Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / What's the deal with stem cell therapy?

Transcript

What's the deal with stem cell therapy? · Wellness, Actually with Emily Oster & Perry Wilson, MD

0:01
Speaker 1: Emily, I, like, I think all medical doctors am a
0:05
Speaker 1: completely horrible patient. I am pretty sure I've had a
0:11
Speaker 1: rotator cuff tear for like eight months and I've done
0:14
Speaker 1: absolutely nothing about it.
0:16
Speaker 2: Okay, I am sorry, we need to say more. So
0:19
Speaker 2: what were you doing? Were you doing something that men
0:21
Speaker 2: in their forty should not be doing? Like sports?
0:24
Speaker 1: Yep, yep. I was trying to get active and healthy,
0:27
Speaker 1: and I was lifting weights. I was bench pressing, and
0:31
Speaker 1: I was, you know, bulking up.
0:33
Speaker 2: Wait, no, for reals, you were you were bench pressing?
0:35
Speaker 1: Yeah, yeah, absolutely, but don't worry. I'd taken my creatine
0:39
Speaker 1: future fined foreshadowing. I'd taken my creatine and I was
0:46
Speaker 1: adding weight and something happened and now I can't lift
0:52
Speaker 1: my left arm above my head. And okay, that's fine.
0:56
Speaker 1: These things happen.
0:57
Speaker 2: That's not fine.
0:58
Speaker 1: But okay, I'm just sitting here realizing, because it's getting
1:01
Speaker 1: into golf season, I need to swing a golf club again,
1:04
Speaker 1: and it hurts, And I'm like, you know, I probably
1:06
Speaker 1: should have seen a doctor about this.
1:08
Speaker 2: And what are you planning to do about it? Which will?
1:11
Speaker 2: Have you been watching wellness influencers because they must have ideas.
1:14
Speaker 1: They have lots of ideas, and I think we're going
1:15
Speaker 1: to talk about one of those ideas today because we're
1:18
Speaker 1: talking about stem cell therapy. But you know what, I'm
1:21
Speaker 1: actually going to do nothing. That's correct, I'm going to
1:25
Speaker 1: do nothing.
1:26
Speaker 2: I have a suggestion for you actually, as a person
1:29
Speaker 2: who has recently injured their hamstring, I have been getting
1:32
Speaker 2: a thing called shockwave therapy, where someone puts a shocker
1:37
Speaker 2: on your injured part and the placebo effect makes it better.
1:43
Speaker 2: And I would really really recommend it.
1:47
Speaker 1: I'm a huge fan of the placebo effect.
1:49
Speaker 2: The placebo effect is great, but how much does it cost?
1:51
Speaker 1: That's the question.
1:51
Speaker 2: Well, okay, it's about seventy five dollars for each placebo effect,
1:55
Speaker 2: and you need like four of them for the placibo
1:56
Speaker 2: effect to really get going, so it's not free. But
2:01
Speaker 2: I have been running totally fine since the placebo effect
2:04
Speaker 2: is kicked in.
2:04
Speaker 1: I'm probably going to do nothing.
2:09
Speaker 2: I'm Emily Aster, I'm an economist and a data expert.
2:12
Speaker 1: And I'm Harry Wilson. I'm a medical doctor.
2:14
Speaker 2: It's Thursday, March twenty sixth, twenty twenty six, and this
2:18
Speaker 2: is wellness.
2:19
Speaker 1: Actually, because you're getting a staggering amount of health and
2:23
Speaker 1: wellness information nowadays from every source imaginable, and some of
2:27
Speaker 1: it is awesome and.
2:28
Speaker 2: Some of it is well actually both Fortunately we're both
2:34
Speaker 2: people who know how to read studies, how to parse
2:36
Speaker 2: the data, and can tell you what's worth thinking about
2:39
Speaker 2: and what you can safely ignore.
2:41
Speaker 1: But before we dig in, a note that this podcast
2:43
Speaker 1: is for educational purposes and should not be construed as
2:46
Speaker 1: medical advice. We don't know your unique situation, so talk
2:49
Speaker 1: to your doctor for personal health decisions.
2:52
Speaker 2: This week, we're asking what's the deal with stem cell therapy.
2:57
Speaker 2: Harry and I will give the official smash or pass,
2:59
Speaker 2: and then we'll get to your question of the week.
3:01
Speaker 2: But first let's do the health news roundup. After the break.
3:19
Speaker 1: And we are back with the health news of the week. Emily,
3:23
Speaker 1: there's a new Netflix series that's coming out that is
3:27
Speaker 1: talking all about lead poisoning, something we probably don't talk
3:30
Speaker 1: about enough. Have you seen this?
3:33
Speaker 2: I haven't seen it. I was watching the Netflix documentary
3:35
Speaker 2: on microplastics, but this is next on my list of
3:38
Speaker 2: things to be afraid of from Netflix. I think this
3:42
Speaker 2: documentary is about lead poisoning in the nineteen seventies in Poland.
3:47
Speaker 2: And I think it's really interesting in part because in
3:50
Speaker 2: the current moment, I get enormous number of questions from
3:52
Speaker 2: people about lead, because we are constantly seeing these headlines
3:57
Speaker 2: that are like, there's lead in your baby food, there's
3:59
Speaker 2: lead and you're you know, or a ring, there's lead
4:02
Speaker 2: in this and that. And what's so interesting is that
4:05
Speaker 2: the current levels of lead exposure that like our kids
4:09
Speaker 2: have are so so much lower than the levels of
4:13
Speaker 2: exposure that we had, right yeah.
4:15
Speaker 1: Yeah, like literally you and me, our generation. The main
4:21
Speaker 1: source of lead in the United States used to be
4:23
Speaker 1: inhalation from leaded gasoline, and the use of leaded gasoline
4:29
Speaker 1: peaked in the late nineteen seventies, just like when we
4:33
Speaker 1: were getting born, leading our generation to have the highest
4:36
Speaker 1: levels of blood lead. In fact, there's an interesting study
4:39
Speaker 1: the threshold for blood lead and babies everyone gets checked
4:42
Speaker 1: is five what are the units nanograms, lead, micrograms, permil leader.
4:47
Speaker 2: Five lad points, five lead points, farge blood.
4:50
Speaker 1: Points my units and they there's a study that looked
4:53
Speaker 1: at the percentage of kids who like have levels below that,
4:57
Speaker 1: like the kids who were good they're good lead levels
4:59
Speaker 1: And you see the graph from like the nineteen fifties
5:02
Speaker 1: and it's like forty or fifty percent have good and
5:04
Speaker 1: then it goes through us and it's zero, literally zero
5:08
Speaker 1: from like nineteen seventy five to nineteen eighty five. And
5:10
Speaker 1: now it's back up. I mean still not one hundred
5:12
Speaker 1: percent obviously, but it's we definitely got hit hard.
5:15
Speaker 2: Yeah, but I think it is worth remembering. So this,
5:18
Speaker 2: this documentary I suspect is quite scary. And it certainly
5:21
Speaker 2: is true that high levels of lead exposure like these
5:23
Speaker 2: kids had in the Poland in the nineteen seventies, and
5:26
Speaker 2: for example, like kids were exposed to in flint when
5:29
Speaker 2: there was lead in the water, that can be very dangerous.
5:31
Speaker 2: But actually some lead exposure is okay, Like a small amount.
5:36
Speaker 2: Your kid's body can process that. And so you know,
5:38
Speaker 2: it's one of these things where you want to hold like, actually,
5:40
Speaker 2: things are so much better than they once were, even though,
5:44
Speaker 2: of course lead is not good for your cognitive performance,
5:48
Speaker 2: and we can test that's why, you know, think about
5:51
Speaker 2: how much more successful we would have been. Oh well,
5:54
Speaker 2: one can only imagine better luck next time. All right,
5:58
Speaker 2: let's talk about stress and and cancer. So a lot
6:01
Speaker 2: of people think that stress causes cancer, but maybe no,
6:07
Speaker 2: say more.
6:07
Speaker 1: Yeah, really interesting new study came out and you're right.
