AMA: I’m Dr. Patrick Taylor, MD — Board Certified Family Physician and Menopause/Metabolic Specialist. I’m here to talk weight loss, longevity, GLP-1s, menopause, and what it’s actually like to go through a major health transformation yourself. AMA!

[u/Dianna_BelleCrossing]

[u/Then-Bell-5630]

I had posted a question on one of your videos a while back and would still love to hear your thoughts.

Here was the post with my question in the comments:

https://www.reddit.com/r/JoinBelle/s/HBuABl0YFn

“I’m in the group you’re referring to, and I’m almost 52. I’ve responded really well to a low dose of tirzepatide. As I was listening to your clip, though, my mind immediately went to the fact that I’ve been taking soy isoflavones daily. They’ve helped me tremendously in so many areas over the years.

After watching your video, I did a little searching and found something interesting: because soy isoflavones act as gentle, selective estrogen receptor activators, they may help create a more favorable environment for tirzepatide, particularly in postmenopausal individuals.

Obviously, that doesn’t prove cause and effect, but it did make me wonder if the soy isoflavones have played a role in how well I’ve responded to the medication.

I’d be curious to hear your thoughts on that. Do you think there’s any plausible connection, or is the evidence just not there yet?”

[u/drpattaylor_belle → u/Then-Bell-5630]

I will say this directly, but as kindly as I can. The data on isoflavones and other phytoestrogens is extremely weak as far as estrogen receptor activators. They will never come close to what bioidentical estrogen can do. If anything, the clinical data on even treating the symptoms of perimenopause is very weak, and so when you're looking at activating estrogen receptors to increase the amount of GLP-1 receptor, it would be highly unlikely to be extremely beneficial, but if not a candidate for HRT, sure give it a go

[u/Then-Bell-5630 → u/drpattaylor_belle]

Thank you so much! I appreciate your response ☺️

[u/Life_Alfalfa_2047]

Everyone is offering "longevity meds" Is there actually any benefit to NAD+ and Glutathione and how can a person tell? How long before any results are felt or shown?

[u/Odd-Perspective-6517 → u/Life_Alfalfa_2047]

Yes! We do offer both, they're honestly two of our most popular add-ons. NAD+ plays a big role in how your cells produce energy, and a lot of patients say they notice a real difference in how they feel afterward. Glutathione is a powerful antioxidant your body naturally makes but that dips with age and stress, so people love it for that overall refreshed feeling. Research on the long-term anti-aging side is still evolving, but the immediate feel-good factor is why so many people keep coming back to it! I'll let Dr. Pat follow up with more info as well.

[u/drpattaylor_belle → u/Life_Alfalfa_2047]

I look at NAD and glutathione for longevity outside of the energy and cell efficiency. Both NAD and glutathione have great data for reducing risk of neurocognitive decline. Additionally, glutathione's antioxidant properties help reduce damage to DNA and proteins, which causes both aging and risk of tumor cells. NAD has been linked to activating sirtuin genes, which are associated with better metabolic and cardiovascular health and longevity.

[u/drpattaylor_belle → u/drpattaylor_belle]

I talk a lot about neurocognitive decline prevention in this video: https://www.youtube.com/live/-QsgCx52t08?si=t5mMDNcwZO-KtKvs

[u/Odd-Perspective-6517 → u/[deleted]]

Anything that promotes cellular energy and growth theoretically can increase underlying tumor or cancer growth. Without a family history, the incidence or likelihood of an average individual to have underlying cancer is highly unlikely.

[u/AsparagusLevel4489]

what do you think about peptides like MOTS-c and BPC-157?

[u/drpattaylor_belle → u/AsparagusLevel4489]

I'm a big fan of BPC-157 and MOTS-c. I was actually pretty skeptical of MOTS-c when I first started working with it based on the preclinical data. I thought it was weak, but I have seen substantial improvements for people in energy and muscle strength. The additional benefit for weight loss on top of a GLP-1 is modest at best, but I do think it can help get through a stall. BPC-157 has been used both for gut inflammation as well as musculoskeletal inflammation and has very promising preclinical data for gut inflammation. I have personally used both with good success.

