The BioReset Podcast

Dr. Cook chats with Doctor Jones On All Things Peptides

September 29, 2020
1h 1min

"If you’re immune system is on the ropes, than the virus will run all over you.", says Dr. Cook.

Dr. Greg Jones interviews Dr. Cook on the topic of peptides, specifically immune modulators, how they work, how they are beneficial and ways they can potentially help change how the immune system functions as part of a strategy to treat or cure many known viruses. Learn also how BioReset Medical currently treats patients using peptides and more here on this new podcast episode.

 If the immune system is not working great, and then something happens like you get coronavirus. If your immune system's on the ropes, then Coronavirus is gonna run all over you. You're listening to a Bio Reset medical podcast with Dr. Cook. If you have questions or want to talk more about your symptoms and issues, you can always reach us at 650 888 7950.

Hey everybody, it's Dr. Greg Jones here with the Optimization Academy. I hope you guys love that name. Uh, it's so original and you know, so far no one's said anything bad about it. So we're gonna go with it and I am extremely honored. Today to have Dr. Matthew Cook with me. Uh, Dr. Cook is kind of a legend in the regenerative medicine space for those who are familiar with that.

You know, I've been stalking him for the last few weeks about doing this podcast, and I finally wrangled him. I, I may have pretended I was someone else, but we got him here and I'm excited. So, so, Dr. Cook is president and founder of Bio. Uh, bio Reset Medical and Medical Advisor, bio Reset Network. He's a board certified anesthesiologist for over 20 years of experience in practicing medicine.

And a lot of that time has been spent in the functional regenerative medicine space. So, with that being said, um, you know, Dr. Cook does treatments ranging from pain and complex illness, anti-aging and wellness. He treats very challenging cases and so that's one of my introductions to him. And some of the lectures I've been in just discussing difficult cases, I'm like, man, that's just awesome the way he thinks thi thinks about things and addresses and approaches things.

And also, you know, not just pain treating patients with Lyme disease and P T S D and, and Michael Toxin illnesses and across the board. So Dr. Cook's approach is to use the most non-invasive, natural, and integrative ways possible. So with that being said, we wanna welcome Dr. Cook and I really appreciate this.

Oh man. Greg, thank you for having me. It's awesome to talk to you. And it's so cool that, uh, you were at, uh, couple of lectures that I get got a chance to give and. So it's great to circle the, circle, the connection and uh, let's get started. Oh, definitely, definitely. So today we're gonna be talking about peptides.

So this is my second peptide talk, but we're gonna drill down and get a little bit more specific today. And again, we talked earlier before you guys got on, this may be the first and the series, but we're gonna focus on, you know, little background on peptides, getting into some immune modulators, and then kind of springboard that into talking about peptides used pain and regenerative injections and medicine.

So the first thing I want to ask you about, and this is a question that I get a lot because, you know, like I'm kind of a peptide nerd myself, and I love peptides and what they've done for my patients. And so we usually, you know, when you get those newer patients who are not familiar with peptides and you say, Hey, I wanna talk to you about peptides, and they give you the, the eyebrow raise, and it's like, well, what are peptides?

And so I like to ask you, how do you answer that question and how do you, you know, introduce that to your patients and explain that to them. Okay, that's a good one. Um, so I've got, uh, I'm, I'm pouring myself some delicious green tea. No worries. So that's a good one. I, it turns out, um, I have a handful of different ways I talk about that, but one way to think about it is that the human body has a bunch of different glands and organs, and then what these different glands and organs do is they, they sense what's happening and then they do something about whatever they see.

And so, one, one thing that a lot of people have heard of is you, you know that, um, we, we have a pancreas and the pancreas measures your blood sugar and kind of manages your blood sugar. And the way that it, uh, manages your blood sugar is if your blood sugar gets too high, it secretes this molecule called insulin.

And insulin lowers your blood sugar and kind of makes, keeps it normal. And so, uh, and so some people have a problem with their pancreas. And so because they have a problem and they can't make insulin, Then they inject it. Well, it turns out insulin's the most famous peptide in the world. So insulin's a peptide.

Now the, and it's too big of a molecule to be able to take it as a pill and absorb it. Um, uh, and, and so what we do is we take, and we give it as a little subcutaneous injection with a little tiny insulin needle. And, um, and so it turns out all of the peptides that we use are basically baby proteins. And they do something and they're bioidentical to, to the actual peptide that is in our body for the most part.