6:11
Speaker 1: Surveys suggest that fifty percent of the public believe that
6:14
Speaker 1: stress is a cancer risk factor, right, Like chronically stressed
6:18
Speaker 1: doctors think this as well. I will tell you I
6:20
Speaker 1: have conversations. We all have stories of like the guy
6:24
Speaker 1: you know who went through a messy divorce and then
6:26
Speaker 1: like a few years later he has cancer, or you
6:29
Speaker 1: know the like stressed out woman who gets a varying
6:31
Speaker 1: cancer at a young age. Like, we construct these narratives
6:35
Speaker 1: and it's definitely in there. But a new study says, nope,
6:38
Speaker 1: not really. This is a study that was a meta analysis,
6:43
Speaker 1: but an individual data meta analysis. So they had individual
6:46
Speaker 1: level data on four hundred and twenty two thousand people
6:48
Speaker 1: of whom like thirty five thousand ended up developing cancer,
6:51
Speaker 1: and they had psychosocial markers on all of them including
6:54
Speaker 1: chronic stress, neuroticism, death of a loved one in the
6:58
Speaker 1: past year, like iety of stressors, divorce, relationship status, and
7:04
Speaker 1: overall there was no link between those things and cancer
7:09
Speaker 1: provided you accounted for age, which is like a real
7:12
Speaker 1: clue here, Like the thing is the biggest risk factor
7:15
Speaker 1: for cancer is age. That's it's not a modifiable risk factor,
7:19
Speaker 1: but it is the largest risk factor. And all the
7:21
Speaker 1: like crappy stuff that happens to us in life like
7:23
Speaker 1: tends to happen more as we get older, we get divorced,
7:26
Speaker 1: we lose loved ones, like all those stresses kind of
7:29
Speaker 1: add up, and so of course we think that it's
7:31
Speaker 1: the stress that led to the cancer. But the truth is,
7:33
Speaker 1: it's just like getting older is stressful, and also getting
7:36
Speaker 1: older leads to cancer. There was one exception, which is
7:40
Speaker 1: that relationship status and loss of a loved one did
7:42
Speaker 1: seem to increase the risk of future lung and smoking
7:46
Speaker 1: related cancers, but once they adjust for smoking status, that
7:52
Speaker 1: basically went away. So it's not that the stress causes
7:55
Speaker 1: the cancer, but stress might lead you to behaviors like
7:57
Speaker 1: smoking or drinking that actually do cause cancer. So I
8:00
Speaker 1: mean there's a way to get from stress to cancer.
8:02
Speaker 1: But it's not just like people will say, like, oh,
8:04
Speaker 1: your cortisol levels are high, and.
8:06
Speaker 2: Your cortisol levels the discussion we need to do a
8:10
Speaker 2: whole thing on cortosol because think there's so much in
8:12
Speaker 2: this sort of like keep your cortosol down like, when
8:14
Speaker 2: you wake up in the morning your cortosol's high. You
8:16
Speaker 2: need to stand outside on your bare feet to lower
8:18
Speaker 2: your cortosol.
8:19
Speaker 1: So it's not the cortisolt, it's the Smoking's not don't smoke.
8:22
Speaker 2: Yeah, it's not the cortasoul. It's the smoking. That's like
8:24
Speaker 2: a that's a good takeaway from this entire podcast. Keep
8:28
Speaker 2: it in mind.
8:29
Speaker 1: A bit of good news here that I saw that
8:33
Speaker 1: I thought you would like. Emily, the large insurance company
8:37
Speaker 1: United Healthcare is starting to cover doulas for births. It's
8:44
Speaker 1: rare that we get to see an insurance company doing
8:47
Speaker 1: something that seems to benefit their members, but here we are.
8:50
Speaker 2: What do you think I was so excited about this,
8:54
Speaker 2: Perry so as background, I am like an enormous doula proponent.
9:00
Speaker 2: It is something that I think everybody should have in
9:04
Speaker 2: their birth. We have a ton of data suggesting that
9:08
Speaker 2: doulas are beneficial for all kinds of birth outcomes, lowering
9:13
Speaker 2: c section rates, improving people's experience of birth. They can
9:17
Speaker 2: be helpful even if you are having a sea section.
9:19
Speaker 2: Like duelers are just totally great, and not everybody has
9:24
Speaker 2: them because they cost money and so seeing insurers start
9:28
Speaker 2: to cover these is totally awesome. This United move follows
9:32
Speaker 2: on actually a number of state medicaid programs starting to
9:35
Speaker 2: cover doulas as part of Medicaid, which is even better
9:40
Speaker 2: because it's reaching those vulnerable people. So that is totally great.
9:43
Speaker 2: I will say that you teed this up as like,
9:47
Speaker 2: isn't it great that this company is doing something nice
9:50
Speaker 2: for their members? This is something nice for their members. However,
9:54
Speaker 2: the reason they are doing this is because dulas pay
9:56
Speaker 2: for themselves because actually the reduction in say ce section
10:01
Speaker 2: rates or use of other interventions actually makes the berth cheaper,
10:06
Speaker 2: and so duelos are not that expensive. If you pay
10:08
Speaker 2: for a doula and then you have a reduction in
10:11
Speaker 2: the c section rate, you pay much less on net
10:14
Speaker 2: because people have to say ce sections are expensives, more
10:17
Speaker 2: time in the hospital and so on. So actually this
10:19
Speaker 2: is just insurance companies saving themselves money. But since it's
10:24
Speaker 2: good for people, I'm still a fan, all right, so.
10:26
Speaker 1: Win when but United Healthcare compliment withdrawn officially.
10:31
Speaker 2: Well compliment, thank you for seeing that.
10:34
Speaker 1: Yes, okay, compliments, the bottom line sometimes aligns. That's it
10:41
Speaker 1: for the health news of the week after the break,
10:45
Speaker 1: what's the deal with stem cells?
10:52
Speaker 2: All right, Perry? So stem cells. I was really excited
10:55
Speaker 2: to learn about this. Actually, unlike some of the stuff
10:57
Speaker 2: we talk about, this is something that I didn't know
10:59
Speaker 2: that much about coming into and then I found an
11:02
Speaker 2: amazing clip on Instagram that told me everything I needed
11:05
Speaker 2: to know. And so we're just going to listen to
11:07
Speaker 2: it and then we'll be able to stop the episode early.
11:11
Speaker 1: Okay, hitting play injuries.
11:13
Speaker 3: Anti aging stem cells might be the closest thing we
11:16
Speaker 3: have to the fountain of youth. Why is this because
11:18
Speaker 3: stem cells are very very special cells. They're called plury
11:22
Speaker 3: potent cells, which means they have the ability to morph
11:25
Speaker 3: into any other type of cells. It's not your baby
11:28
Speaker 3: that doesn't know what it wants to be. When it
11:30
Speaker 3: grows up. You put it in the proximity of other
11:32
Speaker 3: tissue and it decides to become that tissue.
11:34
Speaker 1: Stems are the future, guys.
11:36
Speaker 3: Lots of good anti aging functional medicine practitioners are skilled
11:40
Speaker 3: using these and topical applications to rate you are improve
11:44
Speaker 3: fine lines and wrinkles, thick in the skin, improve collagen,
11:46
Speaker 3: elastin and fibrine, and even reduce joint pain. And discomfort
11:50
Speaker 3: and accelerate. So real one of those people walking around
11:53
Speaker 3: with knee, hip, shoulder rotator cuff or ankle pay rotator
11:57
Speaker 3: thinking about surgery or it's become chronic. Talk to your
11:59
Speaker 3: phoneunctional medicine practitioner about the using the stem cells to
12:03
Speaker 3: accelerate your rate of healing.
12:07
Speaker 2: So are we done? It's kind of like you weren't
12:10
Speaker 2: totally sold on all of them. I did hear a
12:13
Speaker 2: thing about the rotator cuff. I was like, we're going
12:15
Speaker 2: to fix that.