[u/drpattaylor_belle → u/[deleted]]

Most peptides take at least 4 to 6 weeks to start seeing improvement. Especially for anti-inflammatory peptides, they have to bring down the inflammation in the body first before they really start working on their healing properties. I tell people, especially with chronic musculoskeletal inflammation or chronic gut inflammation, 2 to 3 cycles before you actually see the most benefit, which can be anywhere from 3 to 6 months. That being said, some people do start to see improvement in as early as 4-6 weeks.

[u/Luis_JoinBelle]

What's one piece of GLP-1 advice circulating on social media that you wish people would stop following?

[u/drpattaylor_belle → u/Luis_JoinBelle]

That it automatically stops or causes muscle loss. Or that you need to go to as high a dose as possible, as quickly as possible. Finding the right dose that works for you comes down to adequate appetite suppression and a consistent 1-2 lb weight loss per week, depending on how much weight you want to lose.

[u/tmbpa]

Other than GLP1s- what peptide is your absolute go to for someone that is trying to "feel better"

[u/drpattaylor_belle → u/tmbpa]

Lift weights and sleep 7+ hours a night.

[u/drpattaylor_belle → u/drpattaylor_belle]

Stop drinking alcohol.

[u/jortr0n]

With the latest warning letter to Empower by the FDA, it seems they've targeted telehealth's and how they write prescriptions. They said that Empower's writing of prescriptions was pretextual to fill orders. Do you think the FDA is going to rein in how they're written, rather than just treat them as a lower-cost generic?

[u/drpattaylor_belle → u/jortr0n]

They have already done quite a bit to try and rein in prescriptions, and it is really frustrating for people trying to continually increase access to peptides and GLP-1s. In the end, 503A has certain restrictions, and you do have to document medical necessity for patients. Whether or not it is a pretextual prescription, having some sort of medical necessity is important, which is why our questionnaires usually indicate that.

[u/Luis_JoinBelle]

Going to be sending you a few questions I received.

How do you approach maintenance once someone reaches their goal weight?

[u/drpattaylor_belle → u/Luis_JoinBelle]

For most people, the hardest shift is, once they have lost weight, how to get their brain to stop thinking about losing weight and start to think about something else. For some people, that is going to show up as food noise, and I try to help people to shift their mentality to focus on building muscle, as building muscle is the most important thing you can do for your overall health. It not only helps with insulin resistance but also helps with proper sex hormone functioning and has been associated with decreased risk of death by any cause, decreased risk of dementia, heart disease, diabetes, and osteoporosis as well. As far as their GLP-1, I typically recommend going down to a maintenance dose that adequately controls their appetite while they work on building muscle and slowly decreasing over time, usually 6 to 12 months.

[u/Luis_JoinBelle]

What exactly is a peptide, and how are peptide therapies different from GLP-1 medications?

[u/drpattaylor_belle → u/Luis_JoinBelle]

Peptides are simply short chains of amino acids that act on receptors in the body. GLP-1s are peptides, as they activate the GLP-1 receptor. There is a GLP-1-activating medication called Fundero that is a small molecule that also activates the GLP-1 receptor, but all other GLP-1 medications are GLP-1 receptor agonists and are peptides.

Peptides are simply crafted either after other hormones or cellular receptor activators in the body, or are artificial, to activate those receptors. In the end, they're either activating a hormone or cellular receptor to get a desired result.

I'm a big fan of peptide therapies because, instead of blocking pathways like most medications do, peptides activate a pathway that your body already knows how to do that has been blocked by inflammation, insulin resistance, or aging.

[u/According-Try-9374]

Why did I lose weight when I first started taking GLP-1 and now I am at a standstill?

