What's the Deal with Stem Cell Therapy?

Perry: [00:00:01] Emily. I like I think all medical doctors I’m a completely horrible patient. I'm pretty sure I have had a rotator cuff tear for, like eight months, and I've done absolutely nothing about it.

Emily: [00:00:16] Okay. I'm sorry. We need to say more. So what what were you doing? Were you doing something that men in their 40s should not be doing, like sports?

Perry: [00:00:24] Yep, yep. I was trying to get active and healthy, and, um, I was lifting weights. I was bench pressing, and I was, you know, bulking up.

Emily: [00:00:33] Wait, no. For reals. You were you were bench pressing.

Perry: [00:00:35] Yeah, yeah. Yeah, absolutely. But don't worry. I've taken my creatine future episode.

Emily: [00:00:41] You're totally fine.

Perry: [00:00:42] Foreshadowing. I taken my creatine and I was adding weight and something happened. And now I can't lift my left arm above my head and. Okay, that's fine. These things happen.

Emily: [00:00:57] That's not fine. But okay.

Perry: [00:00:59] I'm just sitting here realizing as because it's getting into golf season, I need to I need to swing a golf club again and it hurts. And I'm like, you know, I probably should have seen a doctor about this.

Emily: [00:01:08] And what are you planning to do about it? Which, well, have you been watching wellness influencers because they must have ideas.

Perry: [00:01:14] They have lots of ideas. And I think we're going to talk about one of those ideas today because we're talking about stem cell therapy. But you know what? I'm actually going to do nothing. That's correct. I'm going to do nothing.

Emily: [00:01:25] I have a suggestion for you, actually, as a person who has recently injured their hamstring, I have been getting a thing called shock wave therapy, where someone puts a shocker on your injured part and the placebo effect, uh, makes it better. And I would really, really recommend it.

Perry: [00:01:47] I'm a huge fan of the placebo effect.

Emily: [00:01:48] The placebo effect is great.

Perry: [00:01:50] But how much does it cost? That's the question.

Emily: [00:01:51] Well, okay, it's about $75 for each placebo effect, and you need like four of them for the placebo effect to really get going. So it's not free. But I have been running totally fine since the placebo effect has kicked in.

Perry: [00:02:04] I'm probably going to do nothing.

Emily: [00:02:08] I'm Emily Oster, I'm an economist and a data expert.

Perry: [00:02:12] And I'm Perry Wilson. I'm a medical doctor.

Emily: [00:02:14] It's Thursday, March 26th, 2026. And this is wellness, actually.

Perry: [00:02:20] Because you're getting a staggering amount of health and wellness information nowadays from every source imaginable. And some of it is awesome.

Emily: [00:02:28] And some of it is, well, actually bullshit. Fortunately, we're both people who know how to read studies, how to parse the data, and can tell you what's worth thinking about and what you can safely ignore.

Perry: [00:02:41] But before we dig in, a note that this podcast is for educational purposes and should not be construed as medical advice. We don't know your unique situation, so talk to your doctor for personal health decisions.

Emily: [00:02:52] This week we're asking what's the deal with stem cell therapy? Perry and I will give the official smash or pass, and then we'll get to your question of the week. But first, let's do the health news roundup after the break.

Perry: [00:03:19] And we are back with the Health News of the week. Emily, there's a new Netflix series that's coming out that is talking all about lead poisoning, something we probably don't talk about enough. Have you have you seen this?

Emily: [00:03:32] I haven't seen it. I was watching the Netflix documentary on microplastics, but this is next on my list of things to be afraid of from Netflix. Um, I think the documentary is about lead poisoning in the 1970s in Poland. And I think it's really interesting in part because in the current moment, I get an enormous number of questions from people about lead because we are constantly seeing these headlines that are like, there's lead in your baby food, there's lead in your, you know, aura ring, there's lead in this and, and that. And what's so interesting is that the current levels of lead exposure that like our kids have, are so, so much lower than the levels of exposure that we had. Right?

Perry: [00:04:15] Yeah, yeah. Like literally you and me, our generation, um, the main source of lead in the United States used to be inhalation from leaded gasoline. And the use of leaded gasoline peaked in the late 1970s, just like when we were getting born, leading our generation to have the highest levels of blood lead. In fact, there was an interesting study. The threshold for blood lead in babies. Everyone gets checked is five. What are the units? Nanograms per milliliter, micrograms per milliliter, five.

Emily: [00:04:48] Lead points, five lead points.

Perry: [00:04:49] Five lead points. My units. And there's a study that looked at the percentage of kids who like have levels below that, like the kids who are good, good lead levels. And you see the graph from like the 1950s and it's like 40 or 50% have good and then it goes through us and it's zero. Literally zero from like 1975 to 1985. And now it's now it's back up. I mean, it's still not 100% obviously, but it's we definitely got hit hard.

Emily: [00:05:15] Yeah. But I think it is worth remembering. So this, this documentary, I suspect is quite scary. And it certainly is true that high levels of lead exposure, like these kids had in Poland in the 1970s and for example, like kids were exposed to in Flint when there was lead in the water. That can be very dangerous. But actually some lead exposure is okay, like a small amount. Your kids body can process that. And so it's one of these things where you want to hold, like actually things are so much better than they once were, even though of course, lead is not good for your cognitive performance.

Perry: [00:05:48] And we can test.