12:16
Speaker 1: So you know, in our prior episodes, when I looked
12:19
Speaker 1: through Instagram, I will say there was often a nice mix,
12:23
Speaker 1: like when we talked about peptides. Yes, there were people
12:25
Speaker 1: who were like this is a miracle, but then there
12:27
Speaker 1: are these people that were like, oh no, be careful
12:30
Speaker 1: and they can be contaminated and you don't know where
12:31
Speaker 1: they're coming from. And it was like there was some balance,
12:34
Speaker 1: even if it was inappropriate balance. As I was looking
12:37
Speaker 1: through this regenerative medicine stem cell space, I've never seen
12:40
Speaker 1: it be more wrong. Like everyone is on the side
12:44
Speaker 1: of like this is the miracle, this is the fountain
12:46
Speaker 1: of youth, and there's almost no one sitting on the
12:49
Speaker 1: other side, and when you actually look into the data
12:53
Speaker 1: as we're going to talk about, it's like there's almost
12:57
Speaker 1: nothing there. So I'm excited. I'm like, I'm a little
13:01
Speaker 1: I'm a little piled up. I am amped up about
13:03
Speaker 1: this because there's a lot of a lot of misinformation
13:05
Speaker 1: out there.
13:06
Speaker 2: Okay, So I want to start with it not misinformation,
13:09
Speaker 2: because I think often in these spaces, like it's not
13:13
Speaker 2: that you don't go immediately to vampire or facial. You
13:16
Speaker 2: start with something real. A stem cell is a a
13:22
Speaker 2: cell that has some flexibility relative to other cells. Okay,
13:26
Speaker 2: So when we talk about stem cells, you want to
13:28
Speaker 2: think about that's the stem and then it can branch out.
13:30
Speaker 2: That's why it's it's stem. It's a stem to branch
13:33
Speaker 2: into multiple different kinds of cells like a plant. Yes,
13:37
Speaker 2: and there are medical uses for stem cells. Yes, And
13:41
Speaker 2: so let's like sort of table stakes start there with
13:44
Speaker 2: like what it actually is the potential promise of stem
13:47
Speaker 2: cells in real medical applications.
13:50
Speaker 1: Yeah, I mean they can be miraculous in real medicine applications.
13:54
Speaker 1: But let me can I like walk you through one, Yeah,
13:57
Speaker 1: like sycle cell disease. Okay, Yeah, cell disease a genetic
14:01
Speaker 1: condition that is a genetic mutation hemoglobin, which is the
14:05
Speaker 1: protein in red blood cells that causes them to deform
14:08
Speaker 1: and sickle and get stuck in your blood cells, causing
14:11
Speaker 1: immense pain, clotting, and other problems. So very severe disease,
14:17
Speaker 1: generally untreatable until recently and thanks to stem cells. So
14:22
Speaker 1: what there are two FDA approved therapies for sickle cell
14:25
Speaker 1: disease that are curative now and they both come from
14:27
Speaker 1: stem cells. And here's how it works. If you're a
14:29
Speaker 1: sickle cell patient, you go in, you get your bone
14:32
Speaker 1: marrow harvested from your hip. That hurts a little bit.
14:35
Speaker 1: That bone marrow is taken to a lab. The cells
14:39
Speaker 1: are sorted based on what type of cells they are,
14:42
Speaker 1: based on molecular characteristics on their surface. So the stem
14:45
Speaker 1: cells are pulled out by like very fancy sorting machines
14:48
Speaker 1: that use all sorts of tags. Those cells are then cultured.
14:52
Speaker 1: They are grown up to be millions and millions of
14:55
Speaker 1: fold higher in number than they were. Those grown up
14:59
Speaker 1: cells then get gene edited, so the two different therapies.
15:03
Speaker 1: One uses a viral vector to insert a new hemoglobin
15:06
Speaker 1: gene into those cells. Like a functional hemoglobin gene. Very cool.
15:10
Speaker 1: The other uses crisper cast nine to edit a gene
15:13
Speaker 1: that leads to more fetal hemoglobin in the cell, which
15:16
Speaker 1: doesn't sickle. Either way, you have these non sickling cells.
15:19
Speaker 1: You're not done yet. You go back to the patient.
15:22
Speaker 1: You give the patient incredibly high dose chemotherapy to destroy
15:27
Speaker 1: all the other cells in their bone marrow. So they've
15:31
Speaker 1: got no now, no white blood cells, virtually real system,
15:34
Speaker 1: no immune system. They are in the hospital, in the hospital,
15:39
Speaker 1: very dangerous situation. Once the bone marrow is cleared out,
15:43
Speaker 1: you inject those grown up and gene edited stem cells.
15:46
Speaker 1: You cross your fingers and you hope they ingraft, and
15:49
Speaker 1: then they start to grow and divide and reconstitute the
15:52
Speaker 1: immune system, the red blood cells, the platelets, everything else
15:55
Speaker 1: you need. And if you make it through that, the
15:57
Speaker 1: patient no longer has sickle cell disease. It is amazing
16:02
Speaker 1: therapy and nothing at all like what people are getting
16:05
Speaker 1: in a regenerative medicine clinic. But it is a miracle.
16:10
Speaker 2: And the reason that this stem cell makes this possible
16:13
Speaker 2: is because these stem cells have the capacity to turn
16:17
Speaker 2: into many different kinds of cells.
16:19
Speaker 1: Correct many different but not all different, and that influencer
16:26
Speaker 1: up top use the term plury potent. You'll see that
16:28
Speaker 1: a lot online. There are very few plury potent stem cells.
16:31
Speaker 1: They live in embryos because they need to be able
16:33
Speaker 1: to turn like a cluster of cells into a human
16:36
Speaker 1: so they can turn into any type of cell. But
16:39
Speaker 1: the stem cells that are harvested from adults, even for
16:41
Speaker 1: bone marrow transplant and stuff like this, are called multipotent.
16:44
Speaker 1: They can turn into some cells, so bone marrow drive
16:46
Speaker 1: stem cells can turn into white cells and red cells
16:50
Speaker 1: and platelets, and that's about it. That's still cool. That's
16:53
Speaker 1: three different kinds of cells, but it's not every type
16:55
Speaker 1: of cell.
16:56
Speaker 2: And so the other thing that people will be familiar
16:59
Speaker 2: with I think before sort of in the real medicine
17:02
Speaker 2: space here is the discussion of embryonic stem cells. So
17:05
Speaker 2: an embryonic cell cell is truly pluripotent. It can from
17:09
Speaker 2: the beginning turned into any kind of cell. You start
17:12
Speaker 2: with two cells, four cells, eight cells, and that embryos
17:17
Speaker 2: can turn into anything. There is a lot of controversy
17:20
Speaker 2: which I just want to put aside around through the
17:22
Speaker 2: use of embryonic stem cells. But are there medical circumstances
17:26
Speaker 2: where embryonic stem cells are in fact used or is
17:30
Speaker 2: that still we're not quite there on making anything out
17:33
Speaker 2: of that.
17:34
Speaker 1: There's no approved uses for them. They are used for research,
17:39
Speaker 1: but that is actually quite restricted, at least in this
17:42
Speaker 1: country because of the potential ethical issues that you implied.
17:47
Speaker 1: So really you're not getting that. The real distinction of
17:50
Speaker 1: what kind of stem cells you get in medicine is
17:52
Speaker 1: whether they're your stem cells, which are called autologous stem cells,
17:55
Speaker 1: or someone else's, which are called allogenetic stem cells. So
17:58
Speaker 1: if you get a bone marrow transplant from someone else,
18:01
Speaker 1: a stranger, a relative, you can have someone else's stem
18:04
Speaker 1: cells in your body. But all of these are therapies,
18:06
Speaker 1: as I describe, which are like incredibly intense, you know,
18:10
Speaker 1: hospital level stuff and cost millions of dollars, right, okay.
18:15
Speaker 2: And part of the reason I think this is the
18:17
Speaker 2: sort of worth pausing on because I think it it
18:21
Speaker 2: will link back into why the things that are happening
18:25
Speaker 2: in these regenerative medicine clinics are such scammy disasters. If
18:30
Speaker 2: we think about you know, what's hard about that sickle
18:34
Speaker 2: cell case that you described, It is in part that
18:37
Speaker 2: when you harvest the stem cells from the bone marrow.
18:40
Speaker 2: Almost none of the cells are stem cells, right, You
18:43
Speaker 2: take a ton of cells, so many cells, and then
18:46
Speaker 2: you get like a tiny number of maybe like you know,
18:51
Speaker 2: out of an entire harvest, you like four or three,
18:55
Speaker 2: I mean, very small numbers of cells. And then you
18:58
Speaker 2: have to grow them. And that the sort of whole
19:00
Speaker 2: process there is you grow them and you multiply them
19:02
Speaker 2: and so on, and that is that takes a ton
19:04
Speaker 2: of time.
