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Peptide & Hormone Therapies for Health, Performance & Longevity | Dr. Craig Koniver

Andrew Huberman and Craig Koniver on peptides, NAD, and Mindset: Precision Tools For Modern Health Optimization.

Andrew HubermanhostCraig Koniverguest
Oct 7, 20242h 29mWatch on YouTube ↗
Basics of peptides and how they differ from hormones and supplementsGLP‑1 agonists (semaglutide, tirzepatide): microdosing, muscle loss, and metabolic effectsBPC‑157, FDA removal, and PDA (Penta‑DCA arginate) as a successorGrowth hormone secretagogues (ipamorelin, tesamorelin, GHRP‑6, hexarelin, MK‑677) for sleep, fat loss, and recoveryNAD (IV, subcutaneous, NMN/NR) for mitochondrial function, fatigue, and moodSleep‑specific peptides: pinealon plus glycine, REM sleep, and circadian supportRegulation, FDA crackdowns, compounding pharmacies vs. gray/black market, and the role of mindset in health
AI-generated summary based on the episode transcript.

In this episode of Huberman Lab, featuring Andrew Huberman and Craig Koniver, Peptide & Hormone Therapies for Health, Performance & Longevity | Dr. Craig Koniver explores peptides, NAD, and Mindset: Precision Tools For Modern Health Optimization Andrew Huberman interviews physician Dr. Craig Koniver about the emerging but rapidly expanding world of peptide and hormone-adjacent therapies for health, performance, and longevity. They explain what peptides are, how they differ from classic hormone replacement, and why many sit mechanistically between supplements and full-blown drugs. The discussion covers GLP‑1 agonists, BPC‑157 and its successor PDA, growth hormone secretagogues, pinealon for REM sleep, and NAD in both infusion and injectable forms, including real-world protocols and safety considerations.

At a glance

WHAT IT’S REALLY ABOUT

Peptides, NAD, and Mindset: Precision Tools For Modern Health Optimization

  1. Andrew Huberman interviews physician Dr. Craig Koniver about the emerging but rapidly expanding world of peptide and hormone-adjacent therapies for health, performance, and longevity. They explain what peptides are, how they differ from classic hormone replacement, and why many sit mechanistically between supplements and full-blown drugs. The discussion covers GLP‑1 agonists, BPC‑157 and its successor PDA, growth hormone secretagogues, pinealon for REM sleep, and NAD in both infusion and injectable forms, including real-world protocols and safety considerations.
  2. They also address serious sourcing issues—why compounding pharmacies and physician supervision are crucial compared to gray‑market “research chemical” vendors—and how recent FDA actions have sharply restricted many popular peptides. Beyond molecules, Koniver emphasizes that tools like peptides and NAD work best when layered on a foundation of sleep, exercise, nutrition, and especially a deliberately positive mindset, which he views as the most powerful long-term health lever.

IDEAS WORTH REMEMBERING

5 ideas

Use GLP‑1 agonists slowly and strategically to avoid muscle loss and rebound weight gain.

Koniver sees semaglutide and especially tirzepatide as powerful tools when used via microdosing from compounding pharmacies, starting very low and titrating slowly. He aims for ≤2 pounds of weight loss per week, combines them with resistance training and adequate protein, and often stacks with growth hormone secretagogues (e.g., tirzepatide + sermorelin) to preserve lean mass. Conventional high-dose protocols drive rapid loss, “Ozempic face,” and quick weight regain once stopped.

Avoid gray‑market peptides; work only with physicians using reputable compounding pharmacies.

Many online vendors label products “not for human consumption” and skip rigorous endotoxin and sterility testing. Koniver has seen anaphylaxis and serious inflammatory reactions from such products, largely driven by contaminants like LPS. FDA‑regulated compounding pharmacies must meet strict purity and sterility standards and allow customized dosing and stacking; his protocol always includes a physician consult, contraindication review, and careful dosing rather than self‑experimentation from the internet.

BPC‑157 is off the table, but PDA (Penta‑DCA arginate) is an emerging substitute for systemic repair.