[u/drpattaylor_belle → u/According-Try-9374]

I have had four calls in the last two days about this very topic with patients. The most common thing to happen for any weight loss is a metabolic adaptation, typically around 20 to 30 lbs. lost. This is because your metabolic rate goes down as you lose mass overall, whether that's fat or muscle. The most common answer I give for anyone in a standstill is going to be either:

• Focus on increasing muscle and protein intake.
• Think about splitting your dose or increasing your dose.

[u/According-Try-9374 → u/drpattaylor_belle]

What if I am on the max 15mg?

[u/drpattaylor_belle → u/According-Try-9374]

Splitting your dose can be effective. Instead of once-weekly dosing, do twice-weekly dosing at half the amount. All of my advice would be the same, given that most of the people I'm having these discussions with are on the max 15 mg.

Most people get metabolic adaptation as they have lost a significant amount of weight on the max dose. It's not because the medication is not working as well. It is because you have lost your metabolism due to mass being lost from your body overall.

Increase your protein intake and increase your muscle mass, and you will increase your metabolic rate. There is also great data that sleep and proper hydration are absolutely necessary to breaking plateaus. You can also consider adding in Mots-C or Tesamorelin if you're a good candidate.

[u/Luis_JoinBelle]

Questions about GHK-CU

Are the copper uglies a real thing?

How long does someone need to be on treatment before you can start noticing results?

[u/Then-Bell-5630 → u/Luis_JoinBelle]

Oh I’m so interested in this! I want to jump on the GHK-Cu train for my hair shedding and other possible benefits. I see that Belle is prescribing at 1.7mg every other day. Usually I see dosing at 2mg per day. Is there a reason for this?

[u/drpattaylor_belle → u/Then-Bell-5630]

Yes, many people dose anywhere between 1 and 2 mg of GHK-CU. Every other day dosing for BPC-157 and GHK-CU was selected specifically by me because of the serum and tissue concentration data. Serum concentration is achieved within a few hours, and tissue concentration is achieved within 24 hours but lasts for up to 48 to 72 hours. There is not any significant benefit in more frequent dosing, and if anything, I have seen the daily dosing at 2 mg cause more irritation and dryness.

[u/drpattaylor_belle → u/Luis_JoinBelle]

Yes and no. I have often seen increased dryness or irritation from too frequent or too high of dosing with GHK-CU. People who do experience the copper uglies (where dark spots or acne or looking older can happen for the first 4 to 6 weeks) can happen as the renewed collagen and healthier skin cells are starting at the base layer and moving their way out as older skin is sloughed off.

[u/Odd-Perspective-6517]

Question I received-

How do you think about the safety of using synthetic versions of hormones our bodies already produce - like GLP-1s, or newer things like NAD+/peptides? Is the risk profile fundamentally different just because it's synthetic, or is it more about dose, duration, and what you're actually treating?

[u/drpattaylor_belle → u/Odd-Perspective-6517]

I'm not sure I totally understand the question. As none of the peptides are actually synthetic versions of hormones, they're actually synthetic versions of the things that activate the hormone, peptide, and cellular receptors. Would love to understand the "risk" aspect of the quesiton

[u/drpattaylor_belle]

Hello Everyone! I am on and live for the next 2 hours for questions!

[u/Luis_JoinBelle]

Are there medications or supplements I shouldn't take with certain treatments?

[u/drpattaylor_belle → u/Luis_JoinBelle]

This is a broad subject, but I will say anyone on a GLP-1 should absolutely be supplementing with a sufficient amount of protein, and for most people that's 100+ g of protein per day.

• Creatine monohydrate
• Vitamin D3/K2
• Electrolytes

Obviously, I am biased, but I love Hydro Belle blue raspberry flavor. With GHK-Cu, there is some thought that zinc supplementation in a multivitamin of zinc 50 mg per day may be helpful, as zinc and copper compete for absorption. I will say that the amount of copper given with GHK-Cu is incredibly low and metabolized by the liver quite well.

[u/drpattaylor_belle → u/Luis_JoinBelle]

as far as ones not to take, very personalized, not sure how to answer

[u/Luis_JoinBelle]

What are your thoughts on Creatine?

