The Openly-Acknowledged Black Market in MOTS-c Peptide

"Turns out that tens of thousand of people are injecting themselves with MOTS-c. [That's] black market, illegal, from unknown sources, unknown purity,  unknown sterility, and I strongly object to that."

"We can't stop the black market. So I think it's a better choice to at least guarantee the quality, the sterility and require that real doctors are part of the process. I really think this is a better choice than just letting it go on the way it is." 

"Certain groups of people -- for example the fitness enthusiasts, which is the kind way to refer to gym rats -- those people take one figure from one paper done on mice and take it to become gospel." 

Dr. Pinchas Cohen, dean, USC Leonard Davis School of Gerontology

 

"My impression is that the 'lesser of two evils' argument is a minority perspective. While it's true that most [pharmaceutical] compounders can likely [produce] purer versions of these peptides than what's in the grey market, that doesn't address potential inherent risks of the peptides themselves." 

"There's no special reason they should be allowed to bypass the standard clinical trial system just because there's a peptide fad driven by wellness influencers and telehealth firms." 

Professor Paul Knoepfler,  cell biology and human anatomy, UC Davis School of Medicine

 

Dr. Pinchas Cohen's laboratory at the School of Gerontology, USC Leonard Davis identified the MOTS-c peptide  as one of the thousands of peptides acting as chemical messengers in the human body. It was discovered when Dr. Cohen combed through the 97 percent of human DNA that does not encode for genes. Once dismissed as "junk DNA", or the "Dark genome", this biological hoard has been recognized as being full of hormones and microproteins playing vital roles in directing systems and processes in the body.

 

When he became aware his discovery was being promoted by longevity seekers, fitness enthusiasts and wellness influencers as "exercise in a bottle", he felt dismayed. While not approved by the U.S. Food and Drug Administration, the peptide was available widely online, frequently found in vials marked "for research use only". Social media hype and a public consumer zest for experimental peptides has overwhelmed the public seeking magical fountains of youth and energy, and unregulated peptides now fuels a high-stakes federal government policy conflict.

 

Unsurprisingly, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. is a self-confessed "big fan" of peptide use personally, pledging to put an end to government's "aggressive suppression" of the peptides. Some of which, like insulin, human growth hormone and glucon-like peptide-1 have seen transformational therapeutic effects to humans. However, every one of these peptides (think Ozempic) on a pharmacy shelf has undergone decades of clinical trials and testing for safety.

 

Photo by Innerbody Research

 

The same cannot be said for MOTS-c and a host of other peptides now widely available online. Those wedded to their use claim the substances' effectiveness in aiding weight loss, boosting energy and muscle mass, frequently citing research conducted only on animals, or with a very limited number of humans. Leading to the situation where it is unknown how or when the peptides should be used for humans; no data exists that can attest to their safety and effectiveness.

 

An FDA committee was recently struck to vote whether to recommend compounding pharmacies be permitted to manufacture six different peptides currently available online: BPC-157, TB-500, KPV, epitalon Semax and MOTS-c. Last month, Health Canada announced that a Canadian court had approved their request to permanently ban a Quebec-based online store from selling unauthorized injectable peptides in Canada. 

 

Many of the members comprising the FDA committee work for telehealth, longevity and wellness companies that will profit from the regulation of peptides. Dr. Cohen arrived in Washington to speak before the committee; stating that he believed "quality-controlled, prescriber-supervised" compounding was the safest way forward. FDA staff who also spoke at the meeting advised against peptide compounding on the reasonable basis that insufficient safety data exists to justify the move.

 

It is unknown how long-term use of these peptides would affect humans. Claims by influencers that peptides have a positive effect on human weight loss, muscle mass, longevity and energy have been taken from effects seen on laboratory animals. Nor is it known what formula or dosage might be effective for human use. Molecules are viewed by scientists as a promising area of research where significant health breakthroughs could result. Rigorous science on the other hand takes time; guesswork is just that; unproven assumptions.   

 

viviana loza//Getty Images

 

"Peptides are neither miracle cures nor snake oil. They are signalling molecules. Some have strong evidence. Some have intriguing or early data. Some are wildly overhyped, and some probably should never leave the laboratory."

"Patients are looking for alternatives, and they are looking not at physicians. They're looking at this grey market source." 

Dr. Ben Gonzales, former emergency medicine physician, Walter Reed Army Medical Center 

 

"The big picture is that we're transitioning as a nation from the 20th-century model [in which] all health care was dictated by physicians and insurance companies to a new 21st-century model where consumers are demanding and receiving health and wellness services and products that they pay for in cash."

"I'm not saying that's a better model. But it's the model we're transitioning into."

Dr. Pinchas Cohen 

MOTS-c peptide hype

 

 

Aoh, Those Muscle Cramps!