Emily: [00:05:49] That's why, uh, you know, think about how much more successful we would have been. Oh, well.

Perry: [00:05:54] One can only imagine.

Emily: [00:05:55] Better luck next time. Uh, all right, let's talk about stress and cancer. So a lot of people think that stress causes cancer, but maybe no say more.

Perry: [00:06:07] Yeah. Really interesting new study came out and you're right. Um, surveys suggest that 50% of the public believe that stress is a cancer risk factor, right? Like chronically stressed doctors think this as well. I will tell you, I have conversations. We all have stories of like the guy, you know, who went through a messy divorce and then like a few years later, he has cancer or, you know, like stressed out woman who gets ovarian cancer at a young age. Like we construct these narratives and it's definitely in there. But a new study says, no, not really. Um, this is a study that was meta analysis, but an individual data meta analysis analysis. So they had individual level data on 422,000 people, of whom 35,000 ended up developing cancer. And they had psychosocial markers on all of them, including chronic stress, neuroticism, death of a loved one in the past year, a variety of stressors, divorce, relationship status, and overall, there was no link between those things and cancer, provided you accounted for age, which is like a real clue here. Like the thing is, the biggest risk factor for cancer is age. That's it's not a modifiable risk factor, but it is the largest risk factor. And all the crappy stuff that happens to us in life, like tends to happen more as we get older. We, we get divorced, we lose loved ones. Like all those stresses kind of add up. And so of course, we think that it's the stress that led to the cancer. But the truth is, it's just like getting older is stressful and also getting older leads to cancer. There was one exception, which is that relationship status and loss of a loved one did seem to increase the risk of future lung and smoking related cancers. But once they adjust for smoking status, that basically went away. So it's not that the stress causes the cancer, but stress might lead you to behaviors like smoking or drinking that actually do cause cancer. So, I mean, there's a way to get from stress to cancer, but it's not just like people will say like, oh, your cortisol levels are high and.

Emily: [00:08:06] Your cortisol levels. I mean, the discussion, we need to do the whole thing on cortisol, because I think there's so much in this sort of like keep your cortisol down. Like when you wake up in the morning, your cortisol is high. You need to stand outside on your bare feet to lower your cortisol.

Perry: [00:08:18] So it's not cortisol, it's the smoking. Don't smoke.

Emily: [00:08:22] Yeah. It's not the cortisol. It's the smoking. That's like a, that's a good takeaway from this entire podcast. Keep it in mind.

Perry: [00:08:28] Um, a bit of good news here that I saw that I thought you would like Emily, the, um, large insurance company UnitedHealthCare is starting to cover doulas, um, for, for births. It's, it's rare that we get to see an insurance company doing something that seems to benefit their members. But here we are. What do you think.

Emily: [00:08:51] I was so excited about this. Perry. So as background, I am like an enormous doula proponent. It is something that I think everybody should have in their birth. We have a ton of data suggesting that doulas are beneficial for all kinds of birth outcomes, lowering C-section rates, improving people's experience of birth. They can be helpful even if you are having a C-section, like doulas are just totally great and not everybody has them because they cost money. And so seeing insurers start to cover these is totally awesome. This United move follows on actually a number of state Medicaid programs starting to cover doulas as part of Medicaid, which is even better because it's reaching the most vulnerable people. So that is totally great. I will say that you teed this up as like, isn't it great that this company is doing something nice for their members? This is something nice for their members. However, the reason they are doing this is because doulas pay for themselves, because actually the reduction in, say, C-section rates or use of other interventions actually makes the birth cheaper. And so doulas are not that expensive. If you pay for a doula and then you have a reduction in the C-section rate, you pay much less on net because people have to say C-sections are expensive, more time in the hospital and so on. So actually this is just insurance companies saving themselves money. But since it's good for people, I'm still a fan.

Perry: [00:10:26] All right. So win win. But UnitedHealthCare complement withdrawn officially.

Emily: [00:10:31] Well complement thank you for seeing that. Yes. Okay.

Perry: [00:10:36] Complement with the bottom line sometimes aligns. That's it for the Health news of the week after the break. What's the deal with stem cells?

Emily: [00:10:52] All right, Perry. So stem cells. I was really excited to learn about this. Actually, unlike some of the stuff we talked about, this is something that I didn't know that much about coming into. And then I found an amazing clip on Instagram that told me everything I needed to know. And so we're just going to listen to it and then we'll be able to stop the episode early.

Perry: [00:11:10] Okay. Hitting play.

Influencer: [00:11:11] rom injuries to anti-aging stem cells might be the closest thing we have to the fountain of youth. Why is this? Because stem cells are very, very special cells. They're called pluripotent cells, which means they have the ability to morph into any other type of cell. It's like a little baby that doesn't know what it wants to be when it grows up. You put it in the proximity of other tissue and it decides to become that tissue. Stem cells are the future guys. Lots of good anti-aging functional medicine practitioners are skilled at using these in topical applications, too. I'm not sure about that. Improve fine lines and wrinkles, thicken the skin, improve collagen, elastin, and fibrin, and even reduce joint pain and discomfort and accelerate healing. Not really one of those people walking around with knee, hip, shoulder, rotator cuff or ankle pain. Rotator cuff pain. About surgery or it's become chronic. Talk to your functional medicine practitioner about the. Using the stem cells to accelerate your rate of healing.

