PRP. Stem cells. Now exosomes. Are they the next breakthrough in regenerative medicine—or is the hype getting ahead of the science?
Exosomes are tiny biological messengers involved in cell-to-cell communication, carrying signals such as proteins, lipids and RNA. But as exosome therapy grows in popularity, patients are spending thousands of dollars without always knowing exactly what they're getting.
Neurosurgeon and regenerative medicine specialist Dr. Jeff Gross returns to Crackin' Backs to break down the science behind exosomes, stem cells and PRP—and what patients should know before considering treatment.
We get into 50 billion vs. 500 billion exosomes, why 5 mL may tell you almost nothing, product quality and sourcing, timing after injury, PRP vs. stem cells vs. exosomes, joint degeneration, recovery, and where regenerative medicine may be heading next. Gross explains that volume alone doesn't tell you the source, particle count, processing, quality or protein content of a product.
Most importantly:
How do you know if what you're being sold is legitimate?
Gross explains what he believes patients should ask about experience, sourcing, testing, particle counts and the certificate of analysis before spending the money.
If you're interested in exosomes, PRP, stem cells, MUSE, regenerative medicine, longevity, joint health or recovery—this is a conversation you'll want to hear.
👇 Would you know what questions to ask before getting exosomes? Tell us in the comments.
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Know someone considering regenerative medicine? Share this episode with them before they spend the money.
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Spencer Baron (00:01.368)
PRP, stem cells, now exosomes, they're being called the next breakthrough in regenerative medicine. But are they actually changing the way we heal or has the hype gotten ahead of the science? And if you're about to spend thousands on exosomes, do you even know what you're getting?
Well, Dr. Jeff Gross is a neurosurgeon and regenerative medicine specialist and he's back on Kraken Backs to help us separate the science from the hype. Doctor Jeff, welcome back.
Dr. Jeff (00:33.335)
Thanks for having me back, guys. How you doing?
Dr. Spencer Baron (00:35.938)
Great man, great. We're gonna kick off by asking you, you know, what patients are actually buying? Because you hear it all the time. They're they're buying on the black market, they're buying from their doctor. Talk to me about that.
Dr. Terry (00:36.2)
Fantastic.
Dr. Jeff (00:49.227)
Yeah. Well, I mean it's hard to get regenerative biologics, except for peptides, on your own. You can get peptides on your own, but in terms of stem cells and exosomes and mu cells and all kinds of things, you you really need to get it from a clinician or a clinic. And there's a wide variety in what you're getting, how much you're getting, the quality, the clinical experience, and you got to be a really good consumer about it.
Dr. Spencer Baron (01:17.41)
What are what are exosomes and you know, what is supposed what are they supposed to be doing?
Dr. Jeff (01:23.075)
Great. Well, part of cellular biology is cells communicate with other cells, their neighbors, right? if if a cell is infected, it's gotta warn its neighbors, hey, get ready to defend yourself, you know. So there's ongoing signaling. Some of that signaling is through proteins slash peptides, because peptides are a subset of proteins. Some of those are growth factors, some are cytokines, you may have heard that word. some are pro-inflammatory, some are anti-inflammatory.
But the other side of signaling are these vesicles, extracellular vesicles. So a cell will bubble out a small outpocket, takes a little bit of the membrane. That membrane pinches off some of the cytoplasm from the cell, and with it it takes some RNAs, and it takes some growth factors and peptides, and it takes some lipids, and it goes into.
in the in the neighborhood in between the cells and other cells will pick it up and envelop into the cell, delivering those contents at high efficiency through endocytosis, if you remember that from high school biology. So one cell delivers these, another cell picks them up. There's this ongoing communication. These cells are measured sorry, these vesicles are measured in diameter in nanometers. So we sometimes call them nanoparticles because they're so much smaller than cells. And they're amazing. They can
cross the blood brain barrier, the placenta, they're so small. So those when they're derived from from stem cells, we call those stem cell derived exosomes. And when we use the word exosomes clinically speaking, we really are t talking to those from stem cells because all cells make them, sick cells make them, senescent cells, zombie cells make them. We don't want those. We want the good stuff, the stem cell derived ones. That's what exosomes are and they are the business end of stem cells. They are what stem cells do
So you can skip the stem cells and the real actual medicine from the stem cells is the exosome component.
Dr. Spencer Baron (03:26.315)
Hmm, good explanation. So let me get this right. Exosomes are like the repair crew and more like they're telling as biological instructions, they're telling our own cells what to do. Is that close? Okay. So if a patient tells you I got five milliliters of exosomes, does five milliliters of exosomes mean anything or is it volume wrong? Yeah.
Dr. Jeff (03:37.943)
Yep. Yep.
Dr. Jeff (03:47.416)
That that is zero information. We don't know the the source of the cells they got those from. We don't know if they were in culture or naturally derived. We don't know if they were freeze-dried or fresh frozen. We don't know a count. We don't know the the size they're counting. We don't know the quality. We don't know the protein content in that fluid if there is any proteinslash growth factor. So the milliliters are sometimes just the count number.
is not very meaningful.
Dr. Spencer Baron (04:20.737)
What is a good XSM? What would you have some what would our audience look for or
Dr. Jeff (04:27.779)
Well, my favorite source, and I think, you know, I talked about this in the past, is I I love the cleanest, freshest source from the youngest donor, right? And this is from amniotic fluid or umbilical cord fluid from a non-COVID vaccinated young mother with no history of diseases, no drinking, no drugs, no you know, smoking. very
Very clean and pre-screened individual during the pregnancy on prenatal vitamins, rescreened at the time of healthy baby birth, has to be healthy, going through donor services, just like you'd get a kidney. The same regulated licensed group that takes these donor products, fresh frozen, right to a lab, third-party testing, FDA registered lab, legit. And then I want to know the count. I want to know that they were not.
Handled or mishandled in any way. I want to know the size range that was counted. I don't want them to count everything. I want to count things in usually in a 50 to 150 nanometer diameter particles, spherical particles, not strange particles. And I want to know the protein content if we're going to go with what's called a secretome, which is the stem cell both.
Both signaling sides of the stem cell, the the exosome side and the protein growth factor peptide side.
Dr. Spencer Baron (06:00.789)
Interesting. So it you had mentioned on on our first show, and it's it's interesting, you just we were talking about, you know, other related things like peptides and and PRP and so on, but you s you mentioned clearly that it was up you know, your focus was to get from you know, umbilical cord from a non COVID vaccinated person.
Now, we only have to fast forward a couple months and boy has that been the buzzword that's changed everything. Now you've got people realizing that they've been duped and is it harder to is it harder to find non-COVID vaccin? Really?
Dr. Jeff (06:44.259)
No. No, there there's a a quiet source that's been out there for quite a while. Yeah. Yeah.
Dr. Spencer Baron (06:49.237)
Yeah. That's coming out now. That's great. That's great. In regenerative medicine we tend to assume that, you know, more is better, but with exosomes, can you you mentioned something about particle count. Could you actually tell us what that means as a better biological response?
Dr. Jeff (07:06.147)
Yeah, I mean, so the count refers to, you know, how many of these can affect how many of your cells. And a typical number, you know, if we're doing an intravenous treatment, might be five hundred billion to the s the few trillions. That would be typical. So if you were offered fifty billion, you're getting nothing. You're getting, you know, the exosomes in a tear drop. So and and you see that out there.
You see, I got fifty billion, I got a hundred billion, you're not getting much. It's n it's not that much.
Dr. Spencer Baron (07:42.445)
How that how are exosomes applied?
Dr. Jeff (07:46.35)
Well, we can do them intravenous. We can do them by nasal spray, which is a great brain delivery going through the back of the nasal cavity, through some of the ganglia and the s cribraform plate up through where the little nasal fibers go up. and we could do them by breathing treatment for the lungs. We can do them into tissue directly into muscles, you know, or myoligamentous structures. and we and I do them, you know, directly into
structure surrounding joints, you know, the bone edges. If we did we if we didn't talk about that last time, that's the optimal way to get the best and longest lasting result for cartilage regeneration. Now this is for educational purposes. I'm not making a cure or treatment claim because I want to be compliant, but you know, I don't do that for anything that's not approved for claims like vitamin D and for IV fluids and so many things.
Dr. Spencer Baron (08:43.693)
What are common conditions that come in and ask for exosomes or that you suggest exosomes instead of stem cell or
Dr. Jeff (08:50.231)
What what you know for educational purposes, because again we can't make claims about conditions, but people people tend to have osteoarthritis slash painful joint degeneration, loss of cartilage, bone on bone. That's most common. That can be spine or peripheral joints, thumbs, toes, knees, ankles, shoulders, elbows, wrists, what have you. we're working on a smaller needle to get the TMJ as well.
Dr. Spencer Baron (08:56.471)
True.
Dr. Jeff (09:20.383)
a lot of facet joints. That's right up your alley, right? the other things we do besides direct to those joints was we have some cosmetic applications for thinning hair on the scalp. And we also can do facial rejuvenation, skin rejuvenation by doing some micro needling, micro injection to the face. and we have a s we've made the exosomes into a skin cream.
Great for people recovering from a surgical scar or burns or just want some facial rejuvenation. Have to keep those cold though. It's the only refrigerated skin product, I believe. We did some homework on that. And as far as we know, we have to we ship it on ice and you have to keep it cold. And then the you know, we have some sexual function shots, both for men and ladies, and a few other, you know.
hodgepodge of things depending on people's specific needs, but we're getting we're getting down into the fewer percentages now.
Dr. Spencer Baron (10:24.397)
So we've come a long way from the hyaline injections that they would do for the knee when there was degenerative changes, especially in our athletes, our pro athletes that you know so do they not do that anymore? Is that something that you
Dr. Jeff (10:34.787)
Yeah, yeah.
Dr. Jeff (10:38.839)
Yeah, we do. We we listen, we're trying to get away from cortisone. You know, there's a role for it, you know, very acute injuries, but cortisone over time repetitively has a degenerative effect. and we don't want to add degeneration, it's already degenerating from wear and tear, from inflammatory burden. So we like the lubricant lubricant injections, the hyaluronic acid, the sinvisks, other brands. Sometimes I will pair
Dr. Spencer Baron (10:44.801)
Yeah, yeah.
Dr. Spencer Baron (11:04.663)
Yes.
Dr. Jeff (11:09.099)
a lubricating injection with the regenerative injection to a joint because the regenerative injection takes some time to do its magic and we want them to have some benefit in the short term, so we might add the lubricating injection at the same time.
Dr. Spencer Baron (11:23.479)
Terry, got one more question before you ask. the the you know, sometimes I'll have patients come in, they'll get, you know, the hyaline or the or the the hyal or or cortisone and they go, wow, I'm pain free the next day. Isn't there a a a isn't there like a lidocaine or a novacaine or something like that that they include in that that could be the disguise that yeah.
Dr. Jeff (11:47.748)
Typically. Typically. Yeah, well the the cortisone itself is is creating an artificial r pain reduction, which has a role. If you're completely messed up and you can't walk and your knees, you know, acutely injured, okay, maybe you do need it a cortisone, but it's not something I'd want to do as a recurrent management protocol. And that's really what's on the menu out there at most orthopedic offices or sports medicine offices. So we're trying to
push that into the less useful side, less needed side. Lidocaine is fine. We can't use lidocaine or a numbing agent with biologics because it it actually works. It can lys or rupture cells and exosomes. We don't so we we don't. We might put some in the the skin, but the deeper structures, no, we're not using that as much anymore.
Dr. Spencer Baron (12:38.061)
Great to know. Great to know. Go ahead, Terry, sorry.
Dr. Terry (12:39.474)
Hmm.
Well, I'm still shocked that so many people will do two or three corazone injections with all the new stuff out there. all right, I got a question for you. I got actually a real patient. I'm not gonna mention his name. He's he's a professional athlete and he's he's the one that was r he's really into the exosomes and he asks if you put the exact same five millimeters of exosomes into five hundred milliliters versus a thousand meters of saline, does dilution does does the dilution change the body?
Dr. Jeff (13:13.995)
No, except for the dilution factor, depending on where you're injecting them, you can't fit large volumes into joint structures. So if you're doing them intravenous, it doesn't matter. You can put them in a liter bag or a five hundred milliliter bag or a two hundred fifty milliliter bag, it doesn't matter. Your your body's gonna get the same number.
