A peptide I am not familiar with

[Carrie Hardy]

Hello Everyone!  I have a patient that has been doing her own research into peptides and she had asked me about Humanin for neurological health.  I haven’t heard of this peptide in the past but there appears to be some research into this peptide (apparently mitochondrial derived) that is supportive for CV health.  Does anyone have any experience with this peptide and of course any sourcing recommendations would be welcomed as well.

Thanks in advance

Carrie

[Robb Bird]

I am interested in this as well…..and dosing info.

[Robin Rose]

I recall Dr Seeds remarking this was out of the ballpark expensive. Any update on that?

[Abid Husain]

Humanin was available for a limited period of time but it wasnt a reliable pharmacy.  They no longer provide it and are not a trusted source.  No other trusted compounding pharmacy has picked it up.  The only place to get it now would be from labs that are for “research only” purposes.  The purity can’t be trusted and wouldn’t be recommended.

That being said, what CV benefits are your patient looking for?  There are plenty in the current toolbox to treat most CV conditions without going to a rare and expensive peptide.

Abid

[Carrie Hardy]

Hello Abid

Thank you for taking the time to respond.  This patient is in her late 50s and she has a history of breast cancer.  She has developed significantly reduced ejection fractions (suspected from her chemotherapy).  She is in shape and her cardiologist has placed her on blood pressure medications but she isn’t tolerating this well and she is having difficulties continuing with her exercise (was a runner but is now just trying to swim).  They feel that she will recover but it will take several months and she can’t continue with her chemotherapy

Thanks again.
Carrie

[Abid Husain]

How long ago was her chemo exposure?  Was is Anthracyclin based chemo?

The cardiotoxicity is thought to be ROS mediated with significant reductions in  glutathione and mitochondrial dysfunction.  Supplemental Glutathione would be a good place to start.  I would start her on ketone esters 2.5ml TID.  The failing heart is more dependent on ketones as a fuel source and this will help provide the needed fuel to help it potentially regain improved function.  As well, the immune / inflammasome regulation will be helpful to reduce the ROS mediated inflammation.

Introduction of an SGLT2 inbibitor would be a reasonable option as there is good data for heart failure.

As far as peptides, I would start with BPC-157 500mcg SQ BID,  TA-1 1mg SQ QD,  CJC/Ipamorelin 100mcg/100mcg 5/7 SQ nights for the first month.  then reduce the TA-1 to 500mcg QD.    Depending on budget MOTS-c may be able to help imnprove mitochondrial funtion.

Here is an article to help get some backround infomation on this condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318862/

Abid

[Elizabeth Yurth]

@dr-carriehardygmail-com

Spermidine Promotes Cardioprotective Autophagy

Dan Tong

 and 

Joseph A. Hill

Originally published14 Apr 2017https://doi.org/10.1161/CIRCRESAHA.117.310603Circulation Research. 2017;120:1229–1231

Cardioprotection and lifespan extension by the natural polyamine spermidine

Eisenberg et al

Nat Med. 2016;22:1428–1438

A recent study published in Nature Medicine reports that dietary supplementation with spermidine, a natural polyamine, extends life span and reverses aging-associated cardiac dysfunction in mice through induction of autophagy. Similar protective effects of spermidine on human cardiovascular health were also suggested by epidemiological studies.¹

If can get SS31-it would be amazing !

And @drhusaininterlinkedmd-com..wouldn’t adding telmisartan be useful?

Betsy

[Abid Husain]

Telmasartan may be helpful but BP tolerance may be an issue.  It has been shown to stimulate PPAR aphla and gamma for lipid peroxidation,  prevents vascular smooth muscle cell and cardiac fibroblast hypertrophy, and inhibits platelet derived growth factor.  There also seems to be antioxidant properties that reduce oxidative burden and potentialy reduce atherosclerosis.

This commentary is a great and brief summary.

Benndorf, Ralf A; Böger, Rainer H Pleiotropic effects of telmisartan: still more to come?, Journal of Hypertension: May 2008 – Volume 26 – Issue 5 – p 854-856
doi: 10.1097/HJH.0b013e3282f76481

[Carrie Hardy]

Betsy and Abid

Thank you so much for your input on this case.   The last dose of the chemotherapeutic was in Jan of this year.  I was trying to quickly find what she was taking but I can’t readily locate it.  Your help is greatly appreciated.

Carrie

[Kristelle Reyes]

Claim your CME here: https://earnc.me/GpE2rH

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