Longevity University: Health, Peptides & Optimzation

The FDA advisory committee met at the end of July and voted on seven peptides, recommending six of them for compounding at 503A and 503B pharmacies. Milan and Dr. Rehan go through the full list: what each peptide was actually evaluated for, what it does in the body, what people are really using it for, and which one didn't make the cut.Dr. Rehan also names the one he's most excited about, and it isn't the one everybody expects. It's not BPC-157.Covered in this episode: what an advisory committee recommendation does and doesn't mean, why FDA-regulated sourcing is the real story for patients, DSIP getting rejected for sleep, BPC-157 for ulcerative colitis and why it creates an environment for healing rather than acting as a bandaid, the Wolverine stack and why it sometimes does nothing, KPV as the stronger anti-inflammatory, Semax for stroke, migraines, trigeminal neuralgia and focus, Epitalon for telomeres and insomnia, and MOTS-c as an AMPK activator and exercise mimetic, including how Dr. Rehan cycles it and pairs it with a GLP-1 when weight loss stalls.00:00 The One He's Most Excited About01:19 What the FDA Advisory Committee Actually Voted On02:42 The 7 Peptides, and the 1 That Got Rejected06:51 Why 503 Pharmacy Access Is the Real Story07:58 His #1 Pick, Revealed08:39 BPC-157: Ulcerative Colitis, Gut Healing, Blood Flow13:50 TB-500 and KPV: The Wolverine Stack and Why It Sometimes Fails21:36 Semax: Stroke, Migraines, Trigeminal Neuralgia, Focus33:42 Epitalon: Telomeres, Sleep, and the Fountain of Youth Claim38:35 MOTS-c: The Exercise Mimetic46:22 What Happens Next With the FDAEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. RehanYouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 MilanInstagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth

Eight months ago, Farshad's A1C was 6.2. His regular doctor had already flagged it at 5.7, he made changes, and it went up anyway. That's what brought him to Dr. Rehan. In this episode of our new series Longevity Intervention, Dr. Rehan sits him down and reads him the follow-up bloodwork.Testosterone from the low 300s to 410, and free testosterone from 10 to 53. Total cholesterol from 218 to 202. Triglycerides, the number that told Dr. Rehan he needed an intervention, from 194 to 85. And the one that made the doctor emotional: A1C from 6.2 to 5.6, out of pre-diabetes and back in the normal range. Along the way, Dr. Rehan explains why losing body fat raises testosterone on its own, why he draws his own A1C line at 6, and why his plan for Farshad is to change nothing and retest in three months. Farshad's verdict: he's living proof this works, none of the changes were crazy, and he has family and friends waiting on his numbers before they start. Plus the shirt-off reveal he's planning for his 50th birthday in March.Every week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. RehanYouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 MilanInstagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth

Milan's bloodwork and DEXA results, revealed live on air. He had Dr. Rehan keep everything sealed until cameras rolled, so the reactions are real. Six months after his last labs: testosterone up from 660 to ??? at age 46, no TRT, on the lowest dose of enclomiphene. Then the number that went the wrong way, and the conversation it forces about cholesterol, statins, and whether the fix is worse than the problem. Plus the six week DEXA comparison, Dr. Rehan's honest take on chicken, the red light bed Milan has been quietly using, a sub-20% body fat goal, and a plan to make the friend group compete on health. Retest is booked for November. And Dr. Rehan's own labs go on the table in a future episode.0:00 Intro2:28 What Milan Changed in Six Months11:29 Testosterone: 660 to 813, No TRT15:39 Cholesterol and the Statin Question23:05 The Cholesterol Reveal27:43 A1C and the Rest of the Panel31:57 Diet Adjustments and the Chicken Take39:31 DEXA Results and the Sub-20% Goal50:03 The Red Light Bed55:09 The November Plan and Competing on HealthEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. RehanYouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 MilanInstagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth

Are peptides safe? Dr. Rehan has heard every fear in the clinic. In this episode, he and Milan break down the three biggest: cancer, addiction and dependence, and allergic reactions. Only one of them holds up.They cover the BPC-157 cancer debate and what the mechanism actually suggests, the screenings that rule out a preexisting tumor, why growth hormone peptides catch unfair blame, the GLP-1 weight-regain numbers and how smarter titration changes them, Milan's experience dosing down while feeling his best, MCAS and why sourcing is the one risk Dr. Rehan calls truly real, the FDA advisory committee's vote to recommend six peptides, and the needle phobia keeping people out of peptides altogether.0:00 Intro1:47 Fear #1: Cancer Risk15:59 Fear #2: Addiction & Dependence22:41 Stuck on GLP-1s Forever?37:19 Fear #3: Allergic Reactions45:35 Recap & the FDA Peptide Vote48:49 Needle Phobia & Other Honorable MentionsEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. RehanYouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 MilanInstagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth

