Gregg VeneKlasen DVM

Our finger prints don't fade from the lives we touch.

Although cancer risk is not elevated with GH replacement in adults with GH [132], experimental and animal data have suggested the possible mechanistic links of GH and IGF-I on the development, progression, chemothera- py resistance and metastases of cancers, prompting the hypothe- sis that GHR antagonists could be beneficial in the treatment of cancers with highly functional GHR expression. Ultimately, both excessive and insufficient GH exposure or aberrant GH ac- tion can lead to diverse adverse health outcomes that may im- pact longevity, thus highlighting the importance of balanced GH and IGF-I levels and signaling, and the need to differentiate be- tween endocrine and local autocrine/paracrine GH and IGF-I actions. e-enm.org/upload/pdf/enm…

If you want to learn how a competent operator would run the Test, Reta, and GH Trinity, I have a full safety frameworks course full with decision trees, bloodwork monitoring guide, dose escalations, and side effect management - link in bio.

Most people think GLP-1s work by making you eat less. That's the last 10% of the story. The first thing retatrutide does is upgrade your brain. GLP-1 receptors are densely concentrated in the hippocampus, prefrontal cortex, and hypothalamus - the regions that run memory, executive function, and decision-making. When you activate those receptors, yes - you suppress appetite. AND you're directly modifying how your brain processes glucose, manages inflammation, and... SIGNALS REWARD. My patients and clients often report sharper cognition and clearer thinking within 2-4 weeks of starting Reta or another GLP. This is waaay before any big weight loss or body composition changes. The brain upgrade comes first. The body takes extra time. This is part of the mechanism. GLP-1 agonists hit the brain through four distinct pathways: 1.) Neurotransmitter enhancement - strengthening hippocampal communication - upregulating proteins for long-term potentiation - modulating dopamine in the reward center The result - your signal-to-noise ratio improves. 2.) Direct neuroprotection - activating pathways that prevent neuron death - promoting BDNF production - blocking inflammatory cascades The markers that predict Alzheimer's get reduced. 3.) Improves brain glucose utilization like it does in your body - enhances mitochondrial ATP production - reduces brain insulin resistance 4.) Inflammation reduction - suppresses IL-1β and TNF-α Neuroinflammation is one of the big drivers of brain fog. Reta addresses it directly. THIS IS WHY THE TESTOSTERONE + GH + RETA TRINITY WORKS AT A DIFFERENT LEVEL THAN RETA ALONE. - Add GH alongside it - you add neurogenesis, synaptic plasticity, and improved sleep - the window where memory consolidates. - Add testosterone - you get enhanced dopamine signaling and the executive function improvements that make high-output work feel amazing... SATISFYING. The Trinity is an insane recomp stack for your body - given your diet and training are in line. No one will argue this. But it also creates the neurological environment for higher-level function. For the knowledge worker, creator, or operator running at capacity - this is the actual value prop. The fat loss is visible proof that your metabolism is on a different level. But the cognitive edge is what changes the quality and quantity of your output. That's why guys report increased working memory, faster processing speed, improved verbal fluency, and sustained attention. These are far from placebo effects. They are the downstream compounding effects of a brain running clean fuel, with less inflammation and better receptor sensitivity. Getting shredded is just the part you can see in the mirror.

More important! They are framing it as a comprehensive metabolic system reset. The trial data showed a massive reduction in systolic blood pressure of 14 mmHg, alongside significant improvements in lipid profiles and inflammatory markers. This allows Lilly to argue that a single weekly injection is capable of replacing a patient’s antihypertensive medication, statin, and the high-dose NSAIDs they take for chronic pain. They are securing their lead by offering an ROI that factors in the pharmacy aisles the patient no longer needs to visit. Finally, the most brilliant strategic move is using the osteoarthritis data as a Trojan horse for reimbursement coverage. Insurers have fought to deny coverage for weight management by labeling it as cosmetic. However, the TRIUMPH-4 data showed that retatrutide reduced knee pain by over 75%, with 1 in 8 patients becoming completely pain-free. This creates a medical necessity argument that is impossible to ignore. Lilly knows payers cannot deny coverage for a therapy that explicitly prevents the need for a total knee replacement. By inextricably linking retatrutide to functional mobility and pain reduction, Lilly has handed patients and providers the key to unlocking access. They have elevated the drug from the discretionary budget to the medical necessity budget. This happens at your dose even though the data says much higher.

BREAKING: Retatrutide hit all key endpoints in late-stage trials. Big Pharma is celebrating “15% weight loss.” But weight loss isn’t the goal. Fat loss is. If you’re losing muscle, slowing your metabolism, and running high doses for 9 straight months… that’s not optimization. That’s a setup for rebound. The best results I’ve seen come from smarter dosing, cycling on and off, and preserving muscle. Less drug. Better strategy.