"Experimental data in healthy college-age men suggests that pickle juice inhibits muscle cramps through a reflex involving a nerve in our threats."

"It's why a tablespoon of pickle brine hitting the back of the throat seemed to bring relief within seconds."

"Pickle juice may also work for cramps that aren't induced by exercise. A randomized controlled trial published last year found that a sip of pickle juice reduced muscle cramp intensity in patients with cirrhosis."

"Researchers believe this improvement is due to a similar reflex that occurs almost immediately, rather than by how pickle juice is metabolized by the gut."

Dr. Trisha Pasricha, Ask a Doctor 

Anyone can suffer from leg cramps, they often occur during night-time sleep with no warning; alternately while exercising, and doctors really have no answers that would satisfy the question why it is they occur at all. Muscle cramps are well known to occur frequently among the elderly population and with athletes, during pregnancy, and dialysis, as well as with people with health conditions such as diabetes, cirrhosis or amyotrophic lateral sclerosis.

Midsummer appears to be peak time for leg cramps, while their occurrence has a tendency to decrease during the winter, one study concluded. Athletes experience cramping which tends to increase in periods of hot weather, even while the cramps are not seen to be related to dehydration and electrolyte imbalances from sweating, a popular misconception.

There is no evidence available how best to treat cramps. There are however, two simple solutions that doctors may recommend: to stretch the muscle gently. Or to take a sip of pickle juice. Athletes, it appears, have long sworn by the efficacy and instant relief given them by pickle juice, as bizarre as that may seem. Pickle juice, strained from jars of dill or kosher pickles; alternately other acidic substances like mustard or apple cider vinegar.

"A sip is all it takes. We're not telling people to chug pickle juice", hepatologist at University of Michigan Elliot Tapper said, the 2022's study lead author. Additional research on the effect of pickle juice on muscle cramps is needed. The strategy could be somewhat less helpful for those people with rare leg cramps, or cramps that tend to be of short duration, to justify keeping pickle juice available on short order.

Medical practitioners suggest trial-and-error approaches in the prevention of leg cramps; a few weeks of daily calf and hamstring stretching (reducing the severity, not the frequency of nocturnal leg cramps), magnesium (a recent meta-analysis found this likely produces little effect), or vitamin B complex (which showed some promise in a 1990s small study). Long-acting beta-agonists such as found in Advair or Symbicort and diuretics like spironolactone could be exchanged by a physician for alternate medications.

A double-blind randomized controlled trial published in JAMA Internal Medicine in 2017 found that taking magnesium oxide for a month reduced the number of night leg cramps by about three times weekly, significant enough to go from waking to cramps every night in favour of the same every other night.

• Stretch and massage. Stretch the cramped muscle and gently rub it. For a calf cramp, keep the leg straight while pulling the top of your foot on the side that's cramped toward your face. Also try standing with your weight on your cramped leg and pressing down firmly. This helps ease a cramp in the back of the thigh too.For a front thigh cramp, try pulling the foot on that leg up toward your buttock. Hold on to a chair to steady yourself.
  Apply heat or cold. Use a warm towel or heating pad on tense or tight muscles. Taking a warm bath or directing the stream of a hot shower onto the cramped muscle also can help. Rubbing the sore muscle with ice also might relieve pain.   Mayo Clinic

Higher Prevalence of Atrial Fibrillation in former NFL Players

"We have to be aware that athletes who participate in these kinds of sports, particularly retired NFL players, do have an increased risk of atrial fibrillation compared to the general population."
"Athletes need to make sure they continue to go for annual physicals where this can be checked out." 
"Most former NFL [National Football League] athletes with AFib were unaware of any symptoms and yet should have been taking blood thinners to prevent stroke. [The findings highlight] the importance of being vigilant and intermittently checking for AFib in this group."
"Although the study was observational, which means it identifies a relationship but does not prove cause and effect, the prolonged strength training involved in American football may increase heart chamber size and wall thickness, which can alter heart rhythms and electrical signals in the heart."
“It’s known that endurance athletes - the elite ones who are middle aged and have done it for many years - are at increased risk. This is the first time this has been looked at in strength-type sports."
"For the majority of people, the benefits of both aerobic exercise, such as walking, and strength training, such as working with weights, is strongly linked to a healthier heart, and this study should not discourage people from being physically active."
"Mild to moderate exercise reduces the risk of atrial fibrillation for most people."
Dr.Dermot Phelan, director, Sports Cardiology Center, Cleveland Clinic, Ohio

"[The new study is a] good initial observation, but we will have to have more objective evidence of [other health conditions] and risk factors plus long-term monitoring of atrial fibrillation for there to be a clear correlation."
"[One issue with the study is that] there are many other factors that can increase the incidence of atrial fibrillation, like age, smoking, alcohol use, steroid use, poor sleeping hygiene, and sleep apnea."
Dr.Johanna Contreras, director, heart failure, Mount Sinai St.Luke's, New York city

HealthDay

The atrial is the top chambers of the heart. They are caused to almost quiver instead of pumping blood when the electrical impulses that spark heartbeats fire erratically. This is atrial fibrillation, which can result in the pooling of blood and clotting. Should a clot in an atrium travel to a blood vessel leading to the brain, a stroke can occur. According to an estimate by the American Heart Association, over 2.7 million people in the United States experience atrial fibrillation (AFib); it is the most common irregular heart rhythm that can occur.