Dr. Terry (13:24.436)
So the Saint Lee.
Dr. Terry (13:32.564)
So the concentration of confusion doesn't really matter. All right. how how important is the timing f when you do it for acute injury versus chronic?
Dr. Jeff (13:35.704)
Not really.
Dr. Jeff (13:44.718)
We were finding that the closer you do it to the injury, the more acute you deliver them, the the quicker and and better the response to blunt the damage related to the overactive inflammation. So the body does need some inflammation, it signals the healing process, right? Acute inflammation has a beneficial role to an extent. The problem is modern adults tend to turn on that acute inflammation, overdo it, and not turn it off, and you get chronic inflammation.
Dr. Terry (14:01.233)
Right.
Dr. Jeff (14:12.983)
So we want to get that acute and then blunt it, especially for head injury, traumatic brain injury, concussion type injuries, more so than than anything else, or recovering from a heart attack or stroke or something like that, an acute event, acute injury. Like if you were in a major car wreck and you're banged up everywhere, I mean I'd want to get those going within twenty four hours if possible.
Dr. Terry (14:35.087)
wow. Is there a biological sweet spot to all this? Is there the blood markers that you look at to find that spot?
Dr. Jeff (14:42.787)
That's that's a great question. We're not we're not doing that because it's not practical in the clinic setting. By the time people get to us, they're outside of that. But yeah, we can look at C reactive protein, inflammatory markers, elevation of certain white cells, interleukins. Now this can get expensive in testing. So if I'd rather you save your money for the exosomes and we just give them to you. But yeah, I mean we could look at this scientifically and define a better sweet spot.
we don't know that exactly yet, but it's a great endeavor. We should do a we should get a fellowship going and get some scientists to come help us figure that out.
Dr. Spencer Baron (15:20.205)
Hm hmm.
Dr. Terry (15:20.977)
I mean, how how cool would that be to have like a a specific blood panel that tells you when your biological marker is the sweet spot? That would be amazing.
Dr. Jeff (15:27.745)
Yeah. Those exist and we can do those interleukins, you know, TNF alpha is interleukin six, all these things, and watch them spike after injury and come back down. That's thousands of dollars in lab testing. To you 'cause you have to repeat them, right? to know that.
Dr. Terry (15:40.615)
wow. It it have you noticed a change with the extremities versus spine versus head? Is there you know, like an ankle or even a a like a condition or disease? Is there is there sweet spots for everything or is it ki biologics or biologics?
Dr. Jeff (15:57.208)
Well, chronic problems like chronic degenerative osteoarthritic loss of cartilage. there's there's you know, the earlier the better. There's probably no sweet spot per se. 'Cause we treat people with end stage, you know, grade four bone on bone. We treat people with, you know, they had a meniscal tear surgery, they're doing pretty well, but they want to enhance their cartilage, prevent further accelerated degeneration. That is a side effect of those trimming surgeries.
Dr. Spencer Baron (16:24.599)
What would be the typical protocol when someone walks into your office? in other words, how would you manage a knee, like a weight bearing joint that is degenerative and versus a shoulder that's non weight bearing? Like how does that how does the whole process start and end for you for a patient?
Dr. Jeff (16:47.639)
Well, I I get to put on my biomechanist biomechanist hat because I do have a fellowship in spinal biomechanics, but I do apply that to joints. I mean we've learned a lot about how joints wear and so first clinical correlation, right? We wanna really come to an understanding of where it hurts, when it hurts, why it hurts, what happened. We wanna look at the imaging and good quality three Tesla MRI with inversion recovery sequences off the secret menu. and correlate
the symptoms, the tenderness, the limitation of movement, weight bearing or otherwise, to the symptoms and really define the targets. You know, I was looking at an MRI of a knee right before we got on, a patient I'm meeting with later today. I'd love to share it with you, but it's got her name on it. and and clearly she has loss of the patellar cartilage and inflammatory bone changes on either side. She doesn't really have any meniscal stuff. and I haven't
you know, talked to her since probably a month ago, but now we have a target. I know exactly what I need to do for her, where the problem's stemming from that matches with her symptoms. So we also look at lifestyle, you know, are you doing anything in your life that's inflaming you? Are you smoking? Are you eating poorly? Are you sedentary? Are you not doing exercise and, you know, clearing your head and sleeping r restorative, all the good.
stuff, eating properly, supplements. So we we really want to dial in the entire anti-aging, anti-inflammatory effects. We might add peptides early on and during a procedure and continue them that support anti inflammation and support cartilage regeneration.
Dr. Spencer Baron (18:34.989)
That's great. So speaking of the patient, ha like give us an idea. How is she how old is she? Is she active? Does she run? Is that why their her knees are like that?
Dr. Jeff (18:43.619)
She is a runner, actually ultra marathoner. and of course, she, you know, she's she's got running disease. She wants to keep running. And we have to keep her mobile. We have to keep her car running, you know, we have to keep those those parts working. So I really look forward to offering her an injection procedure for her kneecaps and in the femur just behind the kneecaps. So which should be a one and done.
Dr. Spencer Baron (18:52.535)
Yeah. Yeah.
Dr. Terry (19:09.126)
I Doc, I I got a quick question. Y Spencer just reminded me on something. W Does age really America you know, we've heard for s our entire career, even young kids in gymnastics, this condition called Seavers disease. Or if there's a if an impact injury on a seventeen year old and now he has knee pain but nobody can find it, you know, and maybe it's a growth plate, maybe it's something like that. Has exosomes help for s conditions like that for even kids?
Dr. Spencer Baron (19:09.235)
Interesting.
Dr. Jeff (19:32.866)
Yep. Yep. Okay, can I mean again it comes down to correlating them and and confirming the source of the problem. So an MRI has to be done with inversion recovery sequences. there's a new sequence I'm looking at. I think it's called water fat saturation. Just saw a publication the last couple months on correlating what's called MODIC changes. Now you guys know what those are. but for your listeners that might not know.
It these are inflammatory signal in the bone edge on an MRI adjacent to a disc. And now they with this special sequence on the MRI, they've correlated pain, discogenic pain to the end plates. They can see it. So modic changes, those early observations turn out to be useful in evaluating back pain. And those to me are treatment targets.
Dr. Spencer Baron (20:33.229)
So so if someone was to fly into your to your state, into your to your office to have a consult, would they start with a consult online or having a telemedicine? Because an you would want an MRI done, but obviously a special type of MRI.
Dr. Jeff (20:47.543)
Yeah. yeah.
Dr. Jeff (20:54.519)
We we do. So we we take care of all that remotely. wherever your town is, we've fine we we do the homework and find you a place nearby that can handle what we need and you get that done. You get the images to us in a digital format, whether it's a a disk that you might send us or there are ways to do it through file sharing. they're too big to email and we're not reliant on the report of the MRI, we're la looking at the actual
medical images and I have software that can open those up and look at those and then we get on a video and I share my screen. I show you the images. So I want my patients to have an understanding of where that problem is stemming from. you know, I don't I don't want to work in a a black box situation where I say, you have knee degeneration, you know, don't worry about it. I I know what's going on. I want them to know. I want them to be informed consumers.
Dr. Spencer Baron (21:48.109)
What type of MRI did you suggest?
Dr. Jeff (21:50.446)
Well, it's a three Tesla, which is sort of the the highest magnetic field strength. That's not the only measure of the quality of the MRI, but it really does help enhance the picture quality. and then we order what's called an inversion recovery sequence, which is the the short is called S T I R. And it doesn't cost more, but you have to order it. The doctor has to it's not part of often not part of a standard protocol. If you say if you if you just say knee MRI.
Dr. Spencer Baron (22:07.853)
Is that
Dr. Jeff (22:20.499)
usually you don't get that. You have to it's like the secret menu an In N Out burger. You have to know to order it. So you or I order inversion recovery sequences or stir in all planes. So front plane, side plane, cross section plane. and and we're looking at maybe adding this water fat sequence. A lot of places don't have parameters for it. So we have to send them parameters. So the text get our orders and they have no idea
'Cause th the text just push a button knee. Like this is we're we're really looking at, you know, getting the most out of an MRI. And most MRIs, this just you're just getting the very basic.
Dr. Spencer Baron (23:04.011)
Now not not to go too deep, although I am and I'm asking you about the inversion inversion recovery. Inversion recovery. What are you actually seeing or what are you actually looking at? Because this is new and is it it
Dr. Terry (23:07.748)
go deep, baby.
Dr. Jeff (23:20.791)
Yeah. It it enhances the watery inflammatory change in bone marrow. So you're really bringing out modic changes or inflammatory changes in the the tibial plateau or the femur or the kneecap or whatever structure you're looking at. And sometimes that's the only sequence where you see it. And that is my treatment target. So I'm very specific about where I deliver the biologics, the exosome.
Dr. Spencer Baron (23:47.552)
Is that I is that a application I mean like you have standard MRIs, you know, obviously varying levels of Tesla, but you know, like w I remember when concussion was such a epidemic and we would ask for a DTI diffuse tensor imaging. Is and it that was like a like an upgraded application to a regular MI. Is this the same type of approach? It's a it's
Dr. Jeff (24:05.889)
Yes. Yes.
Dr. Jeff (24:09.985)
Yes. Exactly. somewhat. A D a DTI package, d diffusion tensor looks at white matter tracks and the owner of the MRI actually has to buy some additional software. That's a that's an upgrade on their end and they charge extra for that. Whereas inversion recovery is a standard inclusion in as far as I know every MRI that can do it. So it doesn't cost extra.
Dr. Spencer Baron (24:37.069)
All right. Here's a question that I'm sure you don't have an answer for. Why do they s well why and I've been in search of this answer. Why can a a a hospital or a company spend millions of dollars on an MRI and still give you a damn disk? Who has disc drives anymore?
Dr. Jeff (24:40.887)
Yeah.
Dr. Terry (24:41.786)
Ha ha ha.
Dr. Jeff (24:56.875)
I do I do I have to in my office. We have every computer has a disk drive. be because it's it's HIPAA safe, right? You give a disk to a patient, the patient gives it to the doctor, it's completely compliant HIPAA, you're not sending images over the internet. The a lot of the portals where you can log into are are absolute craziness. There are some good ones, but some of them don't give you proper tools or they're clunky or they don't you know and
Dr. Spencer Baron (25:08.397)
Yeah.
Dr. Spencer Baron (25:16.3)
Yeah.
Dr. Spencer Baron (25:21.058)
Yeah.
Dr. Jeff (25:26.103)
The last thing I want to do is have to learn 50 software packages, right? How you know, because the tools are always different. I need the doctor's viewing tool. So I have this on my computer. I love the disk. The other way you can send is through a Dropbox or a Google Drive or some other version of that where you dump all the actual raw data into if you have a you can put it on a flash drive, it doesn't have to be a disk, but they're not doing that. So yeah, that's fine to me. That's fine.
Dr. Spencer Baron (25:28.981)
Yeah.
Dr. Spencer Baron (25:39.447)
Yeah.
Dr. Terry (25:49.524)
Yeah, flash eye would be so much easier.
Dr. Spencer Baron (25:50.529)
I know, right? Yeah.
Dr. Jeff (25:54.925)
two. I d I don't know why they're not doing that. They're so inexpensive now.
Dr. Spencer Baron (25:59.298)
See, that's why we love Dr. Jeff. He has an answer for something I was sure he didn't have an answer for. Good job. Good job. All right, here's another trick question for you. You got two pa two patients, s nearly identical knee MRIs. You know, the the you know, you they receive similar regenerative treatments, yet you have completely different outcomes. Like what what would make one patient a great candidate and the other one a poor responder?
Dr. Jeff (26:01.207)
Yeah.
Dr. Jeff (26:07.459)
I'm trying, man. I'm trying.
Dr. Jeff (26:12.862)
Yeah.
Dr. Jeff (26:24.343)
Yeah, I mean
Dr. Jeff (26:29.163)
it could be the patient's, you know, health and and biology. It could be, you know, let's assume they use the exact same regenerative biologic, same dose, same quality, same source. Could be how bad the knee is, could be they they didn't target the right places, maybe they didn't get the MRI with inversion recovery and target it. and then listen, this is medicine. Sometimes responses are not always the same. It's it's a practice, it's an art based on science, but it's an art.