Emily: [00:12:05] So are we done? Uh, it sounded like you weren't totally sold on all of them. I did hear a thing about the rotator cuff. It sounds like we're going to fix that.

Perry: [00:12:15] So, you know, in our prior episodes, when I looked through Instagram, I will say there was often a nice mix. Like, like when we talked about peptides, yes. There were people who were like, this is a miracle. But then there were these people that were like, oh no, be careful, and they can be contaminated and you don't know where they're coming from. And it was like there was some balance, even if it was inappropriate balance. As I was looking through this regenerative medicine stem cell space, I've never seen it be more wrong. Like everyone is on the side of like, this is the miracle, this is the fountain of youth, and there's almost no one sitting on the other side. And when you actually look into the data as we're going to talk about, it's like there's almost nothing there. So I'm excited. I'm like, I'm a little I'm a little riled up. I am amped up about this because there's a lot of a lot of misinformation out there.

Emily: [00:13:06] Okay, so I want to start with the not misinformation because I think often in these spaces, like it's not that you don't go immediately to vampire facial, you start with something real. A stem cell is a, a cell that has some flexibility relative to other cells. Okay. So when we talk about stem cells, you want to think about that's the stem and then it can branch out. That's why it's stem. It's a stem to branch into multiple different kinds of cells like a plant.

Perry: [00:13:36] Yes.

Emily: [00:13:37] And there are medical uses for stem cells. Yes. And so let's like sort of table stakes start there with like what actually is the potential promise of stem cells in real medical applications.

Perry: [00:13:50] Yeah. I mean, they can be miraculous in in real medicine applications, but can I like walk you through one? Um, yeah. Like sickle cell disease. Okay. Yeah. Um, sickle cell disease is a genetic condition that, uh, is a genetic mutation in hemoglobin, which is the protein in red blood cells that causes them to deform and sickle and get stuck in your blood cells, causing immense pain, clotting, and other problems. So very severe disease, generally untreatable until recently and thanks to stem cells. So what? There are two FDA approved therapies for sickle cell disease that are curative now. And they both come from stem cells. And here's how it works. If you're a sickle cell patient, you go in, you get your bone marrow harvested from your hip. That hurts a little bit. That bone marrow is taken to a lab. The cells are sorted based on what type of cells they are based on molecular characteristics on their surface. So the stem cells are pulled out by very fancy sorting machines that use all sorts of tags. Those cells are then cultured. They are grown up to be millions and millions of fold higher in number than they were. Those grown up cells then get gene edited so the two different therapies. One uses a viral vector to insert a new hemoglobin gene into those cells, like a functional hemoglobin gene. Very cool. The other uses Crispr Cas9 to edit a gene that leads to more fetal hemoglobin in the cell, which doesn't sickle either way. You have these noncycling cells. You're not done yet. You go back to the patient. You give the patient incredibly high dose chemotherapy to destroy all the other cells in their bone marrow. So they've got no now, no white blood cells, virtually no.

Emily: [00:15:33] Immune system.

Perry: [00:15:34] No immune system.

Emily: [00:15:35] They are in the hospital.

Perry: [00:15:37] In the hospital. Very dangerous situation. Once the bone marrow is cleared out, you inject those grown up and gene edited stem cells. You. Cross your fingers and you hope they engraft. And then they start to grow and divide and reconstitute the immune system, the red blood cells, the platelets, everything else you need. And if you make it through that, the patient no longer has sickle cell disease. It is amazing therapy and nothing at all like what people are getting in a regenerative medicine clinic. But it is a miracle.

Emily: [00:16:10] And the reason that this stem cell makes this possible is because these stem cells have the capacity to turn into many different kinds of cells, correct?

Perry: [00:16:20] Many different but not all different. And, and that that influencer up top used the term pluripotent. You'll see that a lot online. There are very few pluripotent stem cells. They live in embryos because they need to be able to turn like a cluster of cells into a human, so they can turn into any type of cell. But the stem cells that are harvested from adults, even for bone marrow transplant and stuff like this, are called multipotent, they can turn into some cells, so bone marrow derived stem cells can turn into white cells and red cells and platelets. And that's about it. That's still cool. That's three different kinds of cells. But it's not every type of cell.

Emily: [00:16:56] And so the other thing that people will be familiar with, I think sort of in the, in the real medicine space here is the discussion of embryonic stem cells. So an embryonic stem cell is truly pluripotent. It can from the beginning turn into any kind of cell. You start with two, two cells, four cells, eight cells. And and that embryo has can turn into anything. There is a lot of controversy which I just want to put aside around use of embryonic stem cells. But are there medical circumstances where embryonic stem cells are in fact used, or is that still we're not quite there on making anything out of that.

Perry: [00:17:34] There's no approved uses for them. They are used for research, but that is actually quite restricted, at least in this country, because of the potential ethical issues that you you implied. So, so really, you're not getting that the real distinction of what kind of stem cells you get in medicine is whether they're your stem cells, which are called autologous stem cells or someone else's, which are called allogeneic stem cells. So if you get a bone marrow transplant from someone else, a stranger, a relative, you can have someone else's stem cells in your body. But all of these are therapies, as I described, which are like incredibly intense, you know, hospital level stuff and cost millions of dollars.