Long-term endurance sports activities like marathon running has been linked by studies to an increased risk of atrial fibrillation. It had occurred to Dr. Phelan and his research colleagues that a similar link might be discovered in sports requiring muscular strength, and they set about testing their hypothesis by comparing 460 retired pro-football players to 925 men who took part in the Dallas Heart Study, to represent the control group.

Both of the groups, the control group and the retired players,
 were middle-aged and roughly half from each group were African-Americans. Information was collected on participants' history of high blood pressure, high cholesterol, diabetes, coronary artery disease, stroke and heart failure. In both groups this data originated with self-reports, and were not individually measured by the researchers. The finding was that the retired NFL players showed fewer cardiovascular risk factor including type 2 diabetes and high blood pressure. As well, most had lower resting heart rates.

The study was published in the Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association. The study conclusion was clear; former National Football League players were almost six times likelier to have atrial fibrillation than men of similar age who were not professional football players. 

• 5 % of former NFL players had AFib compared to 0.5 % of men in the control group.
• Other predictors for developing AFib were older age, white race and higher weight, all of which have been recognized previously as risk factors for AFib.
• The players group had overall lower risk factors for cardiovascular disease mortality, type 2 diabetes and high blood pressure, and had lower resting heart rates compared to the control group, yet the incidence of atrial fibrillation was still higher.
• Former NFL athletes were 8 times more likely to have pacemakers compared to the control group. Pacemakers are devices that are implanted in a person’s chest, usually to treat slow heart rates and other problems of electrical conduction in the heart.

Centenarian Vigour

"We can improve VO2max and performance at every age."
"[However, Mr. Marchand is] very optimistic, with many friends [studies link social ties with longer life. His simple diet of yogurt, soup, cheese, chicken and one glass of red wine does not reflect most peoples']."
"[Yet his example is inspiring for those who aspire to age well]."
"[B]eyond the establishment of new performance records at an extremely old age, the possibility for improving their performance and maximal oxygen uptake (VO2max) during this last period of life is a way for 'adding life to the life' rather than searching to 'kill the death'."
"This study shows for the first time that, at a very old age, VO2max and performance could still be increased with training."
Dr. Veronique Billat, professor of exercise science, University of Evry-Val d'Essonne, France

AP Photo/Thibault Camus

Robert Marchand is quite the person. Standing at a full [diminutive] 1.5 meters in height, weighing 52 kilo he might not appear at first sight an impressive figure. Although seeing a man of 105 dressed in the bright gear usually associated with biking enthusiasts might cause anyone to do a double-take. This man, however, is unique in a way that men of his age do not normally tend to be. He has the enthusiasm of a 20-year-old and the energy and drive of a 50-year-old. Now that's distinctive.

The working life of this man was as a truck driver. He had also done stints as a gardener, a firefighter, and lumberjack. Most often, when people think of others accomplished at physical tasks they conjure up visions of big, strapping fellows. The reality is, however, that pound for pound, lithe, short and muscular men are able to exert more muscle than their tall and hefty counterparts. Just watch a moving crew in action.

Once this man retired he took up the habit of daily recreational cycling. He cycled on the suburban Paris roads close to his home and also on an indoor trainer, but all the cycling he engaged in was at a leisurely pace, just enjoying himself. Now, the physiology of this remarkable man, has become the subject of a scientific study, one that saw publication in the Journal of Applied Physiology. And the findings from the study may alter how we regard the aging body and how athletic pursuits can prolong life.

Dr. Billat professionally engages in the study of professional and recreational athletes, and is also involved in their training. She found Mr. Marchand's demonstrated physical pursuit and prowess in cycling of great interest. He had competed in cycling events for centenarians, and pedaled over 22.54 kilometers to set a global benchmark for his age group. And Dr. Billat thought of testing the wisdom in exercise science that held that fitness declines after age 50, irrespective of frequent exercise.

She  had previously satisfied herself through research that if older athletes engaged in intense exercise they could indeed increase their V02max, and now wanted to test the method on someone of Mr. Marchand's age; Mr. Marchand himself in fact, since he has no competitors in his field of excellence matching his age. The university human performance laboratory tested his heart rate and allied indices of cardiorespiratory fitness, finding all indices healthy, substantially above average.