Dr. Rehan breaks down the three fundamentals he believes matter most for longevity: movement, recovery, and knowing your own body. He and Milan get into why mobility beats chasing heavy weights, the minimum effective dose of strength training and zone 2 cardio, building VO2 max with the Norwegian 4x4, and the sobering stat behind hip fractures in older adults. All of it adds up to less than five hours a week.Then they cover the recovery side: what actually makes sleep restorative, how late meals, alcohol, and cannabis sabotage it, a dead-simple approach to nutrition and protein intake, and where meditation fits. They close with the third pillar: learning to read your body's feedback and pairing it with objective data like labs and wearables.0:00 Intro5:20 What Longevity Actually Means7:46 Pillar 1: Movement & Mobility17:43 Strength Training: The Minimum Effective Dose24:41 Cardio, VO2 Max & Zone 237:51 Pillar 2: Recovery Starts With Sleep46:22 Meditation & Mental Health50:39 Nutrition, Simplified1:01:01 Pillar 3: Knowing Your Own BodyEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. RehanYouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 MilanInstagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth

Milan tried TRT the way most guys do: walked into a wellness clinic, got injected the same day, and tripled his testosterone. A few months later it took everything he had just to get out of bed. In this episode, Milan shares the full story of his TRT crash with Dr. Rehan, and they break down what actually went wrong: an aggressively dosed aromatase inhibitor, crashed estrogen, and a clinic that couldn't see him for five weeks when it mattered.Dr. Rehan explains why he rarely reaches for TRT first, how enclomiphene works as a gentler alternative that preserves your natural production and fertility, and why aromatase inhibitors are being overprescribed at men's health clinics across the country. Plus: the surprising percentage of erectile dysfunction cases actually caused by low testosterone, the labs you should be checking every three months if you're on TRT, and a patient story that shows just how badly unsupervised testosterone therapy can go.This podcast is for educational purposes only.0:00 Cold Open0:23 Intro1:10 Milan's TRT Story: From Low T to the Crash8:16 Enclomiphene, Explained13:14 Wellness Clinics & the Aromatase Inhibitor Problem17:04 Do You Actually Have Low T?19:02 How to Do TRT Safely24:02 A Patient's TRT Horror Story29:13 Enclomiphene vs. TRT: Milan's Verdict32:14 Peptides, Testosterone & What's NextEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. RehanYouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 MilanInstagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth

Dr. Rehan Muttalib and Milan Costich get into what happens after the GLP-1. Milan asks the question most people land on eventually: if these drugs cost you muscle along with the fat, is there a way to lose one and keep the other? That opens up stacking, and the single rule Dr. Rehan says matters most, which is never running two peptides that bind the same receptor. He walks through growth hormone secretagogues (sermorelin, CJC-1295, tesamorelin), why he'd reach for those long before anyone touches exogenous growth hormone, what cycling on and off actually looks like, and why the worst-case outcome with peptides is returning to baseline rather than ending up worse than you started.From there they get into the part nobody wants to say out loud: where people are actually buying this stuff. Dr. Rehan is candid about the gray market, the "research purposes only" loophole, and why the same website can send you two completely different vials a month apart. He explains what he tells patients who admit they're buying that way, what a 503A or 503B compounding pharmacy changes, and how to check whether one is regulated. The last stretch covers the mitochondrial pathway and NAD+, why "calories in, calories out" stopped satisfying him as an explanation for the patients in front of him, whether a GLP-1 should be cycled at all, and what the next generation of these compounds is going to look like.This episode is for educational purposes only and is not medical advice. Talk to your own physician before starting or changing any treatment.00:00 Intro01:51 What "stacking" means, and the one rule that matters04:15 How many people are actually on a GLP-107:10 Why growth hormone has such a bad reputation11:25 What a growth hormone secretagogue actually does13:59 Body recomposition and muscle as longevity currency18:45 Sermorelin, CJC-1295, and tesamorelin24:54 Cycling on and off, and what happens when you stop28:47 A word from our sponsor29:28 Where to start, and how GHRPs stack31:50 Sourcing peptides and the gray market36:05 503A and 503B pharmacies39:13 Adding a third peptide, and when weight loss stalls42:27 The mitochondrial pathway47:05 NAD+: IV, injectable, and nasal spray51:04 Should you cycle a GLP-1?53:32 What's coming next in this drug class55:30 Why this is so hard to navigate aloneEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: youtube.com/@longevityuniversity Instagram: instagram.com/longevityunversity_ TikTok: tiktok.com/@longevityuniversity X: x.com/longevityupod Dr. RehanInstagram: instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: x.com/askdrrehan MilanInstagram: instagram.com/milancostich TikTok: tiktok.com/@milancostich X: x.com/MilanCostich_Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxXYRX.co/podcastYouTube: youtube.com/@XYRxHealth Instagram: instagram.com/xyrxhealth TikTok: tiktok.com/@xyrxhealth X: x.com/xyrxhealth