Dr. Spencer Baron (26:57.015)
Great. I remember
Good friend of mine who's an orthopedic surgeon had a he was s he took so much pride in his s type of surgeries, especially on the spine. and one particular patient was a successful surgery, but the patient had such ill health that he learned many years you know he he learned that that there is some guidance in the world of sleep, nutrition, lifestyle. How do you approach something?
Yeah.
Dr. Jeff (27:30.945)
Yeah. Well, I'm doing a lot fewer surgeries now that I have these way more interesting and less invasive tools. but in the days when I did plenty of surgeries, you know, patient selection was important, health. And I I've learned so much through the longevity side of medicine now in the last few years that I I wish I could go back and enhance all these patients' ability to grow and be anabolic during that recovery.
Dr. Spencer Baron (27:37.282)
Yeah.
Dr. Jeff (27:59.8)
you know, get their health in order. We used to just do a pre-op, you know, clearance. They'd see their medical doctor, get some labs, get a chest x-ray, get an EKG. If everything was reasonable, we'd do the surgery. we could do a lot better. We could do peptides ahead of time. We could, you know, improve their protein and creatine intake. We could in, you know, you know get them into a growth mode, get their sugar even better balanced and and all kinds of supplements. I mean there there's so much
we could do better. It's not part of the sick care system. So people aren't getting that. They're not getting the optimal outcome because those elements are not built in.
Dr. Spencer Baron (28:36.791)
Well yeah, I mean I I mentioned the the situation where there's surgery, but I'm talking in in your world whether things are much more conservative and and obviously now reaching this this new level of attention. You know, y you're obviously conscientious about their lifestyles, you know, and you know, how you know, if they're a smoker, how's that gonna affect their processing of any kind of metabolic process, you know?
Dr. Jeff (28:54.706)
yeah. yeah.
Dr. Jeff (28:59.217)
yeah.
Dr. Jeff (29:03.469)
yeah, we we're we're very clear about that. But you know, try to get a smoker to quit. That's very that's just saying it's not gonna work. Like they have to have a plan, they have to, you know, get get get to that plan and carry it out and you know, and part of that plan might be exercise. And if their knees keeping them from exercising, you know, then there's a chicken in the egg. You know, maybe we do need to treat the knee as part of a lifestyle change that's happening, you know, and
Dr. Spencer Baron (29:09.549)
Right. Yeah.
Dr. Jeff (29:32.845)
You know, the inflammatory damage from smoking is incredible, but there were some papers, some studies showing that high dose omega-3 fish oil supplements can almost forgive some of that inflammatory damage at the cellular level. So not that that's an excuse for you smokers to keep doing it. It is a thing you can do to help reduce the progression of disease and prevent things because of all that damage you're doing to your cells.
Dr. Spencer Baron (29:58.126)
You know, there's an a you know, it's a curious but very peculiar question. You know, there there you mentioned something about smoking and we realize we're starting to hear more about nicotine patches because of how it well it affects the brain. So what is their you know, you hear different stories. One of the there's constriction of blood vessels. Do you even ask about things like that that people are using nicotine patches for? Yeah. When
Dr. Jeff (30:21.453)
Yeah, yeah.
We're we're learning more about nicotine. we're learning more about mitochondria. Let's back this up. Mitochondria, if you take care of your mitochondria, you're taking care of your cells in a large way. And mitochondria are the main, you know, we always call it the powerhouse of the cell, but it's really the it's the battery. It's the ability to generate electrochemical power by stripping off electrons and creating a charge differential differential.
Right, and then using that charge to to make ATP. So the you know, one of the things we need in our in our mitochondria to move those electrons down the chain is NAD, right? We all hear about NAD these days. Well, you need nicotine to make NAD. So nicotine has a role here, and we do have declining elements of NAD in our system as we age, and we're learning more about how to get that into our system and into our cells. So
The it's still being worked out, but we've we've learning more than ever. So we need nicotine. The question is: do we need supplemental and how much and how to get it? And all this. Yeah. So we have people that have nicotine, you know, in pouches for their mouth and patches for the skin, and there may be some health benefits there. I'm still evaluating that, and maybe next time I'm on, we can talk mitochondria for an hour.
Dr. Spencer Baron (31:46.816)
Ooh, I like that. Yeah Yeah, but the the the bu the buzzword is great, mitochondria. You hear about it all the time and what this affects mitochondria, this is good for mitochondria. Great. No, I like that idea. That would be fantastic. So patient walks in your office, once again, here's a situation that how do you determine whether they're a candidate for how do you decide, exosome or stem cell or PRP?
Dr. Jeff (31:47.703)
See how I invited myself back on the show?
Dr. Jeff (31:55.895)
Yeah. Yeah.
Dr. Jeff (32:15.267)
Th the only thing I'd recommend stem cells right now is if you were recovering from a heart attack or some kind of pulmonary infarction or something, because if you get stem cells intravenous, they're the stell cells are bigger than exosomes, they're sticky, and the heart and lungs take up the lion's share. So if you really want to concentrate those in the heart and lungs, do stem cells. I don't even I don't even have stem cells anymore. We we just haven't done them. Now we are s have access
And are sourcing MUSE cells, which is a subset of stem cells. and you know, we're working on this disc regeneration program using MUSE cells. So that's that changes what we're doing. But most things, exosomes are better for many reasons. One, they travel through tissue better, they skip the delivery van, go right to the package, they cross the blood brain barrier, they're easier to store and handle, they're less expensive. So all in all,
you're really getting the benefits of stem cells when you're getting the exosomes, you're just saving money and a lot of other things. So s exosomes are generally superior except for heart and lungs.
Dr. Spencer Baron (33:22.573)
Say Muse U S E S
Dr. Jeff (33:23.905)
Muse. M-U-S-E. Like you know, a little, you know, angel who gives you ideas, you know, plays a little music on a lute or a s a little harp.
Dr. Spencer Baron (33:28.907)
Yeah. I knew you were gonna do it. Yeah.
Dr. Spencer Baron (33:36.545)
Ha ha that's great. All right, Dr. Jeff, let me ask exosomes are being talked about, you know, far beyond orthopedics now, some of the in the neurological and autoimmune condition world, long covid, yes, and even Lyme disease, which is very challenging. What where are you seeing most of the promising research outside of the musculoskeletals?
Dr. Jeff (33:45.953)
Yeah. Yeah. Yeah.
Dr. Jeff (33:56.578)
Yeah, I mean listen, we are clearly seeing many increasing volume of good publications using stem cell derived exosomes for health benefits. A lot of this is coming out of Asia. The Chinese are way ahead of us. They now have more specific exosomes, maybe neurological stem cell derived, as opposed to just generic umbilical cord stem cell exosomes. Or or you know, we're just trying out some specific dermal pulpillae.
Exosomes for hair regrowth that are have more cargo to stimulate those cells specifically to do what we want them to do, you know, poke poke through some new baby hairs, right? So we're we're getting access to these more specific types of exosomes as opposed to generic. Nothing wrong with generic. They're ubiquitous, they're easy to get, they're they're you know, they they tend to be good across the board. But if we can get more granular and more specific, then
We're moving the needle forward. I think in the next couple of years you're gonna see more of that.
Dr. Spencer Baron (34:59.189)
Lyme disease has always been a very challenging condition for so many. I've had patients come in and it's just a sad, sad story. Are we actually targeting the disease or influencing inflammation or the immune response? What are we trying to do here with regarding the tissue damage?
Dr. Jeff (35:16.237)
When when using regenerative biologics like exosomes for a a a hyper inflammatory residual of a chronic infection, whether it's Lyme's disease, long COVID or something similar, we're really targeting the inflammatory component. We're not targeting the pathogen. We're also targeting the in the immune system. So the immune system gets boosted in its health. The inflammatory
signals that are turned on by these infections can get suppressed and therefore the pain and the joint degeneration and the sluggishness and all the symptoms that go with it can get can get reduced. But we still have to treat the pathogens. So that whether that's an antibiotic, whether it's you know for for long COVID spike proteins that you know plasmapuresis or eBU or you know maybe natokinase to help break it up.
things like that. There are there are protocols as well that need to be hand in hand and of course, all in anti-inflammatory lifestyle, peptides, supplements, diet, exercise, exercise, exercise, sleep, all those.
Dr. Spencer Baron (36:27.159)
Carrie, I got one question one more one more question before you. one of the most common conditions that a patient is told by their medical doctor, they come into our office, you have arthritis. And what okay. So we're talking, yeah, I do, I do. It's so generic, and there's so many other ways of handling it. But at what point, at what point like rheumatoid, let's say, what would would somebody be a candidate for
Dr. Terry (36:28.553)
Yeah, yeah.
Dr. Jeff (36:43.159)
I hate that.
Dr. Jeff (36:48.492)
Ain't too.
Dr. Jeff (36:55.455)
yeah. Yeah. Rheumatoid arthritis, you know, is is the genetic version typically, or some kind of autoimmune overreactive version, that causes diffuse degeneration, which affects the joints first. It affects other parts of the body. You can get psoriasis and skin inflammatory changes, other things. the eyes can be affected, the secraliac joints, all kinds of things. The joints are the low-hanging fruit that are the most
Dr. Spencer Baron (36:56.299)
For real.
Dr. Jeff (37:21.931)
symptomatic thing that inflammation causes in your body first and foremost, generally speaking. So so we we do use the regenerative exosomes to help suppress the overall hyperinflammatory situation. and we usually do that intravenous. If if if that helps quell a lot of the joints, but maybe one or two joints are really bad, we may go direct into those joints then as well.
Dr. Spencer Baron (37:48.845)
That's great. Go ahead, Terry. Sorry.
Dr. Terry (37:50.118)
I wanna actually go back a little bit to Lyme disease because I actually have a patient in mine who's a professional athlete, has been everywhere, is on the supplements, is doing the hyperbaric chamber, is doing PMF, he's done everything possible and the only thing that got got him back to his sport was exosomes. And when he's tried everything and he's flown to all different states and all that kind of stuff. Why did the exosomes work and is he now
he feels like I have to do this every three months or I I can't function. Is that something he's gonna have to do for the rest of his life or is this there's is there an exit plan? W what is he doing? 'Cause he's super healthy and he's super health conscious and he's done everything.
Dr. Jeff (38:34.861)
Yeah. You're doing everything right. The exosomes are suppressing the inflammatory, you know, blow up from the limes. And he's able to suppress that for a few months at a time, which is typical with an exosome treatment. But the limes is still there. So we need to figure out where it's harbored, how to get it out, you know, is there a different antibiotic regimen? Are there some peptides? Is it mitochondrial support? I'd we'd have to look at we'd look more more at those things and maybe
Uncover something that hasn't been yet uncovered.
Dr. Terry (39:06.045)
I mean, is this is Lyme disease? Some people think it once they have it they have it for the rest of their life. Have you seen people where it can be eliminated and be gone?
Dr. Jeff (39:14.519)
Yeah. yeah. You get the bacteria that causes it out of there and and then you can reprogram the inflammatory epigenetics and those cells to get back to normal programming.
Dr. Terry (39:29.105)
Interesting. Yeah, since you've been on the show a couple it's been what, a couple of years now? Agenda medicine, like we talked about at the very beginning, has taken leaps and bounds. What are you doing now in twenty twenty six that you weren't doing in twenty twenty five and twenty twenty four? Where do you see this this accelerated process that you've been you've been going with?
Dr. Jeff (39:49.154)
Yeah. the breadth of peptides have been huge as an additive. the the different types of exosomes, as I mentioned, are coming. And then muse cells. You know, we all these exosomes and the incredible results we have with joints, generally speaking, I'd and I can love to show before and afters of MRIs where cartilage is regrowing. Like it's it's a thing. We do that. Now, can I guarantee it or claim it? No, but I can show you examples, that's legit. I can show you medical evidence and science.
Published, that's legit. but we really struggle with disc regeneration because the disc is a strange cartilage made of two different components, right? So we think there's a well, we we know there's a study in China showing some evidence that these muse cells can regenerate disc nucleus pulposis. and that's the sky, for those listening that don't know, that's the squishy stuff in the center of the disc. So that
Could be the holy grail, hopefully. So we have a sandwich therapy in mind. We're about to start a program where you get MU cells intradiscal in the nucleus and you get regenerative exosomes in the end plates where the motic changes are to stimulate the annulus health. So you get you get the full attention to the disc. And the nucleus is odd, guys, because it's one of the few structures that comes from the layer of the embryo called endoderm.
