lobo issue the other day. And I'm like, man, I keep hearing about and I personally have never done a peptide, but I'm like, I want to get some of this BPC-157 because I hear how great it is. I ordered it offline through one of our supplement vendors. And needless to say, it's still sitting on my desk at the pharmacy. And I haven't quite opened it because I'm like, well, I got better and I don't really know if I want to take it. But some of the stories that I hear about how well these work is quite amazing. And I do think we're going to see more and more stuff about peptides. And I hope that answers your question. As far as what they do, but they are powerful. And I think a lot more practitioners are getting open to trying them. And the results that I hear patients in a number of ways talking about is quite amazing.
Steven - 00:45:24:
Well, yeah. And so before, because I have a few more questions before we start wrapping, but I know a lot of healthcare providers, doctors, allied health professionals that are taking peptides and getting really good results. Now, they are seeing it, they are getting them from a doctor, right? So, and this is also good, you know, when you say talking, working with your pharmacist and your doctor, like you got to be upfront, like all the other things that you might be taking for other things, whether you're on hormone replacement therapy, you know, you're on all these other things because midlife is such a beautiful place. We're just trying to fix all these things. We're trying to just live our best self. So we're just, you know, and I have, I just started taking them. I tell way too much personal information on this podcast, but I feel like I learned from other people who say that they do things. And these are conversations that a lot of us have in the OR, like, what are you doing? You haven't, how come you have so much energy at 6am all of a sudden? What's going on? You know? And so I think it's great. Like you talked about, there's a place. That's why I wanted people to know what they're for. There is a place as long as you get them from the appropriate provider and that, you know, they're coming from a reputable place. Well, and
Rosemarie - 00:46:36:
that's the key. Your provider may write you a prescription for one and know how to do them. I think it's, it's, it's your provider's due diligence. And especially you as the patient to make sure we are getting them from that, that pharmacy, because that's where it's from. Is a quality place. They're reputable. They have sourced those. They make sure they're what they're supposed to be. And there's that aspect of it. Because if not, then you run that risk of, yeah, you think you're doing yourself good, but you could, you may be doing more harm. I mean, as far as that goes, because unfortunately, just because something's out there that you can order doesn't always mean it's the best or what you should be doing. So just keep that in mind. That's the thing I would say.
Steven - 00:47:16:
Okay. I guess too, it's like we've learned from the past, right? And you can't blame doctors, right? Back in the seventies, I think, or wasn't there a time where they said smoking was healthy? It's like, what the heck? So it's like, that is crazy right now, knowing what we know, but it seems like now they just don't want to make these, even though a lot of doctors take this stuff themselves, they don't want to. It's like that, you know, you don't know, am I going to feed this? So I can see. I can see both sides of everything. But I guess as somebody who's trying, and a lot of people who are trying to be their best self, it's like, well, why can't I get this? I'm healthy. You know, why is this such a big deal? You know, I'm a healthy guy or a healthy woman. Like, why is, you know, all of a sudden, you know, why is this difficult or whatnot?
Rosemarie - 00:48:00:
So. No, like I said, I always tell people all the time, you drive your own healthcare bus. So the point is, you know, just realize you can do things that help, but you can do things that hurt. Just, you know, do your due diligence, do your education and make good decisions.
Steven - 00:48:13:
Okay. And then another question, age. Like when, again, I guess it's all relative to like. A safety issue with your doctor when people should start taking these things. And also, you have to really take them. Our body's not working the same in midlife. So a lot of these drugs you have to continually be taking. I think that's like another point too.
Rosemarie - 00:48:33:
Yeah, I mean, I get that question a lot about hormone replacement. I got a lot of ladies in their 50s. 48 and that time where the hormones began to fluctuate, like what can I naturally do to increase my estrogen? What can I naturally do to increase my progesterone? What can I naturally do to increase my testosterone? I hate to say that's part of the problem. That is the problem with aging is you just get where the glands that normally make those, that signaling between the brain and your reproductive system just doesn't work. And you can set your body up to make hormones. You can give it all the building blocks. You can do all those things, but unfortunately, they're just not gonna make them anymore. So at that point, hormone replacement's the only really route you have. And I can tell you like, that's one thing I feel like I do know a lot about, and that is hormone replacement therapy. If it's done right, monitored properly, dosed appropriately. There is way, way, way more benefit than risk. Like no doubt about it. I don't even have to, like, that's a non-subject. I even heard a lecturer say the other day when it comes to women and hormones, and I really liked this. In the health field, we have something called informed consent. Like I need to give you this information and you make a decision. I almost felt, she made a comment was like, and I have to give her credit because this wasn't my idea. She's like, when it comes to hormones, it's almost like we need to give patients informed refusal. Like, hey, if you don't take these, these are the things that are going to go wrong. Now you can say you don't want them and go, don't get me wrong. There are reasons, cancers and different things, genetics, maybe why people don't want to do hormones, but it's almost like you really need to look at this. The problem is I don't think many practitioners give that as an option to patients because they just don't know how to do them, how to monitor them. It takes time, it's personalization. And I think that scares away a lot of providers, but I don't, once again, these things as we get older, yes, that is part of aging, but there are so many things we can do to support that, replace them, you know, with hormone replacement, we're putting back the exact same hormone, the body made. It's not like we're giving it something foreign. You know, the hormone replacement products that we compound, if you take the estrogen out of your body and put that, you know, that's exactly the same molecule. There's no difference. So as long as it's put back properly and dosed right, you're going to get all those benefits, you know? So that's kind of how I see it, so.
