Ep 33 | What you need to know about peptides with bodybuilder Sai V

Dr. Pri sits down with Sai V, a bodybuilding professional and founder of Proseek to discuss the various peptides, meds, and supplements bodybuilders use to optimize human performance and increase longevity. We emphasize when to use these compounds and what blood work to monitor to make sure it's being done safely Where to find our guests: Website - https://proseek.org/YouTube - https://www.youtube.com/@ProseekOfficialInstagram - https://www.instagram.com/proseekofficial/Where to find us:Website | https://vitaveda.healthYoutube | https://www.youtube.com/@vitavedahealthTwitter / X | https://x.com/drprilongevityNewsletter | https://substack.com/@vitavedahealthInstagram | https://www.instagram.com/drprilongevity/Reddit | https://www.reddit.com/r/Vitaveda/  Timestamps: 00:12 Introduction06:38 Sai's Journey Into Bodybuilding10:07 Building Proseek: From Idea to Launch14:50 The Phases of Bodybuilding: Bulk, Cut, Recovery17:41 When and Why to Get Blood Work Done22:20 Testosterone Side Effects: The Cardiovascular Rundown32:36 Managing Cholesterol: Ezetimibe, PCSK9 Inhibitors & More38:19 Cardiac Imaging: Calcium Scores, CT Angiograms & Echocardiograms50:01 Blood Clotting Risk: Nattokinase, Aspirin & Donating Blood56:23 Protecting Your Liver: NAC, TUDCA & FibroScan1:08:27 Mood, "Roid Rage" & Coming Off Compounds1:21:56 Growth Hormone, Insulin Resistance & GLP-1 Drugs1:36:12 Dementia Screening, BPC-157 & Emerging Peptides Bodybuilding Competition CycleOff-season / Bulking: Primary muscle-building phase. Can last several months to a full year or more depending on how much size the athlete needs to add.Health / Recovery phase: Back off compounds, lower training volume, get blood work done. Typically 4–16 weeks (average around 8 weeks).Prep / Cutting phase: Diet down to lose body fat while preserving muscle. Length varies by athlete.Competition → restart cycle Recommended Blood Work TimingDuring or just after prep (peak stress) - see how much damage the compounds are doingEnd of recovery phase (8–10 weeks post-show) - confirm biomarkers are returning to baselineIdeally: test as often as practical. More data points = better decision-making. Cholesterol Ezetimibe - first choice in bodybuilding. Generic, ~$10/month, virtually no side effects, no muscle issues. Blocks cholesterol absorption from the gut.Supplements - citrus bergamot, berberine (also helps blood sugar), garlic (may raise HDL), niacin, high-dose fish oil (caution: slight AFib risk)Statins - effective but potential muscle side effects make them a poor fit for athletesPCSK9 inhibitors (e.g., Repatha) - for people who can't tolerate statins. Reduces cholesterol up to ~70%. (~$500/month without insurance) but often covered after documented statin intolerance.Boston Heart test - determines if you're a hyper-absorber vs. hyper-synthesizer of cholesterol, helping guide whether ezetimibe or a statin is the better fit, as well as how much dietary cholesterol may be impacting levels Liver NAC (N-acetyl cysteine): 1.2–1.8 grams/day - shown anecdotally to reduce AST/ALT from the 200–300 range down to under 100 when using oral anabolicsTUDCA: Supports bile flow, prevents biliary stasisMilk thistle: Commonly used, less evidenceInjectable anabolics are far less hepatotoxic than oral compounds (orals pass through the liver twice due to first-pass metabolism)Oral anabolics (e.g., Winstrol, Halotestin) are typically limited to the last 4–8 weeks of prepLong-term athletes (5+ years): consider a FibroScan (liver ultrasound measuring stiffness/scarring) - liver fibrosis is irreversible Blood Clot PreventionNattokinase - breaks down fibrinogen (end of clotting cascade), mixed resultsBaby aspirin - prevents platelet clumping (separate mechanism), commonly used in patients with serious heart diseaseDonating blood every 8–12 weeks - directly lowers hematocrit, which can build up with anabolic steroidsWatch for easy bleeding/bruising as a sign you've overdone blood thinnersBe extra cautious with head trauma while on any blood-thinning protocol Managing Estrogen Side EffectsDon't take aromatase inhibitors (anastrozole) or tamoxifen preemptively - estrogen has neuroprotective and cardioprotective benefitsStart only when symptoms appear: water retention, nipple sensitivity, acne, libido changesSome compounds (Masteron, Primobolan, Equipoise) naturally lower estrogen when stacked with testosterone, serving double duty as anabolics and estrogen managersIdeal approach: base decisions on blood work (E2 levels) rather than guessingGrowth Hormone Dosing & Insulin Resistance1–2 IU/day: longevity-oriented dose, typically well tolerated4–6 IU/day: muscle-building range, some athletes see insulin resistance8–12+ IU/day: high performance range, insulin resistance is very likelySecretagogues (CJC-1295, Ipamorelin) raise IGF-1 only within natural limits - not comparable to exogenous GH for muscle growthWays to manage insulin resistance for anyone (not just those on growth hormone)MedicationsJardiance (empagliflozinPioglitazoneMetforminRetatutride and other GLP1 agonistsSupplementsBerberineLifestyleZone 2 cardio BPC-157 CautionVery effective for tendon/ligament healing and gut healthMechanism involves angiogenesis (new blood vessel growth) - continuous long-term use raises theoretical cancer riskBased on the mechanism of action it’s a lot more risky to use long term, so Dr. Pri recommends it as-needed for specific injuries in defined time windows (e.g., 4–6 weeks), not year-round, but there is limited data hereLocal injection near the injury site likely reduces systemic side effects vs. oral or distant injection - this is a general principle DisclaimerThis audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. 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