19:05
Speaker 1: Time, expense, effort.
19:07
Speaker 2: Yeah, but it's not like you just pick up a
19:09
Speaker 2: bunch of cells and you know ninety five percent of
19:11
Speaker 2: them or stem cells, and it's no problem to find exactly.
19:14
Speaker 1: So let's talk for a second about what happens in
19:16
Speaker 1: a regenerative medicine clinic that's advertising stem cell therapy. What
19:21
Speaker 1: they are not doing is harvesting your bone marrow and
19:23
Speaker 1: sending it to a lab and growing it up and
19:25
Speaker 1: gene editing it and stuff like that. Of course they're
19:28
Speaker 1: not because the FDA says that if you manipulate the
19:32
Speaker 1: cells of someone more than minimally, that it is not
19:36
Speaker 1: legal to administer it to them. Again, it then becomes
19:40
Speaker 1: a drug or a device or something that needs to
19:42
Speaker 1: be regulated, but it is not illegal to take someone's
19:45
Speaker 1: cells out of their body and really put them somewhere
19:48
Speaker 1: else in the body. You are allowed to do that.
19:50
Speaker 1: Hence vampire facials, okay.
19:52
Speaker 2: And also if fat grafting that's how you get like
19:54
Speaker 2: fat from your ass into your face.
19:56
Speaker 1: Absolutely absolutely, And I think FDA kind of appropriately is like, well,
20:00
Speaker 1: you know, it's your stuff, and like we're not going
20:03
Speaker 1: to regulate like whether you can take that or not,
20:06
Speaker 1: and that's probably fine. So in a stem cell clinic,
20:09
Speaker 1: what they do is they take out either some bone
20:13
Speaker 1: marrow from your hip, which hurts a little bit, but
20:15
Speaker 1: more often it's fat. They do a little liposuction, they
20:19
Speaker 1: get about like one hundred c sees of fat, and
20:21
Speaker 1: remember they can't do anything to it, so all they
20:25
Speaker 1: can do is they take that fat and they centrifuge
20:28
Speaker 1: it in the back room for about fifteen minutes or so,
20:31
Speaker 1: and they pipe that off, they suck off the top
20:33
Speaker 1: layer of cells, and then they inject that back into
20:37
Speaker 1: you and that's really all they can do. And you
20:39
Speaker 1: alluded to how inefficient this is in terms of in
20:44
Speaker 1: terms of harvesting, and I think the most damning paper
20:48
Speaker 1: on This was from Science Advances in twenty twenty four.
20:52
Speaker 1: So this was a research group that did this. They
20:54
Speaker 1: sucked out cells from people's fat. They sucked out bone marrow,
20:57
Speaker 1: and they spun them just like they do in the
20:59
Speaker 1: regenerative meta and clinics, and then they analyzed them to
21:02
Speaker 1: see how many stem cells were there to give you
21:04
Speaker 1: a sense for like those therapies we talked about, like
21:08
Speaker 1: for sickle cell and stuff, you want about one to
21:11
Speaker 1: two million cells per kilogram of body weight. That's the dose.
21:14
Speaker 1: So seventy five kilogram man, you're talking, you know, seventy
21:17
Speaker 1: five hundred million stem cells is what's necessary for treatment.
21:21
Speaker 1: In this study, when they sucked out the bone marrow sample,
21:23
Speaker 1: they found three stem cells, not three million, three three
21:27
Speaker 1: stem cells in fat. One point seven percent of the
21:32
Speaker 1: cells were stem cells. But they had concerned The researchers
21:37
Speaker 1: said that there were a lot of false positives because
21:39
Speaker 1: they they were very they didn't look similar to each other.
21:42
Speaker 1: There was a lot of differences, and when they did
21:45
Speaker 1: more advanced testing they found actually zero percent of the
21:49
Speaker 1: cells they found were stem cells when they came from fat.
21:54
Speaker 1: And so what we have in these regenerative medicine clinics
21:57
Speaker 1: is attaching a real scientific term to make something sound
22:02
Speaker 1: fancier than what it is. It's like, it's it's like
22:04
Speaker 1: if I invented like quantum cola, right, and I'm like,
22:09
Speaker 1: this is this cola is quantum somehow, Right, you just
22:12
Speaker 1: like slap stem cell on it for marketing purposes, but
22:17
Speaker 1: really you're just kind of sucking out fat and reinjecting
22:19
Speaker 1: fat somewhere else, or sucking out bone maron reinjecting it somewhere.
22:22
Speaker 2: Yeah, I mean, I think it's it's worse than the
22:25
Speaker 2: coal example, because at least you put a label on
22:27
Speaker 2: your cola. At least you're drinking a coke and like
22:30
Speaker 2: it's doing something. You're getting whatever you were hoping to
22:32
Speaker 2: get out of out of the coke. This is not
22:34
Speaker 2: a procedure that does well. We can talk about what
22:37
Speaker 2: the evidence says, but there's no reason to think that
22:40
Speaker 2: taking out your fat and putting back in your fat
22:42
Speaker 2: or whatever would have any particular positive impact on you
22:45
Speaker 2: in any direction. Right.
22:48
Speaker 1: We'll get to that as we kind of dig into
22:50
Speaker 1: the individual use cases. But I think we should say
22:53
Speaker 1: that just because there's no stem cells or very few
22:58
Speaker 1: in the stuff you're injecting doesn't mean it's the same
23:00
Speaker 1: as injecting nothing. There's other stuff in there, right, Like
23:03
Speaker 1: if I suck out your bone marrow, there's other cells
23:05
Speaker 1: in there, there's proteins in there, there's you know, various
23:08
Speaker 1: molecules of various types. So it's certainly plausible that something
23:12
Speaker 1: could be happening. But you know, the prices people are
23:16
Speaker 1: charging for this stuff are like akin to you know,
23:22
Speaker 1: getting a bone marrow transplant or something like that. Here
23:24
Speaker 1: actually have a clip of an influencer couple who spent
23:28
Speaker 1: fifty thousand dollars to get stem cell injections overseas in
23:33
Speaker 1: Panama City, Panama. Take a listen.
23:35
Speaker 4: If you're new into my world, my name is Jess.
23:37
Speaker 4: My husband and I run an eight figure coaching company,
23:40
Speaker 4: and we're borderline.
23:41
Speaker 2: Obsessed with biohacking.
23:42
Speaker 4: We found the stem Cell Institute listening to a Joe
23:45
Speaker 4: Rogan episode where Mel Gibson talked about his experience getting
23:49
Speaker 4: stem cells and so flying down to Panama City for
23:51
Speaker 4: a full service package and getting injections for a week
23:54
Speaker 4: sounded like our idea of a good time.
23:57
Speaker 2: Yeah, I mean, that's that's a lot of money.
24:00
Speaker 1: Yeah, well it demands a premium because people hear stem
24:03
Speaker 1: cell and they think like cool science, amazing. I just
24:06
Speaker 1: saw an article in the New York Times that stem
24:08
Speaker 1: cells cured sickle cell disease, Like, of course it can
24:11
Speaker 1: cure my knee osteoarthritis.
