Thomas Scully MD

@DocBottsNY @CoffeeBlackMD @aclong111 Well said! Algorithms, “care plans”, population health… all detract from that ability to listen, lay on hands and synthesize a diagnosis.

What happened is the “art of medicine” is not taught anymore. I hate that phrase because it is not art, it is doctoring. Clinicians have to balance what is known - history, physical exam, and testing. All imperfect. Against what is not known, we do not have anywhere near a perfect understanding of physiology and pathophysiology. Most docs now do it reverse. Look at the tests first and then decide. Being a great clinician requires a deep understanding of human nature and the individuals we treat. Understanding the problem as best we can and working through tremendous uncertainty with confidence. It is not trainable in 4-6 years. It’s takes a long time and a lot of reps with the guidance of great mentors. Getting a black belt in karate is step one toward real learning. It takes about 4-5 years in many instances, but is individuals in most systems to the person on that journey. Getting a black belt in medicine is 4 years undergrad, 4 years med school, 3-5 years residency. And the the real learning starts as an attending. And it’s only possible to become great at that starting point with great colleagues, mentors, and the time needed for continued learning. Our system is broken and tried to break down patient encounters into relative value units. It’s broken. This is nonsense. To be great at this job, the level of introspection is unfathomable to most people. Doctors work in a space that 99% of people do not have high school level competency - science. And we apply an imperfect science and its principles in treating infinitely complex humans. AI is here. And it will augment the skill of those with skill. It will cripple those without foundations in real clinical medicine. Reminder, we need to take back medicine from the government, insurance, and corporate interests. 💊 @DutchRojas @mass_marion @txsportsdoc @realdocspeaks @BrentAWilliams2 @LighthouseDPC @paulsaladinomd @drcraigwax @BrianSuttererMD @Paul_Wischmeyer @doctorwes @DocLibertarian

I agree that nuance is best. That’s exactly why I’m not convinced an absolute rule like “no recommendation unless there is clear RCT benefit” works. Medicine is full of situations where the evidence is imperfect, evolving, or indirect, and clinicians still have to make decisions. The question is not whether recommendations should ever exist, but how to make them carefully, transparently, and with appropriate restraint when certainty is low.

@lawsonhmansell @CrisAlvaradoMD @DrDiGiorgio Exactly what happened to our over 20 year private practice of neurosurgery

I cannot speak more highly of @DrDiGiorgio's testimony before House E&C this morning: "The system effectively starves independent practices of revenue while burying them in paperwork, making selling to a hospital the only viable way out." Full testimony: democrats-energycommerce.house.gov/sites/evo-subs…

@DrDiGiorgio @IsaacYangMD @HouseCommerce Thank you for doing that. I certainly appreciate it!

It was an honor to testify in front of the @HouseCommerce subcommittee on health regarding healthcare affordability. We discussed consolidation and the demise of independent physician practice. My solutions include: Repeal section 6001 of the ACA which banned physician owned hospitals Reform Stark law Implement site neutral payments Reform 340B Use FMAP to encourage states to be pro-competition (repeal CON, eliminate non competes)

@__DestinyGreen @sonodoc99 Congrats! I’ve been in practice as a neurosurgeon for 32 years. It is a blessing and a calling.

I can’t stop crying!! God has never failed me 🙌🏾 I’m going to be a NEUROSURGEON!! 🤍🙏🏾 #Match2026