Emily: [00:18:14] Right. Okay. And part of the reason I think this is the sort of worth pausing on because I think it, it will link back into why the things that are happening in these regenerative medicine clinics are such scammy disasters. If we think about, you know, what's hard about that sickle cell case that you described, it is in part that when you harvest the stem cells from the bone marrow, almost none of the cells are stem cells, right? You take a ton of cells, so many cells, and then you get like a tiny number of maybe like, you know, out of an entire harvest, you like 4 or 3. I mean, very small numbers of cells. Yeah. And then you have to grow them. And that the sort of whole process there is, you grow them and you multiply them and so on. And that is that takes a ton of time.

Perry: [00:19:05] Time, expense, effort.

Emily: [00:19:07] Yeah. But it's not like you just pick up a bunch of cells and, you know, 95% of them are stem cells and it's no problem to find them.

Perry: [00:19:13] Exactly. So, so let's talk for a second about what happens in a regenerative medicine clinic that's advertising stem cell therapy. What they are not doing is harvesting your bone marrow and sending it to a lab and growing it up and gene editing it and stuff like that. Of course, they're not, because the FDA says that if you manipulate the cells of someone more than minimally, that it is not legal to administer it to them again, it then becomes a drug or a device or something that needs to be regulated, but it is not illegal to take someone's cells out of their body and really put them somewhere else in the body. You're allowed to do that. Hence vampire facials. Okay.

Emily: [00:19:52] And also fat grafting. That's how you get fat from your ass into your face.

Perry: [00:19:56] Absolutely, absolutely. And I think FDA kind of appropriately is like, well, you know, it's your stuff. And like, we're not going to regulate like whether you can take that or not. And that's, that's probably fine. So in a stem cell clinic, what they do is they take out either some bone marrow from your hip, which hurts a little bit, but more often it's fat. They do a little liposuction. They get about like 100 cc's of fat. And remember, they can't do anything to it. So all they can do is they take that fat and they centrifuge it in the back room for about 15 minutes or so, and they pipe that off. They suck off the top layer of cells, and then they inject that back into you. And that's really all they can do. And you alluded to how inefficient this is in terms of in terms of harvesting. And I think the most damning paper on this was from Science Advances in 2024. So this was a research group that did this. They they sucked out cells from people's fat. They sucked out bone marrow and they spun them just like they do in the regenerative medicine clinics. And then they analyzed them to see how many stem cells were there. To give you a sense for like those therapies we talked about, like for, uh, sickle cell and stuff, you want about 1 to 2 million cells per kilogram of body weight, that's the dose.

Perry: [00:21:14] So 75 kilogram, man, you're talking, you know, 75, 100 million stem cells is what's necessary for treatment in this study. When they sucked out the bone marrow sample they found three stem cells, not 3,000,003 three stem cells. In fact, 1.7% of the cells were stem cells. But they had concern. The researchers said that there were a lot of false positives because they they were very they didn't look similar to each other. There was a lot of differences. And when they did more advanced testing, they found actually 0% of the cells they found were stem cells when they came from fat. And so what we have in these regenerative medicine clinics is attaching a real scientific term to make something sound fancier than what it is. It's like, it's, it's like if I invented like quantum cola, right? And I'm like, this, this cola is quantum somehow, right? You just like slap stem cell on it for marketing purposes, but really you're just kind of sucking out fat and re-injecting fat somewhere else or sucking out bone marrow and re-injecting it somewhere else.

Emily: [00:22:22] Yeah. I mean, I think it's, it's worse than the Cola example because at least you put a label on your cola, at least you're drinking a Coke and like it's doing something, you're getting whatever you were hoping to get out of, out of the coke. This is not a procedure that does well, we can talk about what the evidence says, but there's no reason to think that taking out your fat and putting back in your fat or whatever would have any particular positive impact on you in any direction. Right?

Perry: [00:22:48] We'll get to that as we kind of dig into the the individual use cases. But I think we should say that just because there's no stem cells or very few in the stuff you're injecting, doesn't mean it's the same as injecting nothing. There's other stuff in there, right? Like if I suck out your bone marrow, there's other cells in there, there's proteins in there. There's, you know, various molecules of various types. So it's certainly plausible that something could be happening. But, you know, the prices people are charging for this stuff are like akin to, you know, getting a bone marrow transplant or something like that here actually have a clip of an influencer couple who spent $50,000 to get stem cell injections overseas in Panama City, Panama. Take a listen.

Influencer: [00:23:35] If you're new into my world. My name is Jess. My husband and I run an eight figure coaching company, and we're borderline obsessed with biohacking. We found the Stem Cell Institute listening to a Joe Rogan episode where Mel Gibson talked about his experience getting stem cells, and so flying down to Panama City for a full service package and getting injections for a week sounded like our idea of a good time.

Emily: [00:23:56] Yeah. I mean, that's that's a lot of money.

Perry: [00:24:00] Yeah. Well, it demands a premium because people hear stem cell and they think like cool science. Amazing. I just saw an article in the New York Times that stem cells cured sickle cell disease. Like, of course it can cure my knee osteoarthritis.

