How to Choose the Best Stem Cell Sources for Your Practice with Dr. Joy Kong

How to Choose the Best Stem Cell Sources for Your Practice with Dr. Joy Kong
Tue, Oct 03, 2023 4:54PM • 1:23:24
SUMMARY KEYWORDS
cells, stem cells, bone marrow, umbilical cord blood, patients, mesenchymal stem cells, umbilical cord, derived, shown, tissue, jelly, amniotic membrane, potential, msc, senescence, form, markers, doctors, put, inflammation
SPEAKERS
Bill Clearfield

01:09
You’re just starting.

01:12
Okay, I didn’t want to talk if you were so as you might have been doing more of the

01:20
so everything instead of doing well still the 6% but can we just not add it to my checks and just give it to you for what we owe you? Okay? Okay.

04:26
Howdy. Bill.

04:58
Oh, well now I got you. Okay. Thank you. Thank you.

05:05
Dr. Kong, Nigeria.

05:08
Here. Yeah. Wow. Pretty great speakers you’re bringing in here. Oh, we’re gonna we’re trying.

05:17
I just I just got off the phone with Michael’s Stravinsky. Maybe Okay. Your stem cell guy with Biogenics Okay, now we’re getting Dr. Kong and we already have David. It’s like all his stem cell stuff is really fascinating. It’s wonderful. Yeah, okay.

05:39
What are you up to?

05:41
Trying to get in touch with you so we can get our show together. I figure we can get a plan together within a month and give everybody a one month warning. And I know doing CME is a lot of work on you. So part of it can be CME, AAA or none of it or whatever you want to do. I was even thinking if you want to do a two day CMA thing where you always have to be restricted not to put a foot in your mouth and get in trouble right.

Bill Clearfield 06:07
I always get myself in trouble, you know.

06:12
Anyway, so maybe one part of a day some of the day one of the days, the third day, we might not just

Bill Clearfield 06:22
the way we’re going to partner with the homeopaths here, because they they need CME credits by the end of the year. So we’re going to work on that we’re

06:30
going to get that so how do they get that through Noma? Oh, we’re

Bill Clearfield 06:33
going to do it through Noma. Yeah,

06:35
okay. Okay. Now, but, but so we can have total freedom and what we say and how we say it. We might have a virtual non CMA exchange

Bill Clearfield 06:49
on CME hours too. So

06:53
just trying to make your job easier, because I know how much work is involved in pulling that off.

Bill Clearfield 06:58
Well, I probably have to do it for Noma, the regular normal guy won’t, you know won’t do it for us. But I know how to do it. So you know, I’ve done it. I’ve done it enough times. So. All right,

07:11
then I’ll help any way I can just let me know. That we have are you going to be there? It’s December 1 second third. We have planned is that kind of

Bill Clearfield 07:20
person second so far. So there is a we found a place in Reno that is looks like it’s going to be a void affordable. If that’s okay. I know it’s a little out of the way but it’s easier for me. At the element hotel, it’s across from the peppermint. I called the pepper mill. And the first thing they asked me was how many rooms do we want to reserve?

07:45
Well, what’s fun about that I see Dr. prongs on now. So we’ll talk

Bill Clearfield 07:49
business. Thanks. No worries, okay. Okay, so Dr. cog.

07:57
Thank you for joining us.

Bill Clearfield 08:01
And when you’re ready, can open your mic and introduce yourself and

08:12
yes, I am. There allows me to Yeah,

Bill Clearfield 08:16
so thank you for being with us. We were the American Osteopathic society rheumatic diseases. We sort of go by the moniker of integrative medicine now, and also the alliance of integrative medicine. So that’s kind of our our claim to fame now. We’ve been doing these webinars for three years. I’m going to let folks in and I got your name from Dr. Helaas. I think it was that’s where your name came up. So and I want to let you introduce yourself. You You were well known well well written well spoken about so I can only I can’t do do you justice. So I’m gonna let you away. If you have a PowerPoint, please put it you know, you can share the screen and you’ve done these before your so and then we do a little question and answer at the end. And we really, really appreciate your being with us. It’s Is it okay with what we recorded? We do have? We do a put the recordings on our website for anybody who misses them. I hope that’s okay.

09:24
Oh, yeah, that’s fantastic. Yeah, I’m, I’m on YouTube a lot. You know, some of the lectures are on there as well. So yeah,

Bill Clearfield 09:31
so I’ve seen them so. Oh, okay.

09:35
Wonderful. Thank you so much. Thank you for inviting me. I’m, I’m honored to be here. I have seen I’ve met of course, a lot of physicians in my life, but some of the smartest doctors are osteopaths. I don’t know why how you guys just got the smartest people. They’re remarkable. Physician. So I’m really honored to be here. And of course, integrative medicine. That’s, you know, that’s, that’s my passion after having been traditionally trained. And but realizing the lack of, you know, just just the inadequacies of the traditional approach and stem cell therapy is very inspiring field. And I think, you know, the wave has been catching us on, partially because it’s driven by, by people, by, by patients, because people are sick of not getting enough help and they’ve heard of great hope offered by stem cell therapy. And that’s where I’ve heard other doctors coming to me wanting to learn how to do it because patients were asking them that they want it. So I think it’s only wise that we are ahead of the game and understand enough about stem cells so we can properly console, consult our patients, and then give them the best possible treatment and then best way of treatment of course through proper training, so it’s still a new field. So I’m excited to share some information I’ve given various presentations on stem cell therapy. The first one is on choosing the proper source of stem cells. So that’s kind of, you know, fundamental before you go into anything else. So that’s what I’m going to be covering because I think it’s still a new, it’s still new information to a lot of doctors. We’ve all heard about stem cells. We heard about using your own bone marrow or fat or use on vocal cord sores and what do they all these mean? So I want to you know, cover that subject. I’ve also have other presentations on anti aging benefits of stem cells and stem cell treatment for autoimmune conditions. So there are various ways of you know, looking at this aspect. I’m also a founder of the American Academy of integrative cell therapy, where I do have an online course. And I also have a mentorship program. So if anyone wants more in depth, information and training, they can find me there. So as aict.org I’ll talk about at the end of the presentation, so I’m just going to open up

12:08
a little bit.