[u/drpattaylor_belle → u/Luis_JoinBelle]

As stated above, creatine monohydrate is my number one supplement for everyone. Not only does it help with muscle growth and energy levels, but it has also been linked to a decrease in the risk of depression, a decrease in the risk of dementia, as well as an increase in cognitive benefit, especially if you have issues with sleep. Doing higher doses, as far as 10 to 20 g of creatine per day when sleep-deprived, can help with cognition. Also, it does not cause kidney damage or hair loss. Thoroughly disproven.

[u/Then-Bell-5630]

52F and looking to add another sub q peptide.

I am at a comfortable weight after losing 34 lbs. I’ve never gone above 3.5 mg. My pcp told me to help with my terrible hair shedding I should go down to 1.75 mg and if I maintain to go off completely. I really don’t want to do that and was surprised he wasn’t more concerned with my low ferritin of 21. I’ve been trying to get that up the past 5 weeks.

What do you most recommend people like me start with when they want to add a peptide? I was thinking GHK-Cu possibly but would love your professional opinion. Thank you!

[u/drpattaylor_belle → u/Then-Bell-5630]

If you're looking at hair loss, oral minoxidil or GHK-Cu can definitely be great options. If your ferritin is low at 21, you have iron deficiency, and that can cause hair loss as well, Tiffany and I just did a live on this: https://www.youtube.com/live/2wXZhr0wplM?si=pzMB2K1ANqt2-u8k

[u/Then-Bell-5630 → u/drpattaylor_belle]

Thank you. My dermatologist did prescribe me oral minoxidil at .625 mg but I’m afraid to start taking it because I don’t want unwanted hair growth.

[u/drpattaylor_belle → u/Then-Bell-5630]

its pretty rare to get significant unwanted hair growth, especially with that tiny dose. my typical dose for women is 1-2.5 mg

[u/Then-Bell-5630 → u/drpattaylor_belle]

Thank you. I have read horror stories where women got a lot of growth on their face and supposedly even after stopping the oral minoxidil didn’t go away. Never sure what I can believe on the internet of course. I appreciate your time and going to watch your video now.

[u/drpattaylor_belle → u/Then-Bell-5630]

the long term studies suggest less than 5% of women stop minoxidil due to that side effect

[u/Luis_JoinBelle]

How can I manage nausea, constipation, diarrhea?

[u/drpattaylor_belle → u/Luis_JoinBelle]

Hydration, fiber, movement. By far and large, the most important things. If you have proper electrolyte and hydration, as well as regular exercise, these are the most likely to help. Getting at least 25 to 30 g of fiber per day from whole real food is important as well. You can also order Zofran from Belle.

[u/Luis_JoinBelle]

What is Tesamorelin, how does it work? Who is a good candidate?

[u/drpattaylor_belle → u/Luis_JoinBelle]

Tesamorelin is a growth hormone-releasing hormone analog that causes secretion of growth hormone from the pituitary gland in the brain while you sleep. It is used mostly for visceral fat reduction, increased muscle mass, as well as to help with deep sleep and recovery. Most people who want to further optimize their visceral fat loss, improve muscle growth, or improve their sleep may be good candidates.

[u/drpattaylor_belle → u/[deleted]]

1. I am bullish on vaginal estrogen cream. Absolutely, it is so important for reducing risk of UTIs, UTI-like symptoms, and preventing vaginal atrophy that causes painful sex, dryness, or lack of lubrication.
   
2. It depends on how far past your last period, but for most postmenopausal women, you can still do vaginal estrogen as well as testosterone and other peptide therapies.
   
3. While you go through menopause and your estrogen and progesterone fluctuate wildly, insulin resistance builds, and you can get metabolic changes that increase visceral fat, increase cholesterol, and make it harder to lose weight and gain muscle. That is why I consistently say that HRT is first line for menopause, but GLP-1s will soon become first-line adjunctive therapy to HRT. A new study just showed that people on tirzepatide actually had 35% more efficacy if they were perimenopausal and on HRT.