Emily: [00:24:13] Okay, so that gets us to a place where we sort of say these regenerative medicine clinics. There's kind of no, it's not stem cells. And the question is like, okay, but is it is there any evidence that these kind of things that whatever is happening there works in some other sense, whether it's because of the three stem cells or because of of something of something else. And that's where we need. Not just the kind of theory for why this might or might not work, but actual data. So let's start with these. I love studying these because people have a lot of knee problems, tons of knee problems, and knees are a great example of the placebo effect. My favorite effect, there's like constant evidence that the that we do to fix your knee actually does nothing, right? Like many of these studies where it's like we did sham knee surgery, we cut into the wrong knee, we cut into the knee and did nothing. And it turns out if you just cut into someone's knee and do nothing, they feel better, right? Like, oh, tons of stuff happened. And so it's like a great knees are like a great example of the placebo effect. And we see some of that here too, where different kinds of treatment in a sort of total vacuum of a control group, it actually does look like, oh, this is so great. But of course, anything you did to people's needs, you know, waving your hands over them, saying the shaman words would affect your knee because that's how knees are.

Perry: [00:25:38] It's subjective. The best study on this, in my opinion, was in the British Journal of Sports Medicine. That's a very, um.

Emily: [00:25:46] Very good journal.

Perry: [00:25:46] Very good journal.

Emily: [00:25:47] My favorites.

Perry: [00:25:48] Oh, good. Uh, a randomized trial of 120 patients with knee osteoarthritis. And this was a blinded placebo controlled design. So they had two syringes. One was fat derived stem cells. But again, like I'm putting stem cells in quotes.

Emily: [00:26:02] It's some fat that they took centrifuged fat, maybe had some cells, don't know, could be anything.

Perry: [00:26:07] And then the other was just saline, just straight up salt water into the knee. And there was no difference in knee pain, which was their primary outcome at any time point through two years of follow up. So they actually followed them for two years. This is like the best quality data you're probably going to get. By the way, as you pointed out, everyone got better, everyone's knees improved, but saline costs $0.03 and stem cell fat costs $10,000 like people are charging. I mean, maybe less than that.

Emily: [00:26:39] But also, just to be clear, it's not that the saline helped. It's just the placebo effect help. And maybe you need the saline. Like maybe you need to do something to get the that's how the placebo effect works. You think you did something. But fundamentally, this is something that would have improved if you did nothing.

Perry: [00:26:53] Exactly, exactly. Meta analyses, which are combinations of trials, sort of confirm this general thing, which which says for for example, there was a meta analysis from the Orthopaedic Journal of Sports Medicine, not quite as good as the British Journal, but that's fine. Um, meta analyses never get published in the highest tier journals, but basically finding yes, stem cell injections or whatever you want to call them do improve things, but no advantage over other things like hyaluronic acid, which is another injection that often gets put in the knees, also with limited evidence.

Emily: [00:27:26] That's the penis injection.

Perry: [00:27:28] Oh, that's what they were using in the Olympics.

Emily: [00:27:30] Jumpers were putting in the in their penises in the Olympics. See, you got to listen to all the episodes of this podcast to go back to. To know what hyaluronic acid is. But if you did, you would know it has many uses. Fake meat, fake fixing your knee and making your penis big. So your ski jumping suit is looser and you can go farther.

Perry: [00:27:48] There you go.

Emily: [00:27:49] Do you think that it would fix the rotator cuff? I'm thinking it might.

Perry: [00:27:54] I'd feel more comfortable, I think. Injecting hyaluronic acid into my rotator cuff than, uh, than my fat cells, probably.

Emily: [00:28:01] I thought you were going to say injecting in your penis. Okay, let's move on. Move on.

Perry: [00:28:06] I haven't ruled that out yet.

Emily: [00:28:08] No. Um, okay, so knees are one example, but I think what is true in these studies is that at least in these, like medical study settings, there wasn't any downside to, again, this is like studies being done by actual doctors in actual doctoring environments. I think the piece that is more worrisome is all of the kind of wellness Face, etc. stuff. And so there my read is there is again no evidence that anything about this would improve your face.

Perry: [00:28:44] Yeah.

Emily: [00:28:45] No good evidence.

Perry: [00:28:48] Things aren't going to improve your face because stem cells are there doing things. When you inject stuff into your face, things do kind of get better, right? Like, even if I inject saline into my wrinkles and stuff, at least temporarily, until the saline gets absorbed. You know, things fill out a little bit. And if I inject something that has some mild inflammatory properties, like the stuff you might get from, you know, fat or bone marrow aspirate, you might get some localized swelling tissue edema, as we call it, that can potentially, you know, fill in some wrinkles and stuff like that. But again, we have ways to do this. Like one of the challenges in a space like this is especially if you're listening to wellness influencers online. If you trust everything you hear on a place like Instagram and you want to get rid of wrinkles on your face, you have about 3000 different options, of which stem cell regeneration regenerative therapy clinics is just one. We've already talked about red light therapy. There's so much out there that people need a filter to sort of decide like how, you know, how would I possibly know what actually works? And that filter is called science. And that's fundamentally what this podcast is about, right? It's like, it's the only way we have to move from anecdote to reality. And along those lines, because I think anecdote is so powerful and for all the wrong reasons. Um, I want to play you a clip of Mel Gibson talking about his father's experience with stem cell therapy, because I think we need to address this head on. Like we can show all the data that shows it doesn't work any better than placebo, but you hear something like this online and it sticks in your head. So let's play that for a second. Mel Gibson: It's 92 and he was doing all the old man stuff. You know, his hip was killing him and he was like, uh, he had he had multiple problems. I mean, he wasn't in good shape at all.