12:10
Let me see it open up the screenshare so we can get right into the

12:21
get right into

12:24
the presentation so anyone can see fine, right? Just wanna make sure everything’s working out as I just have to look looks fine. Okay, great. So So the topic is aro MSE is created equal? Because I don’t know if you know there are various stem cell types and stem cells of course, our original cell you know, first fertilized egg is the first stem cell but there are probably 1000 Shades of Gray 1000 different variations until the cell becomes a tissue specific stem cells. But all along the lineage. They’re all stem cells, but they have gained further function but lost certain capacity. So they’re becoming more specialized, and which means that they can’t be as broad in how they can differentiate. So MSCs is a special group of stem cells, where they are all over your body anywhere you have blood circulation, you have the stem cells that are kind of hovering over the blood vessels waiting for the signals to to you know, arrive, if there’s any inflammation and injury your body will send out signals. And these MSCs mesenchymal stem cells can traverse into your blood vessels and swim upstream to find the signal. That’s why they’re so powerful. That’s why they were proposed to be renamed medicinal signaling cells because that’s one of the main functions is that they will find the location of the signal and get out and start to send out you know, their own signals signals to the immune system and to neighboring cells to promote regeneration. So they’re considered the gold standard these days as far as therapy, because they’re everywhere in the body, and they have powerful regenerative potentials for the body. So there are all kinds of sources. And the topic of this talk is, what are the sources and which one should you use as a doctor? So first of all, what are MSE? So I talked a little bit but in 1980s and early 90s, it was still believe that hematopoietic stem cells were the only stem cells existing in the adult body, right? Because in the 1960s, that’s when they performed the first stem cell transplant, which were bone marrow transplant. No one No one knew at the time. This was stem cell transplant, but later on, they found out Oh, we were transplanting stem cells, but they thought that the stem cells only stem cells left in the body. Were still in the bone marrow and that was it. But in the 19 early on, you know, later on, you know, 80s 90s and then they started realize that there may be something else going on, officially named as mesenchymal stem cell. MSC is, is a new class of cells that have do have the capacity to differentiate into different tissue cells such as bone cartilage or fat and supposedly they were able to be induced to form Misal. Dermal tissues, right so bone, cartilage, fat, you know, the mesoderm layer, but the we have evidence that they can form cells into the into an actual term and endoderm such as neurons liver, so they are able to cross different germ layers, and there are multiple names and they all come to MSC marrow stromal cells. Oh, so anyhow, so they’re all these different names, but Arno Kaplan who discovered the cells wanted to rename them as medicinally medicinal signaling cells because of the way the cells are able to signal the body to heal. They were derived from parasites. So Perry, you know, perivascular so they were all along the vascular chair and they can be isolated from every vascularized tissue and every tissue specific stem cell. For example, liver stem cell or, you know, cartilage stem cell is sitting next to and in communication with a parasite. Or MSC is called MSC once to trans to traverse itself into the blood vessel, but with the sitting along the blood vessels as a parasite. So, why are they important? So, they have all these properties, regenerative properties also considered tropic property. So, these are paracrine effect what they can do is that they can hold me into areas of inflammation and injury and induce changes in nearby cells. by secreting different growth factors and cytokines, they can induce angiogenesis, differentiation, or proliferation. They’re very anti inflammatory so, they secrete anti inflammatory cytokines. In response to inflammation, they have immune modulating properties they can modify or regulate immune function, facilitating T one to t to shift in autoimmune disorders, for example, they’re anti a pet, a pop tonic, which means that if the cells are injured and are about to go, go on to program cell death, these MSCs are able to rescue them. For example, trauma, you know, crash injury, chemical injury, radiation damage, or hypoxic injuries like stroke, neighboring cells. May be receiving signals then they need to die, even though they have not been themselves deprived of nutrients, but they may go on dying anyhow, but these mesenchymal stem cells can’t rescue them from that process. There’s also antimicrobial properties they they seem to be effective against acute chronic and systemic infections. Actually, during COVID time, China was doing a lot of studies and using stem cells, such as mesenchymal stem cells and and it have drastic, remarkable results. You know, I remember in the very beginning of COVID, six different studies getting people out of the hospital within five, six days, these are people who are on ventilators. So yeah, they have new immune modulating, but anti microbial, they have very interesting mechanisms of action. So and I haven’t even talked about on this slide of anti cancer properties. So mesenchymal stem cells have been used to treat cancer. There are a lot of research around but we’ll talk about cancer later on as far as the differences between different Messies that’s why we want to choose the proper source because some sources are not ideal. And they also have the ability to elevate cellular energy. One way they do that is by transferring mitochondria, they can donate their fresh new mitochondria, especially if you get fresh new cells such as the younger source, then the recipient can receive more younger and more vibrant mitochondria, so helping them to function better. So these are some of the different mechanisms of action, why it makes them important. So if they’re everywhere, are they all functionally equivalent? That’s the question so you can get it from bone marrow, from bone marrow. Extraction, or you can get from liposuction. You know, liposuction came on board later on and bone marrow extraction was much earlier these are very much popularized by the orthopedic surgeons. They’re still the biggest fan of bone marrow extraction because early on they realized oh, we break a bone in the marrow leaks out, things heal heal up really nicely. So that’s how we started and liposuction became very popular as well. You know, a lot of overseas locations they spin it down when they extract the fat so you can see the top layers the fat and then you have a little pellet on the bottom after they spin it. That’s the stromal vascular fraction. And that’s containing a lot of adipose derived stem cells. So, so one question is if you either choosing, choosing either getting it from a person’s own or from a younger source, does he actually matter? So I’m going to present to you some some evidence, it really because I delve deep into this question, because I wanted to give patients whatever that’s the best. Whatever that’s going to be the best is what I’m going to devote my resources and energy into understanding as you know, and learning and implementing. So before I started doing any stem cell work, that’s what I I just went on a deep dive does age matter. So the fact that we live a long time and we carry with us, ourselves, especially stem cells, because they stayed in our body for the entire time that we’re alive, right? We’re running out of stem cells, but the ones that are with us have been with us since since we were born. So that means everything that we do every alcoholic drink we take every you know inset we take every medication every terrible you know preservative additive, we have in our food. Every toxic exposure, we have had EMF, you know you name it. Stress. So everything can can tear the cell apart in a way right in a sense can cause damage to DNA. So they do carry with us. So not only they can lead to cell death, they can lead to cell senescence, loss of regenerative functions or even cancer transformations changes. And when you have neonatal stem cells such as from Wharton’s jelly word and jelly is a component of the umbilical cord tissue, right? That’s the the gelatinous material that’s wrapping around the arteries and veins.