Whereas most of the body comes from the middle layer called mesoderm or mesenkyme. You've heard mesenchymal stem cells, right? So it stimulates mesodermal structures like musculoskeletal structures generally, some organs, things like that. And then the other layers, ectoderm, which is the nervous system, the teeth, and some gland cells. So now that we have MUSE cells in MUES, in MUSE stands for
Multilineage, meaning it can affect all three layers of the embryo. So we think that's gonna help that endoderm that's not getting touched adequately by mesenchymal exosomes.
Dr. Terry (41:55.79)
All right. On that on that note, you when you were a neurosurgeon years ago, the hot topic was disc replacement. Now are you are you still seeing disc replacements as being hot? Or what happens now when these guys got disc replacement and now they're having mechanical back pain? what's your what's your thing? I are are you seeing disc replacements gonna be go away or are you gonna still they're
Dr. Jeff (42:03.362)
Yeah.
Dr. Spencer Baron (42:03.799)
Mm-hmm.
Dr. Jeff (42:17.889)
No, no, no. Disc disc replacement is still a viable option. Listen, when you herniate a disc, there's no regenerative medicine that's gonna make that herniation go away, right? You've got a thorn in the tiger's paw. You have to remove the thorn. And in doing so, sometimes you remove so much disc to clean it up that you don't leave much left. And especially in the neck, it's very hard to remove a herniation in the neck. If the disc is so small, by by the time you've removed it, you remove the whole most of the disc.
You know, although there is a procedure where you can take just a little corner. So disc replacement, especially in the neck, has still has legs, and it helps reduce the stress above and below, which fusions can cause. So it's ultimately biomechanically a good result. Now, people can down the line develop pain because the the disc replacement, if it's not put in just exactly physiologically.
can overstress the facet joints, because the facet joints are still moving. They haven't been replaced. Now some people have come up with a facet joint replacement. to me it seems like a little aggressive, but I and frankly I haven't been trained on it, so I may be speaking out of turn, but I think disc replacement is still a better surgery than fusion. And I think fusions were overdone for so many decades because it was all all we had until the early two thousands.
And the early generation disc replacements weren't great. The the new generations are much better.
Dr. Terry (43:50.742)
All right. I do have a go ahead. Go ahead. I can see Spencer's like lean forward.
Dr. Spencer Baron (43:52.854)
I I gotta a wait, I gotta ask. I gotta ask. yeah. Yeah. Because because from what I understand you put in this this disc replacement that's made out of you know, you know, metal or ceramic or what have you, depending on the product. And it's so durable that it actually deteriorates the adjacent vertebra. So ha right?
Dr. Jeff (44:18.741)
It can. This is this is a patient selection problem. This is, I have an older lady with soft bone who's not on bioidentic hormone replacement. She's osteopinic or osteoproduct. That is a bad surgeon's decision. That's a fool with the tool, applying a tool he shouldn't be using because he's a fool.
Dr. Spencer Baron (44:22.849)
Yeah.
Dr. Spencer Baron (44:32.94)
Yeah.
Dr. Spencer Baron (44:39.883)
A f a fool with a tool. I am that it I am owning that. I love it because that then
Dr. Terry (44:41.334)
I gotta use that one. I gotta use that one.
Dr. Jeff (44:45.731)
Well, I borrowed it. I I wanna give credit to my professor, Doctor Ed Benzel, who used to say that. So I'm passing it down to you now.
Dr. Terry (44:51.682)
that's awesome. All right. You know, I still have patients that can't get their head around PRP and and what's your thoughts on PRP? Is it still viable or have we moved beyond that?
Dr. Spencer Baron (44:55.105)
Doctor Ed Benzell, thank you. That's great.
Dr. Jeff (45:07.117)
Yeah. Yeah. There's nothing wrong with PRP. It's it's an entry level regenerative biologic from your own body. And you usually have to do multiple sessions of it. so it it's it's less costly. and I I understand that some health insurances are now paying for it, even though it's not yet approved for marketing claims by the FDA. So here's where insurance is making decisions because of costs, not science.
However, PRP is viable. To me, I want to do something more effective. So exosomes are leveling up in terms of the potency. Nothing wrong with PRP. I'm not judging. A lot of people can easily do PRP.
Dr. Terry (45:49.909)
All right. So if you got it somebody listen to the show and they go, I really wanna I think I need to try the sexosomes, what's w what's the clinical thinking? What should they walk in? What questions should they walk in to their doctor and what are some red flags that they hear they need to walk out?
Dr. Jeff (46:08.327)
they they need to say, Okay, doc, I'm interested in this. you know, do you have experience with it? And the doc should have some experience with it. Okay, great. Tell me your experience, get get a little education there. what are you using? Where do you get it from? And can I see an example certificate of analysis?
Where it goes over the counts, the viral testing, the protein content and distribution, endotoxin to make sure it's not infected. I wanna see that. And every time we do a treatment, we have four pages of testing from that treatment. We show it to the patient, we put it in the file, we track the lot number, we send it back to the FDA registered lab and track each and every dose.
Dr. Spencer Baron (46:55.089)
Thorough. I like that. So let me ask you I I I started to allude to this before but I think I took a turn with the question and that was like if if a patient comes in and they now wait, better yet if a
and I know 'cause you've become very popular amongst amongst our chiropractic community and and by the way, the the where you spoke at the Florida Chiropractic Association, the the doctors text me that day. A couple of said, Where'd you find this guy? He's great. They love you.
Dr. Jeff (47:23.139)
Thank you. Yeah. Had a great a great meeting, great place, great time. I wish I could have stayed longer. Really well done, by the way. FCA, good job.
Dr. Spencer Baron (47:32.171)
Yeah, yeah. So with that said, and you know, you're you're in Las Vegas. If somebody had to fly in and they had an issue with a weight bearing joint versus an an upper extremity, are they able to walk out or they do they need crut you know really?
Dr. Jeff (47:48.358)
yeah. yeah. Yeah. They we want them. There's no downtime. We want them on that joint using it. we have people that play golf the next day after a shoulder procedure, walk the strip if it's not 108 degrees like it is today. all that. Absolutely. We want you using it. We want you to stimulate the mechanoreceptors that release the healing cytokines and all that. We want that. That's one of the other beauties of this. No downtime.
Dr. Spencer Baron (48:01.066)
Yeah right yeah.
Dr. Spencer Baron (48:13.752)
Yeah.
Dr. Jeff (48:16.727)
so we have people when we do invite them to come in, you know, they can fly in maybe the day before or the same morning. we can do the procedure. We do prefer you stay overnight, but hey, if you're coming all the way to Las Vegas, schedule a nice dinner, see a show at the sphere, stay and enjoy for a few days, you know, enjoy it. You will be sore where we injected you, but it's not it's rarely sore enough that's gonna keep you from walking or doing stuff.
Dr. Spencer Baron (48:46.252)
Terry, I think I'm gonna fly out for pro sport just to see Dr. Jeff.
Dr. Terry (48:51.958)
Well, I'm gonna be scheduling a lunch with him. He doesn't know that yet, but he's gonna say yes. So if you wanna come out you can join us.
Dr. Spencer Baron (48:57.632)
We'll go. May maybe maybe k maybe you can inject my wrists during dessert, you know, or after lunch, right?
Dr. Jeff (48:59.142)
Yeah.
Dr. Terry (49:02.94)
Ha ha ha.
Dr. Jeff (49:05.111)
Let's let's get together. If you're all coming out for pro sport, I'd be happy to meet you down there. We have some mutual friends we'll invite as well.
Dr. Terry (49:12.426)
There you go. Love it. Love it. Love it.
Dr. Spencer Baron (49:12.548)
that'd be great. Dr. Jeff, we're ready for our rapid fire questions. We got five of them for you. If you recall last time, re sock it to me. That was from Laughing. Do you remember that show? my my god, that's great. yeah. Yeah. yeah. Alright, question number one. If you could regenerate one part of your own body back to its twenty-five year old version.
Dr. Jeff (49:17.441)
Yes. Soc it to me, as I said last time.
Dr. Jeff (49:24.747)
I I do already saw, yeah.
Dr. Terry (49:25.167)
yeah.
Dr. Jeff (49:29.419)
Only for us old guys. Yeah.
Dr. Terry (49:31.486)
Yeah, right. Right.
Dr. Spencer Baron (49:41.834)
What body part are you choosing?
Dr. Jeff (49:44.236)
Ooh, I probably want my hippocampus where my memory is stored. Not that I'm having memory issues, but man, there are probably so many things that we don't even know we've forgotten. So I wanna I would wanna enhance my memory and and push that into the future. Yeah.
Dr. Terry (49:55.966)
Dr. Terry (49:59.575)
All right, I'm going for that one. You're y you're getting no, you already said your wrist. You're getting your wrist done, I'm getting my hippocampus done.
Dr. Spencer Baron (49:59.895)
That is so n yeah, me too. I w
Dr. Spencer Baron (50:06.337)
Forget
That is so not the answer I thought, but that is a beautiful answer. Question number two. What's one health habit you know works, but you still struggle to do consistently?
Dr. Jeff (50:22.519)
Diet. I mean, gosh, I I still love pizza. I still I still love a great cheeseburger. you know, I I I still when we go, you know, my wife and I like to go to the go clubbing. That means we go to Costco and we you can't pass up the hot dog at Costco. So yeah, we go we go to we go clubbing to get some hotties. That means we're going to get rotisserie chicken at Costco.
Dr. Spencer Baron (50:41.32)
that is not what I thought.
Dr. Terry (50:43.956)
Love me.
Dr. Jeff (50:52.706)
Yeah.
Dr. Spencer Baron (50:54.388)
I am so using that. my god, that was great.
Dr. Terry (50:55.106)
That's okay, that's brilliant.
Dr. Jeff (50:56.259)
I borrowed that from somewhere, so I'm sorry I don't know the source.
Dr. Spencer Baron (51:02.456)
Terry, Terry, we we gotta we gotta, you know, use these colloquialism, you know, tool for the fool and then now the hotties at the clubbing and all that. I'm I'm all over this. All right. Question number three if you could eliminate one piece of bad health advice from the internet forever, what would it be?
Dr. Jeff (51:06.893)
Yeah.
Dr. Terry (51:09.578)
Go clubbing. Yeah. Totally.
Dr. Jeff (51:21.287)
that that sunlight alone is adequate to make vitamin D. It's not enough, guys. I love it, it's great. Sunlight's healthy. You need vitamin D, significant vitamin D. The lab numbers are only to prevent deficiency. They're not optimal health. I want your numbers higher. I want you on ten thousand IUs a day, most of you. It helps to build bone. It reduces all causes of death. All causes.
So why are you not on vitamin D?
Dr. Spencer Baron (51:52.982)
Very nice. Very nice. Is there a particular D, vitamin D, that you suggest or no?
Dr. Jeff (51:57.678)
I like when you they have vitamin K two in there. they do well together, but no, I don't have a brand I'm pushing. but we could start a Kraken Bax Vitamin D brand together and you know, do really well.
Dr. Spencer Baron (52:00.737)
Yeah.
Dr. Spencer Baron (52:08.3)
I think that'd be great. All right, question number four. What's something you believed about health or longevity that at f thirty that you see completely different today?
Dr. Terry (52:10.27)
Love it.
Dr. Jeff (52:22.999)
Well, I think it's the type of exercise. I thought that cardio would be the right exercise long term for you as long as you're doing cardio and I was wrong. You gotta you gotta have big muscles, you gotta not big, but you gotta have muscles and you g you gotta you gotta lift heavy and do resistance and weight bearing.
Dr. Spencer Baron (52:40.854)
Very nice. Very nice. And it's so funny how we talk about exercise but no you know, some doctors don't prescribe it because there's no, you know, financial incentive to tell you to exercise. So
question last one, Dr. Jeff. If you could give every person listening one thing, not a d treatment, drug, or supplement that can improve the quality of the next twenty years of their life, what would it be?