@bigangrylaw Since its inception in 1932, the Houston Livestock Show and Rodeo has committed more than $660 million to the youth of Texas and education, the 2026 season, the Rodeo announced a landmark, record-setting educational commitment of over $30 million! @RODEOHOUSTON

Going to the rodeo for a regular family is an absolute nightmare of expensive and hassle. Traffic is insane. Parking is costly and a long trek. The train is both unsafe and overcrowded and runs from a place people work to another place people work. Decent tickets where you can actually see the action and concert stage for a family of four is at least $1000.00. The carnival rides outrageously priced. The food (except @trillburgers) is ridiculously priced as well. Now imagine you get to go for free. You get escorted there in a luxury SUV driven by public servants who have the authority to run lights and drive around traffic. You get to park up close and be escorted in with no lines ever. You are catered to by both rodeo staff and people paid by taxpayers to do actual work. You get free merch. You get access to the most expensive and closest area for almost every night you wanted but one night you are told you can only be in your free, catered luxury suite. But instead of being happy you try to bully your way in and when rejected lie and say you were assaulted and faced racism and misogyny. You publish recordings of you sounding like a shrill, entitled bipolar brat but, somehow, believe it vindicates you. Someone in her inner circle, please get our county judge some help.

@PeptideList The real deal

Been in this space a long time. Studying peptides, testing on myself, obsessing over the science. The one thing I kept coming back to: people deserve better tools. Your genetics should guide your decisions not Reddit threads. That's why I'm bringing a custom PGx genomics test to market. Built to help you have smarter conversations with your healthcare provider. More soon. thepeptidelist.com

We use lots of B-12 if we took a FDA approved drug and put B-12 in it and called it something else it would be illegal. Same rules, same everything as human medicine. That to me is the big deal. Mine had glycine in it. Also not all aqueous solutions are the same. Some have ammonium sulphate some do not and it has nothing to do with the B-12 component. We use many compounding pharmacy’s and just because we want something together most of the time its illegal, unless its a deer or something no other FDA drug is labeled for that species. So not all tirzepatide B-12 combinations are created equal.

I appreciate your perspective, and may be willing to accept it with more information. But answer me this, what are the odds that this (knowing how these tests are done) is *the first* Lilly knows of this potential issue? I know firsthand that Lilly has been testing these compounds for years.

So, I’m guessing you haven’t spent much time on small-molecule/protein/peptide characterization. That’s fine (and why we have an @US_FDA with professional CMC reviewers). Here’s the PoV from someone who knows LCMS plumbing better than he’d like. In short, these questions aren’t easily answered. It’s easy to see if something is present in a sample that shouldn’t be - I.e. an unexpected HPLC peak vs reference TZP - but figuring out what that peak is can be really hard. Mass Spectrometry may give you a mass which gives ideas about possible identity, but confirming impurity identity can take months to years depending on abundance and mechanism of formation That peak - is it toxic? Well, to find out, you can either expose rats to large quantities of the counterfeit material of unknown origin (lol) or try to synthesize it. You’re lucky if it’s only 1-2 unexpected products. Otherwise, enjoy repeating this process in parallel. Many of your questions aren’t easily answered best pointed towards the counterfeiters (how can Lilly know where tf these shops sourced the API let alone stored and prepared it??). They are fair questions. Every FDA approved drug product has to answer them. But, the counterfeiters aren’t selling FDA approved drugs. They’re selling knock-offs and pretending it’s equivalent. They’re exploiting consumer trust of the FDA and the ignorance writ large of drug CMC Ultimately, Process is Product. I’m happy to go deeper if you want

My clones teaching Taylor to transfer embryos.

Always know the last week of the rotation ⁦@TTUVetMed⁩ senior Taylor will get to transfer clones. Jessica will help her. She has been fantastic.

@NBSaphierMD I don’t think its wise to wait.

@cremieuxrecueil You can by real mounjaro in the kwikpen from India for 299 says unopened refrigerator 2 years 10 mg

It finally happened. The FDA is actually shutting down GLP-1 compounding. They'll end up pricing GLP-1s out of reach for millions of Americans. But no problem (yet): I've written a helpful guide to ~$20/mo GLP-1s! Link below.

@MichaelAlbertMD @rorynotsorry How did you script it, another doctor and extra-label. Think its awesome you shared! Reason I ask its important for everyone to understand how and why prescriptions work.

@rorynotsorry I only used branded drugs (Zepbound/Mounjaro).

This is the most personal thing I've published. I've been taking low-dose tirzepatide for 2 years. Not for weight loss. Not for diabetes. I'm a physician who made a calculated bet on the multi-organ potential of this drug class. I know how some colleagues will read this. I know exactly how the internet will reduce it: "Doctor admits to using Ozempic for productivity." That's not what this is. But staying silent felt worse than being misunderstood. ⚠️ I don't endorse others doing what I've done — my clinical background affords a level of informed consent that most people don't have. Full piece → substance-over-noise.beehiiv.com/p/special-edit…

@rorynotsorry Wait until you see what Forzinity does to a person with Barths Syndrome.

My skepticism on mitochondria and creatine has been confirmed. Its all related. I think I have uncovered the biggest conspiracy theory of the century!

