Longevity University: Health, Peptides & Optimzation

XYRx

Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.

Listen in PodNod RSS feed Show website

4 episodes
Updated Thursday

Episodes4

Newest first

Thursday · 34 min
#04 TRT Wrecked Me: What Many Wellness Centers are Getting Wrong
Milan tried TRT the way most guys do: walked into a wellness clinic, got injected the same day, and tripled his testosterone. A few months later it took everything he had just to get out of bed. In this episode, Milan shares the full story of his TRT crash with Dr. Rehan, and they break down what actually went wrong: an aggressively dosed aromatase inhibitor, crashed estrogen, and a clinic that couldn't see him for five weeks when it mattered. Dr. Rehan explains why he rarely reaches for TRT first, how enclomiphene works as a gentler alternative that preserves your natural production and fertility, and why aromatase inhibitors are being overprescribed at men's health clinics across the country. Plus: the surprising percentage of erectile dysfunction cases actually caused by low testosterone, the labs you should be checking every three months if you're on TRT, and a patient story that shows just how badly unsupervised testosterone therapy can go. This podcast is for educational purposes only. 0:00 Cold Open 0:23 Intro 1:10 Milan's TRT Story: From Low T to the Crash 8:16 Enclomiphene, Explained 13:14 Wellness Clinics & the Aromatase Inhibitor Problem 17:04 Do You Actually Have Low T? 19:02 How to Do TRT Safely 24:02 A Patient's TRT Horror Story 29:13 Enclomiphene vs. TRT: Milan's Verdict 32:14 Peptides, Testosterone & What's Next Every week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery. Longevity University YouTube: https://youtube.com/@longevityuniversity Instagram: https://instagram.com/longevityunversity_ TikTok: https://tiktok.com/@longevityuniversity X: https://x.com/longevityupod Facebook: https://www.facebook.com/profile.php?id=6159205029460 Dr. Rehan YouTube: https://www.youtube.com/@AskDrRehan Instagram: https://instagram.com/askDr.Rehan TikTok: https://www.tiktok.com/@askdrrehan X: https://x.com/askdrrehan Facebook: https://www.facebook.com/profile.php?id=61592050294604 Milan Instagram: https://instagram.com/milancostich TikTok: https://tiktok.com/@milancostich X: https://x.com/MilanCostich_ Facebook: https://www.facebook.com/profile.php?id=61591943139077 Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.co XYRx YouTube: https://youtube.com/@XYRxHealth Instagram: https://instagram.com/xyrxhealth TikTok: https://tiktok.com/@xyrxhealth X: https://x.com/xyrxhealth
July 22 · 58 min
#03 Where to Get Peptides: Sourcing, Compounding & Gray Markets
Dr. Rehan Muttalib and Milan Costich get into what happens after the GLP-1. Milan asks the question most people land on eventually: if these drugs cost you muscle along with the fat, is there a way to lose one and keep the other? That opens up stacking, and the single rule Dr. Rehan says matters most, which is never running two peptides that bind the same receptor. He walks through growth hormone secretagogues (sermorelin, CJC-1295, tesamorelin), why he'd reach for those long before anyone touches exogenous growth hormone, what cycling on and off actually looks like, and why the worst-case outcome with peptides is returning to baseline rather than ending up worse than you started. From there they get into the part nobody wants to say out loud: where people are actually buying this stuff. Dr. Rehan is candid about the gray market, the "research purposes only" loophole, and why the same website can send you two completely different vials a month apart. He explains what he tells patients who admit they're buying that way, what a 503A or 503B compounding pharmacy changes, and how to check whether one is regulated. The last stretch covers the mitochondrial pathway and NAD+, why "calories in, calories out" stopped satisfying him as an explanation for the patients in front of him, whether a GLP-1 should be cycled at all, and what the next generation of these compounds is going to look like. This episode is for educational purposes only and is not medical advice. Talk to your own physician before starting or changing any treatment. 00:00 Intro 01:51 What "stacking" means, and the one rule that matters 04:15 How many people are actually on a GLP-1 07:10 Why growth hormone has such a bad reputation 11:25 What a growth hormone secretagogue actually does 13:59 Body recomposition and muscle as longevity currency 18:45 Sermorelin, CJC-1295, and tesamorelin 24:54 Cycling on and off, and what happens when you stop 28:47 A word from our sponsor 29:28 Where to start, and how GHRPs stack 31:50 Sourcing peptides and the gray market 36:05 503A and 503B pharmacies 39:13 Adding a third peptide, and when weight loss stalls 42:27 The mitochondrial pathway 47:05 NAD+: IV, injectable, and nasal spray 51:04 Should you cycle a GLP-1? 53:32 What's coming next in this drug class 55:30 Why this is so hard to navigate alone Every week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery. Longevity University YouTube: youtube.com/@longevityuniversity Instagram: instagram.com/longevityunversity_ TikTok: tiktok.com/@longevityuniversity X: x.com/longevityupod Dr. Rehan Instagram: instagram.com/askDr.Rehan TikTok: https://www.tiktok.com/@askdrrehan X: x.com/askdrrehan Milan Instagram: instagram.com/milancostich TikTok: tiktok.com/@milancostich X: x.com/MilanCostich_ Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.co XYRx XYRX.co/podcast YouTube: youtube.com/@XYRxHealth Instagram: instagram.com/xyrxhealth TikTok: tiktok.com/@xyrxhealth X: x.com/xyrxhealth