24:13
Speaker 2: Okay. So that gets us to a place where we
24:16
Speaker 2: sort of say, these regenerative medicine clinics, there's kind of
24:20
Speaker 2: it's it's not stem cells. So then the question is like, okay,
24:23
Speaker 2: but is it is there any evidence that these kind
24:26
Speaker 2: of things, that whatever is happening there works in some
24:29
Speaker 2: other sense, whether it's because of the three stem cells
24:33
Speaker 2: or because of something of something else. And that's where
24:36
Speaker 2: we need not just the kind of theory for why
24:39
Speaker 2: this might or might i'll work, but actual data. So
24:42
Speaker 2: let's start with knees. I love studying knees because people
24:47
Speaker 2: have a lot of knee problems, tons of knee problems,
24:49
Speaker 2: and knees are a great example of the placebo effect,
24:53
Speaker 2: my favorite effect. There's like constant evidence that did we
24:58
Speaker 2: do to fix your knee actually does nothing right? Like
25:01
Speaker 2: many of these studies where it's like we did sham
25:04
Speaker 2: knee surgery, we cut into the wrong knee. We cut
25:07
Speaker 2: into the knee and did nothing. And it turns out
25:09
Speaker 2: if you just cut into someone's knee and do nothing,
25:12
Speaker 2: they feel better, right, Like, oh, tons of stuff happened,
25:15
Speaker 2: and so it's like a great Knees are like a
25:16
Speaker 2: great example of the placebo effect, and we see some
25:20
Speaker 2: of that here too, where different kinds of treatment in
25:25
Speaker 2: a sort of total vacuum of a control group, it
25:28
Speaker 2: actually does look like, oh, this is so great. But
25:31
Speaker 2: of course anything you did to people's knees, you know,
25:33
Speaker 2: waving your hands over them, saying this shaman words, would
25:36
Speaker 2: affect your knee, because that's how knees are.
25:38
Speaker 1: It's subjective. The best study on this, in my opinion,
25:42
Speaker 1: was in the British Journal of Sports Medicine. That's a
25:45
Speaker 1: very very good journal, very good journaly my favorites, Oh good.
25:49
Speaker 1: A randomized trial of one hundred and twenty patients with
25:51
Speaker 1: knee osteoarthritis. And this was a blinded, placebo controlled design.
25:55
Speaker 1: So they had two syringes. One was fat drived stems.
26:00
Speaker 1: But again, like I'm putting stem cells in CLIs.
26:02
Speaker 2: It's some fat that they took Snetrifewgod fat maybe has
26:05
Speaker 2: themselves don't know, could be anything.
26:07
Speaker 1: And then the other was just sailing, just straight up
26:10
Speaker 1: salt water into the knee and there was no difference
26:14
Speaker 1: in knee pain, which was their primary outcome at any
26:17
Speaker 1: time point through two years of follow up. So I
26:19
Speaker 1: actually followed them for two years. This is like the
26:22
Speaker 1: best quality data you're probably going to get. By the way,
26:25
Speaker 1: as you pointed out, everyone got better, everyone's knees improved. Yeah,
26:29
Speaker 1: but saline costs three cents and stem cell fat costs
26:35
Speaker 1: ten thousand dollars like people are charging. I mean, maybe
26:38
Speaker 1: less than that.
26:39
Speaker 2: But also, just to be clear, it's not that the
26:41
Speaker 2: saline helped, it's just the placebo effect help. And maybe
26:44
Speaker 2: you need the sailing, like maybe you need to do
26:46
Speaker 2: something to get the that's on the placebo effect. Of
26:49
Speaker 2: course you think you did something, but fundamentally this is
26:52
Speaker 2: something that would have improved if you did nothing exactly exactly.
26:55
Speaker 1: Meta analyses, which are combinations of trials, sort of confirm
26:59
Speaker 1: this gen role thing, which which says, for example, there
27:02
Speaker 1: was a meta analysis from the Orthopedic Journal of Sports Medicine,
27:06
Speaker 1: not quite as good as the British Journal, but that's fine.
27:09
Speaker 1: Meta analyses never get published in the highest tier journals.
27:12
Speaker 1: But basically finding yes, stem cell injections or whatever you
27:15
Speaker 1: want to call them, do improve things, but no advantage
27:18
Speaker 1: over other things like highaluronic acid, which is another injection
27:23
Speaker 1: that often gets put in the knees also with limited evidence.
27:27
Speaker 2: That's the penis injection.
27:28
Speaker 1: Oh, that's what they were using in the Olympics.
27:30
Speaker 2: Jumpers were putting in in their penises in the Olympics. See,
27:34
Speaker 2: you got to listen to all the episodes of this
27:36
Speaker 2: podcast to go back to know what hiuronic acid is.
27:39
Speaker 2: But if you did, you would know it has many
27:41
Speaker 2: uses bake fixing your knee and making your penis big
27:45
Speaker 2: so you're ski jumping suit is looser and you can
27:47
Speaker 2: go farther.
27:48
Speaker 1: There you go.
27:49
Speaker 2: Do you think they would fix the rotator cuff? It might.
27:54
Speaker 1: I'd feel more comfortable I think injecting high uronic acid
27:57
Speaker 1: into my rotator cuff than in my fat cells. Probably.
28:01
Speaker 2: I thought you were going to say injecting and grey penis. Okay,
28:04
Speaker 2: let's move on.
28:06
Speaker 1: I haven't ruled that out yet.
28:08
Speaker 2: No, Okay, So these are one example. But I think
28:12
Speaker 2: what is true in these studies is that at least
28:15
Speaker 2: in these medical study settings, there wasn't any downside to Again,
28:20
Speaker 2: this is like studies being done by actual doctors in
28:23
Speaker 2: actual doctoring environments. I think the piece that is more
28:27
Speaker 2: worrisome is all of the kind of wellness face, et
28:32
Speaker 2: cetera stuff. And so there my read is, there is
28:37
Speaker 2: again no evidence that anything about this would improve your face. Yeah,
28:45
Speaker 2: no good evidence.
28:48
Speaker 1: Things aren't going to improve your face because stem cells
28:54
Speaker 1: are there doing things. When you inject stuff into your face,
29:00
Speaker 1: things do kind of get better, right Like, even if
29:02
Speaker 1: I inject saline into my wrinkles and stuff, at least
29:06
Speaker 1: temporarily until the sailing gets absorbed, you know, things fill
29:09
Speaker 1: out a little bit. And if I inject something that
29:12
Speaker 1: has some mild inflammatory properties like the stuff you might
29:16
Speaker 1: get from you know, fat or bone marrow, aspir it,
29:19
Speaker 1: you might get some localized swelling tissue edema as we
29:23
Speaker 1: call it, that can potentially you know, fill in some
29:26
Speaker 1: wrinkles and stuff like that. But again, we have ways
29:30
Speaker 1: to do this. Like, one of the challenges in a
29:33
Speaker 1: space like this is, especially if you're listening to wellness
29:37
Speaker 1: influencers online, if you trust everything you hear on a
29:40
Speaker 1: place like Instagram, and you want to get rid of
29:43
Speaker 1: wrinkles on your face. You have about three thousand different options,
29:47
Speaker 1: of which stem cell regeneration, regenitive therapy clinics is just one.
29:51
Speaker 1: We've already talked about, red light therapy. There's so much
29:55
Speaker 1: out there that people need a filter to sort of
29:58
Speaker 1: decide like how, you know, how would I possibly know
30:01
Speaker 1: what actually works? And that filter is called science, and
30:03
Speaker 1: that's fundamentally what this podcast is about, right. It's like
30:07
Speaker 1: it's the only way we have to move from anecdote
30:12
Speaker 1: to reality and along those lines, because I think anecdote
30:17
Speaker 1: is so powerful and for all the wrong reasons. I
30:22
Speaker 1: want to play you a clip of Mel Gibson talking
30:26
Speaker 1: about his father's experience with stem cell therapy, because I
30:32
Speaker 1: think we need to address this head on, Like we
30:35
Speaker 1: can show all the data that shows out it doesn't
30:36
Speaker 1: look work any better than placebo. But you hear something
30:39
Speaker 1: like this online and it sticks in your head. So
30:41
Speaker 1: let's play that for a second.
30:43
Speaker 5: He's ninety two and he was doing all the old
30:45
Speaker 5: man stuff. You know, his hip was killing him and
30:47
Speaker 5: he was like he had multiple problems. I mean, he
30:51
Speaker 5: wasn't in good shape at all.
30:52
Speaker 6: You know, his kidneys were in trouble. His heart was
30:54
Speaker 6: in trouble. And when you're ninety two and you have
30:57
Speaker 6: multi organ failure, you're basically running on and so you
31:00
Speaker 6: put these day zero young healthy cells that kind of
31:05
Speaker 6: restarts everything.
31:06
Speaker 1: So what was his response to this IVY treatment.