Influencer: [00:30:52] You know, his kidneys were in trouble. His heart was in trouble. And when you're 92 and you have multi-organ failure, you're basically running on fumes. And so you put these day zero young, healthy cells that kind of restarts everything.

Joe Rogan: [00:31:06] So what was his response to this IV treatment? Mel Gibson: It was like he got a new lease of life, affixed all his inflammation and pain, and he started walking again. And his kidneys were good. And his heart. He had a prolapsed valves in there, and they healed. And, uh, his, um, cognitive powers improved, his eyesight improved.

Joe Rogan: [00:31:26] Whoa.

Emily: [00:31:27] Okay. Yeah, I mean, I think listening to that, it's so compelling, right? It's like, this is a person, Mel Gibson, who we seem to trust for some reason. And what he's saying sounds amazing. It sounds like we basically it's, it's too good to be true. But, you know, but I think it connects. This is why this you using the phrasing stem cells and talking about stem cells, I think is so much of where the misinformation comes in here because it's like has this aura of, you know, well, these are cells from a young this is a young cell, you know, this is a cell from the beginning. And so we put it in and it can do everything. It regrows your valve, it regrows your brain, it regrows your kidneys, you know, it just goes all around your body and makes all the pieces young again. And of course, that is totally not how stem cells work. But it sounds like it could, you know, it sort of has this like, I guess it could. I guess it could be like that. And, and again, sort of like getting back to the sales pitch, if you said, you know, we're going to inject some fat into your face. Okay. Yeah. You inject some fat into my face like I like. Yeah, that's a, that's a thing. I can imagine how that would smooth stuff out and plump it up. If you say we're going to inject stem cells in your face that feels like, wow, then you're going to make me younger. You're not just going to like make my face fatter with the fat you put in my face, you're actually going to make the face younger with the stem cells. And I think that's what people are paying for. And that's the grift. That clip is the grift.

Perry: [00:33:07] Exactly. And, and, you know, not not to say I have no idea if Mel Gibson makes money off stem cells or anything like that. And people really do believe this, but, you know, anecdote isn't evidence. And when you are telling stories and humans are wonderful storytellers, you can manipulate a lot of things, right? You even heard them saying like, oh yeah, wasn't he in a wheelchair? And like, oh yeah, he could barely talk and stuff like that. And it's really. And then all of a sudden he could and all you have to do is kind of take that baseline state pre-stem cell and be like, you know, kind of exaggerate how sick the person was. And then, and then you take the state post-stem cell and kind of exaggerate how well they became. And you make that delta look really huge. And it's just it's not reliable. I want to point out, because we've hit on this a few times, that stem cells are not magic. Adult derived stem cells can only turn into a few different cell types. And I will tell you what they are. So the cells derived from your bone marrow can only make blood cells that is as potent as they are. They can't make brain cells. They can't make heart valve cells. There are stem cells in your skin that make skin cells fine. No one's harvesting those because it's quite painful to take out chunks of your skin. And then there's mesenchymal stem cells, which is what most of these regenerative medicine clinics are doing, and they're capable of differentiating into bone cells, cartilage, muscle cells, and fat. And that certainly sounds like a lot. And, you know, cartilage is something that it's particularly when we're talking about knee osteoarthritis and things like that, you can sort of say, oh, well, okay, yeah, cartilage.

Perry: [00:34:41] But it's not everything. It doesn't, you know, it's not going to fix your brain. We don't have stem cells for that. And so I think if people just kind of know that they're just biological limitations to how this could work, because I said cartilage, let me just point out that there have been relatively rigorous MRI studies looking at cartilage thickness before and after stem cell injection in the knees. It also looks similar to injection with other things like hyaluronic acid. And there might be, in both cases, about a millimeter of cartilage regeneration, probably by just increasing blood flow to the area. Some influencers are starting to be a little bit more honest about this. So there's still a ton of misinformation, a ton of like their magic. They turn into whatever cell their next to. Not true. In fact, very few stem cells do anything when they're in the body in terms of differentiating further. They do release some cytokines, some small proteins that might have immunomodulatory effects. So like either inducing inflammation or reducing inflammation. So these cells do kind of have a talking effect, like sort of talk to other cells. But we have lots of different ways, including like steroid injections if we want to tamp down the immune system. And so you'll see some people who kind of acknowledge that it's not just about magically turning into, you know, a new heart valve when you don't have a heart valve, but you still have to ask yourself, why am I paying these ridiculous amounts when there are other ways to get the same effect?

Emily: [00:36:11] Yeah. I mean, I think, you know, for me, this is a, I find this space really understandable, but such a clear example of something we see in many of these wellness Cases where you take a sort of vague biological plausibility like that, that comes a real good story and then kind of take it all the way down the road into something which is which is crazy. You know, they kind of go all the way from this can cure sickle cell anemia under these very, very complicated conditions into like, well, that means it must be magic. And, you know, here are all the things we're going to, we're going to do with it. And it preys on, of course, people's like desire for youth. And so much of this is a kind of I want to look younger. I want to seem younger, I want to be younger. This is telling you like we're not just going to make you look younger. This isn't Botox, you know, we're going to like put young cells in. We're actually make you younger. And that's of course, impossible, but very compelling.