Dr. Jeff (53:12.205)
well since I've already tapped into exercise, I'm gonna I'm gonna move this one into sleep. Quality s deep restorative sleep. And that means you need to have a sleep plan, sleep action, sleep rituals, cold room, perhaps, you know, turning off screens, maybe doing some red light therapy at at you know nighttime you know and and
really you know maybe some melatonin supplementation not just to fall asleep but to sleep deeper maybe use some health tech to track your sleep quality sleep you do your repair when you sleep and if you're not repairing well you're doing more breaking down than repairing so you're gonna age faster
Dr. Spencer Baron (53:59.114)
Dr. Jeff, I gotta tell ya, thank you so much for being on the show. You don't realize but you are absolutely the bridge between the traditional mainstream medicine and our version of alternative, you know, holistic care. Thanks so much.
Dr. Jeff (54:15.767)
Thank you for having me, guys. Love talking with you.
PRP, stem cells, now exosomes, they're being called the next breakthrough in regenerative medicine. But are they actually changing the way we heal or has the hype gotten ahead of the science? And if you're about to spend thousands on exosomes, do you even know what you're getting?
Well, Dr. Jeff Gross is a neurosurgeon and regenerative medicine specialist and he's back on Kraken Backs to help us separate the science from the hype. Doctor Jeff, welcome back.
Dr. Jeff (00:33.335)
Thanks for having me back, guys. How you doing?
Dr. Spencer Baron (00:35.938)
Great man, great. We're gonna kick off by asking you, you know, what patients are actually buying? Because you hear it all the time. They're they're buying on the black market, they're buying from their doctor. Talk to me about that.
Dr. Terry (00:36.2)
Fantastic.
Dr. Jeff (00:49.227)
Yeah. Well, I mean it's hard to get regenerative biologics, except for peptides, on your own. You can get peptides on your own, but in terms of stem cells and exosomes and mu cells and all kinds of things, you you really need to get it from a clinician or a clinic. And there's a wide variety in what you're getting, how much you're getting, the quality, the clinical experience, and you got to be a really good consumer about it.
Dr. Spencer Baron (01:17.41)
What are what are exosomes and you know, what is supposed what are they supposed to be doing?
Dr. Jeff (01:23.075)
Great. Well, part of cellular biology is cells communicate with other cells, their neighbors, right? if if a cell is infected, it's gotta warn its neighbors, hey, get ready to defend yourself, you know. So there's ongoing signaling. Some of that signaling is through proteins slash peptides, because peptides are a subset of proteins. Some of those are growth factors, some are cytokines, you may have heard that word. some are pro-inflammatory, some are anti-inflammatory.
But the other side of signaling are these vesicles, extracellular vesicles. So a cell will bubble out a small outpocket, takes a little bit of the membrane. That membrane pinches off some of the cytoplasm from the cell, and with it it takes some RNAs, and it takes some growth factors and peptides, and it takes some lipids, and it goes into.
in the in the neighborhood in between the cells and other cells will pick it up and envelop into the cell, delivering those contents at high efficiency through endocytosis, if you remember that from high school biology. So one cell delivers these, another cell picks them up. There's this ongoing communication. These cells are measured sorry, these vesicles are measured in diameter in nanometers. So we sometimes call them nanoparticles because they're so much smaller than cells. And they're amazing. They can
cross the blood brain barrier, the placenta, they're so small. So those when they're derived from from stem cells, we call those stem cell derived exosomes. And when we use the word exosomes clinically speaking, we really are t talking to those from stem cells because all cells make them, sick cells make them, senescent cells, zombie cells make them. We don't want those. We want the good stuff, the stem cell derived ones. That's what exosomes are and they are the business end of stem cells. They are what stem cells do
So you can skip the stem cells and the real actual medicine from the stem cells is the exosome component.
Dr. Spencer Baron (03:26.315)
Hmm, good explanation. So let me get this right. Exosomes are like the repair crew and more like they're telling as biological instructions, they're telling our own cells what to do. Is that close? Okay. So if a patient tells you I got five milliliters of exosomes, does five milliliters of exosomes mean anything or is it volume wrong? Yeah.
Dr. Jeff (03:37.943)
Yep. Yep.
Dr. Jeff (03:47.416)
That that is zero information. We don't know the the source of the cells they got those from. We don't know if they were in culture or naturally derived. We don't know if they were freeze-dried or fresh frozen. We don't know a count. We don't know the the size they're counting. We don't know the quality. We don't know the protein content in that fluid if there is any proteinslash growth factor. So the milliliters are sometimes just the count number.
is not very meaningful.
Dr. Spencer Baron (04:20.737)
What is a good XSM? What would you have some what would our audience look for or
Dr. Jeff (04:27.779)
Well, my favorite source, and I think, you know, I talked about this in the past, is I I love the cleanest, freshest source from the youngest donor, right? And this is from amniotic fluid or umbilical cord fluid from a non-COVID vaccinated young mother with no history of diseases, no drinking, no drugs, no you know, smoking. very
Very clean and pre-screened individual during the pregnancy on prenatal vitamins, rescreened at the time of healthy baby birth, has to be healthy, going through donor services, just like you'd get a kidney. The same regulated licensed group that takes these donor products, fresh frozen, right to a lab, third-party testing, FDA registered lab, legit. And then I want to know the count. I want to know that they were not.
Handled or mishandled in any way. I want to know the size range that was counted. I don't want them to count everything. I want to count things in usually in a 50 to 150 nanometer diameter particles, spherical particles, not strange particles. And I want to know the protein content if we're going to go with what's called a secretome, which is the stem cell both.
Both signaling sides of the stem cell, the the exosome side and the protein growth factor peptide side.
Dr. Spencer Baron (06:00.789)
Interesting. So it you had mentioned on on our first show, and it's it's interesting, you just we were talking about, you know, other related things like peptides and and PRP and so on, but you s you mentioned clearly that it was up you know, your focus was to get from you know, umbilical cord from a non COVID vaccinated person.
Now, we only have to fast forward a couple months and boy has that been the buzzword that's changed everything. Now you've got people realizing that they've been duped and is it harder to is it harder to find non-COVID vaccin? Really?
Dr. Jeff (06:44.259)
No. No, there there's a a quiet source that's been out there for quite a while. Yeah. Yeah.
Dr. Spencer Baron (06:49.237)
Yeah. That's coming out now. That's great. That's great. In regenerative medicine we tend to assume that, you know, more is better, but with exosomes, can you you mentioned something about particle count. Could you actually tell us what that means as a better biological response?
Dr. Jeff (07:06.147)
Yeah, I mean, so the count refers to, you know, how many of these can affect how many of your cells. And a typical number, you know, if we're doing an intravenous treatment, might be five hundred billion to the s the few trillions. That would be typical. So if you were offered fifty billion, you're getting nothing. You're getting, you know, the exosomes in a tear drop. So and and you see that out there.
You see, I got fifty billion, I got a hundred billion, you're not getting much. It's n it's not that much.
Dr. Spencer Baron (07:42.445)
How that how are exosomes applied?
Dr. Jeff (07:46.35)
Well, we can do them intravenous. We can do them by nasal spray, which is a great brain delivery going through the back of the nasal cavity, through some of the ganglia and the s cribraform plate up through where the little nasal fibers go up. and we could do them by breathing treatment for the lungs. We can do them into tissue directly into muscles, you know, or myoligamentous structures. and we and I do them, you know, directly into
structure surrounding joints, you know, the bone edges. If we did we if we didn't talk about that last time, that's the optimal way to get the best and longest lasting result for cartilage regeneration. Now this is for educational purposes. I'm not making a cure or treatment claim because I want to be compliant, but you know, I don't do that for anything that's not approved for claims like vitamin D and for IV fluids and so many things.
Dr. Spencer Baron (08:43.693)
What are common conditions that come in and ask for exosomes or that you suggest exosomes instead of stem cell or
Dr. Jeff (08:50.231)
What what you know for educational purposes, because again we can't make claims about conditions, but people people tend to have osteoarthritis slash painful joint degeneration, loss of cartilage, bone on bone. That's most common. That can be spine or peripheral joints, thumbs, toes, knees, ankles, shoulders, elbows, wrists, what have you. we're working on a smaller needle to get the TMJ as well.
Dr. Spencer Baron (08:56.471)
True.
Dr. Jeff (09:20.383)
a lot of facet joints. That's right up your alley, right? the other things we do besides direct to those joints was we have some cosmetic applications for thinning hair on the scalp. And we also can do facial rejuvenation, skin rejuvenation by doing some micro needling, micro injection to the face. and we have a s we've made the exosomes into a skin cream.
Great for people recovering from a surgical scar or burns or just want some facial rejuvenation. Have to keep those cold though. It's the only refrigerated skin product, I believe. We did some homework on that. And as far as we know, we have to we ship it on ice and you have to keep it cold. And then the you know, we have some sexual function shots, both for men and ladies, and a few other, you know.
hodgepodge of things depending on people's specific needs, but we're getting we're getting down into the fewer percentages now.
Dr. Spencer Baron (10:24.397)
So we've come a long way from the hyaline injections that they would do for the knee when there was degenerative changes, especially in our athletes, our pro athletes that you know so do they not do that anymore? Is that something that you
Dr. Jeff (10:34.787)
Yeah, yeah.
Dr. Jeff (10:38.839)
Yeah, we do. We we listen, we're trying to get away from cortisone. You know, there's a role for it, you know, very acute injuries, but cortisone over time repetitively has a degenerative effect. and we don't want to add degeneration, it's already degenerating from wear and tear, from inflammatory burden. So we like the lubricant lubricant injections, the hyaluronic acid, the sinvisks, other brands. Sometimes I will pair
Dr. Spencer Baron (10:44.801)
Yeah, yeah.
Dr. Spencer Baron (11:04.663)
Yes.
Dr. Jeff (11:09.099)
a lubricating injection with the regenerative injection to a joint because the regenerative injection takes some time to do its magic and we want them to have some benefit in the short term, so we might add the lubricating injection at the same time.
Dr. Spencer Baron (11:23.479)
Terry, got one more question before you ask. the the you know, sometimes I'll have patients come in, they'll get, you know, the hyaline or the or the the hyal or or cortisone and they go, wow, I'm pain free the next day. Isn't there a a a isn't there like a lidocaine or a novacaine or something like that that they include in that that could be the disguise that yeah.
Dr. Jeff (11:47.748)
Typically. Typically. Yeah, well the the cortisone itself is is creating an artificial r pain reduction, which has a role. If you're completely messed up and you can't walk and your knees, you know, acutely injured, okay, maybe you do need it a cortisone, but it's not something I'd want to do as a recurrent management protocol. And that's really what's on the menu out there at most orthopedic offices or sports medicine offices. So we're trying to
push that into the less useful side, less needed side. Lidocaine is fine. We can't use lidocaine or a numbing agent with biologics because it it actually works. It can lys or rupture cells and exosomes. We don't so we we don't. We might put some in the the skin, but the deeper structures, no, we're not using that as much anymore.
Dr. Spencer Baron (12:38.061)
Great to know. Great to know. Go ahead, Terry, sorry.
Dr. Terry (12:39.474)
Hmm.
Well, I'm still shocked that so many people will do two or three corazone injections with all the new stuff out there. all right, I got a question for you. I got actually a real patient. I'm not gonna mention his name. He's he's a professional athlete and he's he's the one that was r he's really into the exosomes and he asks if you put the exact same five millimeters of exosomes into five hundred milliliters versus a thousand meters of saline, does dilution does does the dilution change the body?
Dr. Jeff (13:13.995)
No, except for the dilution factor, depending on where you're injecting them, you can't fit large volumes into joint structures. So if you're doing them intravenous, it doesn't matter. You can put them in a liter bag or a five hundred milliliter bag or a two hundred fifty milliliter bag, it doesn't matter. Your your body's gonna get the same number.
Dr. Terry (13:24.436)
So the Saint Lee.
Dr. Terry (13:32.564)
So the concentration of confusion doesn't really matter. All right. how how important is the timing f when you do it for acute injury versus chronic?
Dr. Jeff (13:35.704)
Not really.
Dr. Jeff (13:44.718)
We were finding that the closer you do it to the injury, the more acute you deliver them, the the quicker and and better the response to blunt the damage related to the overactive inflammation. So the body does need some inflammation, it signals the healing process, right? Acute inflammation has a beneficial role to an extent. The problem is modern adults tend to turn on that acute inflammation, overdo it, and not turn it off, and you get chronic inflammation.