People get nervous when resting heart rate climbs 2 to 10 bpm on these compounds, and elevated resting heart rate is linked to mortality in population studies. But context changes everything. When heart rate rises because of chronic stress hormones, uncontrolled hypertension, or an underlying arrhythmia, that reflects real cardiovascular strain. What we see with tirzepatide and retatrutide is direct activation of GLP-1 receptors on the sinoatrial node, not sympathetic overdrive. We know the mechanism, and it's not a distress signal. What is your opinion. The increase also happens when you inject it in a joint of a horse.

GLP-1 drugs don’t just reduce appetite. They reduce craving. Food. Alcohol. Shopping. Some people even report less libido. So here’s the uncomfortable longevity question: If a drug helps you live longer… but dulls desire… Is that still longevity medicine? My new deep dive: 🔗open.substack.com/pub/doctormurp…🔗

@rorynotsorry This doesn’t work without it and its the beginning.

Peptides I have tried and failed at: GLOW/KLOW - I hate the GHK-cu sting MOTS-C - I dont even believe in mitrochondria SS-31 - once again... I dont know anyone who has seen a mitrochondria Tesamorelin - if I take a daily shot it better do something for me... not make me wait two months. SEMAX - I'm already ADHD Tirz - made me tired

@rn_flex @bioinvestor24 Osteoarthritis?

@bioinvestor24 Just say no to DACRA. That's the lesson I think. Selective Amylin will be the way to go and even then as second line/failed GLP1/etc Meanwhile we're now ~2 weeks out from topline for this if you wanna see some great weight loss in 40 weeks 😂

Institutions are worried that $VKTX may disappoint in trials like $ZEAL and $NVO. Very informed institutions like Norges ,Deutsche bank and FMR 😂

Having a large veterinary hospital and allowing that 90 percent of the people trust their veterinarian way more than their doctors one might be able to see just about everything. We probably have 500 clients on Zepbound and 20 percent are at 15 mg(a huge mistake) one might see everything and hear everything. I am putting liraglutide in equine joints so I understand glp have even stuck tirzepatide and its magic. I agree with your statement but haven’t heard it. All of the data will come from people like me not a doctor’s office.

@GreggDvm @DanielJDrucker The vast majority on tirzepatide haven’t reached the top doses, let alone spent considerable time there. It’s fine to admit we just might not know everything about these meds.

I don’t know that I’d couch it as “falling in love”…. But sexual desire? Yes. And as someone who leads a community of hundreds of thousands of people on these meds, sex drive is absolutely impacted for large numbers of people on these meds. He’s right to flag it. Even $LLY CEO refers to tirzepatide as an “anti-hedonic” medication. There are trade-offs, people deserve to know what they might be. Also, if you think plastic surgeons are hurting in the GLP-1 economy, how the heck do you think someone at 200 pounds (who was 450 pounds two years ago) deals with all that extra skin? By the way, #tirzepatide 2.0 from Lilly is called #brenipatide which is being studied in: -Alcohol use disorder -Opioid use disorder -Smoking -Major Depressive Disorder -Asthma The next frontier of incretins is neurological, and our understanding of how these GIP dominant drugs work in the brain is still relatively infantile.

@rorynotsorry 1 mg Phase 2 the 1 mg dose resulted in a 7.2% reduction in body weight, increasing to -8.7% at 48 weeks.

For Retatrutide, I would consider any weekly dose 3mg or under a microdose. I base this on 4mg being the lowest therapeutic dose studied by Eli Lilly. If you take 2mg twice a week, this is not a microdose, this is just a split dose. Agree?

@RegenRandy Thank you

@GreggDvm I fix up the engine before I take the car to the track. But some figure “I’ll do the repairs as I go.”

SS-31 is not the peptide you feel in 20 minutes. It is the one you notice after a 14 hour day when you are still sharp. I think a lot of executives and hedge fund guys chase intensity. More caffeine. More stimulants. More “push.” The problem is that most of us are not limited by motivation. We are limited by energy quality. There is a difference. SS-31 is about improving how efficiently your body produces energy. Not in a hyped up way. In a sustainable way. The kind that shows up as: • Better mental endurance late in the day • More stable energy across travel weeks • Workouts that feel powerful instead of grindy • Faster bounce back after brutal stretches When I ran it, the change was subtle but meaningful. My mornings were the same. But by 3 or 4 PM, when I would normally feel a cognitive dip after calls and decision fatigue, I stayed even. Not wired. Just steady. That matters if you are making capital allocation decisions, negotiating term sheets, or managing risk in real time. The edge is rarely brilliance. It is consistency. Most performance stacks focus on pushing output. Growth hormone. Fat loss agents. Nootropics. Those have their place. But if your baseline energy production is inefficient, you are building on a shaky foundation. SS-31 feels more like reinforcing the base. It has been studied in contexts related to age related fatigue, cardiac performance, and muscle endurance. The consistent theme is improved energy efficiency and reduced fatigue under stress. Translate that into real life and it means your body handles load better. Physical load. Cognitive load. Travel load. If you are 28 and sleeping 9 hours a night, you might not feel much. Skip this one. If you are 42, managing a firm, lifting at 6 AM, eating client dinners, flying twice a week, and still trying to be present with your family at night, this one is for you. SS-31 is about raising your floor so your worst days look a lot closer to your best ones.