22:03
Those are spared from these pro aging factors. So I want to show you some evidence of why age matters. So for example, the first one age, adipose derived MSCs are significantly compromised in their ability to support vascular network formation. And they were looking at cutaneous wound healing, how well the wound can heal. And when they use these adipose derived stem cells, they realize oh, they weren’t able to rescue these age related impairments. And then when they use bone marrow derived MSCs they also have less ability to form new muscles and less ability to engraft you know, stay in the area and develop in comparison to developmentally early MSCs. And bone marrow derived MSCs exhibit age related decline in inflammatory response in their cytokine and receptor expression that’s important for the migration of the cells and the activation of them. And their ability to exert immunomodulatory actions. So which means you know, the older you are, the older your bone marrow stem cells are, and the less capable they are to to mount these these responses to migrate and be activated. So some other evidence, genes related to senescence also start to increase in adipose derived stem cells. So you get more senescence going on. And aging alters the availability of certain cell types. So this is important cell type cd 34 You know, very much sought after, but decrease the availability of the cell types and decrease their angiogenic potential and a cell’s age for example, in aging bone marrow derived stem cells, they have increased the level of reactive oxygen species and not only are they they have more of these reactive oxygen species, they’re these older cells are also more sensitive to these reactive oxygen species impairing their effectiveness. So double whammy, they have more of these elements that are causing damage, and they’re more sensitive to them. So they’re just you know, they get more weakened over time. And age matters. Some other evidence that when they were using young stem cells from a person one to five years of age, compared to older stem cells from somebody that’s aged 50 to 70. They realize that when they try to help somebody recover, after MI, the younger selves were much more effective at helping the you know, helping recover, were improved the cardiac parameters, and MI C’s from young individuals can undergo neuroectodermal differentiation in vitro, but bone marrow derives the mercies from an elderly patient cannot do that anymore. So you’re losing capacities. So all these you know, every one of these little excerpts it’s, you know, from somebody’s careful study, right, these are not arbitrary. And then adult MSCs are exposed to lifetime of factors including, you know, certain anti inflammatories we take, you know, a lot of people pop them like candies, and even just so even just NSAIDs it may inhibit MSCs ability to form cartilage and disrupt bone formation from these these cells. And some more evidence so lifestyle factors do affect MSCs. They were looking at mice, they were feeding them either high fat diet. They were feeding them high fat diet. And then the adipose derived stem cells from high fat diet mice showed higher a, you know, potential to form fat cells and lower potential to form endothelial endothelial cells. So endothelial differentiation, the when compared to control group, so the high fat diet is changing how the cells are able to differentiate. And if you’re looking at obese patients, looking at their stem cells, ability to form bone so the mineralization nodules are fewer and smaller. So the beasts patients stem cells are just not very, you know, they’re not as good as forming bones, which is part of their job. And metabolic diseases like diabetes can alter the environment of the stem cells. And diminish the cell’s ability to establish vascular network, in vitro and in vivo. So metabolic diseases can affect how the stem cells work. So if you’re extracting stem cells from diabetic patients, then you have to understand that these are not sub optimal stem cells. Knowing especially knowing how prevalent diabetes and obesity is in our country. And if you look at perinatal stem cells, so this is just to refresh your memory this is the placenta with umbilical cord. And there’s the maternal surface, if you’re getting cells from the placenta there, they’re usually a combination of the mothers and the baby stem cell. But if you’re getting cells from the umbilical cord, then is these are all babies stem cells, you don’t have any cells from the mother. And this is one reason I’m choosing to use umbilical cord as a source and that’s, you know, so far considered the most potent there are a few people who dissent, but the consensus generally is the umbilical cord is the superior source when it comes to birth tissue. And here’s there’s a cross section of the umbilical cord. Here, you have amniotic membrane, and then you have a Wharton’s jelly. That’s, that’s, you know, protecting the arteries and vein. And, and this is where you can get cells from the blood that’s floating around in the blood vessels. Or you can get cells from the Wharton’s jelly, which is full of mesenchymal stem cells. You can even get cells from the amniotic membrane, which is also full of mesenchymal stem cells, that even though they’re all mesenchymal stem cells and all from the birth tissue, still it doesn’t make them the same. So these are comparison between the tissue cells and the blood cells. So cord blood cells, you can get sales from the cord blood and you will have majority of these cells are mononuclear cells. So there are primitive immune cells, and some are about 1% or Humana poetic stem cells. So they will of course, regenerate all the blood cells, right? You you can have white red blood cells from the hematopoietic stem cells. And core tissue. On the other hand, that’s full of Wharton’s jelly has huge percentage of mesenchymal stem cells. And this is this is important because even people who are doing cord blood transplantation, they are talking a lot about mesenchymal stem cells, but the cord blood composition is very similar to the bone marrow, the bone marrow has about point 01 to point 1%, of mesenchymal stem cells. So all those cells in the bone marrow, very small fraction are actually mesenchymal stem cells. So cord blood also have similar composition, very few mesenchymal stem cells. But it doesn’t mean that the amount of work stem cells are not helpful and useful, or the mononuclear cells, but it’s true. The gold standard is is the MSCs and it’s also true a lot of cord blood companies only talk about MSCs when they have almost well they have very few MSCs in the in their product. So I want to give you a direct comparison. So this is a comparing between umbilical cord blood MSCs versus bone marrow derived MSCs and adipose derived MSCs. They were comparing the growth profile the cellular senescence and anti inflammatory properties. So let’s look at the growth profile. How well are they able to proliferate? So the bone marrow and adipose rev MSCs their growth stops at passage 11 to 12. So, so the passages is when you replate the cells so the cells will be

30:51
on on a on a petri dish, when it gets become fluent, you know, filling out the dish completely. That’s when you move on to next passage. So at passage 11 to 12. That’s when the girls just stops, whereas umbilical cord blood derived MSCs, which are much younger, they have quite a few more passages left, right they have more life in them. And girls rate, the cord blood MSPs have the highest rate by just how fast they can double their population. And as adipose derived MSCs have the lowest rate clone Gen genericity. So how much of a clone Can you form so they will plate the cells on a you know on a petri dish and see how many colonies can form. So the umbilical cord blood MSC is formed the most and then the bone marrow and then the adipose derived and then there’s comparison of their senescence. So there’s a particular measure called Gaul staining, looking at this particular senescence marker, the umbilical soI passage six six that vocal cord blood red MSCs have no senescence, you know, doesn’t show up, but the bone marrow and adipose derived stem cells have shown some of these senescence markers.

32:11
And then the these Snezana is Hello.

