Anonymous GLP-1 expert 'Cremieux' on the drug's expanding use cases — sleep apnea, cancer, ADHD — and the risks of gray market access

anyway, we have our first guest in the studio, Kremx. Welcome to the stream. There he is looking handsome as ever. How you guys How you doing? Doing well. Can you hear me? Yeah, we can hear you fine. Um, perfect. I'm I'm I'm looking forward to uh to you know a future date when we can potentially see your face.

Um but for now your avatar looks great soon. Okay. I'm looking forward to it. Um we wanted to have you on to chat about a couple things. Uh what's going on GLP1 world reaction to the hims and herm hers breakup. Uh Jordy, where would you like to start? Uh highlevel update on the GLP1 market.

Yeah, I guess uh I mean it's this miracle drug that keeps on we keep on learning about new uh new diseases or problems that it can treat. It seems like it can't just stop. We got the diabetes, then weight loss, then maybe gambling addiction and other stuff.

Well, walk us through where how people are using or how doctors are prescribing GLP1s for various uh conditions and what's most promising, what's on the horizon, and what you're tracking next. Yeah. Yeah.

So, I'm actually really glad you asked this right now because right now the ADA, the American Diabetes Association conference is ongoing and it seems like every other presentation is about GLP1s. They are just talking about all the latest advances.

Uh just yesterday, Amjen showed off a once monthly instead of once weekly injectable. Um Eli Liy showed off an amazing combo therapy with a an inhibitor called uh Bimaguma. It's a very weird name that makes people not lose any muscle when they're on the drugs.

Um, they've been showing off just incredible advances all week. They've been showing off new treatments uh for like different conditions and whatnot. There are increasingly many indications that these drugs are getting approved for. In December, Tzepide was approved for sleep apnea.

Um, there's osteoarthritis indications incoming.

Um there might even be there's some effort being put into people trying to uh do something for cancers as well because it does seem to help with obesity related cancers and it seems to help for I don't know why with hematological cancers the blood cancers I don't know understand really the mechanism behind that but it seems like it's just hitting every single indication now.

Wow. Um why do you think that is? I have some guesses. I think the big reason has to do less with the direct effects of GLP-1s and more with the fact that obesity sucks. Uh, obesity is just really, really bad. It affects so many different systems. It makes your health worse on so many different levels.

And the things that lead to obesity are also quite bad, like the bad diet, the bad habits, the uh not moving around very much. It's actually interesting. A lot of people after they've been on these drugs for a little while, they decide to move around more. They become more likely to go to the gym.

They report that their physical functioning is improved. Uh it turns out that getting fat has made them get to the point where they are no longer looking to be active. And so they just kind of fall into a hole. Practically everything is improved I think for that reason.

And there are some improvements that are due to direct effects of the drugs. Uh this has like for example this one is major adverse cardiac events major cardiovascular events.

Um those seem to be reduced in number immediately after starting the stuff which suggests that there's a mechanism that's pretty direct and this mechanism is also independent of weight loss. So that seems to be how that works. Same with chronic kidney disease.

Are you looking are you looking um you know I feel like the sort of biohacker alternative health world has for a long time you know talked about cancer being you know this metabolic disease. Do you think that could be a factor and why it should could show some promise in in treating various types of cancers?

Yeah, I I think it does makes a lot of sense in that direction for uh the obesity related ones, but I don't think it makes sense.

So years ago there were people who suggested I think quite wrongly replacing certain cancer therapies with fasting because it seems to like uh augment the effects of sysplatin based therapies and stuff and that didn't really hold up very well.

it was a bunch of theory work that didn't go anywhere and I don't think that this would help through those purported mechanisms which again I don't really believe in.

Um I really think it's mostly just cutting down on for example the number of cells you have or well not really the number of cells you have but uh like the activity of being fat. It's just you have you're not as big of a person. You have less to less opportunity for cancer to really hit you when you are smaller. Yeah.

Smaller. It's like how short people tend to live longer of everything else. Bad for me. Yeah. Bad for you. Bearish for me.

Um well ho how much of the recent uh like advances in GLP-1 indications or or recent like benefits have been uh just looking at all the people that are taking GLP1s for weight loss or diabetes and then seeing a secondary effect in the population that's actually running uh the drug versus a new double-blinded trial for a different indication.

Are both things happening or or is it is are are these drugs diffuse enough that you can just look at the overall population and get an idea of what's happening? Yeah.

So for approved indicate FDA approved indications like obstructive sleep apnnea, you do have to run additional trials, but they are seeing that these things are possible from their trials. They're seeing the these things are possible from the literature and they're running based on that.