@BasedBiohacker How bioavailable is the oral? I just ran 4 weeks of subq. My understanding is to do it twice a year. (Age 65)

the part of epitalon almost nobody talks about: it's one of the most potent neuroprotective antioxidants EVER studied. here's what's actually happening: your brain is roughly 60% fat. specifically polyunsaturated fatty acids; the most oxidatively vulnerable molecules in your entire body. when reactive oxygen species (ROS) attack these fatty acids, you get lipid peroxidation. a chain reaction. one free radical attack produces lipid peroxy radicals, which steal electrons from neighboring molecules and generate more radicals. it cascades. it doesn't stop until something ends it. lipid peroxidation products like 4-hydroxynonenal (4HNE) and malondialdehyde (MDA) are found at elevated levels in the brains of alzheimer's, parkinson's, and ALS patients. they bind to amyloid beta and accelerate plaque formation. they accumulate in dopaminergic neurons and trigger the protein misfolding behind parkinson's. this process is happening in your brain right now, at varying rates, every single day. the brain is uniquely fucking TERRIBLE at defending itself against this. it has the highest oxygen consumption per unit mass of any organ. it runs hot, oxidatively. and its antioxidant defense system is comparatively weak. this is where epitalon becomes genuinely esoteric knowledge. in studies on drosophila - the gold standard model organism for oxidative stress and aging research - epitalon outperformed epithalamin, the raw bovine pineal extract it was originally derived from, at 1000 times lower doses. not 10x. not 100x. one thousand times lower doses for equivalent or superior antioxidant effect. it inhibits lipid peroxidation directly. it reduces reactive oxygen species. it protects neurons specifically from hypoxic damage, the kind of low-oxygen cellular stress that accelerates brain aging and is implicated in cognitive decline. four amino acids. alanine, glutamic acid, aspartic acid, glycine. and somehow this tiny tetrapeptide is doing what gram-scale antioxidants struggle to do, at microscopic doses. fucking A. the mechanism isn't fully characterized in the western literature. most of the research is still in russian. but the working theory is that epitalon's tissue-specific action on pineal cells extends to broader neuronal protection through its regulation of oxidative signaling pathways. it appears to modulate the systems that regulate oxidative balance upstream. most people taking epitalon are thinking about sleep, circadian rhythm, maybe telomeres. i am one of them. they're the easy things to focus on. and don't get me wrong - they're huge. but we're missing the fact that every cycle we run, we're also quietly running one of the most potent anti-neurodegeneration protocols available outside of a clinical setting. the cognitive aging you're trying to prevent isn't coming from one big event. it's a slow oxidative fire. epitalon interrupts it at a molecular level. not medical advice. oral epitalon: yourprotocol.co/products/epita… subq epitalon: swisschems.is/product/epital…

@TooLateBlue @AbudBakri Do PT, exercises, epidural injections etc until you can no longer tolerate the symptoms. (Unless you have neuro weakness) then surgically fix it

@braindoc69 @AbudBakri Any advice for spondylolisthesis w/ pars defects? L5/S1

Just spoke with a PI at a major university that is organizing the the first injectable post surgical BPC-157 safety trial Working in the background with the team to help them get the right product and on inclusion/exclusion This will be huge Stay tuned

@DocPriyamMD IDWA. Fe deficiency without anemia. Happened to me despite eating Iron rich diet. No response to oral Fe. Needed infusions x 3!

Patient: "I have been on Pantoprazole daily since 2006." What’s the FIRST clinical sign or lab abnormality you’re looking for? 👇

@Crispytongue @AbudBakri Probably not, but I added it for healing/skin purposes.

@braindoc69 @AbudBakri Do you think the ghk-Cu is needed or the klow?

@CIDPwarrior @AbudBakri Thank you for the kind words! My dad was my idol. Smartest, best clinician I ever knew. He always said “do what is best for every patient, regardless of how it affects you”

@braindoc69 @AbudBakri And you are amazing surgeon and a great value to Tucson! Glad you healed so much faster.

@RegenRandy Thank you for the kind words. I am almost 65 years old and still working full time! Trying different mitochondrial peptides currently

When a neurosurgeon does his own deep dive and chooses BPC-157 + TB-500 after a 2-level back fusion, that gets my attention. These peptides aren’t magic. They amplify angiogenesis, collagen deposition, and cellular migration. The biology makes sense. If he can be back to performing brain surgery in 5 weeks, imagine what this can do for normies like us.