And so then, uh, peptides are things that have an effect on human physiology, and we use them, uh, different ones depending on how patients present with different issues. Okay. That's great. And, and I think that's a good way to look at it, starting with what someone knows and going to it, you know, like, Hey, let's relate it to what it does in the body.

And so one thing I I, I don't wanna say I pride myself on is I try to do analogies with people. It's kinda like my trademark and some of them hit the mark. Some of 'em don't make any sense at all. And one of the ones I love when I explain what peptides do is I'll use the analogy of a, of a doorbell and I'll say, Hey, you know, with peptides, just imagine if I ring the doorbell.

And that signal goes throughout the house and it's like, Hey, I'm ring the doorbell. And it may be heard in different rooms and it's gonna tell, Hey, someone's at the door, make something happen. Where sometimes there are certain medications and hormones, it's like that hor like that person went in the house and went in every single room and started yelling at you.

And some people are meant to hear that and some people aren't. And the people who aren't, those are your side effects, you know? So it's really kind of making, you know, the connection between what it's doing in the body. I don't know if that's a good one. That's the one I like doing. You know what? That's a good one.

I'm gonna, I'm gonna use, I'm gonna, I'm gonna somewhat steal that. Okay. Steal that now. But, and now, so then we got 30 million people in North America injecting peptides i e insulin every day. Yeah. Now it turns out that that peptide is a signal that's going all over the body. And that signal is kind of one thing.

That is a signal to open up glucose channels and drive sugar into cells. So then, so I like where this conversation's going because what that means is there turns out there are thousands of peptides that the human body makes. Each one is a signal that does a different thing. And so there are some signals that are kind of like a doorbell that just wake up everybody in the whole house.

There are some signals that send a message to the kitchen. There are some signals that send a message to the living room. There's another signal that might just send a message to the couch in the living room. And so then the name of the game is to understand the biology of the whole house. And then once I have that, and I kind of know the problems.

And the problems is, you didn't make the bed this morning and the kitchen's a mess, but basically otherwise it's fine. And so then if that's, and, and, and so then these are, and the common problems that we have in biology are common, just like the common problems in our house. Mm-hmm. And so then basically what we need to do is start to send some signals that are gonna clean that bedroom up, make the bed clean up the laundry.

We got some other signals that are gonna clean up that kitchen and we're gonna clean up, just send a message, toof up the pillows on that couch, and then it's gonna look like a beautiful house. Everybody's gonna feel great in that house. Right. And that's kind of one way to think about, um, pep pads. Good, good.

So I'm gonna take my analogy still yours, and we'll just kind of make it a package of, of house analogies here. And so it's just so amazing to think about that way now then. That's great. I like that. Now then what I wanna add on to that is, everything in human biology is signaling. Mm-hmm. Okay. So for example, it used to be that we had this idea that a stem cell was gonna show up on the scene and like look and see that there was like some cartilage damage, and then go turn itself into a cartilage cell and then heal that.

Okay. Turns out. That's not really what happens. What a stem cell does is it shows up, it sees there's some inflammation, and then it starts to make signaling molecules. Now, the signals in the human body are sometimes cytokines, sometimes they're hormones, sometimes there's other small molecules, and then sometimes they're peptides.

So there's a whole bunch of different, and sometimes they're vitamins, but these can be signals that can represent energy. They can represent a doorbell turning things on. They could represent something that turns things off. Um, and so then now the name of the game is to begin to kind of talk through biology and then determine as we're working through what the main structural problems are, and then which type of signaling.

Uh, tools we can use to influence biology. Exactly. And that's an amazing way to think about it as well. So I'm gonna do a quick gear shift here away from the doorbells. And so I know we wanted to structure this around, you know, in the pain and regenerative medicine space, but as we talked before, we can't really get into that space until we get into the immune modulating space.

So I think this is where we want to talk about, you know, starting with the thiamine and if you'd like to talk about, you know, how those immune modulating, you know, how those peptides work or why we want to use them and how they can transition in into how they're beneficial in the pain in regenerative medicine space.

Space. Okay. That's a great end question. That was a good one. Um,

so then I'm gonna sort of talk you through, The immune system and the immune system is super interesting. The immune system is, um, you know how they have like the man of the year and the woman of the year. Mm-hmm. Definitely for 2020 the immune system is gonna be the system of the year. So something that everybody's kind of, uh, suddenly become interested in.