32:17
These senescent expressions, goes increases drastically. From passage nine to 12. But umbilical cord MSCs are still remaining at the lowest level. And there are also other senescence related proteins. That germ progressive passages the umbilical cord blood MSCs have the weakest expression whereas the other two have stronger, much stronger expression of this NSS. And if you look at their anti inflammatory properties, so there’s a model for inflammatory you know, this LPS induced inflammatory model, they were looking at umbilical cord blood MSCs compared to bone marrow and fat derived MSCs and it showed that Core Plus MSC is significantly downregulated inflammatory cytokines in comparison to the other two and it secretes much higher level of anti inflammatory protein, which is closely associated with upregulation of anti inflammatory factors. So this is you know, nice is because it’s direct comparison. And here are some other examples. This is in orthopedic cases. So they found out the umbilical cord, derived MSCs produced three times as much collagen as bone marrow derived MSCs and then umbilical cord derived MSCs showed greater mineralization in a culture that was supposed to, you know, help with bone formation, right? So it has better ability to form bones and better ability to form cartilage. Contra genic pellets. So, yeah, they’re just more effective when it comes to these functions that they are supposed to perform. And some other comparisons. This is really interesting one. So they were actually looking at umbilical cord blood derived MSCs versus adipose derived MSCs. They were looking at their effects on glioblastoma. So they put it in a petri dish, put these cells next to cancer cells, and they put it on live animals body and in both cases, when you put umbilical cord blood drive NICs, next to glioblastoma cells, the cancer was inhibited, and they start to shrink and go away. But the adipose derived MSCs actually promoted their growth because they keep growing and they just you know, get bigger. So this is one reason I think is important for providers to know. If you are wanting to give your patients the safest and most effective treatment, you really need to look at what has been found. umbilical cord blood derived MSCs induces apoptosis through this trail leg end, and the umbilical cord blood MSCs express these trips, this leg end much more strongly than adipose derived MSCs. So that’s one of the mechanisms and Wharton’s jelly. MSCs do not induce teratoma and do not induce tumors, and Wharton’s jelly derived MSCs are not associated with enhanced growth of solid tumor can even help you get rid of certain solid tumors. So they found out in breast cancer, ovarian cancer Oster carcinoma, they the evidence is that words jelly derived MSCs can help you get rid of cancer. Some other comparisons, this is about angiogenesis wasn’t jelly Dr. MSCs have expressed more angiogenic factors, they are more immune regulatory. And the words jelly also have stronger expressions of the of these growth factors known to have anti fibrotic properties. So they can be used to reduce and prevent fibrosis and scarring. Then I’ve seen that a lot in my own clinical practice, which is super fun, because how many things you know in medicine actually can break down scars and you know, can can, you know really have truly anti fibrotic properties. So it’s very exciting. When I give people IV stem cells and their testicular nodules go away, or their thyroid nodules go away or their liver nodules go away. I mean, it’s amazing or their COPD drastically improves, you know, getting off oxygen. So these are all what’s inspiring to me. And I think you know, as a doctor, if you haven’t been using stem cells, you really owe that to your patients to consider bringing that into your practice, because you can reduce so much suffering wasn’t jellies MSCs are able to induce endothelial cells to migrate more effectively than bone marrow derived MSCs. So you know, all these different aspects of how they function. We’ve shown we’ve seen again, again, these are all different studies from different scientists from different parts of the world, all showing similar conclusions that these younger stem cells have a lot of superiority in comparison to the older stem cells. Some other comparisons about when it comes to neural protection, Wharton’s jelly derived MSC secrete factors that have better neuroprotective effects than those from bone marrow MSCs and they’re more effectively decreasing cell death and apoptosis. And the gene expression patterns also shows that Wharton’s jelly MSCs have a tendency to, you know, basically show more gene expression tailored towards cell proliferation, neurogenesis, nervous system development and blood vessel development. Whereas bone marrow derived MSCs have a different set of skills. They’re more tailored towards ossification and skeletal development. So even though they’re all called MSCs, and they, you know, when you stain them, they all have surface markers. Yes, I can name them MSCs but they’re drastically different. Right? If you get something from really young, early sores, like words jelly, I just want to remind you guys, once jelly is formed when the baby is getting formed, right? It’s during embryogenesis. So a lot of these cells are actually trapped in the umbilical cord when the fetus is forming. So they’re very, very young. They’re so young that they’re in between the baby stem cells and the embryonic stem cells. So a lot of surface markers that that are no longer present in the baby’s stem cells are still present in these Wharton’s jelly stem cells in these MSCs. So very different like I said, you know, it’s like 1000 layers of, of evolution of the cells. So there’s no distinct demarcation when the cells become what it is continued life is a continuous stream at the very end of the stream. That’s a tissue specific stem cells. Yes. Now we come to the end stage, but before the N stage comes, there are all these gradations you know, 1000s Shades of Grey, so, so the orange jelly MSCs contains a lot of these early potentials, these powerful potentials that have been lost as the person develops in ages. And I want to talk a little bit more about the permittivity. So I mentioned you know that these cells from Wharton’s jelly, they have high expression of embryonic genes. So these are all the embryonic genes that are still present. But, but no longer present in the in the older sources. So that makes them somewhere in between embryonic stem cells and adult mature stem cells. So when we say adult stem cells, a baby is an adult in the embryo logical term. So when we get stem cells from the baby, even though the baby’s zero day old, that is adult stem cell, so which means that these cells are you know, are just more primitive but without the risk of embryonic stem cells because embryonic stem cells because they haven’t been proven how many pregnancies actually result in life, healthy birth, right? How many things can go wrong? When you have a new embryonic stem cell trying to make a person lots of times, there’s genetic defects, there’s little things can go wrong, and it doesn’t make it so when you try to use the cells that’s really close to that stage, you really haven’t proven yourself that you can form a full human being all your genes are functioning perfectly that you can make a perfect symphony. So you haven’t proven that and then you are trying to use that and give it to a person. Yes, sometimes you can form a teratoma. But when you use something from Wharton’s jelly, when the cells you know, this is after a baby has been born, the baby has been formed. All the genes, pretty much work and everything you know, the jigsaw puzzle has been fitted together, and now you’re using the cells of a proven product right? And when you use these mesenchymal stem cells, even though they have embryonic markers, and they’re very potent, but they’ve been proven, and they no longer can form teratoma, so that’s no longer a risk. And more about umbilical cord stem cells as far as as far as differentiation, so that wasn’t jelly MSCs and the whole umbilical cord derived MSCs have the best osteogenic potential

41:52
versus the the cord umbilical cord artery vein and unquote umbilical cord lining MSCs so this just shows you that you know, even within the court not everything is the same. So there’s a lot of nuances and the word jelly MSCs can differentiate into heart cells, right heart muscle cells, neurons, glia, oligodendrocytes, and hepatocytes in addition to the traditional bone cartilage and fat cells. And then more about the umbilical cord mi sees the gene expression so look at these different compartments, amniotic membrane, Coriell membrane and umbilical cord so deriving from each of these different components are different genes that are upregulated, the amniotic membrane MSCs are more upregulated when it comes to cellular growth and proliferation. The chorionic membrane, more toward cardiovascular hematopoietic hematological system development and umbilical cord NIC is more toward nervous system and behavior. So

43:02
yeah, the umbilical cord right. So hello, yeah.

43:08
Is there a difference between ossification and osteogenic? Potential? I’m referring to the previous slide.