July 21 · 40 min
#02 Conor McGregor’s Injury: Diagnosis, Recovery, and How Peptides Could Help
Two weeks after their last conference, Dr. Rehan and Milan are back in Las Vegas for Milan's birthday and a UFC card that ended in one of the most talked-about injuries of the year: Conor McGregor's leg buckling on his very first strike. In this episode, Dr. Rehan gives his thoughts on why he's leaning toward a full-thickness ACL tear over a meniscus injury, and what a realistic recovery timeline looks like for a fighter coming back from five years out. After that, Dr. Rehan gives the exact protocol he would put McGregor on if he does in fact need ACL surgery. From there the guys get into Paddy Pimblett's clinical finish, that fighter's brutal weight cuts, Max Holloway's night, and why "movement practice" athletes like McGregor seem to age better than everyone else. 01:35 Vegas, Milan's birthday & watching McGregor go down 02:41 The diagnosis: why it looks like a full ACL tear 07:14 Realistic recovery timeline & what surgery can't skip 09:26 Where peptides actually help before and after surgery 11:16 The full protocol Dr. Rehan would run for McGregor 13:57 Sponsor: XYRx (code LU10) 14:39 BPC-157 and TB-500 explained 17:17 The drug-testing pool problem 18:48 ACL vs. meniscus & why surgery is unavoidable 22:49 Paddy Pimblett's finish, his camp & those weight cuts 29:48 Max Holloway, the Vegas weekend & Conor's comeback odds Every week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery. Longevity University YouTube: youtube.com/@LongevityUniversity Instagram: instagram.com/longevityunversity_ TikTok: tiktok.com/@longevityuniversity X: x.com/longevityupod Dr. Rehan Instagram: instagram.com/askDr.Rehan TikTok: https://www.tiktok.com/@askdrrehan X: x.com/askdrrehan Milan Instagram: instagram.com/milancostich TikTok: tiktok.com/@milancostich X: x.com/MilanCostich_ Support our sponsor (and the Milan and Dr. Rehan's company) XYRx.co XYRx YouTube: youtube.com/@XYRxHealth Instagram: instagram.com/xyrxhealth TikTok: tiktok.com/@xyrxhealth X: x.com/xyrxhealth
July 16 · 54 min
#01 What Are Peptides?
Everyone is suddenly on GLP-1s. Almost nobody is taking them correctly. In the first episode of Longevity University, Dr. Rehan Muttalib, a Southern California primary care physician who prescribes these medications daily, sits down with XYRx President Milan Costich to break down what peptides actually are, how GLP-1s like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) really work, and why he disagrees with the dosing protocols the pharmaceutical companies taught doctors to follow. Dr. Rehan shares real stories from his practice: the patient whose entire life transformed when the "food noise" finally went quiet, and the cautionary tale of a patient who maxed out her dose too fast and stalled. He lays out his lowest-effective-dose philosophy, the safe rate of weight loss, how to come off these medications without rebound weight gain, and the emerging off-label uses for inflammation, autoimmune conditions, and longevity, including microdosing. In this Episode: What a peptide actually is (and why insulin was the first) • Semaglutide vs. tirzepatide: why the GIP component may be the difference maker • "Food noise" and why quieting it changes behavior, not just appetite • The dosing protocol Dr. Rehan uses instead of the pharma playbook • How fast you should actually lose weight, and the risks of going faster • Muscle loss, bone loss, and nutritional deficits: the tradeoffs nobody mentions • Diet, protein targets, and resistance training while on a GLP-1 • Could peptides replace steroids? A preview of what's coming 0:00 Cold open: "I've never seen a patient transform like this" 0:24 Welcome from Dr. Rehan (and a quick disclaimer) 1:15 Meet the hosts: how BJJ started all of this 1:54 "Everyone at this dinner was on peptides" 3:20 Insulin: the first peptide 5:04 What is a peptide, actually? 6:18 How GLP-1s work: semaglutide vs. tirzepatide 9:04 The patient story: what happens when the food noise stops 12:14 From diabetes drug to weight loss breakthrough 13:48 This episode is brought to you by XYRx 14:22 Why Dr. Rehan disagrees with pharma's dosing protocols 16:05 The safe rate: 2 to 4 pounds per month 17:23 Milan lost 50 lbs in 3 months. Here's what fast loss costs you 19:59 Dosing by patient type + benefits beyond weight loss 22:21 The ideal protocol: start low, go slow 24:54 Maxed out on the dose and still stalled? 28:03 Switching from semaglutide to tirzepatide 29:07 Coming off GLP-1s the right way 33:34 Diet on a GLP-1: the only rule that matters 37:41 Training and protein: how to keep your muscle 40:19 Building muscle without steroids: peptide stacks 42:56 Dr. Rehan's verdict + what's next Every week, Physician Dr. Rehan Muttalib and XYRx founder Milan Costich on the real science of male longevity: peptides, GLP-1s, training, and recovery.

Longevity University: Health, Peptides &amp; Optimzation

#04 TRT Wrecked Me: What Many Wellness Centers are Getting Wrong

#03 Where to Get Peptides: Sourcing, Compounding & Gray Markets

#02 Conor McGregor’s Injury: Diagnosis, Recovery, and How Peptides Could Help

#01 What Are Peptides?

Longevity University: Health, Peptides & Optimzation