@morellifit Just finished SS31. Still doing Reta, BPC157/Tb500, NAD+, HGH at night. Almost 65 years old. Best shape I’ve been in since college

@braindoc69 What ya having? 👀

GM !! Who’s have peptides for breakfast? I just started a cycle of Cartalax. Wbu?

@PeptideList Check your spelling of peptidelist.com in your post. I know you will want to fix it 👍🏻

The race to $50/month GLP-1s is real but the pricing gap right now is wild. Same compound, same dose, prices range from $99 to $1,500+ depending on the provider. That's why we built theptidelist.com 800+ providers compared so you can see who's actually competitive.

#LouHoltz I had the good fortune of meeting Coach a few times. But, the best 3 days ever were with him and 2 great buddies playing Augusta! He was the ultimate host! And I eagled 13. RIP my friend

@PeptideList It’s a fabulous site. I red some articles on it tonight. Congrats!

10,000 visitors. First major mini milestone. Launched TPL on January 5th with zero. Today: 10,152 visitors, 38,837 page views, 1,000+ followers on this new account. What an adventure it's been. Every decision on the site gets filtered through one question: what would I want or need to make an informed choice? 823+ verified providers. 102+ peptide profiles. 54 articles. I found the intersection of two things I love. Peptides and building with AI. Secret to life if you want to be happy: give and contribute. That's been the whole driver and the ethos behind this project. A lot more in the works. If you're new to peptides, I built this for you. Next stop: 100K. Then a million. 🫶🏼 Big love.

@IUBarstool Endless, mindless dribbling. No offensive movement.

Oh my god.

@PeptideList It’s awesome! Great work!

Some things about me & @PeptideList: • Started as a side project. Snowballed into the largest independent peptide directory online. • I don’t sell peptides. Never will. • I don’t make money on this. No affiliate links. No sponsored content. It’s free. • I’m not a doctor and I don’t pretend to be one. • I don’t care about letters behind your name. Truth is truth regardless of who says it. • 20+ years in health, fitness, and competitive athletics. But this isn’t about me. It’s about the person Googling “what is BPC-157” at 1am for the first time. • Peppy is a mascot. I’m just a dude building something useful. • TPL exists to give, not to take. • Some accounts won’t give you the time of day right now. Give it 6 months. They’ll be asking me on their podcast. • Built this whole thing solo with AI tools and stubbornness. If you’re new to peptides and overwhelmed by the noise that’s exactly who I built this for. Photo: me in the mountains looking for peptides

@tweetsbyeric So sad. What a clown show of senators we have in Arizona.

It’s embarrassing having a US Senator like this guy representing my state.

@Helios_Movement Files

@PeptideList I have followed along as you build this. It is terrific. I ama still practicing neurosurgeon (in my 60’s). Started peptides peri-operative and have used a variety, with overall good success. Still learning! Hoping to help patients guide their way also

That's awesome Dr. Scully, you're going to like what you see. So far in the pilot the only hiccup has been that 23andMe data retrieval takes about 2 to 3 days on their end before the raw file is ready. Once you have it, the report generates almost instantly. Besides that the reports have been flawless. Next week I'm continuing talks to offer custom kits with all of the relevant SNPs included so we're not dependent on what 23andMe or AncestryDNA chose to genotype. That will make the report significantly more accurate and robust. As a clinician, your perspective is exactly what I'm looking for. I'm going to reach out to you directly because I want to be talking to real experts as I continue iterating on this. The goal is to make this the best tool it can be for both patients and the physicians guiding them. Appreciate you giving it a look.

$7K on peptides and still guessing. Without knowing your genetics, you have no idea how your body metabolizes each compound. SNPs in GLP1R, PCSK1, and GHRHR directly affect individual response. We built the first consumer facing genetics report for peptide optimization. Upload your 23andMe or AncestryDNA data and get a personalized breakdown. thepeptidelist.com/genetics