Perry: [00:37:14] If I could talk about the power of hope for a minute and get a little bit personal with my own stem cell story. So a couple of years ago, my mom was diagnosed with a very rare neurodegenerative condition called multiple system atrophy. There's no treatment. It's kind of a horrible neurologic condition where you just sort of like gradually your body stops functioning. Um, I'm a doctor. I run clinical trials. I'm a scientist. I have a lab here. So when she got that diagnosis, the first thing I did was go to ClinicalTrials.gov and see, you know, I knew there was no treatments, there's no nothing approved. But I'm going to go to ClinicalTrials.gov and I'm going to see what's out there. Like what are people testing, right? Like let's take a shot on something. And so I'm going through the filters and what's actively recruiting and, and whatnot. And I see a study of stem cell therapies for multiple system atrophy. And, you know, these are trials that are like in the, it reads like it's in the medical space, right? It's going to be, it's the sickle cell thing, not the regenerative medicine clinic thing. At least that's what I was thinking. So I, I dig into this and I'm looking at the, the report on clinicaltrials.gov and the first red flag I had is that they have to list the conditions that they're testing the, the stem cells for and including multiple system atrophy. Also listed in this protocol are traumatic brain injury, stroke, progressive supranuclear palsy, ALS, diabetic neuropathies, dementia, frontotemporal dementia, Lewy body disease, cognitive impairment, nervous system diseases in general, Lewy body variant of Alzheimer's disease. That's a very broad protocol, right? Like no, no one is is testing that many things.

Emily: [00:39:03] No one treatment is doing all of those things.

Perry: [00:39:05] And nor would you if you were like a company trying to prove that your therapy worked, you would never enroll that diverse group, right? You would test it on one thing. So you know what's going on. I dig in deeper and I see that this protocol has been active at least since 2016 and has never reported any results. So then I dig in to where this is coming from and it's being run out of a clinic in Florida. I think it's called MD stem cells. Com and it is a regenerative medicine clinic in Florida. And all over their website they are saying, you know, oh, we've got these clinical trials that are running to to test these different things. And, you know, obviously people searching clinical, desperate people like me searching clinical trials are clearly a source of patience for them. But it still seemed odd to me because I was like, well, how could they make money on this? You can't charge people to participate in a clinical trial. Well, they're charging people to participate in a clinical trial. So I found a news report talking about this same clinic that said where someone pretended to call so that, you know, like fake secret shop to them, basically. And we're told it would be about $20,000 for one of these treatments, which again, is just like taking bone marrow out.

Perry: [00:40:20] And they were going to inject it into your blood and into your nose. Like that was the treatment $20,000. The doctor who ran this clinic, I actually used to have a license in Connecticut. That license was revoked by my state, which is a good thing. But he is licensed to practice in Florida because of course he is. And this, I don't think anything made me angrier than this particular experience in this space. And I'm trying not to let it color my view of the entire, like regenerative medicine and stem cell industry. This is someone who's clearly preying on very desperate. This isn't someone who has, you know, it's like, oh, I've got my knee hurts. Like, maybe I should try this injection. This is like my mom is dying of an incurable disease. Should I give you $20,000 to, you know, put some some fat cells up her nose or whatever. But the fact is, these things live in the same space. And although, you know, he's promising a lot more than someone who says, we're going to do some injections and make your knee feel better? People need to understand that these are for profit enterprises, and stem cell is a marketing term and a powerful one.

Emily: [00:41:32] And I think what is so tough also about that story is, you know, imagine you were not a doctor who does research and you've come across clinical trials.gov, which is not some scam or site. Clinicaltrials.gov is in fact where people register their actual clinical trials. This is an actual government website. And people, how would you know as a person that you're not going to be charged to be in a clinical trial? That's like, that's true. You know that because you're a doctor. I know that, but people might not know that. You look at this, it's on clinicaltrials.gov. You go to this website, they tell you like in order to be in this trial, it's $20,000. And of course, this seems official because it is, you know, it is has the word stem cell and is listed on this government website. And I think it's an extreme example, but also not an extreme example of where people are just there is real, you know, real costs. Yeah. Especially because, you know, in this case, maybe there isn't something else you can do, but in many cases, there is something else you can do. People are being told, you know, you should get stem cell therapy instead of chemotherapy, immunotherapy, something that might actually address your, your problems. And so.

Emily: [00:42:46] Relative to some of the things we've talked about on this podcast. You know, we talked about red light therapy. And, you know, my view is like, that's a stupid scam, but like, it's a stupid scam in the sense of like, who cares? You bought a mask and like, you put the mask on and you think you, you feel better, but you don't. This is like potentially very damaging and preying on people who in some cases are really, really desperate for answers. Yeah. And I will say there are a lot of very bad things that can happen as a result of some of these things. So there are many cases in which People going to. Some of these clinics have actually ended up with very, very bad, dangerous outcomes. So there's a clinic in Florida in which a number of people were actually blinded after some stem cells were injected in their eyes. There are a lot of stories like that.