Mr. Marchand was also exceptional in that at his age he was not on any medication regimen. Dr. Billat placed her new test subject on a new training regimen where 80 percent of his workouts were to be performed at an easy intensity while the remaining 20 percent was performed at a difficult intensity, over a period of two years. At that point he made the effort to increase his one hour track world record of 24.25 kilometers.

AP Photo/Thibault Camus

All the physiological markers tested two years previously were re-tested, and the discovery made that Mr. Marchand's V02max was 13 percent higher than before, and he had increased pedaling power, to an increase of close to 40 percent. He then pedaled for almost 27 kilometers at 105 years of age. While Dr. Billat was more than satisfied with the results, Mr. Marchand claimed not to be, and intends to improve his distance, targeting age 106.

High Hopes in Defiance of Low Realities

"I cannot fight for my country. I will fight for the Olympics."
"I will fight for all refugees in the world, to defend all refugees in the world."
"If my family see me on television, I can give my number, everything [renewed contact]. Because I want one day to talk even with my dad and my brothers."
"If I participated in the Olympics, I think it would change my life."
Yolande Mabika, refugee from Democratic Republic of Congo, Brazil

"I wondered sometimes how to live when so many people were dying."
"We practise judo to forget everything we saw in the war. If you think about it, you lose."
"I represent everyone. I'll get a medal for all refugees."
Congolese athlete Popole Misenga, Brazil

"The point is that they stand for these million [outstanding athletes among the millions of the world's refugees]. They are one of the very popular chances to give face to the anonymity."
Michael Schirp, deputy head media relations and public affairs, German Olympic Sports Confederation

"Many times in my head I thought it would not happen because of politics, visa problems, lack of money and I could travel to ranking events."
"I do it for my dad and my family."
Raheleh Asemani, Iranian refugee, Belgium

You’re an Olympic-caliber athlete who has fled your home country. As the 2016 Olympic Games approach, you know you could qualify, but you’re not sure what team to call your own. You’re left in limbo, but you’re not alone. Countless migrants have sought refuge from situations of political unrest within the last year, 43 of whom have been identified as Olympic hopefuls. Fortunately, the International Olympic Committee (IOC) realized this, and officially created a team of Refugee Olympic Athletes (ROA) to cater to the needs of these talented men and women 

They have much in common, these outstanding athletes, in their dedication to the competitive sport they excel at, in their wish to compete on the world stage among the most talented, and to demonstrate that despite the disadvantage of immense proportions that fate has hobbled them with, their spirit and their capacity to endure, to use their extraordinary competence to advantage despite their burden motivates them to aspire toward world championship status.

Through the auspices of the International Olympic Committee's recognized obligation to aid these national orphans of huge athletic talent to realize their dreams despite having been exiled by conflict and fear, these recognized sport figures are being given the support and opportunity to participate on a team comprised of talented athletic refugees eager to compete at the Summer Olympics in Brazil.

Among them will be a young Syrian champion swimmer who, with her sister, managed to escape death in the Mediterranean on their way to reach Greek Lesbos. The inflatable dinghy Ysra and Sarah Mardini were on with other refugees was typically overloaded by the human smugglers they had paid to convey them to Europe. Mid-trip the overloaded vessel took on water, slipping into the Mediterranean. The Mardini sisters survived because they were able to swim for three hours to reach Lesbos.

Ysra Mardini, left, and her sister Sarah, right (Michael Sohn/AP)

The IOC has supported the formation of a refugee team which will represent the IOC, not their countries of origin where their lives had been blighted by violent oppression bred of tribal, sectarian and clan hatreds, leading to homelessness and often death. The sisters now live in Germany. Ysra is able to practise her swimming style at a pool that was built for the 1930 Olympics, in the hopes of competing in Brazil.

Any medals any of the 43 selected refugee athletes may win, will be presented with the Olympic flag behind them, and the Olympic anthem resounding. Yolande Mabika and Popole Misenga describe how, in their war-torn country they would be locked up when they lost a competition and be deprived of food. The violence disrupting normalcy in the DRC, and the loss of their relatives to that violence persuaded them to voluntarily seek refuge elsewhere.

The estimated twenty million refugees currently on the world stage as testament to the sad dysfunction of far too many countries will be represented by this new, state-unaffiliated group of talented refugees under the banner of Team ROA [Refugee Olympic Athletes]. Some of these young people aspiring to international athletic fame hope this may aid them in once again making contact with their families back in the countries they had come from.

William Kopati, 22, was a high-jumper and long-jumper in Bangui before he was forced to flee in late March 2013, when militants attacked the house where he was living. Since 2006, he has competed several times in the national championships for high jump, long jump and 400-meter run – winning the gold medal for high-jump in 2009. This is the second time he has fled to the DRC, having been a refugee from 2001 to 2003. His dream is to continue his career in athletics, despite the challenges.  © UNHCR / Brian Sokol