31:09
Speaker 5: It was like he got a new lease of life,
31:11
Speaker 5: fixed all his inflammation and pain, and he started walking again,
31:15
Speaker 5: and his kidneys were good, and his heart he had
31:17
Speaker 5: a prolapse valves in there and they healed, and his
31:23
Speaker 5: cognitive powers improved, his eyesight improved.
31:26
Speaker 2: WHOA, Okay, yeah, I mean I think listening to that,
31:32
Speaker 2: it's so compelling, right, It's like this is a person,
31:37
Speaker 2: Mel Gibson, who we seem to trust for some reason,
31:42
Speaker 2: and what he's saying sounds amazing. I mean, it sounds
31:47
Speaker 2: like we basically it's it's too good to be true.
31:50
Speaker 2: But you know, but I think it connects. This is
31:52
Speaker 2: why this you using the phrasing stem cells and talking
31:55
Speaker 2: about stem cells, I think is so much of where
31:59
Speaker 2: the misinformation comes in here, because it's it like has
32:03
Speaker 2: this aura of you know, well, these are cells from
32:06
Speaker 2: a young this is a young cell. You know, this
32:09
Speaker 2: is a cell from the beginning and so we put
32:11
Speaker 2: it in and it can do everything. It regrows your valve,
32:14
Speaker 2: it regrows your brain, it regrows your kidneys. You know,
32:18
Speaker 2: it just goes all around your body and makes all
32:21
Speaker 2: the pieces young again. And of course that is totally
32:27
Speaker 2: not how stem cells work, but it sounds like it could.
32:33
Speaker 2: You know, it sort of has its like I guess
32:34
Speaker 2: it could. I guess it could be like that. And
32:36
Speaker 2: and again it sort of like getting back to the
32:39
Speaker 2: sales pitch. If you said, you know, we're gonna injact
32:42
Speaker 2: some fat into your face, Yeah, okay, hey Jackson, fatten
32:45
Speaker 2: in my face? Like I like, yeah, that's that's the thing.
32:48
Speaker 2: I can imagine how that would smooth stuff out and
32:51
Speaker 2: plump it up. If you say we're gonna injact stem
32:54
Speaker 2: cells in your face, that feels like wow that then
32:55
Speaker 2: you're gonna make me younger. You're not just gonna like
32:57
Speaker 2: make my face fatter with the fat, you what in
33:00
Speaker 2: my face? You're actually going to make the face younger
33:02
Speaker 2: with the stem cells. And I think that's what people
33:04
Speaker 2: are paying for. And that's the grift. That clip is
33:07
Speaker 2: the grift exactly.
33:08
Speaker 1: And you know, not to say I have no idea
33:10
Speaker 1: if mel Gibson makes money off stem cells or anything
33:13
Speaker 1: like that, and people really do believe this, but you know,
33:16
Speaker 1: anecdote isn't evidence. And when you are telling stories, and
33:20
Speaker 1: humans are wonderful storytellers, you can manipulate a lot of things. Right.
33:26
Speaker 1: You even heard them saying like, oh yeah, wasn't he
33:28
Speaker 1: in a wheelchair and like, oh yeah, he could barely
33:31
Speaker 1: talk and stuff like that, and it's really and then
33:32
Speaker 1: all of a sudden he could. And all you have
33:35
Speaker 1: to do is kind of take that baseline state pre
33:37
Speaker 1: stem cell and be like, you know, kind of exaggerate
33:39
Speaker 1: how sick the person was, and then you take the
33:42
Speaker 1: state post stem cell and kind of exaggerate how well
33:45
Speaker 1: they became, and you make that delta look really huge,
33:47
Speaker 1: and it's just it's not reliable. I want to point out,
33:50
Speaker 1: because we've hit on this a few times, that stem
33:54
Speaker 1: cells are not magic. Adult derived stem cells can only
33:57
Speaker 1: turn into a few different cell types, and I will
34:00
Speaker 1: tell you what they are. So the cells derived from
34:03
Speaker 1: your bone marrow can only make blood cells that is
34:06
Speaker 1: as potent as there. They can't make brain cells, they
34:09
Speaker 1: can't make car filt cells. There are stem cells in
34:12
Speaker 1: your skin that make skin cells, Fine, no one's harvesting
34:18
Speaker 1: those because it's quite painful to take out chunks of
34:20
Speaker 1: your skin. And then there's mesenchymal stem cells, which is
34:23
Speaker 1: what most of these regenerative medicine clinics are doing, and
34:27
Speaker 1: they're capable of differentiating into bone cells, cartilage, muscle cells,
34:31
Speaker 1: and fat. And that certainly sounds like a lot. And
34:35
Speaker 1: you know, if cartilage is something that you know, it's
34:36
Speaker 1: particularly when we're talking about neiosty arthritis and things like that,
34:39
Speaker 1: you can sort of say, oh, well, okay, yeah, cartilage,
34:41
Speaker 1: but it's not everything. It doesn't you know, it's not
34:44
Speaker 1: going to fix your brain. We don't have stem cells
34:46
Speaker 1: for that. And so I think if people just kind
34:48
Speaker 1: of know that there are just biological limitations to how
34:52
Speaker 1: this could work. Because I said cartilage, let me just
34:55
Speaker 1: point out that there have been relatively rigorous MRI studies
34:59
Speaker 1: looking at cartilage thickness before and after stem cell injection
35:03
Speaker 1: in the knees. It also looks similar to injection with
35:06
Speaker 1: other things like hyaluronic acid, and there might be in
35:09
Speaker 1: both cases about a millimeter of cartilage regeneration, probably by
35:13
Speaker 1: just increasing blood flow to the area. Some influencers are
35:18
Speaker 1: starting to be a little bit more honest about this,
35:20
Speaker 1: So there's still a ton of misinformation, a ton of
35:24
Speaker 1: like their magic they turn into whatever cell their next to.
35:27
Speaker 1: Not true. In fact, very few stem cells do anything
35:31
Speaker 1: when they're in the body in terms of differentiating further,
35:34
Speaker 1: they do release some cytokine, some small proteins that might
35:39
Speaker 1: have immunomodulatory effects, so like either inducing inflammation or reducing inflammation.
35:45
Speaker 1: So these cells do kind of have a talking effect,
35:48
Speaker 1: like sort of talk to other cells. But we have
35:51
Speaker 1: lots of different ways, including like steroid injections if we
35:54
Speaker 1: want to tamp down the immune system. And so you'll
35:57
Speaker 1: see some people who kind of acknowledge that it's not
35:59
Speaker 1: just about magically turning into you know, a new heart
36:02
Speaker 1: valve when you don't have a heart valve. But you
36:05
Speaker 1: still have to ask yourself, why am I paying these
36:07
Speaker 1: ridiculous amounts when there are other ways to get the
36:11
Speaker 1: same effect.
36:12
Speaker 2: Yeah, I mean, I think you know, for me, this
36:14
Speaker 2: is a I find this space really understandable, but such
36:20
Speaker 2: a clear example of something we see in many of
36:23
Speaker 2: these wellness cases where you take a sort of vague
36:27
Speaker 2: biological plausibility like that that comes a real good story
36:32
Speaker 2: and then kind of take it all the way down
36:35
Speaker 2: the road into something which is which is crazy. You know,
36:38
Speaker 2: they kind of go all the way from this kind
36:41
Speaker 2: of cure sicco selenemia under these like very very complicated
36:44
Speaker 2: conditions into like, well that means it must be magic,
36:48
Speaker 2: and you know, here are all the things we're gonna
36:51
Speaker 2: we're going to do with it, and it prays on.
36:52
Speaker 2: Of course, people's like desire for youth, and so much
36:57
Speaker 2: of this is a kind of I want to look younger,
36:59
Speaker 2: I want to see younger. I want to be younger.
37:02
Speaker 2: This is telling you, like, we're not just going to
37:03
Speaker 2: make you a look younger. This isn't botox. You know,
37:05
Speaker 2: we're going to like put young cells in. We're actually
37:08
Speaker 2: make you younger. And that's of course impossible, but very compelling.
37:14
Speaker 1: If I could talk about the power of hope for
37:16
Speaker 1: a minute and get a little bit personal with my
37:18
Speaker 1: own stem cell story. So a couple of years ago,
37:22
Speaker 1: my mom was diagnosed with a very rare neurodegenerative condition
37:28
Speaker 1: called multiple system atrophy. There's no treatment. It's kind of
37:32
Speaker 1: a horrible neurologic condition where you just sort of like
37:35
Speaker 1: gradually your body stops functioning. So I'm a doctor, I
37:41
Speaker 1: run clinical trials. I'm a scientist. I have a lab here.