And that's because if the immune system is not working great and then something happens, like you get coronavirus, if your immune system's on the ropes, then coronavirus is gonna run all over you. And so one of the things that everybody's trying to do on the planet right now is kind of build up their immune system.

Um, when, when there are a variety of problems that that happen in life, the immune system can start to get stressed. And when the immune system gets stressed, It doesn't work quite as well as it could, and it starts to have problems. And we call this immune dysfunction. Uh, one of the examples of it, the most common one is something called autoimmunity, where the immune system, instead of attacking invaders, it starts to attack yourself.

Um, uh, one of the things that can happen is people can get a lot of inflammation in their gut, and then that can spill over into the, the, the, the blood in the vascular system, which can lead to inflammation all over. And in general, uh, inflammation in the body can lead to stress for the immune system. And so what I try to do is I try to talk to people and get a sense of, and I can generally do this fairly quickly just from talking to people to, I'll get a sense of, does this person have an immune problem?

And whatever else problem they came to see me for. So they may be coming to see me for their knee pain, but there may be an immune component to the story, or there may be just the picture of health. So for example, I might have one person that comes to see me and they've got leaky gut and they've got food poisoning and they've been having abdominal symptoms and gas and bloating for years and they've got, you know, a variety of other problems that all came on after their leaky gut and, and they're not sleeping and they're stressed and two or three other things.

So that might be one person. And then I got another person like you, you're a naturopathic doctor, you've been doing everything right, you're on all the right programs, but you might have this knee pain. So what I do is I try to sort out, when I'm talking to people, which category they're in. Um, if everything is straight up perfect, like maybe in your case and my hypothetical knee pain case that I have of you, then I say, oh, okay great.

And then I'm just gonna take me down one road if I'm really feeling like the immune system is stressed and there's a bunch of immune problems going on, then I go with the number one immune peptide. And that immune peptide is called thymosin alpha one. So there's two main peptides. They both regulate the immune system.

One is called, one is alpha and one is beta. So it's kind of easy to remember. Uh, and uh, the name for the one that's alpha is alpha one, and the beta one is beta four. Peptides all have kind of crazy names, so it's kind of hard to remember 'em when you first rehear 'em. But then once you get used to 'em, um, it's a little bit easier.

And so the important reason why I tell you this is, and this is, I, I tell you I've found this, and if people hear this, it will really, really be helpful. This is a great insider tip. A lot of times there are people and they've, they have had all of this. Gastrointestinal stuff. They might have mold, they might have Lyme.

They've had chronic fatigue. They might have had Epstein Barr Orano, they might have had some other viral problems and their immune system has been stressed. They might have taken a lot of antibiotics when they were young. A lot of those people, they wanna jump to regenerative medicine because they've got joint pain and they wanna get better.

Those people. What I always do is I say, you know what, this is a real immune outta control thing and we're gonna do a little bit of functional medicine, start to dial things in, and I'm gonna put you on this thymus alpha one peptide. And so thy one is a great peptide to start to regulate the immune system and it's, it seems to balance it.

Now it's interesting to, for me to just mention the dosing here for people if they wanna get started on it. The traditional dose that people will start at is, is 500 micrograms a day. Okay? If I talk to somebody who I mentioned all of these things, if they've got all of it, I start 'em at one or 200 micrograms a day.

I start 'em real low, and then I'll have 'em do that dose for two or three days and double it and go for two or three days and double it till I get 'em up to 500, and then I'll have 'em stay there for a few weeks. What I have found is I have kind of a, a practice where I take care of a lot of complex illness people flying in from all over the world for injections, and we take care of a lot of people with Lyme disease, for example.

Uh, Lyme disease is really, has a strong association with autoimmune disease and with immune dysregulation. And what I'll do is I will start people low and slow on these peptide protocols. A lot of times I, you know, I, I just saw four or five people who I talked to in um, April, and I got them going on the peptides and I started them real low at 200 micrograms and I worked their way up to 500 and slowly got 'em up to 750 and they all came into the office and they said, you know what, uh, it took a while.