So um in some cases they do see these secondary end points. In fact, obesity is an example of this. Back in the day when they first introduced these drugs uh back around 2005 or so the CEO of Nova Nordisk at the time actually said and I quote obesity is primarily a social and cultural problem.

It should be solved by team by means of a radical restructuring of society. There is no business for Novon Nordisk in that area referring to obesity. Wow. Yeah. So they their scientists had to push for about a decade to go hey you should look at the weight loss data. It's really impressive.

And then they finally finally did it and now we have weight loss drugs. Yeah, that is that is wild. Um what uh what concerns you? What's the catch? Seems uh you know uh somebody too good to be true. Yeah, somebody might say is it too good to be true?

We're running this sort of massive uh experiment on huge swaths of the population right now.

seems to be, you know, many many positive indicators, but uh what are what are kind of red flags that you think uh people should be kind of looking out for or or the scientific community uh should be wary of broadly from your point? Yeah. So, I think that physicians need to be careful about prescription.

Uh and they already are.

are they like they don't tend to prescribe this to people who are very skinny but the fact that this stuff is available through the gray market um very easily without prescription for very very cheap uh unfortunately I've contributed to that um has led to a lot in what way you mean just oh I made a I made a guide to doing this and a few thousand people actually like paid me $8 a piece to see uh all the details on it and now I have a few thousand people who unprompted I didn't tell them to do this messaged me their weight loss progress and such.

So, uh, through writing this guide a few months ago, I've led to almost 12,000 pounds of weight loss. And that's just what's been reported to me. Not everybody's telling me all the results. And is that is that at a high level? People just finding uharmacies that will compound the drug for them.

What What does that actually look like? So, what it looks like is buying from China. So, you are ordering from a Chinese factory. you are uh testing the purity of the stuff and finding oh it's 99.

9% I can use it and then using all of that uh it is not sold by Nova Nordisk Eli Liy or any other major company working on these drugs it's just from some Chinese company that is ripping them off so is that patent infringement I we've been seeing that kind of go back and forth like him and hers was able to compound because there's a shortage that news about Eli and say hey can you knock this off.

Yeah. I mean, they could do import bans or or or seize the packages at the ports. Like, that's the design of this. You can't just buy a knockoff iPhone and have it delivered through the port of Los Angeles. Like, if a whole truckload comes through, they should stop that, but it's clearly not happening.

So, right now, the FDA allows this to happen because they have an exemption for research chemicals. You're technically not supposed to use these things, but everybody knows that everybody uses them. It's just how it is. They're researching weight loss on researching kind of one. I'm research research maxing.

Um so you were saying the the uh the potential uh red flags or or things to be wary of is around uh what what about uh the prescription activity concerns you? Mostly abuse uh not not really prescription activity as so much as the abuse. There are people who are obtaining these drugs.

There are people who are getting other people to get the prescriptions. There are people who are not really visiting doctors. They're using teley health services to get prescriptions. and they are not in need of them. But why would someone abuse this?

This doesn't feel like something that has like the euphoria associated with a stimulant. So the concern I think would be testosterone body dysmorphia. There are going really skinny unfortunately. I've met a few dozen women now who have taken these drugs and been around 120 130 lbs normal height.

Uh and now they're around 100 and they are they don't look good anymore. They look like they're aging very quickly. They look uh unfortunate and it's it's sad to see that they're using these drugs when they didn't even need them in the first place. Interesting. The same negative effects of of start actual starvation.

Yeah. Yeah. Yeah. You start getting really bad harmful effects. You probably are eating at that point more lean mass than fat mass. It is uh quite bad. Yep. Yep. That makes sense. Yeah. That's always the risk. Interesting. Um how are you what was your reaction to the HIMS Nova Nordisk uh partnership blow up?

So, I actually think this was a big failure on Nova Notice part. It seems as though what they did was they partnered with HIMS in order to catch them. Um, my understanding is that HIMS has been selling a little too much, more than they've been supplied by the person producing the drugs, which is uh interesting.

I guess we'll get more details relatively soon if the laws all theoretically WGOI gives them a million doses and then HIMS is somehow selling 1. 2 million doses of WGOI. Is that is that what you're Yeah, something like that. They're either compounding themselves or ordering from something from China.

They are doing something and uh I don't know if that will hold up or show up in trial. It's an accusation. Um it's so I guess it's alleged, but we we'll see. We'll see.

What about what about HIMS's general position that patients should have as much choice as possible uh as much access you know access at different price points things like that. They are completely correct to do that. I think that him providing different dosages than are provided by Novanorisk is a wonderful thing.

There are people who can get legitimate uses out of um sort of micro doing this stuff because it gets rid of noise. I've met many many people now and this is uh an increasingly common thing.