37:44
Speaker 1: So when she got that diagnosis, the first thing I
37:47
Speaker 1: did was go to clinical Trials dot gov and see,
37:51
Speaker 1: you know, I knew there was no treatments, there's no
37:52
Speaker 1: nothing approved. But I'm going to go to clinical Trials
37:55
Speaker 1: dot Gov and I'm going to see what's out there,
37:56
Speaker 1: like what are people testing right, Like, let's take a
37:59
Speaker 1: shot on something. And so I'm going through the filters
38:02
Speaker 1: and what's actively recruiting and whatnot. And I see a
38:06
Speaker 1: study of stem cell therapies for multiple system atrophy, and
38:13
Speaker 1: you know, these are trials that are like in the
38:15
Speaker 1: it reads like it's in the medical space, right, it's
38:17
Speaker 1: going to be it's the sickle cell thing, not the
38:19
Speaker 1: regenerative medicine clinic thing. At least that's what I was thinking.
38:22
Speaker 1: So I dig into this and I'm looking at the
38:26
Speaker 1: report on clinical Trials dot gov. And the first red
38:30
Speaker 1: flag I had is that they have to list the
38:33
Speaker 1: conditions that they're testing the stem cells for and including
38:38
Speaker 1: multiple system atrophy. Also listed in this protocol are traumatic
38:43
Speaker 1: brain injury, stroke, progressive supernuclear palsy als, diabetic neuropathies, dementia,
38:49
Speaker 1: frontotemporal dementia, Louis body disease, cognitive impairment, nervous system diseases
38:54
Speaker 1: in general, Louis body variant of Alzheimer's disease. That's a
38:59
Speaker 1: very broad protocol, right, Like, no one is testing that
39:02
Speaker 1: many things.
39:03
Speaker 2: No one treatment is doing all of those things.
39:06
Speaker 1: And nor would you if you were like a company
39:08
Speaker 1: trying to prove that your therapy worked, you would never
39:10
Speaker 1: enroll that diverse group, right, You'd like test it on
39:13
Speaker 1: one thing, so you know what's going on. I dig
39:15
Speaker 1: in deeper and I see that this protocol has been
39:17
Speaker 1: active at least since twenty sixteen and has never reported
39:21
Speaker 1: any results. So then I dig in to where this
39:24
Speaker 1: is coming from, and it's being run out of the
39:27
Speaker 1: clinic in Florida. I think it's called mdstem cells dot
39:31
Speaker 1: com and it is a regenerative medicine clinic in Florida.
39:36
Speaker 1: And all over their website they are saying, you know, oh,
39:39
Speaker 1: we've got these clinical trials that are running to test
39:43
Speaker 1: these different things. And you know, obviously people searching clinical desperate,
39:47
Speaker 1: people like me searching clinical trials are clearly a source
39:49
Speaker 1: of patients for them, But it still seemed odd to
39:52
Speaker 1: me because as like, well, how can they make money
39:55
Speaker 1: on this? You can't charge people to participate in a
39:58
Speaker 1: clinical trial. Well, they're charging people to participate in a
40:02
Speaker 1: clinical trial. So I found a news report talking about
40:06
Speaker 1: this same clinic that said where someone pretended to call
40:10
Speaker 1: so that they you know, like they secret chopped to
40:13
Speaker 1: them basically, and we're told it would be about twenty
40:15
Speaker 1: thousand dollars for one of these treatments, which again is
40:18
Speaker 1: just like taking bone marrow out and they were going
40:21
Speaker 1: to inject it into your blood and into your nose
40:24
Speaker 1: like that was the treatment. Twenty thousand dollars. The doctor
40:27
Speaker 1: who ran this clinic I actually used to have a
40:30
Speaker 1: license in Connecticut. That license was revoked by my state,
40:35
Speaker 1: which is a good thing. But he is licensed to
40:37
Speaker 1: practice in Florida because of course he is. And this
40:42
Speaker 1: I don't think anything made me angrier than this particular
40:46
Speaker 1: experience in this space, and I'm trying not to let
40:49
Speaker 1: it color my view of the entire like regenerative medicine
40:52
Speaker 1: and stem cell industry. This is someone who's clearly praying
40:55
Speaker 1: on very desperately This isn't someone who has you know,
40:57
Speaker 1: it's like, oh, I've got my knee hurts, Like maybe
40:59
Speaker 1: I should try this injection. This is like my mom
41:01
Speaker 1: is dying of an incurable disease. Should I give you
41:04
Speaker 1: twenty thousand dollars to you know, put some some fat
41:07
Speaker 1: cells up her nose or whatever. But the fact is
41:10
Speaker 1: these things live in the same space. And although you
41:14
Speaker 1: know he's promising a lot more than someone who says
41:17
Speaker 1: we're going to do some injections and make your knee
41:19
Speaker 1: feel better, people need to understand that these are for
41:24
Speaker 1: profit enterprises and stem cell is a marketing term and
41:30
Speaker 1: a powerful one.
41:32
Speaker 2: And I think what is so tough also about that
41:36
Speaker 2: story is imagine you were not a doctor who does research,
41:43
Speaker 2: and you've come across clinical trials dot com, which is
41:46
Speaker 2: not some scammer site. Clinical trials dot Gov is, in
41:49
Speaker 2: fact where people register their actual clinical trials. This is
41:52
Speaker 2: an actual government website. And people, how would you know
41:57
Speaker 2: as a person that you're not going to be charge
41:59
Speaker 2: of being a clipical trial That's like, that's true. You
42:01
Speaker 2: know that because you're a doctor. I know that, but
42:04
Speaker 2: people might not know that. You look at this, it's
42:06
Speaker 2: on clinical trials, like go you go to this website,
42:08
Speaker 2: they tell you, like, in order to be in this trial,
42:10
Speaker 2: it's twenty thousand dollars. And of course this seems official
42:13
Speaker 2: because it is you know, it is has the word
42:15
Speaker 2: stem cell and is listed on this government website. And
42:18
Speaker 2: I think it's an extreme example but also not an
42:23
Speaker 2: extreme example of where people are just there is real,
42:27
Speaker 2: you know, real costs, especially because you know, in this
42:31
Speaker 2: case maybe there isn't something else you can do, but
42:33
Speaker 2: in many cases there is something else you can do.
42:35
Speaker 2: People are being told, you know, you should get stem
42:37
Speaker 2: cell therapy instead of chemotherapy, immunotherapy, something that might actually
42:42
Speaker 2: address your problems. And so it is relative to some
42:47
Speaker 2: of the things we've talked about on this podcast. You know,
42:49
Speaker 2: we talked about red light therapy, and you know, my
42:51
Speaker 2: view is like that's a stupid scam, but like it's
42:53
Speaker 2: a stupid scam in the sense of like who cares
42:55
Speaker 2: you bought a mask and like you put the mask
42:57
Speaker 2: on and you think you feel better, but you don't.
43:00
Speaker 2: This is like potentially very damaging and preying on people
43:03
Speaker 2: who in some cases are really really desperate for answers.
43:08
Speaker 2: And I will say there are a lot of very
43:11
Speaker 2: bad things that can happen as a result of some
43:14
Speaker 2: of these things. So there are many cases in which
43:17
Speaker 2: people going to some of these clinics have actually ended
43:20
Speaker 2: up with very very bad, dangerous outcomes. So there's a
43:25
Speaker 2: clinic in Florida in which a number of people were
43:27
Speaker 2: actually blinded after some stem cells were injected in their eyes.
43:33
Speaker 2: There are a lot of stories like that.