Dr. Terry (14:01.233)
Right.
Dr. Jeff (14:12.983)
So we want to get that acute and then blunt it, especially for head injury, traumatic brain injury, concussion type injuries, more so than than anything else, or recovering from a heart attack or stroke or something like that, an acute event, acute injury. Like if you were in a major car wreck and you're banged up everywhere, I mean I'd want to get those going within twenty four hours if possible.
Dr. Terry (14:35.087)
wow. Is there a biological sweet spot to all this? Is there the blood markers that you look at to find that spot?
Dr. Jeff (14:42.787)
That's that's a great question. We're not we're not doing that because it's not practical in the clinic setting. By the time people get to us, they're outside of that. But yeah, we can look at C reactive protein, inflammatory markers, elevation of certain white cells, interleukins. Now this can get expensive in testing. So if I'd rather you save your money for the exosomes and we just give them to you. But yeah, I mean we could look at this scientifically and define a better sweet spot.
we don't know that exactly yet, but it's a great endeavor. We should do a we should get a fellowship going and get some scientists to come help us figure that out.
Dr. Spencer Baron (15:20.205)
Hm hmm.
Dr. Terry (15:20.977)
I mean, how how cool would that be to have like a a specific blood panel that tells you when your biological marker is the sweet spot? That would be amazing.
Dr. Jeff (15:27.745)
Yeah. Those exist and we can do those interleukins, you know, TNF alpha is interleukin six, all these things, and watch them spike after injury and come back down. That's thousands of dollars in lab testing. To you 'cause you have to repeat them, right? to know that.
Dr. Terry (15:40.615)
wow. It it have you noticed a change with the extremities versus spine versus head? Is there you know, like an ankle or even a a like a condition or disease? Is there is there sweet spots for everything or is it ki biologics or biologics?
Dr. Jeff (15:57.208)
Well, chronic problems like chronic degenerative osteoarthritic loss of cartilage. there's there's you know, the earlier the better. There's probably no sweet spot per se. 'Cause we treat people with end stage, you know, grade four bone on bone. We treat people with, you know, they had a meniscal tear surgery, they're doing pretty well, but they want to enhance their cartilage, prevent further accelerated degeneration. That is a side effect of those trimming surgeries.
Dr. Spencer Baron (16:24.599)
What would be the typical protocol when someone walks into your office? in other words, how would you manage a knee, like a weight bearing joint that is degenerative and versus a shoulder that's non weight bearing? Like how does that how does the whole process start and end for you for a patient?
Dr. Jeff (16:47.639)
Well, I I get to put on my biomechanist biomechanist hat because I do have a fellowship in spinal biomechanics, but I do apply that to joints. I mean we've learned a lot about how joints wear and so first clinical correlation, right? We wanna really come to an understanding of where it hurts, when it hurts, why it hurts, what happened. We wanna look at the imaging and good quality three Tesla MRI with inversion recovery sequences off the secret menu. and correlate
the symptoms, the tenderness, the limitation of movement, weight bearing or otherwise, to the symptoms and really define the targets. You know, I was looking at an MRI of a knee right before we got on, a patient I'm meeting with later today. I'd love to share it with you, but it's got her name on it. and and clearly she has loss of the patellar cartilage and inflammatory bone changes on either side. She doesn't really have any meniscal stuff. and I haven't
you know, talked to her since probably a month ago, but now we have a target. I know exactly what I need to do for her, where the problem's stemming from that matches with her symptoms. So we also look at lifestyle, you know, are you doing anything in your life that's inflaming you? Are you smoking? Are you eating poorly? Are you sedentary? Are you not doing exercise and, you know, clearing your head and sleeping r restorative, all the good.
stuff, eating properly, supplements. So we we really want to dial in the entire anti-aging, anti-inflammatory effects. We might add peptides early on and during a procedure and continue them that support anti inflammation and support cartilage regeneration.
Dr. Spencer Baron (18:34.989)
That's great. So speaking of the patient, ha like give us an idea. How is she how old is she? Is she active? Does she run? Is that why their her knees are like that?
Dr. Jeff (18:43.619)
She is a runner, actually ultra marathoner. and of course, she, you know, she's she's got running disease. She wants to keep running. And we have to keep her mobile. We have to keep her car running, you know, we have to keep those those parts working. So I really look forward to offering her an injection procedure for her kneecaps and in the femur just behind the kneecaps. So which should be a one and done.
Dr. Spencer Baron (18:52.535)
Yeah. Yeah.
Dr. Terry (19:09.126)
I Doc, I I got a quick question. Y Spencer just reminded me on something. W Does age really America you know, we've heard for s our entire career, even young kids in gymnastics, this condition called Seavers disease. Or if there's a if an impact injury on a seventeen year old and now he has knee pain but nobody can find it, you know, and maybe it's a growth plate, maybe it's something like that. Has exosomes help for s conditions like that for even kids?
Dr. Spencer Baron (19:09.235)
Interesting.
Dr. Jeff (19:32.866)
Yep. Yep. Okay, can I mean again it comes down to correlating them and and confirming the source of the problem. So an MRI has to be done with inversion recovery sequences. there's a new sequence I'm looking at. I think it's called water fat saturation. Just saw a publication the last couple months on correlating what's called MODIC changes. Now you guys know what those are. but for your listeners that might not know.
It these are inflammatory signal in the bone edge on an MRI adjacent to a disc. And now they with this special sequence on the MRI, they've correlated pain, discogenic pain to the end plates. They can see it. So modic changes, those early observations turn out to be useful in evaluating back pain. And those to me are treatment targets.
Dr. Spencer Baron (20:33.229)
So so if someone was to fly into your to your state, into your to your office to have a consult, would they start with a consult online or having a telemedicine? Because an you would want an MRI done, but obviously a special type of MRI.
Dr. Jeff (20:47.543)
Yeah. yeah.
Dr. Jeff (20:54.519)
We we do. So we we take care of all that remotely. wherever your town is, we've fine we we do the homework and find you a place nearby that can handle what we need and you get that done. You get the images to us in a digital format, whether it's a a disk that you might send us or there are ways to do it through file sharing. they're too big to email and we're not reliant on the report of the MRI, we're la looking at the actual
medical images and I have software that can open those up and look at those and then we get on a video and I share my screen. I show you the images. So I want my patients to have an understanding of where that problem is stemming from. you know, I don't I don't want to work in a a black box situation where I say, you have knee degeneration, you know, don't worry about it. I I know what's going on. I want them to know. I want them to be informed consumers.
Dr. Spencer Baron (21:48.109)
What type of MRI did you suggest?
Dr. Jeff (21:50.446)
Well, it's a three Tesla, which is sort of the the highest magnetic field strength. That's not the only measure of the quality of the MRI, but it really does help enhance the picture quality. and then we order what's called an inversion recovery sequence, which is the the short is called S T I R. And it doesn't cost more, but you have to order it. The doctor has to it's not part of often not part of a standard protocol. If you say if you if you just say knee MRI.
Dr. Spencer Baron (22:07.853)
Is that
Dr. Jeff (22:20.499)
usually you don't get that. You have to it's like the secret menu an In N Out burger. You have to know to order it. So you or I order inversion recovery sequences or stir in all planes. So front plane, side plane, cross section plane. and and we're looking at maybe adding this water fat sequence. A lot of places don't have parameters for it. So we have to send them parameters. So the text get our orders and they have no idea
'Cause th the text just push a button knee. Like this is we're we're really looking at, you know, getting the most out of an MRI. And most MRIs, this just you're just getting the very basic.
Dr. Spencer Baron (23:04.011)
Now not not to go too deep, although I am and I'm asking you about the inversion inversion recovery. Inversion recovery. What are you actually seeing or what are you actually looking at? Because this is new and is it it
Dr. Terry (23:07.748)
go deep, baby.
Dr. Jeff (23:20.791)
Yeah. It it enhances the watery inflammatory change in bone marrow. So you're really bringing out modic changes or inflammatory changes in the the tibial plateau or the femur or the kneecap or whatever structure you're looking at. And sometimes that's the only sequence where you see it. And that is my treatment target. So I'm very specific about where I deliver the biologics, the exosome.
Dr. Spencer Baron (23:47.552)
Is that I is that a application I mean like you have standard MRIs, you know, obviously varying levels of Tesla, but you know, like w I remember when concussion was such a epidemic and we would ask for a DTI diffuse tensor imaging. Is and it that was like a like an upgraded application to a regular MI. Is this the same type of approach? It's a it's
Dr. Jeff (24:05.889)
Yes. Yes.
Dr. Jeff (24:09.985)
Yes. Exactly. somewhat. A D a DTI package, d diffusion tensor looks at white matter tracks and the owner of the MRI actually has to buy some additional software. That's a that's an upgrade on their end and they charge extra for that. Whereas inversion recovery is a standard inclusion in as far as I know every MRI that can do it. So it doesn't cost extra.
Dr. Spencer Baron (24:37.069)
All right. Here's a question that I'm sure you don't have an answer for. Why do they s well why and I've been in search of this answer. Why can a a a hospital or a company spend millions of dollars on an MRI and still give you a damn disk? Who has disc drives anymore?
Dr. Jeff (24:40.887)
Yeah.
Dr. Terry (24:41.786)
Ha ha ha.
Dr. Jeff (24:56.875)
I do I do I have to in my office. We have every computer has a disk drive. be because it's it's HIPAA safe, right? You give a disk to a patient, the patient gives it to the doctor, it's completely compliant HIPAA, you're not sending images over the internet. The a lot of the portals where you can log into are are absolute craziness. There are some good ones, but some of them don't give you proper tools or they're clunky or they don't you know and
Dr. Spencer Baron (25:08.397)
Yeah.
Dr. Spencer Baron (25:16.3)
Yeah.
Dr. Spencer Baron (25:21.058)
Yeah.
Dr. Jeff (25:26.103)
The last thing I want to do is have to learn 50 software packages, right? How you know, because the tools are always different. I need the doctor's viewing tool. So I have this on my computer. I love the disk. The other way you can send is through a Dropbox or a Google Drive or some other version of that where you dump all the actual raw data into if you have a you can put it on a flash drive, it doesn't have to be a disk, but they're not doing that. So yeah, that's fine to me. That's fine.
Dr. Spencer Baron (25:28.981)
Yeah.
Dr. Spencer Baron (25:39.447)
Yeah.
Dr. Terry (25:49.524)
Yeah, flash eye would be so much easier.
Dr. Spencer Baron (25:50.529)
I know, right? Yeah.
Dr. Jeff (25:54.925)
two. I d I don't know why they're not doing that. They're so inexpensive now.
Dr. Spencer Baron (25:59.298)
See, that's why we love Dr. Jeff. He has an answer for something I was sure he didn't have an answer for. Good job. Good job. All right, here's another trick question for you. You got two pa two patients, s nearly identical knee MRIs. You know, the the you know, you they receive similar regenerative treatments, yet you have completely different outcomes. Like what what would make one patient a great candidate and the other one a poor responder?
Dr. Jeff (26:01.207)
Yeah.
Dr. Jeff (26:07.459)
I'm trying, man. I'm trying.
Dr. Jeff (26:12.862)
Yeah.
Dr. Jeff (26:24.343)
Yeah, I mean
Dr. Jeff (26:29.163)
it could be the patient's, you know, health and and biology. It could be, you know, let's assume they use the exact same regenerative biologic, same dose, same quality, same source. Could be how bad the knee is, could be they they didn't target the right places, maybe they didn't get the MRI with inversion recovery and target it. and then listen, this is medicine. Sometimes responses are not always the same. It's it's a practice, it's an art based on science, but it's an art.
Dr. Spencer Baron (26:57.015)
Great. I remember
Good friend of mine who's an orthopedic surgeon had a he was s he took so much pride in his s type of surgeries, especially on the spine. and one particular patient was a successful surgery, but the patient had such ill health that he learned many years you know he he learned that that there is some guidance in the world of sleep, nutrition, lifestyle. How do you approach something?
Yeah.
Dr. Jeff (27:30.945)
Yeah. Well, I'm doing a lot fewer surgeries now that I have these way more interesting and less invasive tools. but in the days when I did plenty of surgeries, you know, patient selection was important, health. And I I've learned so much through the longevity side of medicine now in the last few years that I I wish I could go back and enhance all these patients' ability to grow and be anabolic during that recovery.