BPC‑157 was one of Koniver’s most broadly useful peptides for systemic anti‑inflammatory effects and tendon/ligament repair, often injected subcutaneously away from the injury site with strong whole‑body benefits. After FDA removal, he now uses PDA—a single amino acid variant—with similar clinical outcomes so far. His starting dose: 250–500 mcg subcutaneously once daily, Monday–Friday, to support joint recovery, post‑viral inflammation, and general tissue healing.

Choose growth hormone secretagogues based on your specific goals: sleep and leanness vs. appetite and mass.

Ipamorelin (≈100 mcg at bedtime, 5 days on/2 off) is his “clean,” sleep‑supportive, fat‑loss‑favoring GH secretagogue with minimal side effects when dosed properly. Tesamorelin (≈2 mg) targets visceral fat and often works especially well in women. Hexarelin (≈100 mcg in the morning) is more of an energy/endurance enhancer. By contrast, GHRP‑6 and MK‑677 strongly stimulate appetite and may raise prolactin and cortisol; he reserves them for hard‑gainers who specifically want rapid muscle and strength gains.

Pinealon plus glycine can dramatically increase REM sleep and improve sleep architecture.

Pinealon is a very small pineal‑targeted peptide that, in Koniver’s practice and Huberman’s personal experience, can substantially increase REM sleep time and improve overall sleep quality without sedation or observed side effects. Koniver compounds pinealon with injectable glycine (for inhibitory neurotransmission and liver support) and typically doses it subcutaneously at bedtime. Huberman reports roughly doubling his REM sleep on nights he uses it and seeing better sleep even on off nights, consistent with pineal support rather than simple sedation.

WORDS WORTH SAVING

5 quotes

Most of the medicines prescribed, particularly in America, are prescribed off label, meaning they've never ever been approved for what they're used.

Dr. Craig Koniver

If I can help people lose weight first, literally by using something like tirzepatide, then they're going to be motivated. The light bulb turns on, and that's the aha moment that I love helping people with.

Dr. Craig Koniver

Anything you expose yourself to continually doesn't work as well.

Dr. Craig Koniver

If I had to pick one thing for people, engaging in NAD would be it.

Dr. Craig Koniver

No good has ever come from a negative thought.

Dr. Craig Koniver

QUESTIONS ANSWERED IN THIS EPISODE

5 questions

For a patient already doing resistance training and eating high protein, how would you decide between starting with a GLP‑1 agonist plus GH secretagogue stack versus trying NAD infusions first if their main goals are fat loss and energy?

Andrew Huberman interviews physician Dr. Craig Koniver about the emerging but rapidly expanding world of peptide and hormone-adjacent therapies for health, performance, and longevity. They explain what peptides are, how they differ from classic hormone replacement, and why many sit mechanistically between supplements and full-blown drugs. The discussion covers GLP‑1 agonists, BPC‑157 and its successor PDA, growth hormone secretagogues, pinealon for REM sleep, and NAD in both infusion and injectable forms, including real-world protocols and safety considerations.

You mentioned that BPC‑157 and now PDA seem to promote systemic healing even when injected away from injury sites; what do you suspect is happening biologically to allow such precise targeting, and how might that compare mechanistically to IV stem cell homing?

They also address serious sourcing issues—why compounding pharmacies and physician supervision are crucial compared to gray‑market “research chemical” vendors—and how recent FDA actions have sharply restricted many popular peptides. Beyond molecules, Koniver emphasizes that tools like peptides and NAD work best when layered on a foundation of sleep, exercise, nutrition, and especially a deliberately positive mindset, which he views as the most powerful long-term health lever.

Given your observation that tesamorelin often works better in women and that different GH secretagogues have distinct 'flavors,' how would you design a sex‑specific or age‑specific peptide protocol for sleep, leanness, and joint health?

Methylene blue acts both on mitochondria and as a mild MAOI; in practice, how do you screen and monitor patients already on SSRIs or other serotonergic drugs to safely harness its cognitive and antiviral benefits?

You argue that no good comes from a negative thought and that positivity amplifies all these interventions; what concrete practices do you recommend to a peptide‑curious, data‑driven patient who is skeptical of 'mindset work' but clearly stuck in self‑sabotaging thought loops?