Steven - 00:50:42:
Without violating anybody's privacy, is there any instance that somebody came into your, is there just a brief, just example of somebody that came into your pharmacy, pretty frustrated, not feeling their best self where, you know, you've helped them reach a more optimal. You know, an optimal level of themselves.
Rosemarie - 00:51:05:
Yeah, I mean, I offer, I've been doing consults for 15 years. And I would just say that that's the common story. You know, they've done been to the GP, the endocrinologist, the, you know, you name it, the rheumatoid doctor, this doctor, that doctor, they didn't been to all these practitioners. And I'm not here to knock them, but so much medicine is taught in silos. And it's like, if this is the one thing I treat, I don't look at everything. But if you don't look at that total patient, and that goes back to that triad, like you mentioned when we started, it's looking at all of that and what the patients do. And I see that a lot. They're on this med caused these two side effects. So now they're on four. And then those four medicine caused those side effects and nutrient depletions. And now they're taking seven and then they take a supplement. And so, yeah, I mean, it's really looking at that patient history, trying to figure out the triggers. But yeah, that happens so, so much. And it's really sad because, you know, patients just want to feel better. They don't want to feel lousy. And then aging doesn't make it any easier. And that's the part is just where the healthcare system is really broken. And I do feel for patients all the time.
Steven - 00:52:05:
Yeah. Okay. And what are you most excited about? And is there any, like when it comes to health and wellness, is there something that you are excited about? And is there something today that we did not? Cover that was worth mentioning. And maybe what's in your medicine cabinet? Is there something that you have a non-negotiable?
Rosemarie - 00:52:24:
That's funny. I think what's happening now is, and good and bad, because we've talked about this, but I think the volume of quality information out there explodes exponentially. I mean, that's one of the reasons why you're doing what you're doing. That's why I've started my own podcast is because, unfortunately, I'm in a little town in Magnolia, Texas, and my patients love us, and they come in. I've got great pharmacists and great staff, but I'm only accessible to that small community. It's like, hey, why don't we take some of this outside the four walls of Magnolia pharmacy and try to educate the public? Because, I mean, really, that's what we all got into healthcare for was to help patients. I'm most excited about is the volume of information that's coming out, quality information. There's so many good, high-quality doctors, practitioners that are doing this type of stuff to educate their patients to have better health. To me, that's what's exciting. It's really cool because I think the balance is going online and Googling or ChatGPT and whatever you want to do to find out the answers. But then it's one thing to get the answer. And how does it apply to me? Because I'm unique. I have my own set of circumstances. And I think that's the crossroads of this whole AI Revolution and healthcare. It's going to take this. And when we figure that out, that's when patients are going to start to get better. And that's the part I'm excited about as far as that goes. My one negotiable that's in my medicine stack that I would say is a must, I am a believer in, and this is my mentor taught me this years ago, is ultra pure, high quality omega-3. Like, I mean, I take about 15 supplements, but that's the one. It's like, if there's any one supplement, I think that's got the biggest bang for the buck. Granted, don't get me wrong. Cheap fish oil is there. Don't take it. High quality fish oil, there's too many benefits, but that's the one negotiable for me with the lifestyles we lead and inflammation as a driver. A high quality ultra pure omega-3 is the must that you must have for overall good health.
Steven - 00:54:12:
Thank you. And that's easy to get, right? You don't need a prescription for that. It's easy to obtain.
Rosemarie - 00:54:17:
Just get a quality product. That's what's key because keep in mind, a lot of those products, the way they're processed, it's not good. And you want a super pure, very fresh, non-rancid product because you want to, that's why I said, if you're going to get cheap fish oil, just don't take any fish oil at all. Yeah.
Steven - 00:54:31:
Well, there you have it. And how can people find you?
Rosemarie - 00:54:34:
Oh, awesome. Yeah. So probably the easiest place is you can go to our website at magnoliapharmacy.com. If you want more health information, if you enjoyed today's podcast, you'd like this type of stuff. I've got a new podcast out called The Trusted Pharmacist. You can find it on all the things like Spotify and Apple and YouTube. But I mean, we're here to serve and help. That's why I got into this and super excited. Being able, my social media has grown over the last year, just getting to interact with patients from all over the world and be able to help and provide answers. It's such an awesome thing. So yeah, we encourage that interaction. That's for sure.
Steven - 00:55:05:
Great. Well, thank you so much. I know I'll be listening and I'm still going to be following you and maybe I will be actually catching up with you again for more because clearly there's a lot to talk about. But for now, that is a wrap for today's episode of Second Opinion. A huge thanks to Dr. Steven Hoffart for breaking down the science of cell health, supplements, and peptides in a way that's practical, empowering, and grounded in real life care. If this conversation got you thinking differently about your health or even inspired you to ask your provider a new question, don't forget to subscribe, rate, and leave a review. It helps others find the show. And if you have a topic you'd love for us to explore, drop us a note. We're always looking for new ideas. Until next time, I'm Rosemarie reminding you to take care of yourselves, your curiosity, and most of all, yourself. And remember, always get a Second Opinion.