Perry: [00:43:34] I saw that report also. I think it was done under kind of a research protocol. And it's actually like doing this podcast. I'm beginning to see this other side, like this world of using research to get around the regulatory state. Right? Like I file research protocols because that's my job. And like, I do research. And this happened with the peptides too, right? It's like, how can we inject these unapproved substances into people and like not be liable? Oh, we call it research and we have them sign a consent form. And yet, you know, the purpose of research is to create generalizable knowledge, right? To like benefit humankind. To publish your results. That's one of the reasons why it's unethical to charge participants to participate in a research project because they are giving you something, right? They are. They're volunteering themselves to be, you know, experimented on. It is not medicine. You don't do research for curative intent. You do research to find out whether something is curative or not. And then once you prove it, then sure you can, you can sell it all you want. That's how capitalism works. But research isn't medicine. And, and yeah, that particular study with the eyes, like the dumbest thing you would never do in a research study where you're injecting something into people's eyes is due both at the same time. Are you insane? You would of course, only do one and then see what happens. And then these women, you know, are blind in both eyes because it's a bad protocol.

Emily: [00:45:04] Okay, so we can do a smash or pass, but I actually, I want to pause here on what I think is the most important takeaway. So before we started this episode, we kind of came at it with like, you know, what are we, what do we want people to take away? And I think that here it is really quite important to both of us that people take away that you should not go to a stem cell clinic to do anything that that, you know, there are if you are a person with sickle cell anemia, it is a this is, of course, a kind of therapy that you will be discussing with your doctor. But if you are thinking about using stem cells or some kind of stem cell clinic for something in your health, do not do that.

Perry: [00:45:47] Yeah. You're not getting stem cells. I mean, that's what I want people to take home. It's like there are ways to get stem cells. They generally happen in a hospital. It's generally for people with cancer, sickle cell, very severe diseases. These clinics say they're selling stem cells. They're not they're charging you too much. Even if they're safe, you know, what they're injecting is safe. They're charging you an arm and a leg for stuff that isn't really there.

Emily: [00:46:14] Smash or pass. Stem cell therapy.

Perry: [00:46:16] Yeah, I'm. When it comes to regenerative medicine clinics, I'm a hard pass on this. How about you, Emily?

Emily: [00:46:23] I am a hard pass except for sickle cell anemia and a few cancers.

Perry: [00:46:27] Blood cancers? Yes. Real stem cells are great. It's just. This is fake.

Emily: [00:46:33] All right, that's it for stem cells. So your mailbag. Question of the week after the break.

Mailbag: [00:46:42] Hi, Emily. And Perry, this is Wade in Santa Fe. I've read that taking magnesium can help you sleep better. And I'm wondering if that's really true or is that just more internet wellness crap? Thanks.

Emily: [00:46:54] I take magnesium for sleep, Perry.

Perry: [00:46:57] Oh, okay. Cool. What do you think?

Emily: [00:47:01] Um, so I started taking this because I'm a perimenopausal woman, and I read the evidence as suggesting it is possible that this could affect sleep in a positive way. A little bit. And I have a lot of self trackers. And so I figured that I would try it and I would see if it improved my sleep. So I don't know. Do you think that it did? Based on the data.

Perry: [00:47:24] The day I read the data the same way. I think there's, you know, evidence of modest benefit. We're talking like 15, 20 minutes of increased sleep duration, a little lower sleep latency. So falling asleep a little quicker. No large randomized trials, but you get so much exercise, I feel like you must sleep well. But then why are you taking magnesium? I'm going to say, yeah, I think it improved your sleep a little bit.

Emily: [00:47:46] That is not correct. Uh, I am looking at my whoop recovery analysis here on my phone, and it tells me my magnesium supplement is plus 1%. Uh, and it's not statistically significant in contrast to other things like not drinking, which is a plus 8%. Okay. Yeah, that's what I would.

Perry: [00:48:07] Take magnesium, but I'm not going to give up alcohol.

Emily: [00:48:09] Geez, please don't be ridiculous. Um, yeah, I mean, this feels to me like something where there's no real downside. And if you said, you know, I'm interested in trying it, I can't see any reason people should not. And the the data is not large. I'm surprised we haven't seen larger randomized trials on this, but I guess the point is that it's no one would benefit from that because magnesium is a generic over-the-counter thing. And so there's not a lot of incentive to run a to run a trial.

Perry: [00:48:38] Yeah. That's probably why Doctor hat put on don't overdose. Take the recommended dose. You can there is magnesium toxicity at super high doses, so don't go crazy.

Emily: [00:48:46] My dad asked me about this the other day, which, you know, tells me it's out in the zeitgeist because my father will read any fad and try to follow it. So we'll see what he says.

Perry: [00:48:57] Let us know. Emily's dad.

Emily: [00:48:59] Hi, dad. That's it for us today. Stick with us next week when we will ask, what's the deal with creatine? Well, this actually is produced in association with iHeartMedia. Our senior producer is Tamar Avishai, our executive producer at iHeart is Jennifer Bassett. Our theme music is by Eric Deutsch, and our content is for educational purposes only.

Perry: [00:49:23] If you like the show, help other people find us. Leave a rating and review on Apple Podcasts or your podcatcher of choice, and help us spread the word about the show. You can follow us on Instagram at pod. And don't forget, we want to hear from you. Head over to wellness FM and leave us a question for our mailbag, or suggest a topic for a future show.

Emily: [00:49:45] We'll let the influencers have the last word.

Influencer: [00:49:47] You did. You did the labrum surgery. Rotator cuff.

Joe Rogan: [00:49:50] No surgery. I put out a full length rotator cuff tear. Okay. And they used exosomes and it was gone. The next MRI I had. The tear was gone. Yeah, just it goes it just seals up.