Chapter Breakdown

Peptides 101, GLP‑1 Agonists, and the Landscape of Performance Medicine

Huberman introduces Dr. Craig Koniver and frames peptides as a middle ground between nutrition/supplements and full hormone replacement. They define peptides, outline the explosion in GLP‑1 agonist use (semaglutide, tirzepatide) from diabetes into weight loss, and discuss off‑label prescribing and the context of America’s chronic disease and obesity burden.

GLP‑1 Microdosing: Weight Loss, Muscle Preservation, and Inflammation

They examine the polarized narratives around GLP‑1 agonists: miracle drugs vs. dependency traps. Koniver explains his microdosing approach with compounded tirzepatide, his rule of ≤2 pounds per week of loss to avoid muscle wasting, and the synergistic role of exercise and protein. They also review emerging observations about GLP‑1’s effects on inflammation and autoimmunity.

BPC‑157: Systemic Repair, FDA Ban, and PDA as a Successor

The conversation turns to BPC‑157, once a workhorse peptide in Koniver’s practice for systemic anti‑inflammation and tissue repair. He details its effects on joints, gut, and connective tissue, the rationale for subcutaneous rather than local injections, and the lack of notable side effects. They then cover the FDA’s October 2023 crackdown and Koniver’s move to PDA (Penta‑DCA arginate) as a near‑analog replacement.

Safety, Sourcing, and the Role of Compounding Pharmacies

Huberman raises serious concerns about gray‑market peptide vendors that label products “not for human use.” Koniver explains how compounding pharmacies differ—from regulatory oversight to endotoxin testing—and why some patients have had life‑threatening reactions to research chemicals. They also distinguish compounded peptides and hormones from truly black‑market anabolic steroids.

Growth Hormone Secretagogues: Sleep, Fat Loss, and Performance

They explore growth hormone biology and how peptide secretagogues can enhance endogenous GH pulses without exogenous hormone. Koniver contrasts ipamorelin, GHRP‑6, hexarelin, sermorelin, and tesamorelin, emphasizing goal‑specific selection and conservative dosing to avoid rare but real risks like anaphylaxis with overshooting.

Methylated B Vitamins, CoQ10, Methylene Blue, and Mitochondrial Support

They zoom out from peptides into foundational metabolic support, focusing on mitochondria. Koniver explains the electron transport chain in practical terms and how specific nutrients feed different complexes. He highlights CoQ10, methylated B vitamins for homocysteine control, and methylene blue as a cognitive and mitochondrial enhancer that also acts as a mild MAOI and antiviral.

Pinealon, Glycine, and Deep Sleep Architecture

Huberman shares his own striking experience with pinealon plus glycine: roughly doubling his REM sleep duration without sedation, with benefits that carry into non‑use nights. Koniver discusses pinealon as a pineal bioregulator, its pairing with glycine for inhibitory neurotransmission and liver detox, and how it compares to other sleep agents, including DORA‑class pharmaceuticals that failed for Huberman.

NAD: IV Loading, SubQ Protocols, and Transformational Clinical Effects

They deep dive on NAD as a central mitochondrial and signaling molecule. Koniver recounts the history of NAD infusions in addiction treatment and his optimization of dosing to 750 mg infusions and a 5‑in‑10‑days loading protocol. He reports consistent, often dramatic improvements in mood, cognition, and energy, then explains monthly maintenance and subcutaneous alternatives for cost and access.

FDA Crackdowns, Pharma Incentives, and Patient Self‑Advocacy

Huberman presses Koniver on the recent FDA bans of many peptides and the possibility of pharma repackaging them into expensive drugs. Koniver believes there is both legitimate safety/regulatory concern and significant financial incentive. They argue that while pharmaceuticals are lifesaving in acute care, the chronic disease system is failing, and individuals must become informed advocates rather than passive recipients.

Mindset, Time With Patients, and Positivity as a Health Multiplier

In closing, they set molecules aside and address the human element. Koniver describes leaving insurance‑based seven‑minute visits to build a practice that focuses on helping patients feel better fast, build trust, and then work on deeper behavioral and mindset changes. He argues that no good ever comes from negative thinking and that choosing positive interpretations and purposes is the most scalable and enduring health strategy.

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