It took a few months, but I'm about 30 or 40% better. One of them said, I'm, I'm 20% better. But I feel like, I feel like what we're gonna do is gonna work cuz nothing's ever gotten any better. And so what that peptide was doing, the peptide, the thymosin, it helps your white blood cells make antibodies. It regulates the way that they do it.

It helps your white blood cells actually kill bacteria and viruses. Uh, if you're a little immunocompromised, I e your immune system is not working quite as well as it could. It, it seems to bring it back up to being less immunocompromised. And there's animal models that they've done that proved, proved that it did in animal models.

And so then what we do is we will try to get people on a program like this. And often what it'll take a little while, sometimes it'll take a couple weeks, sometimes it'll take a month. But really often people will start to say, man, I'm feeling better, and then I know that I've done the right thing and I started them in the right place.

Now the other peptide that, remember I said there's alpha and beta. So the other peptide that is comes from the thymus gland. And it turns out, remember I said there's glands and organs. The thymus gland is the home base of your immune system. It's where everything happens and your whole immune system is centered in there.

And so there's uh, two main peptides that come from the thymus plant and the thymosin beta four is really important for regulating the immune system. And in particular, it seems to regulate the immune inflammatory component, not just of the immune system, but of the nervous system, cuz your immune system is to some extent embedded in your gastrointestinal and your nervous system.

So we're constantly working with this triad of systems and how they're interacting with each other. And so then typically what I'll do is I'll for, for the people with kind of the immune version of it, I'll get them going on the thymosin alpha one first, and then shortly after I'll layer in thymus and beta.

And so then the protocol that we'll use is if I started somebody at 200 and then I might have worked them up to seven 50 over a week or two, then a lot of times in week two I'll layer in the thymosin beta. Uh, people don't have as many side effects, and so as long as they're relatively healthy, I'll start 'em right at 500 and then work them up to seven 50.

Um, if I feel like they're fragile or if they've had a hard time or if they had kind of quote unquote, Her I reactions where they had detox reactions from other medications or other treatment programs, then I just go much more slowly and carefully as I kinda onboard them to what we're doing. Okay. And that's pretty awesome.

And now here's a question, um, and I've seen this from a few pharmacies and, and some of the literature that I've seen in protocols. Is there a time limit on how long you can use the Diamond sense? Cause I've seen six weeks, I've seen two months. And if there is why,

so to some extent there are, there are feedback loops within the body. And so then for example, like hormones, the good thing about if you, if your, if your hormones are low, Like, for example, uh, if you've got no testosterone, I can give you testosterone. If I give you testosterone, your body may stop making it.

Okay? Now, uh, there may be kind of a, a hypothetical reason to think, well, if somebody, uh, if, if, if somebody is fragile, we don't wanna just do all the work of the immune system. We wanna get the immune system to do some of its own work as well. Now, what I will tell you is I think of it a little differently than that.

I don't have a rule as explicitly as that, but what I do is I'm always cycling my peptides. So almost everybody I'm working with is on two or three peptides. If I had this person that had leaky gut, some parasites, some inflammation, they had small intestinal bacterial overgrowth, they had chronic fatigue and they had Lyme, and they'd been on this like this for a long time and they came in and they had knee pain.

What I would do is I would get them going on the thymus and alpha one. I might have them do that for a month or two. And then once that, they were stable with that and I had them on the i, I added on thymosin beta four. What I'll do is I'll rotate those out and rotate some other peptides in. And so then by rotating out your body, it's kinda like if you went to the gym and then you changed up your program all the time.

I have muscle confusion, so you never know exactly, uh, what your body, your muscles, never know what you're getting. And in the same way, I'm rotating through my protocols. That being said, You know, there are certain situations, so let me give you an example. I got some people with catastrophically crazy post covid.

Okay? So these people are in 10 out of 10 immune stress. And so most of those people, I tell 'em, I'm gonna put you on thymus and alpha one, and you're gonna probably be on this for six months. If I've got a really bad case of Lyme disease, I'll tell 'em you're probably gonna be on thymus and alpha one for six months.

We're probably gonna, we may rotate you out and then rotate you back in. Often I'll, I'll have them on a protocol will, they'll be on thymus and alpha one and thymus and beta four. Understand that I'm dealing with some fairly significant immune problems. Um, or, uh, if you came to see me and you were super healthy, then what I might, I'm gonna probably rotate you through, but you're gonna rotate through shorter cycles.