43:17
So it’s a very similar I’m just referring to the same thing. Yeah. So this is okay. me showing you this. This is I am giving you an idea why actually, when I use a stem cell product, I actually use a combination. I use cells from the amniotic membrane cells from umbilical cord tissue, and I use cells from the umbilical cord blood because as you can see different components, you know, have different upregulated genes right then I can really give the patient more breadth of potential for healing. So, so that just kind of shows give you an idea of why, you know, where my philosophical, you know, my my philosophy come from, and, and when you look at autologous stem cell transplant right from a person’s own bone marrow fat, you can get it from menstrual blood, Denzel Pope. Yes, it’s a perfect HLA match. And there’s a higher chance of long term engraftment. That’s very true. When you put the cells in the body, the cells can differentiate, and there’s less chance for your immune system to attack. That’s absolutely true. But the caveat is that when we do stem cell transplant, the engraftment is actually a very, very tiny fraction of the picture. The majority of the benefit we get from stem cell therapy is not from engraftment as from the undercurrent or not the paracrine effect. So that’s from the signaling effect, because if you read any articles from the last 15 years about stem cell therapy and how the stem cell treatment worked, almost all article they would, you know, some lovin would test to see if the final repaired Oregon actually have the new cells in them. We’ll see if they were the descendants of the stem cells, and almost always none. So I mean, there’s it’s become a mantra from these. These articles, they say, well, obviously the result of the benefit, the clinical benefit is not from the fact that the cells differentiate into local tissue cells is from the paracrine effect is from the signaling effect. So it’s been proven over and over at nauseam so now it’s an accepted fact. Although some doctors still don’t know they still think that I need to put cells right into that organ I’m trying to repair. No, you don’t. First of all, the cells have the ability to be attracted to the area of injury and inflammation. Second of all, when they get there, they will send signals so your own stem cells can differentiate and can start to replenish the tissue. You don’t need the cells to be right there. So so that’s the, you know, the so called advantage of autologous cells. I don’t know how much advantage there is if we don’t need the cells to actually stay and be a perfect match. But there are a lot of disadvantages. So first of all, it is invasive, invasive and inconvenient. I actually published an article with Dr. smiler on on maxillofacial surgery using the stem cells that that that I use, which is umbilical cord derived Of course. And when that was mixed with bone graft, a bone matrix that can promote you know, drastically improve the healing of the bone. So, that was the article and before he started using the perinatal source and vocal cord source, he was doing bone marrow transplant of you know, basically extracting bone marrow from the, from the same person. And he’s done that for over 30 years. And what he realized was that people came back they complain more about their hip pain, and then about their dental pain. Because, you know, it was just it’s painful. It’s very inconvenient, it is invasive. And also just remember when you cause an acute injury like that, especially if you’re trying to help something that systemic, if you put yourself into the IV line, the cells are going to be attracted to the injury you just made. So a lot of cells are going to go right back to try to heal the drilling in the bone that you just made. So this is something to consider. So it is invasive is inconvenient. And there’s also a quality control issue. Right. These are done in physicians offices, they take your bone marrow fat out and they’re processing it. These are not GMP labs. You know, we all know we know each other, we are doctors, we’re not bench scientists, you know, we don’t have that kind of standard and capabilities. And with aging disease, the quantity and quality of stem cells declined. So the bone the red bone marrow would change to yellow marrow as when ages and there’s toxic buildup in adipose tissue just so you know and I sees decline with age. When we are born. Every one in 10,000 cells is an MSc when we reach our teenage years becomes one in every 100,000 So it’s from 10,000 to 100,000. We reach our 40s it becomes one in 400,000 when we reach our ad is one in 2 million. There’s no way around this as we live more cells senesce and die and we lose them and that’s it we lose you know the mount and then we also lose quality as I’ve shown you so stems are less potent, shorter telomeres. They’re less versatile in their differentiation capabilities and less inflammatory with less than your protection, senescence more CNS more rapidly, and they also have less concentration of growth factors in the transplant product. And of course the cells are attracted to areas of injury and it’s very difficult to achieve frequent and regular dosing. You How many times can you drill and do liposuction on a patient? Before that becomes just, you know, extremely cumbersome especially if you want to do anti aging treatment that’s you know, that’s pretty hard to do anti aging using your own old cells. So what are the disadvantages for perinatal stem cells? So possible immune response? Yes, there’s potential, especially if you have very little MSCs if you just use cord blood which have very few MSCs there are more chances that a person will get shortness of breath will get some chest congestions and malaise. sniffling so all these are possible. All these I’ve seen, you know, the reason I’ve derived the product I’m using was because I’ve used everything else so I’ve used Cord Blood Products alone, and that’s one of the problems is because they have so few MSCs but stem cells, these young stem cells, they do have some HLA markers. The HLA one marker is actually very important. They mark your cells as humans so your your own immune system is not going to attack it. The HLA two markers are immune immunogenic but those are there very few expressions of these markers. These HLA two markers on stem cells. So using somebody else’s stem cells, yeah, there’s potentially less chance to engraft but then we now know the main mechanism of action of the cells is not through engraftment, but through paracrine effects. And what are the advantages so there’s actually no matching necessary? I’ll tell you something that’s really fascinating. When you do bone marrow transplant, if you transplant between two perfectly matched, so called matched that’s matching all the HLA markers we know about right, but how many we don’t know that. So a perfectly matched donor to adult right to adults, you get into you give to another adult there’s still a chance of rejection. But if you give the person umbilical cord blood transplantation, remember the cord blood is very similar to the bone marrow composition. So if you give umbilical cord blood transplant and you do absolutely no matching at all, there’s still less chance of rejection than if you use perfectly matched adult bone marrow transplant. So that’s how drastically different young versus old, the younger have more ability to adapt to a new host. So the cells are more primitive they proliferate proliferate faster with more differentiation potentials, and they contain more pluripotent stem cell populations with more embryonic characteristics cells are more potent, right secrete more growth factors have longer telomeres, less accumulated genetic changes. They have more abundant growth factors more types, and you know more more of these growth factors that are associated with us. And they’re also easy to obtain with no ethical controversy. So what’s special about umbilical cord tissue I was telling you about the the high MSE content in the cord tissue so up to one in 300 cells are MSCs, whereas Cord blood is one in 2 million. Right? So they’re just very, very few. And my C’s are more primitive