43:34
Speaker 1: I saw that report. Also, I think it was done
43:37
Speaker 1: under kind of a research protocol. And it's actually, like
43:40
Speaker 1: doing this podcast, I'm beginning to see this other side,
43:43
Speaker 1: like this world of using research to get around the
43:47
Speaker 1: regulatory state. Right, Like I file research protocols because that's
43:51
Speaker 1: my job, and like I do research. And this happened
43:54
Speaker 1: with the peptides too, Right, It's like, how can we
43:56
Speaker 1: inject these unapproved substances into people and like not be liable. Oh,
44:01
Speaker 1: we call it research and we have them sign a
44:03
Speaker 1: consent form. And yet you know the purpose of research
44:06
Speaker 1: is to create generalizable knowledge, right, to like benefit humankind,
44:11
Speaker 1: to publish your results. That's one of the reasons why
44:15
Speaker 1: it's unethical to charge participants to participate in a research project,
44:19
Speaker 1: because they are giving you something, right, they are, they're
44:22
Speaker 1: volunteering themselves to be you know, experimented on. It is
44:26
Speaker 1: not medicine. You don't do research for curative intent. You
44:30
Speaker 1: do research to find out whether something is curative or not.
44:33
Speaker 1: And then once you prove it, then sure you can.
44:35
Speaker 1: You can sell it all you want. That's how capitalism works.
44:38
Speaker 1: But research isn't medicine. And yeah, that particular study with
44:43
Speaker 1: the eyes, Like the dumbest thing you would never do
44:46
Speaker 1: in a research study where you're injecting something into people's
44:48
Speaker 1: eyes is do both at the same time. Are you insane?
44:53
Speaker 1: Would of course only do one and then see what happens,
44:58
Speaker 1: and then these women you know, are blind in both
45:01
Speaker 1: eyes because it's a bad protocol.
45:04
Speaker 2: Okay, so we can do a smash or pass. But
45:06
Speaker 2: I actually I want to pause here on what I
45:11
Speaker 2: think is the most important takeaway. So before we started
45:13
Speaker 2: this episode, we kind of came at it with like,
45:16
Speaker 2: you know what, what do we want people to take away?
45:19
Speaker 2: And I think that here is really quite important to
45:22
Speaker 2: both of us that people take away that you should
45:26
Speaker 2: not go to a stem cell clinic to do anything
45:29
Speaker 2: that that you know there are if you are a
45:31
Speaker 2: person with sickle cell anemia. It is of This is
45:34
Speaker 2: of course a kind of therapy that you will be
45:36
Speaker 2: discussing with your doctor. But if you are thinking about
45:40
Speaker 2: using stem cells or some kind of stem cell clinic
45:43
Speaker 2: for something in your health, do not do that.
45:47
Speaker 1: Yeah, you're not getting stem cells. I mean, that's what
45:49
Speaker 1: I want people to take home. It's like, there are
45:51
Speaker 1: ways to get stem cells. They generally happen in a hospital.
45:55
Speaker 1: It's generally for people with cancer, sickle cell, very severe diseases.
45:59
Speaker 1: These clinics say they're selling stem cells, they're not. They're
46:04
Speaker 1: charging you too much, even if they're safe. You know,
46:07
Speaker 1: what they're injecting is safe. They're charging you an arm
46:10
Speaker 1: and a leg for stuff that isn't really there.
46:14
Speaker 2: Smash your pass stem cell therapy.
46:16
Speaker 1: Yeah, I'm when it comes to regenerative medicine clinics, I'm
46:20
Speaker 1: a hard pass on this. How about you, Emily?
46:23
Speaker 2: I am a hard pass. I accept for sickle cellingemium
46:27
Speaker 2: and a few canclood cancers.
46:29
Speaker 1: Yes, right, real stem cells are great. It's just this
46:32
Speaker 1: is fake.
46:33
Speaker 2: All right. That's it for stem cells. So your mail
46:35
Speaker 2: back Question of the week after the.
46:36
Speaker 7: Break, Hi, Emily and Perry, this is Wade in Santa Fe.
46:45
Speaker 7: I've read that taking magnesium can help you sleep better,
46:48
Speaker 7: and I'm wondering if that's really true or is that
46:51
Speaker 7: just more Internet wellness crop.
46:53
Speaker 2: Thanks, I take magnesium for sleep, Perry.
46:57
Speaker 1: Oh okay, cool? What do you think?
47:02
Speaker 2: So? I started taking this because I'm a perimenopausal woman,
47:06
Speaker 2: and I read the evidence as suggesting it is possible
47:11
Speaker 2: that this could affect sleep in a positive way a
47:14
Speaker 2: little bit. And I have a lot of self trackers,
47:16
Speaker 2: and so I figured that I would try it and
47:18
Speaker 2: I would see if it improved my sleep. So, I
47:21
Speaker 2: don't know, do you think that it did based on
47:23
Speaker 2: the data.
47:25
Speaker 1: I read the data the same way. I think there's,
47:29
Speaker 1: you know, evidence of modest benefit. We're talking like fifteen
47:32
Speaker 1: to twenty minutes of increased sleep duration, a little lower
47:35
Speaker 1: sleep latency, so falling asleep a little quicker. No large
47:37
Speaker 1: randomized trials. Yeah, but you get so much exercise, I
47:40
Speaker 1: feel like you must sleep well. But then why are
47:42
Speaker 1: you taking magnesium? I'm going to say, yeah, I think
47:45
Speaker 1: it improved your sleep a little bit.
47:47
Speaker 2: That is not correct. I am looking at my WHOOP
47:50
Speaker 2: recovery analysis here on my phone, and it tells me
47:54
Speaker 2: my magnesium supplement is plus one percent and it's not
47:57
Speaker 2: statistically significant in contras has to do other things like
48:01
Speaker 2: not drinking, which is a plus eight percent.
48:06
Speaker 1: Yeah, I would take magnesium, but I'm not going to
48:08
Speaker 1: give up alcohol.
48:09
Speaker 2: Jeez, please'm be ridiculous. Yeah, I mean this feels to
48:13
Speaker 2: me like something where there's no real downside. And if
48:16
Speaker 2: you said, you know, I'm interested in trying it, I
48:19
Speaker 2: can't see any reason people should not, and the data
48:23
Speaker 2: is not large. I'm surprised we haven't seen larger randomized
48:26
Speaker 2: trials on this, but I guess the point is that
48:28
Speaker 2: it's no one would benefit from that because magnesium is
48:32
Speaker 2: a generic over the counter thing and so there's not
48:35
Speaker 2: a lot of incentive to run to run a trial.
48:38
Speaker 1: Yeah, that's probably why doctor hatput On. Don't overdose. Take
48:41
Speaker 1: the recommended dose you can. There is magnesium toxicity at
48:44
Speaker 1: super high doses, so don't go crazy.
48:46
Speaker 2: My dad asked me about this the other day, which
48:49
Speaker 2: you know, tells me it's out in the zeitgeist, because
48:50
Speaker 2: my father will read any fad and try to follow it.
48:54
Speaker 2: So we'll see what he says.
48:57
Speaker 1: Let us know.
48:57
Speaker 2: Emily's dad, Hi, Dad, that's it for us today, stick
49:04
Speaker 2: with us next week, when we will ask what's the
49:06
Speaker 2: deal with creating? Wellness Actually is produced in association with iHeartMedia.
49:13
Speaker 2: Our senior producer is Tamar Avishai. Our executive producer at
49:16
Speaker 2: iHeart is Jennifer Bassett. Our theme music is by Eric Deutsch,
49:20
Speaker 2: and our content is for educational purposes only.
49:23
Speaker 1: If you like the show, help other people find us,
49:26
Speaker 1: leave a rating and review on Apple Podcasts or your
49:29
Speaker 1: podcatcher of choice and help us spread the word about
49:32
Speaker 1: the show. You can follow us on Instagram at Wellness
49:35
Speaker 1: Actually pod and don't forget We want to hear from you.
49:38
Speaker 1: Head over to Wellness Actually dot fm and leave us
49:41
Speaker 1: a question for our mailbag or suggest a topic for
49:43
Speaker 1: a future show.
49:45
Speaker 2: We'll let the influencers have the last word.
49:47
Speaker 1: You did the labor room surgery, no surger, wrap it
49:50
Speaker 1: out of full length rotator cuff tear okay, And they
49:53
Speaker 1: used ex's homes and it was gone. The next MRI
49:57
Speaker 1: have the tear was gone. It just it goes. It
50:01
Speaker 1: just seals up.
50:05
Speaker 5: Mhm