Okay. That's pretty cool. That's a good way to look at it as well. And I like the, you know, and it, it's so funny cause I was like, oh, we're gonna talk about just the regenerative medicine piece, but understanding, and this is, this is right up my alley, right here is a naturopathic position because we're always looking at treating the root cause is.

So, it's, uh, the temptation is, especially as someone who loves injecting, is like, oh, you've got knee pain. I'm gonna inject the hell outta your knee because that's, you know, that's the fun, sexy part of it in many ways. But making sure that we get better outcomes by looking at the whole person. And again, like you said, there may be immune dysfunction and maybe other things that need to be addressed before you get to that point.

And so that being said, You know, once we're at a point where you've addressed all the root cause stuff, immune system is calmed down and nice and modulated, now it's like, okay, we've done all that. And whether it be imaging, whether it be orthopedic exams, like, okay, you have this injury, now we're gonna transition to the point where we're actually treating that injury directly.

How do you bring in peptides into that space? Okay. Can I, can I, can I say one thing before we go there? Oh yeah, sure. Okay. This can be good. So, um, so it, it turns out that, um, when I'm thinking about a joint, I'm, I remember I actually, when I gave that lecture, I gave that lecture about the five compartments of pain.

So there can be pain in the bone if I go from inside to outside. There can be pain in the bone marrow, there can be pain in the joint, there can be pain in the joint capsule. There can be pain in the, um, nerves that are outside the joint, and then there can be pain in the ligaments and tendons and fascia, and then even in the arteries and veins.

So I can have pain in any of those categories. It turns out, and this is I think gonna be probably the defining, one of the defining things of my life and, and what I've, what I've figured out from my clinical experience is the people who were in that first category with a lot of immune problems seemed to have much more immune inflammation of their nerves.

So, for example, Lyme patients have a lot of immune problems in their nerves. Um, uh, autoimmune patients do, a lot of times the rheumatoid and autoimmune patients will have more immune inflammation of their nerves. And so then what happens is you say to yourself, well, what are we getting? So they've got an, an immune problem with their nerve, so we've got to do something that's gonna help them regulate that nerve.

Well, how are we gonna do that? What could we do to regulate the immune system around that nerve? It's interesting. My friend Mark Hyman was here last week and so we were talking a lot and we were talking and he was saying, you know, I feel like if I really do a good job on functional medicine, he said, A lot of times what happens is all of a sudden that, um, That, uh, that immune pain will go away and all of a sudden the knee pain goes away.

And we used to think that a lot of Lyme patients had joint pain, and certainly many do, but a lot of 'em don't have much in the way of joint pain, but they just have nerve pain and in the nerve that goes to that joint. And so then what I found is I can put those peptides by the nerve, and when I do that, it modulates the nerve right there.

So now I could inject that peptide just like I was in doing an insulin injection or in my belly. I can also, in the subcutaneous tissue over the knee, inject that peptide down by the knee. Okay. Or I could take it a step further and I could get my ultrasound out. I could look and I could see that nerve, and then I could take a needle in and I could put fluid with peptides around that nerve.

When I do that, when I do any one of those things that will start to regulate the immune component of that nerve, and a lot of times those people will do a lot better, and peripheral neuropathy is in that category, so, so then what can happen is what, so then I'm, when I'm doing a regenerative medicine consult, I have my mind on that.

And so then if I, if imagine I had somebody that had a mild case. And I realized, oh, okay, let's say they, they, they had some mild immune dysfunction and it seemed like they have some nerve pain cuz I do a neurological exam and I touch all those nerves and I look at it with their ultrasound. If I think there's something immune going on and they've got nerve pain, then what I'll do is I'll do a hydro dissection of that joint, I mean of that nerve, and then I'll also treat their joint.

So I might make plate platelet-rich plasma or something like that and then inject that into the joint. But then I'll also do a nerve hydro dissection to the nerve. The other thing that I'll do, and I've started doing this with a really great success, is I'll do a nerve hydrodissection and then I'll teach the patient how to do some subcutaneous.

Injections by where that nerve is. And so then they can keep the healing going on in that nerve. And so we're doing a lot with teaching and making videos and coaching people and then I'm noticing that that's super helpful. So then that is kind of category one. Now then, let's say I got category two. I just got this straight up person, super healthy.