52:23
from the umbilical cord tissue. They have pluripotent markers. So these are, you know, proven potency. Which means you can go cross go across germ layers and becoming cells of any tissue type. And they have more ability to develop into cardiomyocytes. myocyte or neurons, and or more to protect neuroprotective and angiogenic. And here’s a quick overview of the tissue source comparison. There’s the placenta, umbilical cord or autologous so you can look at the number of cytokines, growth factors, and total cell count. So, so there’s the amniotic membrane, so a lot of people use embryonic fluid. As you can see, there’s almost no cells pretty much it’s FDA considered a cellular product. So yes, you’re getting a lot of growth factors, but you’re getting no cells. But if you use umbilical cord blood, which is has a high cell count, but very few MSCs versus cord tissue, the cord matrix has not so much cell count. You know less but what am I sees so amniotic membrane very you know less even less out count a lot of my C’s so the product I use combined the three right amniotic membrane cord, blood and cord tissue, all three of them. So not only you have high cell count with different cell types, but you have a lot of MSCs. And also I want to talk about Native versus expanded cells, because a lot of your patients may already have thought about going to Panama going to Mexico, Colombia, they want to get the cells because they were promised that they weren’t going to be given, you know 200 million 400 million stem cells. This is a presentation I attended one of the conferences. So somebody actually studied what happens when you use the cells and looking at their clinical, you know, their you know, the efficacy they were able to produce so looking at cells that are not MSDS that’s control, there’s not much clinical effect. And when you use 100 cells, I mean 100 I mean 10,000 These are native MSDs, which means they haven’t been expanded, which means that they haven’t been grown in the culture, you know, in an incubator, so they’re not allowed to start to make duplicate duplicates of themselves. So these are native, pure MSCs without expansion 100,000 cells, I mean, 10,000 cells produce this level of benefit and when you use 100,000, which is 10 times that you produce a dose responsive, you know, the dose response relationship that you’re getting a higher amount, higher level of response, but when you give 10 times that, but these are expanded cells, these are actually cells that been growing culture, even though you’re given 10 times you’re giving 10 times you’re having less of a benefit. So more is not better. So that’s something I’m trying to educate my patients. I just treated a 911 responder who went to Mexico and he wanted to get the treatment. And he had a lot of lung pathology, brain fog, all kinds of problems he did. Get relief three months after the treatment, but he had three months of extreme fatigue. And it’s not just him, where he was there. There were 20 other patients that were all there and they all connected with each other. So they were corresponding with each other. Every one of them had extreme fatigue for months. So everyone and then a month ago he came to my clinic to get the treatment, very simple treatment. I didn’t tell him not to exercise not to do this and that but anyhow so he was able to get quick response. His lungs was was doing better very quickly. Absolutely no fatigue, and he said it was night and day. So that just goes to show when you get people expanded cells. Not only you’re decreasing efficacy, you’re also causing potential reactions, which I think is some kind of immune reaction because you are allowing the cells to differentiate to express surface markers. Then the cells are ended up showing, you know the markers of who they were, then you’re causing rejection because they’ve seen nest, they in a sense, have matured, became more adult like cells that you’re causing rejection. So there’s a big difference. You know, maybe after seeing this, you will feel you know, better able to, you know, counsel your patient about the risks they’re taking on by going overseas. In the US when you start to expand the cells, the FDA says then you’re producing a drug, then you can only give these cells in to a patient under a clinical trial, which is why all these companies have left the US and they set up shop overseas where there’s no such restriction. But I think there’s good reason that FDA set that. So that’s that, you know, that’s an entire presentation. So I My goal is for physicians to be well educated on the differences between these MSCs and why they’re powerful, and how you can pick the best one for your patients so they can get the best results. Yeah, so I am gonna stop here.

57:42
I have a question. We’re treating a patient FSHD fasho humeral, scapular muscular dystrophy, and we’ve managed to hold more or less his muscle breakdown and we’re dealing with the scar tissue. And we think we may have found a way to to recruit satellite cells. But my question is, what stem cells or their signaling mechanism helped to recruit stem, the stem the stem cells, which are inactive in muscular dystrophy patients.

58:30
I I’m not sure. So you I think Muscular Dystrophy is still a tough condition to treat. Yes, you can transplant cells in that area, but I don’t know if there’s enough inflammation in the muscular dystrophy region, you know, in the dystrophic region to actually attract the cells. I don’t know if there’s

58:56
all of the regions and this gentleman Well, you know, everything from his neck into his pelvis is inflamed out as and that is where the where the scar tissue comes from. It has, in a sense, it’s an inflammatory disease but a genetic one. But you don’t know what

59:21
is inflammation and do I think if there is inflammation involved, then definitely there’s a good chance when I consult with patient when they asked me a doctor can sometimes help this and help that you know, I always go for research evidence first, but a lot of times no one has studied that particular condition then I look at the mechanism, the pathophysiology, the person, right, I’m not going to be able to fix the genetic defect for sure. That’s gene therapy, but I can fix the downstream effect, which includes tissue damage. So if there’s tissue damage and inflammation, immune dysregulation, as part of the picture, I think stem cells has a good good chance of helping it.

1:00:05
Okay, okay. That’s what I wanted to know. Thank you.

1:00:08
Yeah, good luck. I hope you let me know how the patient does.

1:00:17
Anyone else have any questions? Hello, yep.

Bill Clearfield 1:00:26
There’s a question here. Do you have any experience using stem cells in relation to cancers?

1:00:34
Releasing a cancer so actually have a I have a Yeah, I have. I’ve been talking about this a little bit, and I no longer consider it a contraindication. When I first started to doing stem cell therapy, I was not touching cancer patients, but well my mom had cancer and that didn’t prevent me from, you know, grabbing stem cells and bringing back to her in China. But the problem is, you know, I mean, she was already getting better from lymphoma, unfortunately, than the doctors persuaded to her to take chemotherapy, you know, three days after the stem cell so so that pretty Yeah, that killed her. But nowadays, I think if somebody has cancer, if they get proper consent, I’m happy to share it and consent form with you guys. The then you will have, you know, I think there’s a chance that you can really help them not only helping boosting their own immune system to fight the cancer, but also have direct anti cancer benefits. So, but just be careful if a person is going through chemotherapy, avoid giving your stem cells really close to time where they’re getting chemotherapy. I usually want them to finish chemotherapy, give it at least for half lives of the chemo, chemo agent, so that is pretty much out of the system before you give stem cells.

1:01:59
Okay, great.

Bill Clearfield 1:02:01
Okay, anybody else have any questions?

1:02:06
Comment? Yes? Yes. Hello. Yes. Yes. Hi, Bill.

1:02:13
Great lecture. Thank you learn quite a bit. My question, several of them but let me go backwards. As you’re talking about the expanded MSCs. So is it no matter the generation you still have? The same lack of effect? Let’s say in other words, you spoke about the 11 to 12 generation 1416 generation. Let’s say they take the younger, expanded them and see, is there a possibility that they have more effects than the the older one?

1:02:45
Or the younger mean as tug of war, depending on how young the cells are, how many generations you have, I don’t use expanded cells, unless I can be guaranteed that there’s less than three generations. Unfortunately, all these overseas companies expand them to huge number of of generations. So they are they’re very much you know, I think compromising our quality. But yeah, but all I all I use is first generation right and there have been expanded and when I give the number of stem cells that’s 1/10 of what overseas companies are giving. I think I’m getting, you know, at least as good if not better results. So there’s no to me, there’s no need to give these expanded cells. Right, right. Make sense?

1:03:31
So the earlier question that I asked you about? Let’s see ossification versus osteogenic potential. It’s because there’s one of the slides you mentioned that what was it again, I think you mentioned that the bone marrow MSC does tend to ossify and, and later on, you spoke about the water and jelly MSC, and you spoke about a cog in a potentiality. So potential, so I was wondering whether one want to handle whether there is a difference and you told me there’s a difference basically, that’s basically the same thing. But from your experience. Is there a one that is more likely to to go toward ossification? That’s one of the questions that I had. And then is there a potential side effect for example, calcification of soft tissue, stuff like that?

1:04:23
I haven’t seen calcification of soft tissue actually. MSCs have been shown to have great benefits for for atherosclerosis in breaking down you know, the, the the calcification of the lining and enlarging the aortic root. So that’s not a concern of mine. Most of these MSCs should be having should have osteogenic potential. Of course, if you use younger and umbilical cord derived stem cells, they will have the stronger capabilities to form bones.