Dr. Spencer Baron (27:37.282)
Yeah.
Dr. Jeff (27:59.8)
you know, get their health in order. We used to just do a pre-op, you know, clearance. They'd see their medical doctor, get some labs, get a chest x-ray, get an EKG. If everything was reasonable, we'd do the surgery. we could do a lot better. We could do peptides ahead of time. We could, you know, improve their protein and creatine intake. We could in, you know, you know get them into a growth mode, get their sugar even better balanced and and all kinds of supplements. I mean there there's so much
we could do better. It's not part of the sick care system. So people aren't getting that. They're not getting the optimal outcome because those elements are not built in.
Dr. Spencer Baron (28:36.791)
Well yeah, I mean I I mentioned the the situation where there's surgery, but I'm talking in in your world whether things are much more conservative and and obviously now reaching this this new level of attention. You know, y you're obviously conscientious about their lifestyles, you know, and you know, how you know, if they're a smoker, how's that gonna affect their processing of any kind of metabolic process, you know?
Dr. Jeff (28:54.706)
yeah. yeah.
Dr. Jeff (28:59.217)
yeah.
Dr. Jeff (29:03.469)
yeah, we we're we're very clear about that. But you know, try to get a smoker to quit. That's very that's just saying it's not gonna work. Like they have to have a plan, they have to, you know, get get get to that plan and carry it out and you know, and part of that plan might be exercise. And if their knees keeping them from exercising, you know, then there's a chicken in the egg. You know, maybe we do need to treat the knee as part of a lifestyle change that's happening, you know, and
Dr. Spencer Baron (29:09.549)
Right. Yeah.
Dr. Jeff (29:32.845)
You know, the inflammatory damage from smoking is incredible, but there were some papers, some studies showing that high dose omega-3 fish oil supplements can almost forgive some of that inflammatory damage at the cellular level. So not that that's an excuse for you smokers to keep doing it. It is a thing you can do to help reduce the progression of disease and prevent things because of all that damage you're doing to your cells.
Dr. Spencer Baron (29:58.126)
You know, there's an a you know, it's a curious but very peculiar question. You know, there there you mentioned something about smoking and we realize we're starting to hear more about nicotine patches because of how it well it affects the brain. So what is their you know, you hear different stories. One of the there's constriction of blood vessels. Do you even ask about things like that that people are using nicotine patches for? Yeah. When
Dr. Jeff (30:21.453)
Yeah, yeah.
We're we're learning more about nicotine. we're learning more about mitochondria. Let's back this up. Mitochondria, if you take care of your mitochondria, you're taking care of your cells in a large way. And mitochondria are the main, you know, we always call it the powerhouse of the cell, but it's really the it's the battery. It's the ability to generate electrochemical power by stripping off electrons and creating a charge differential differential.
Right, and then using that charge to to make ATP. So the you know, one of the things we need in our in our mitochondria to move those electrons down the chain is NAD, right? We all hear about NAD these days. Well, you need nicotine to make NAD. So nicotine has a role here, and we do have declining elements of NAD in our system as we age, and we're learning more about how to get that into our system and into our cells. So
The it's still being worked out, but we've we've learning more than ever. So we need nicotine. The question is: do we need supplemental and how much and how to get it? And all this. Yeah. So we have people that have nicotine, you know, in pouches for their mouth and patches for the skin, and there may be some health benefits there. I'm still evaluating that, and maybe next time I'm on, we can talk mitochondria for an hour.
Dr. Spencer Baron (31:46.816)
Ooh, I like that. Yeah Yeah, but the the the bu the buzzword is great, mitochondria. You hear about it all the time and what this affects mitochondria, this is good for mitochondria. Great. No, I like that idea. That would be fantastic. So patient walks in your office, once again, here's a situation that how do you determine whether they're a candidate for how do you decide, exosome or stem cell or PRP?
Dr. Jeff (31:47.703)
See how I invited myself back on the show?
Dr. Jeff (31:55.895)
Yeah. Yeah.
Dr. Jeff (32:15.267)
Th the only thing I'd recommend stem cells right now is if you were recovering from a heart attack or some kind of pulmonary infarction or something, because if you get stem cells intravenous, they're the stell cells are bigger than exosomes, they're sticky, and the heart and lungs take up the lion's share. So if you really want to concentrate those in the heart and lungs, do stem cells. I don't even I don't even have stem cells anymore. We we just haven't done them. Now we are s have access
And are sourcing MUSE cells, which is a subset of stem cells. and you know, we're working on this disc regeneration program using MUSE cells. So that's that changes what we're doing. But most things, exosomes are better for many reasons. One, they travel through tissue better, they skip the delivery van, go right to the package, they cross the blood brain barrier, they're easier to store and handle, they're less expensive. So all in all,
you're really getting the benefits of stem cells when you're getting the exosomes, you're just saving money and a lot of other things. So s exosomes are generally superior except for heart and lungs.
Dr. Spencer Baron (33:22.573)
Say Muse U S E S
Dr. Jeff (33:23.905)
Muse. M-U-S-E. Like you know, a little, you know, angel who gives you ideas, you know, plays a little music on a lute or a s a little harp.
Dr. Spencer Baron (33:28.907)
Yeah. I knew you were gonna do it. Yeah.
Dr. Spencer Baron (33:36.545)
Ha ha that's great. All right, Dr. Jeff, let me ask exosomes are being talked about, you know, far beyond orthopedics now, some of the in the neurological and autoimmune condition world, long covid, yes, and even Lyme disease, which is very challenging. What where are you seeing most of the promising research outside of the musculoskeletals?
Dr. Jeff (33:45.953)
Yeah. Yeah. Yeah.
Dr. Jeff (33:56.578)
Yeah, I mean listen, we are clearly seeing many increasing volume of good publications using stem cell derived exosomes for health benefits. A lot of this is coming out of Asia. The Chinese are way ahead of us. They now have more specific exosomes, maybe neurological stem cell derived, as opposed to just generic umbilical cord stem cell exosomes. Or or you know, we're just trying out some specific dermal pulpillae.
Exosomes for hair regrowth that are have more cargo to stimulate those cells specifically to do what we want them to do, you know, poke poke through some new baby hairs, right? So we're we're getting access to these more specific types of exosomes as opposed to generic. Nothing wrong with generic. They're ubiquitous, they're easy to get, they're they're you know, they they tend to be good across the board. But if we can get more granular and more specific, then
We're moving the needle forward. I think in the next couple of years you're gonna see more of that.
Dr. Spencer Baron (34:59.189)
Lyme disease has always been a very challenging condition for so many. I've had patients come in and it's just a sad, sad story. Are we actually targeting the disease or influencing inflammation or the immune response? What are we trying to do here with regarding the tissue damage?
Dr. Jeff (35:16.237)
When when using regenerative biologics like exosomes for a a a hyper inflammatory residual of a chronic infection, whether it's Lyme's disease, long COVID or something similar, we're really targeting the inflammatory component. We're not targeting the pathogen. We're also targeting the in the immune system. So the immune system gets boosted in its health. The inflammatory
signals that are turned on by these infections can get suppressed and therefore the pain and the joint degeneration and the sluggishness and all the symptoms that go with it can get can get reduced. But we still have to treat the pathogens. So that whether that's an antibiotic, whether it's you know for for long COVID spike proteins that you know plasmapuresis or eBU or you know maybe natokinase to help break it up.
things like that. There are there are protocols as well that need to be hand in hand and of course, all in anti-inflammatory lifestyle, peptides, supplements, diet, exercise, exercise, exercise, sleep, all those.
Dr. Spencer Baron (36:27.159)
Carrie, I got one question one more one more question before you. one of the most common conditions that a patient is told by their medical doctor, they come into our office, you have arthritis. And what okay. So we're talking, yeah, I do, I do. It's so generic, and there's so many other ways of handling it. But at what point, at what point like rheumatoid, let's say, what would would somebody be a candidate for
Dr. Terry (36:28.553)
Yeah, yeah.
Dr. Jeff (36:43.159)
I hate that.
Dr. Jeff (36:48.492)
Ain't too.
Dr. Jeff (36:55.455)
yeah. Yeah. Rheumatoid arthritis, you know, is is the genetic version typically, or some kind of autoimmune overreactive version, that causes diffuse degeneration, which affects the joints first. It affects other parts of the body. You can get psoriasis and skin inflammatory changes, other things. the eyes can be affected, the secraliac joints, all kinds of things. The joints are the low-hanging fruit that are the most
Dr. Spencer Baron (36:56.299)
For real.
Dr. Jeff (37:21.931)
symptomatic thing that inflammation causes in your body first and foremost, generally speaking. So so we we do use the regenerative exosomes to help suppress the overall hyperinflammatory situation. and we usually do that intravenous. If if if that helps quell a lot of the joints, but maybe one or two joints are really bad, we may go direct into those joints then as well.
Dr. Spencer Baron (37:48.845)
That's great. Go ahead, Terry. Sorry.
Dr. Terry (37:50.118)
I wanna actually go back a little bit to Lyme disease because I actually have a patient in mine who's a professional athlete, has been everywhere, is on the supplements, is doing the hyperbaric chamber, is doing PMF, he's done everything possible and the only thing that got got him back to his sport was exosomes. And when he's tried everything and he's flown to all different states and all that kind of stuff. Why did the exosomes work and is he now
he feels like I have to do this every three months or I I can't function. Is that something he's gonna have to do for the rest of his life or is this there's is there an exit plan? W what is he doing? 'Cause he's super healthy and he's super health conscious and he's done everything.
Dr. Jeff (38:34.861)
Yeah. You're doing everything right. The exosomes are suppressing the inflammatory, you know, blow up from the limes. And he's able to suppress that for a few months at a time, which is typical with an exosome treatment. But the limes is still there. So we need to figure out where it's harbored, how to get it out, you know, is there a different antibiotic regimen? Are there some peptides? Is it mitochondrial support? I'd we'd have to look at we'd look more more at those things and maybe
Uncover something that hasn't been yet uncovered.
Dr. Terry (39:06.045)
I mean, is this is Lyme disease? Some people think it once they have it they have it for the rest of their life. Have you seen people where it can be eliminated and be gone?
Dr. Jeff (39:14.519)
Yeah. yeah. You get the bacteria that causes it out of there and and then you can reprogram the inflammatory epigenetics and those cells to get back to normal programming.
Dr. Terry (39:29.105)
Interesting. Yeah, since you've been on the show a couple it's been what, a couple of years now? Agenda medicine, like we talked about at the very beginning, has taken leaps and bounds. What are you doing now in twenty twenty six that you weren't doing in twenty twenty five and twenty twenty four? Where do you see this this accelerated process that you've been you've been going with?
Dr. Jeff (39:49.154)
Yeah. the breadth of peptides have been huge as an additive. the the different types of exosomes, as I mentioned, are coming. And then muse cells. You know, we all these exosomes and the incredible results we have with joints, generally speaking, I'd and I can love to show before and afters of MRIs where cartilage is regrowing. Like it's it's a thing. We do that. Now, can I guarantee it or claim it? No, but I can show you examples, that's legit. I can show you medical evidence and science.
Published, that's legit. but we really struggle with disc regeneration because the disc is a strange cartilage made of two different components, right? So we think there's a well, we we know there's a study in China showing some evidence that these muse cells can regenerate disc nucleus pulposis. and that's the sky, for those listening that don't know, that's the squishy stuff in the center of the disc. So that
Could be the holy grail, hopefully. So we have a sandwich therapy in mind. We're about to start a program where you get MU cells intradiscal in the nucleus and you get regenerative exosomes in the end plates where the motic changes are to stimulate the annulus health. So you get you get the full attention to the disc. And the nucleus is odd, guys, because it's one of the few structures that comes from the layer of the embryo called endoderm.
Whereas most of the body comes from the middle layer called mesoderm or mesenkyme. You've heard mesenchymal stem cells, right? So it stimulates mesodermal structures like musculoskeletal structures generally, some organs, things like that. And then the other layers, ectoderm, which is the nervous system, the teeth, and some gland cells. So now that we have MUSE cells in MUES, in MUSE stands for
Multilineage, meaning it can affect all three layers of the embryo. So we think that's gonna help that endoderm that's not getting touched adequately by mesenchymal exosomes.