It seems I I really don't know uh how far this is going to go but a lot of people who are micro doing this because it helps with their ADHD. Their ADHD is like the pathological end of foodbased distraction. They're not losing weight from this anymore, but they are just using it in order to not think about food at all.

It gets rid of that nagging feeling in the back of their head, and they can focus on I I did a 24-hour uh dry fast uh from Friday night to Saturday night. Yeah. And all day Saturday, I was shocked at how much time my I was just thinking about food and water, wanting food and water.

Uh, and I was and and it was very freeing to some degree because I was like, well, I'm not just not having any until around dinner time. But so many points throughout the day, my mind was just going to, oh, I should go get a little tasty drink from the fridge. I should, you know, I should I'm not addicted.

I'm not addicted. I'm not addicted to water. I'm not addicted to water. I'm not beating the water addiction allegations. Big water guy. Um, what what else are you tracking right now broadly? Uh, any reactions to the NIH funding? Oh, yeah. 40%. Uh we had Andrew Humemerman on the show.

He was breaking it down for us and what's going on with Jay Badacharia. Uh what's your take on the cuts that have been proposed? So I don't know how much I should reveal about that. There's a lot of really good things coming. Uh there might be some interesting developments there very soon.

I'm especially hopeful about Well, you know, actually I shouldn't say that. Uh just there there will be good news there soon. Um there'll be a some changes. Uh I'm not going to say Yeah. Yeah. I guess zooming out like what what does good look like to you? Are you generally in favor of taxpayer funded?

Every American gets a $10,000 biohacking budget annually. They can buy research chemicals biohacking vouchers. Yeah. I mean, some people would say like, you know, the the big pharma companies are profitable. They should bear this expense, not the American. So, they're not profitable enough.

Um they have troubles with R&D. uh that public money is very very useful. We need more public funding than we currently have. Yeah.

When you actually look at biotech returns, you know, just looking at the asset class, the logical thing to do would just be to invest elsewhere and that that was with historical levels of public funding uh that that kind of contributed to those returns to some degree.

Yeah, we have a deer of funding at the moment and we need to increase it. We need to improve the allocation and also increase the amount. There's really no way around it. If we want to keep making progress, you just have to throw more money at these things and I think we will start doing that very shortly.

Um these cuts are a little alarming to start, but they are not the end of the discussion. Remember, we are it's still only 5 months into this presidency and they have a lot of really big plans.

They have a lot of trouble getting appointees through the Senate and they have a hiring freeze ongoing right now that is uh interminable. We don't know when it's going to end, but once that is over, they'll be issuing NPRMs left and right. It's going to be uh deregulatory on like massacre. It's going to be wonderful.

Wow. Well, that's what else is exciting to you in uh biotech right now in Well, I wanted to say on the HMS point with the different pricing and whatnot, I think perhaps the most exciting thing right now in that area is that Novo Nordisk is run by idiots. Like they're very smart people, but they're just total idiots.

They Hey, everybody misses a the the patent. You know what do they do? They they forget. I think Eli Liy, but uh they This is Nova. Oh, those Novo that lost the the the patent uh fee. Yeah, they just they forgot to pay the bill. 450 bucks or something?

Yes, it was 250 and then they missed it and they were told you're one year out. You had can pay a late fee like an extra $200 late fee on it and they just didn't. They still failed. Yes, it is amazing. That's wonderful. So, uh that enables a wonderful wonderful program that the FDA should pursue immediately.

the FDA and the CMS have to collaborate on this, but it's the section 804 importation program and it allows individual US states to import as much of the generic drugs or any other type of drug that's produced in Canada um and has like an indication of proof here and whatnot uh as they want to reduce costs.

So, for example, Florida will whenever they get this actually going have much cheaper EpiPens. They'll be able to lower the cost of their drugs by importing cheap generics from Canada. And because cheap generic Ozmpic is going to be coming from Canada in 2026, every state can just jump on the program.

And if we're giving people if we're giving Americans $5 a week oimpic, then we're going to see perhaps an end to the chronic disease crisis. We're going to see obesity tackled meaningfully. We're going to see people getting hot again and make America hot again. The real meaning of aa.

The real meaning of a real meaning of There we go. There we go. Inside baseball. Amazing. Very exciting. Well, 15 minutes was not enough time to have you back on again soon. Uh thank you for uh thank you for all the insights. Yeah. Thanks for coming on. We'll we'll we'll have you back on soon. This is great. Absolutely.

And if you dox yourself anywhere other than here, we will be very upset. So, might have to Sorry, guys. You guys have a good one. We'll talk to you soon. Bye. Um, next up we have Clement from Hugging Face coming into the studio. I believe he's here already. Very excited to talk to him. Fascinating business.

We'll dig into