1:04:56
Right, thank you. You’re welcome. Okay,

Bill Clearfield 1:05:06
John, you got anything for us here for Dr. Khan?

1:05:14
Sorry, I

1:05:14
just think Thank you, Dr. Khan. You’re welcome. Wonderful, wonderful information. There’s been so many of the a 4am crowd that have been working with us for what 40 years. Oh, wow. So it goes way back. I don’t know if you know, Dr. David Steen block is it

1:05:36
what a guy Huh? Huh?

1:05:40
He was leading the way many decades ago and it sounds like you’re leading the way now. So I congratulate

1:05:46
Thank you very much. We’re all trying to do our best. Yeah, so if anybody is interested, you know, I put on my email. I don’t know if you saw just joy Kong md@gmail.com. You’re welcome to email me. I’m happy to you know, one of the most fun thing to do is to work with other doctors, you know, who are you know, pioneers who are you know, open minded, and to really bring something new and powerful to patients. So yeah, I’m happy to to talk with any one of you if you’re interested. In, you know, the training or, you know, utilizing the product that that I put together, because I’ve seen all kinds of products out there. One reason I started my own stem cell company was because I mean, I really had no interest in in getting into business. I just wanted to get people a really good product, but that has been very difficult, because most companies are started by business people. And it seems like the bottom line is is profit, not signs and in quality. So So anyhow, so initially, I wanted to provide good quality but then I realized that I could tweak the formula and make it more potent and more complete. And that’s where the, you know, the product came about where you can incorporate different components of the diverse tissue. Yeah, so I’m happy to talk with anybody who wants to look into it. Thank you.

1:07:14
Giving us some contact information. I didn’t see anything in the chat.

1:07:20
Yeah, so is okay, let me put in the chat. The chat, so Okay. So I’m gonna put my email here, join calm md@gmail.com And then the academy is aict.org which is very helpful because as a physician, you cannot post you can not post testimonials, which is really strange because the FDA or the medical board thinks that if you’re posting testimonials, that means you’re making a claim. So, you know, with the academy is really helpful because all the case studies are posted on the Academy site. And the academy is not making claims that you have them you’re just reporting what has been happening with different patients. So you can utilize that if your patient was let’s say rheumatoid arthritis, with lupus with osteoporosis, you know, with cardio, you know, with MI, you can go on there and see if there’s any case studies that’s already reported and you can share that with your patients. So it’s very just very helpful and it also protects

1:08:24
you. Okay,

Bill Clearfield 1:08:27
there is another question here. Do you give stem cells during a flare of an auto immune disease or wait for the flare to be over?

1:08:35
I give it during the flare. Actually, they’ve done research showing that when you have an acute inflammatory episode, it makes the cells work so much harder and better. So I used to think that you want to reduce the inflammation. Now I was like, it’s fine. You can be as inflamed as you want, and let’s just get the regeneration going.

Bill Clearfield 1:08:54
I would think that’s that’s the whole purpose of what you’re doing in the first place. Right? So that wouldn’t be would that would make sense during this during during the worst of it?

1:09:03
Right? Exactly. Yeah. No need to suffer first. And just, yeah, let’s just start now.

Bill Clearfield 1:09:09
You hear that John? I hear you suffering.

1:09:16
I hear and I believe

Bill Clearfield 1:09:20
Okay, okay. So we have your, your email address, and of course I have it if anybody needs it. We will send you if you want, when we’re done the contact information for everybody that was here. Okay. Anything that you you’d like to share with them? You’ll get to do that.

1:09:36
Okay, wonderful.

Bill Clearfield 1:09:38
I can’t thank you enough for being with us. I know you’re very busy. And we sort of Shanghai you out of the blue. But we’d love to have you back again. You know for part two down the road at ease. And anybody have any their experience with the you know, stem cells exosomes? Do you use exosomes? Is that part of your repertoire or no?

1:10:06
Yeah, we produce exosome product as well but I used it more like an adjunct because I always say stem cells are the mothers of the exosomes. So if I can give them mother that lives a month to three months, rather than giving something the progeny which is just little particles that will go in and dissipate. The effect only lasts for one to three months. But if you give stem cells, which lives for one to three months themselves, and then they will continue to secrete more targeted exosomes as they go, and you will have much extended time of healing. So that’s why stem cells generally, their effect lasts for three to six months rather than one to three months as as in exosomes, but I do use exosomes as an adjunct to stem cells because they are you know, you’re giving a lot of information all at once. And for people who have acute inflammation or have central nervous system conditions, then these exosomes can cross the blood brain barrier very easily and you can you know, it’s much easier to target the brain. So high inflammation and brain conditions I add exosomes. Okay,

Bill Clearfield 1:11:15
just as a reminder for everybody. The videos will be on aos or d.org/webinars. It’s also been showing up on YouTube for some reason I don’t know why I don’t put it there myself, but it ends. A lot of them have ended up there and under my name for some reason, and I apparently have over 1000 people in the chat as in the channel which I don’t even, you know, I don’t know how I

1:11:42
got away from you. Okay.

Bill Clearfield 1:11:45
So, you know, we are that we are the font of misinformation here. So, the and we’re sort of proud of it too. So what about mixing? What about mixing the either the stem cells or the exosomes with a PRP? Is that Yeah,

1:12:00
I’m a big fan PRP is like nutrition, you know food for the stem cells. For local tissue injections, I almost always mix them together. So not only will nourish the cells will give you added benefit, but also will give you volume for migration, right if you inject into certain soft tissue like the back, you know, the diffusion, if you give a tiny bit of stem cells, you know, it’s going to stay in that area. But if you give more volume, then he’s going to have a better factor fraction of you know, capability of diffusion. So for several reasons.

Bill Clearfield 1:12:31
There’s a question the delivery system do you like I am IV

1:12:39
Yeah, so that’s, that’s the art of it. I am pretty heavy on IV use because there’s a lot of research, you know, using IV therapy and I think IV produced more profound benefits not only it can be attracted to local areas, but also interact with your immune system which have more profound benefits. You know, which can be shown in the case of

1:13:04
people who have stroke

1:13:07
at the same time of a splenectomy is a very strange, strange way of, you know, occurs, but people who had a stroke at the same time got a splenectomy initially actually have less infarct size, which just because the immune system is not involved in you know, bringing in all these white blood cells and you know, all these neutrophils that actually cause more damage, but over the long term, you do need your immune system to heal. So when they look at the infarct size, like three or six months down the road, the infarct size is the same between people who have the spleen versus don’t. But this just gives you an idea of how much the immune system is involved in local damage. So I think if when you bring your immune system on board, you’re going to have more drastic, more drastic healing. Okay,

Bill Clearfield 1:13:56
can I give you a scenario and maybe you can give us your thoughts on it. So, like, 66 year old male he’s had an L four l five disc issue and l five s one. He’s had four surgeries that have failed, and the surgeon wants to go in and do another a fifth one now. So we showed up in my office, and we discussed all of the things we’ve been discussing here. What would what would what would be your some recommendations under under that scenario, or what other information would you need?