They don't have anything on the immune side, but they may have some nerve pain and they may have some joint pain. So then we might make a decision that we wanted to do platelet rich plasma for both of those people. Now when I see nerve pain, uh, I'm gonna use I'm, whether that person has a real bad immune problem or they're just healthy.

My number one nerve hydro dissection solution is thymosin beta four. Okay. So that's number one. Um, and so I'll use that in either one. Uh, the person with no immune problems, I may not even bother with thymosin alpha one. Okay. I may go straight to just thymosin beta four when we, we also will do combinations of thymosin alpha one and BPC 1 57.

And we'll do that both for fascia, for and for nerves, uh, and uh, for hydro hydrodisection. Okay. That's awesome. That's the sound of me ordering a lot of diamonds and alpha one and beta four because that is an amazing solution. Um, because, you know, I. We, I've been doing perineural injections with a lot of my joint injections as well, just because, oh, I, I think about, I think about Wilson's Law and it's like, Hey, if I know I have this joint pain, I'm most likely I'm gonna have nerve pain supplying the joint.

And it's just a combination therapy, you know, especially if it's indicated. But that's kind of good for me. Maybe some other docs that are listening is using those peptides and, uh, you know, a novel way of treating the nerve pain. Because for me, I've always thought when I think nerve pain, to be very honest, I've always thought cerebral lysin, which is another peptide, which, you know, is kind of difficult to get.

But I always thought about that one. And this is a. A good way to think about it and actually probably a little bit more affordable for the patient as well, um, to look at that as well. So that's excellent right there. Biore Reset Medical is a medical practice specializing in integrative therapies and advanced wellness protocols.

At Biore Reset Medical. We treat some of the most challenging to diagnose and difficult to live with ailments that people suffer from today, including Lyme disease, chronic pain, P T D, and mycotoxin illness. Our team has a wealth of experience and advanced integrative strategies to get you to optimum wellness, many of which can be conducted remotely from the comfort of your own home.

Right now, our team's approach is to use the most non-invasive, natural, and integrative way as possible. Find out how we can help you by reaching out to us at 6 5 0 8 8 8 7 9 5 0, or at our website www. That bio reset medical com, it's gonna be amazing. So I love SRE license for, for that. Okay. It's a, that's a home run, but it's difficult.

It's difficult to get. Mm-hmm. Um, now you brought up a, a great concept and so I'm gonna take you all the way down this road. And so, um, imagine if, uh, if we look at a piece of tissue, and so then very superficially is there subcutaneous tissue and there's a bunch of nerves. So for example, superficially, there's skin and nerves, and then underneath that there's muscles, and then all the way down, there's the bone.

Now it turns out the nerves that go to the skin, Are the same nerves that go to, to the bone that's underneath the skin for the most part. Okay? And so then there was this guy who's a friend of mine and who's been a mentor and an influence to me, and I love him. He is a great human being and a great person.

And his name is John Liftoff. And so he came up with something that was called Neuro Prolo. And so then they turned what they did into perineural injection technique and or the left off method. And so their idea was, is that if you did a little tiny subcutaneous injection to the superficial nerves and calmed them down, that would heal the nerve and that would make the pain both superficially and deep down in the bone go away.

Now that's a provocative idea. And in general, I think that there's quite a bit of validity. To that approach. And I'm, I'm a fan of that approach. Now, the approach and the concept that Dr. Liftoff had was that with the, um, nerve is that the nerve was in a state of low glucose and if there's a lack of blood flow or impingement and there's not enough glucose to that nerve, it puts the nerve in spasm and pain.

Okay? And so they call that glucco. Penia, okay? This is what his, his intellectual concept is. And so then he said, oh, okay, so then what I'm gonna do is I'm gonna palpate, I'm gonna find that nerve and then put some glucose subcutaneously. And often if you're treating a joint, but you put some glucose superficially, It will calm down that superficial nerve and then they'll, they'll actually, their joint will feel better.

And so this is a, this is, it seems kind of wacky, but I, the science is pretty good. And the concept is, what they have found is, is that that low glucose triggers these certain, um, nerve uh, nerves, uh, called Tripp one receptors to be, uh, outta control and in pain. What I have personally found is that I get about 10 times better results if I do a perineural injection with thymus and beta four than I do if I, if I use.

Glucose. And that is because thymus and beta four is regulating that, that that nerve. And then what I do is I make a judgment call when