Two weeks after their last conference, Dr. Rehan and Milan are back in Las Vegas for Milan's birthday and a UFC card that ended in one of the most talked-about injuries of the year: Conor McGregor's leg buckling on his very first strike.In this episode, Dr. Rehan gives his thoughts on why he's leaning toward a full-thickness ACL tear over a meniscus injury, and what a realistic recovery timeline looks like for a fighter coming back from five years out. After that, Dr. Rehan gives the exact protocol he would put McGregor on if he does in fact need ACL surgery.From there the guys get into Paddy Pimblett's clinical finish, that fighter's brutal weight cuts, Max Holloway's night, and why "movement practice" athletes like McGregor seem to age better than everyone else.01:35 Vegas, Milan's birthday & watching McGregor go down02:41 The diagnosis: why it looks like a full ACL tear07:14 Realistic recovery timeline & what surgery can't skip09:26 Where peptides actually help before and after surgery11:16 The full protocol Dr. Rehan would run for McGregor13:57 Sponsor: XYRx (code LU10)14:39 BPC-157 and TB-500 explained17:17 The drug-testing pool problem18:48 ACL vs. meniscus & why surgery is unavoidable22:49 Paddy Pimblett's finish, his camp & those weight cuts29:48 Max Holloway, the Vegas weekend & Conor's comeback oddsEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.Longevity UniversityYouTube: youtube.com/@LongevityUniversity Instagram: instagram.com/longevityunversity_ TikTok: tiktok.com/@longevityuniversity X: x.com/longevityupod Dr. RehanInstagram: instagram.com/askDr.RehanTikTok: https://www.tiktok.com/@askdrrehanX: x.com/askdrrehan MilanInstagram: instagram.com/milancostich TikTok: tiktok.com/@milancostich X: x.com/MilanCostich_Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.coXYRxYouTube: youtube.com/@XYRxHealth Instagram: instagram.com/xyrxhealth TikTok: tiktok.com/@xyrxhealth X: x.com/xyrxhealth

Everyone is suddenly on GLP-1s. Almost nobody is taking them correctly.In the first episode of Longevity University, Dr. Rehan Muttalib, a Southern California primary care physician who prescribes these medications daily, sits down with XYRx President Milan Costich to break down what peptides actually are, how GLP-1s like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) really work, and why he disagrees with the dosing protocols the pharmaceutical companies taught doctors to follow.Dr. Rehan shares real stories from his practice: the patient whose entire life transformed when the "food noise" finally went quiet, and the cautionary tale of a patient who maxed out her dose too fast and stalled. He lays out his lowest-effective-dose philosophy, the safe rate of weight loss, how to come off these medications without rebound weight gain, and the emerging off-label uses for inflammation, autoimmune conditions, and longevity, including microdosing.In this Episode: What a peptide actually is (and why insulin was the first) • Semaglutide vs. tirzepatide: why the GIP component may be the difference maker • "Food noise" and why quieting it changes behavior, not just appetite • The dosing protocol Dr. Rehan uses instead of the pharma playbook • How fast you should actually lose weight, and the risks of going faster • Muscle loss, bone loss, and nutritional deficits: the tradeoffs nobody mentions • Diet, protein targets, and resistance training while on a GLP-1 • Could peptides replace steroids? A preview of what's coming0:00 Cold open: "I've never seen a patient transform like this"0:24 Welcome from Dr. Rehan (and a quick disclaimer)1:15 Meet the hosts: how BJJ started all of this1:54 "Everyone at this dinner was on peptides"3:20 Insulin: the first peptide5:04 What is a peptide, actually?6:18 How GLP-1s work: semaglutide vs. tirzepatide9:04 The patient story: what happens when the food noise stops12:14 From diabetes drug to weight loss breakthrough13:48 This episode is brought to you by XYRx14:22 Why Dr. Rehan disagrees with pharma's dosing protocols16:05 The safe rate: 2 to 4 pounds per month17:23 Milan lost 50 lbs in 3 months. Here's what fast loss costs you19:59 Dosing by patient type + benefits beyond weight loss22:21 The ideal protocol: start low, go slow24:54 Maxed out on the dose and still stalled? 28:03 Switching from semaglutide to tirzepatide29:07 Coming off GLP-1s the right way33:34 Diet on a GLP-1: the only rule that matters37:41 Training and protein: how to keep your muscle40:19 Building muscle without steroids: peptide stacks42:56 Dr. Rehan's verdict + what's nextEvery week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.