1:14:30
So say it again, so

1:14:32
you want to

Bill Clearfield 1:14:33
get an L four l five l five s one. He’s had multiple surgeries that have failed, severe pain is barely able to he’s had a lumbar fusion also I forgot that and he’s barely functional. And the family wants to know is there any What else can be done? So in your in your world, stem cells, exosomes PRP will

1:15:01
definitely be helpful, but I do think that the back issues are a little bit more complex. I don’t personally inject into the facet joint or the the intradiscal space but you can certainly do that and I you know there has been some positive reports. But mainly what I’m doing is address address the fascial layer, that most of the back pain comes from actually the you know, the the inflammation, the fascial layer, so I tend to address that but for further more you know, targeted injections. Yeah, I there has been some positive results. So they can certainly try to inject stem cells right into

Bill Clearfield 1:15:44
your using fluoroscopy. I take it or ultrasound guidance or

1:15:48
Yeah, was it for those injections you would need to do that and I don’t have that capability.

Bill Clearfield 1:15:55
So if you’re doing say, a shoulder joint are you using?

1:16:00
I’m just using anatomical landmarks. Yeah. You know, I was trained by an orthopedic surgeon so I think he knows what he’s doing. So I’ve had some good successes.

Bill Clearfield 1:16:13
Just asking because, you know, there’s this, you know, big push to everything has to be done under sort of fluoroscopy or, or ultrasound guidance and things like that. So, you could

1:16:26
you could it’s more for show for the patient.

1:16:30
Okay,

1:16:32
I know we’re dealing with somebody very honest here. I’ve done about maybe a million euro facade injections, and I raise I’ve resisted the radiation and the the showmanship with increased prices as well. Can I just simply ask if you’re doing pair of facetted injections without forcing into the joint Have you tried that and have you had success?

1:16:58
No, I’ve only done pair spinal muscle injections. I didn’t. Yeah,

1:17:04
I was even even with the anatomy, the anatomical placement. You can Bullseye that facetted every time that’s not a problem. That’s great. And we have great success. But I I’m doing some patients now with post surgical just like Bill said, and we’re going to the facettes and we’re ready to do that. So I’ll be in touch on that because I want to see what happens. I think it’s a difference between a wheelchair and not. And I’m hoping that the stem cells and exosomes can be of great benefit we’re gonna try it

1:17:40
is certainly a lot more potent for sure. Then PRP Yeah.

Bill Clearfield 1:17:46
Are you going to be at any of the you know, the upcoming, you know, shows or conferences do you do date?

1:17:54
I haven’t I haven’t done a 4am yet. I mean, as a presenter, but I will be presenting at the next there’s an ozone conference. I presented Shallan burgers conference last just this year, and then I’m presenting another ozone conference in Santa Barbara in beginning of November. But yeah, I haven’t looked further but if you guys have conferences I’ll be I would love to come present.

1:18:19
You go John.

1:18:20
Terrific.

Bill Clearfield 1:18:24
Touch if we ever get our act together here.

1:18:27
So you haven’t had a conference yet.

Bill Clearfield 1:18:29
It’s a long story we’ve had we’ve had him in the past but it’s a long story. I don’t want to go into it.

1:18:37
Okay, all right, whenever it happens all right. So my contact info is there and I look forward to hearing from and, and thank you for the kind words about my presentation, you guys and I’m always impressed that you know you guys must be some of the most dedicated doctors, you know, late at night after a long day in the clinic and then still listen to, you know, these technical presentations. So so thank you for being here.

Bill Clearfield 1:19:05
Well, you were the fantasy football loser. So all right. Thank you, Mike. Thank you.

1:19:15
Thank you, everybody. Okay. Take care. Great meeting y’all. The by next week. We

Bill Clearfield 1:19:21
have Emily row and she’s going to be speaking about oxalates So something I don’t know as some of you know a lot about some of us don’t know nothing about so we’ll learn all about oxalates next week. Okay. So if you’re if you want to do are you on our mailing list, Dr. Calm because

1:19:38
I’m not I’d be happy to be on it.

Bill Clearfield 1:19:40
I’ll make sure you’re there. Okay. Thank you. Thank you so much. And we’ll be in touch.

1:19:46
Okay, wonderful. Thank you Dr. Clearfield. Okay, bye bye.

1:19:52
Okay. John, did you leave?

Bill Clearfield 1:19:57
I guess you left to Okay. Okay, everybody, thank you so much. We’ll be here next week, same time. Same station. Anybody have any comments or questions? And thank you all for being here. Some of the some of the newer faces. Doctors you know, thank you for being with us. Thank you for your questions. Please, please return are you on our mailing list? Yes,

1:20:23
I am. Quite a few. But I’m back again.

Bill Clearfield 1:20:28
Hey, don’t be a stranger. No. All right. Oh, just to let you know, so October 18 19th. I’ll be in Houston and also the 22nd for a MMG age management Medical Group. They got me doing a simple introduction to male hormones. That’s on Thursday. That’s their workshop and then I’m doing non hormonal ways to manipulate hormones so and so on. That’s on Sunday. So I go through as far as I’ll get it all the way from testosterone through prolactin, how to increase testosterone how to decrease testosterone without using testosterone, estrogen, progesterone, insulin growth hormone thyroid DHEA, bringing along all of them. So we always put that at the end of our conferences. Oh, by the way, you can do this. So this is going to be the oh by the way, a whole lecture. And so you’ll have you know, you’ll have wait so I have 20 ways to raise testosterone 20 ways to lower testosterone without using it. So, you know, we have a lot of our colleagues either can’t prescribe it or or don’t feel they’re confident in it. So that’ll be that’ll be my presentation. So, okay, so that’s on age management Medical Group, age mid.org. And that’s October 19, through the 22nd. And if anybody else’s is presenting anything, please let me know. And we’re always open for anybody to present their ideas here. We’re non CME, so you can present your ideas you can use trade names like Dr. Khan did, and we have sent you the contact information after the show and if you have any special offers and whatnot, you can certainly you know, offer that out. Anybody else have any comments or questions? It’s good to see everybody again. Dr. Dalton has been a while. Again, don’t be don’t be a stranger. And please let us know. Give us if you have any ideas about what you’d like to hear. Please let me know. We’re going to have coming up in the future we’re going to have Dr. Patel is going to give us some insight on how to how to begin a Environmental Medicine evaluation. Right coming up to Okay, so thank you all and we’ll see you again next week. Same time same station eight o’clock Eastern five o’clock Central, five o’clock Pacific. And you can always get me you know where to find me. Whenever so. Okay. Thank you all and we’ll see you again.

1:23:17
Bye. Take care.

Bill Clearfield 1:23:18
I’ll have this up. I’ll have the video up as soon as I can when usually within 24 hours on our website