Dr. Terry (41:55.79)
All right. On that on that note, you when you were a neurosurgeon years ago, the hot topic was disc replacement. Now are you are you still seeing disc replacements as being hot? Or what happens now when these guys got disc replacement and now they're having mechanical back pain? what's your what's your thing? I are are you seeing disc replacements gonna be go away or are you gonna still they're
Dr. Jeff (42:03.362)
Yeah.
Dr. Spencer Baron (42:03.799)
Mm-hmm.
Dr. Jeff (42:17.889)
No, no, no. Disc disc replacement is still a viable option. Listen, when you herniate a disc, there's no regenerative medicine that's gonna make that herniation go away, right? You've got a thorn in the tiger's paw. You have to remove the thorn. And in doing so, sometimes you remove so much disc to clean it up that you don't leave much left. And especially in the neck, it's very hard to remove a herniation in the neck. If the disc is so small, by by the time you've removed it, you remove the whole most of the disc.
You know, although there is a procedure where you can take just a little corner. So disc replacement, especially in the neck, has still has legs, and it helps reduce the stress above and below, which fusions can cause. So it's ultimately biomechanically a good result. Now, people can down the line develop pain because the the disc replacement, if it's not put in just exactly physiologically.
can overstress the facet joints, because the facet joints are still moving. They haven't been replaced. Now some people have come up with a facet joint replacement. to me it seems like a little aggressive, but I and frankly I haven't been trained on it, so I may be speaking out of turn, but I think disc replacement is still a better surgery than fusion. And I think fusions were overdone for so many decades because it was all all we had until the early two thousands.
And the early generation disc replacements weren't great. The the new generations are much better.
Dr. Terry (43:50.742)
All right. I do have a go ahead. Go ahead. I can see Spencer's like lean forward.
Dr. Spencer Baron (43:52.854)
I I gotta a wait, I gotta ask. I gotta ask. yeah. Yeah. Because because from what I understand you put in this this disc replacement that's made out of you know, you know, metal or ceramic or what have you, depending on the product. And it's so durable that it actually deteriorates the adjacent vertebra. So ha right?
Dr. Jeff (44:18.741)
It can. This is this is a patient selection problem. This is, I have an older lady with soft bone who's not on bioidentic hormone replacement. She's osteopinic or osteoproduct. That is a bad surgeon's decision. That's a fool with the tool, applying a tool he shouldn't be using because he's a fool.
Dr. Spencer Baron (44:22.849)
Yeah.
Dr. Spencer Baron (44:32.94)
Yeah.
Dr. Spencer Baron (44:39.883)
A f a fool with a tool. I am that it I am owning that. I love it because that then
Dr. Terry (44:41.334)
I gotta use that one. I gotta use that one.
Dr. Jeff (44:45.731)
Well, I borrowed it. I I wanna give credit to my professor, Doctor Ed Benzel, who used to say that. So I'm passing it down to you now.
Dr. Terry (44:51.682)
that's awesome. All right. You know, I still have patients that can't get their head around PRP and and what's your thoughts on PRP? Is it still viable or have we moved beyond that?
Dr. Spencer Baron (44:55.105)
Doctor Ed Benzell, thank you. That's great.
Dr. Jeff (45:07.117)
Yeah. Yeah. There's nothing wrong with PRP. It's it's an entry level regenerative biologic from your own body. And you usually have to do multiple sessions of it. so it it's it's less costly. and I I understand that some health insurances are now paying for it, even though it's not yet approved for marketing claims by the FDA. So here's where insurance is making decisions because of costs, not science.
However, PRP is viable. To me, I want to do something more effective. So exosomes are leveling up in terms of the potency. Nothing wrong with PRP. I'm not judging. A lot of people can easily do PRP.
Dr. Terry (45:49.909)
All right. So if you got it somebody listen to the show and they go, I really wanna I think I need to try the sexosomes, what's w what's the clinical thinking? What should they walk in? What questions should they walk in to their doctor and what are some red flags that they hear they need to walk out?
Dr. Jeff (46:08.327)
they they need to say, Okay, doc, I'm interested in this. you know, do you have experience with it? And the doc should have some experience with it. Okay, great. Tell me your experience, get get a little education there. what are you using? Where do you get it from? And can I see an example certificate of analysis?
Where it goes over the counts, the viral testing, the protein content and distribution, endotoxin to make sure it's not infected. I wanna see that. And every time we do a treatment, we have four pages of testing from that treatment. We show it to the patient, we put it in the file, we track the lot number, we send it back to the FDA registered lab and track each and every dose.
Dr. Spencer Baron (46:55.089)
Thorough. I like that. So let me ask you I I I started to allude to this before but I think I took a turn with the question and that was like if if a patient comes in and they now wait, better yet if a
and I know 'cause you've become very popular amongst amongst our chiropractic community and and by the way, the the where you spoke at the Florida Chiropractic Association, the the doctors text me that day. A couple of said, Where'd you find this guy? He's great. They love you.
Dr. Jeff (47:23.139)
Thank you. Yeah. Had a great a great meeting, great place, great time. I wish I could have stayed longer. Really well done, by the way. FCA, good job.
Dr. Spencer Baron (47:32.171)
Yeah, yeah. So with that said, and you know, you're you're in Las Vegas. If somebody had to fly in and they had an issue with a weight bearing joint versus an an upper extremity, are they able to walk out or they do they need crut you know really?
Dr. Jeff (47:48.358)
yeah. yeah. Yeah. They we want them. There's no downtime. We want them on that joint using it. we have people that play golf the next day after a shoulder procedure, walk the strip if it's not 108 degrees like it is today. all that. Absolutely. We want you using it. We want you to stimulate the mechanoreceptors that release the healing cytokines and all that. We want that. That's one of the other beauties of this. No downtime.
Dr. Spencer Baron (48:01.066)
Yeah right yeah.
Dr. Spencer Baron (48:13.752)
Yeah.
Dr. Jeff (48:16.727)
so we have people when we do invite them to come in, you know, they can fly in maybe the day before or the same morning. we can do the procedure. We do prefer you stay overnight, but hey, if you're coming all the way to Las Vegas, schedule a nice dinner, see a show at the sphere, stay and enjoy for a few days, you know, enjoy it. You will be sore where we injected you, but it's not it's rarely sore enough that's gonna keep you from walking or doing stuff.
Dr. Spencer Baron (48:46.252)
Terry, I think I'm gonna fly out for pro sport just to see Dr. Jeff.
Dr. Terry (48:51.958)
Well, I'm gonna be scheduling a lunch with him. He doesn't know that yet, but he's gonna say yes. So if you wanna come out you can join us.
Dr. Spencer Baron (48:57.632)
We'll go. May maybe maybe k maybe you can inject my wrists during dessert, you know, or after lunch, right?
Dr. Jeff (48:59.142)
Yeah.
Dr. Terry (49:02.94)
Ha ha ha.
Dr. Jeff (49:05.111)
Let's let's get together. If you're all coming out for pro sport, I'd be happy to meet you down there. We have some mutual friends we'll invite as well.
Dr. Terry (49:12.426)
There you go. Love it. Love it. Love it.
Dr. Spencer Baron (49:12.548)
that'd be great. Dr. Jeff, we're ready for our rapid fire questions. We got five of them for you. If you recall last time, re sock it to me. That was from Laughing. Do you remember that show? my my god, that's great. yeah. Yeah. yeah. Alright, question number one. If you could regenerate one part of your own body back to its twenty-five year old version.
Dr. Jeff (49:17.441)
Yes. Soc it to me, as I said last time.
Dr. Jeff (49:24.747)
I I do already saw, yeah.
Dr. Terry (49:25.167)
yeah.
Dr. Jeff (49:29.419)
Only for us old guys. Yeah.
Dr. Terry (49:31.486)
Yeah, right. Right.
Dr. Spencer Baron (49:41.834)
What body part are you choosing?
Dr. Jeff (49:44.236)
Ooh, I probably want my hippocampus where my memory is stored. Not that I'm having memory issues, but man, there are probably so many things that we don't even know we've forgotten. So I wanna I would wanna enhance my memory and and push that into the future. Yeah.
Dr. Terry (49:55.966)
Dr. Terry (49:59.575)
All right, I'm going for that one. You're y you're getting no, you already said your wrist. You're getting your wrist done, I'm getting my hippocampus done.
Dr. Spencer Baron (49:59.895)
That is so n yeah, me too. I w
Dr. Spencer Baron (50:06.337)
Forget
That is so not the answer I thought, but that is a beautiful answer. Question number two. What's one health habit you know works, but you still struggle to do consistently?
Dr. Jeff (50:22.519)
Diet. I mean, gosh, I I still love pizza. I still I still love a great cheeseburger. you know, I I I still when we go, you know, my wife and I like to go to the go clubbing. That means we go to Costco and we you can't pass up the hot dog at Costco. So yeah, we go we go to we go clubbing to get some hotties. That means we're going to get rotisserie chicken at Costco.
Dr. Spencer Baron (50:41.32)
that is not what I thought.
Dr. Terry (50:43.956)
Love me.
Dr. Jeff (50:52.706)
Yeah.
Dr. Spencer Baron (50:54.388)
I am so using that. my god, that was great.
Dr. Terry (50:55.106)
That's okay, that's brilliant.
Dr. Jeff (50:56.259)
I borrowed that from somewhere, so I'm sorry I don't know the source.
Dr. Spencer Baron (51:02.456)
Terry, Terry, we we gotta we gotta, you know, use these colloquialism, you know, tool for the fool and then now the hotties at the clubbing and all that. I'm I'm all over this. All right. Question number three if you could eliminate one piece of bad health advice from the internet forever, what would it be?
Dr. Jeff (51:06.893)
Yeah.
Dr. Terry (51:09.578)
Go clubbing. Yeah. Totally.
Dr. Jeff (51:21.287)
that that sunlight alone is adequate to make vitamin D. It's not enough, guys. I love it, it's great. Sunlight's healthy. You need vitamin D, significant vitamin D. The lab numbers are only to prevent deficiency. They're not optimal health. I want your numbers higher. I want you on ten thousand IUs a day, most of you. It helps to build bone. It reduces all causes of death. All causes.
So why are you not on vitamin D?
Dr. Spencer Baron (51:52.982)
Very nice. Very nice. Is there a particular D, vitamin D, that you suggest or no?
Dr. Jeff (51:57.678)
I like when you they have vitamin K two in there. they do well together, but no, I don't have a brand I'm pushing. but we could start a Kraken Bax Vitamin D brand together and you know, do really well.
Dr. Spencer Baron (52:00.737)
Yeah.
Dr. Spencer Baron (52:08.3)
I think that'd be great. All right, question number four. What's something you believed about health or longevity that at f thirty that you see completely different today?
Dr. Terry (52:10.27)
Love it.
Dr. Jeff (52:22.999)
Well, I think it's the type of exercise. I thought that cardio would be the right exercise long term for you as long as you're doing cardio and I was wrong. You gotta you gotta have big muscles, you gotta not big, but you gotta have muscles and you g you gotta you gotta lift heavy and do resistance and weight bearing.
Dr. Spencer Baron (52:40.854)
Very nice. Very nice. And it's so funny how we talk about exercise but no you know, some doctors don't prescribe it because there's no, you know, financial incentive to tell you to exercise. So
question last one, Dr. Jeff. If you could give every person listening one thing, not a d treatment, drug, or supplement that can improve the quality of the next twenty years of their life, what would it be?
Dr. Jeff (53:12.205)
well since I've already tapped into exercise, I'm gonna I'm gonna move this one into sleep. Quality s deep restorative sleep. And that means you need to have a sleep plan, sleep action, sleep rituals, cold room, perhaps, you know, turning off screens, maybe doing some red light therapy at at you know nighttime you know and and
really you know maybe some melatonin supplementation not just to fall asleep but to sleep deeper maybe use some health tech to track your sleep quality sleep you do your repair when you sleep and if you're not repairing well you're doing more breaking down than repairing so you're gonna age faster
Dr. Spencer Baron (53:59.114)
Dr. Jeff, I gotta tell ya, thank you so much for being on the show. You don't realize but you are absolutely the bridge between the traditional mainstream medicine and our version of alternative, you know, holistic care. Thanks so much.
Dr. Jeff (54:15.767)
Thank you for having me, guys. Love talking with you.