Weight loss

Tirzepatide: GLP1- A GLP-1 (Glucagon- like Peptide) and GIP hormone produced in the small intestine that stimulates insulin secretion and inhibits glucagon secretion, lowering blood sugar.  Has demonstrated effects on hyperglycemia, decreased appetite thus decreasing daily caloric intake. Available in a 2ml, 3ml and 5ml vial. 

Semaglutide: GL1- A once weekly injection. Semaglutide is a GLP-1 (Glucagon- like Peptide), hormone produced in the small intestine that stimulates insulin secretion and inhibits glucagon secretion, lowering blood sugar.  Has demonstrated effects on hyperglycemia, decreased appetite thus decreasing daily caloric intake. Available in a 2ml, 3ml and 5ml vial. 

Per Vial Per Visit Option: A visit will be required at least monthy on this option: Patient must provide labs before initial visit. 

 Office fees

-Initial fee- $150

-Follow up- $100

-Med refill fee (no visit)- $25

Semaglutide- per vial pricing

-2cc vial- $240

-3cc vial- $340

-5cc vial- $440

Tirzepatide- per vial pricing

-2cc vial- $330

-3cc vial- $500

-5cc vial- $675

Pack of syringes (10 syringes) $5

LIPO-B INJECTIONS 

 Methionine 25mg/ Choline Chloride 50mg/ Cyanocobalamin 1mg 

Home - weekly self-injections:  dosing 1ml SQ week

10ml vial with syringes $90 

30ml vial- $265 

**Lipo-B should generally not be administered to pregnant or breastfeeding mothers to minimize any risks to the fetus or infant.

LIPO B MIC
 

The Lipo-B injection is a product that contains a combination of compounds that have been shown to exhibit lipotropic effects. The lipotropic effects facilitate the burning of adipose tissue within the human body which may, consequently, result in some degree of weight loss. Lipo-B injections are typically used as fat loss supplements, in combination with diet and exercise, in weight loss plans. The combination of products that make up the Lipo-B injection are methionine, choline, and cyanocobalamin (vitamin B12).

Methionine

Methionine is one of the four sulfur-containing amino acids; the other three are cysteine, homocysteine, and taurine. Additionally, it is one of the nine essential amino acids in the human body. As an essential amino acid, it cannot be synthesized de novo by the human body due to a lack of the require metabolic pathway needed for its synthesis. Therefore, methionine has to be exogenously introduced into the human body either within the diet or as a supplement.

Methionine serves several key roles in the human body such as:

• Substrate in the production of critical hormones and proteins including L-cysteine, carnitine, adrenaline, choline, and       melatonin, among others.
• Increasing liver production of lecithin which helps lower serum cholesterol levels.
• Provides sulfur which aids development of nails and promotes hair growth.
• Chelating agent which helps get rid of heavy metals such as mercury.
• Provides protection against hepatotoxins such as       acetaminophen.

Choline

Choline is an essential nutrient that plays a key role in a number of metabolic pathways in the human body. Even though choline is produced endogenously in the liver, it is still considered an essential nutrient because the quantities produced is not sufficient to meet the body’s metabolic needs; as such, dietary supplementation of choline is necessary. Choline can be found in both animal and plant food sources, with animal food sources generally having more choline per gram of food product.

Some functions that choline serves in the body are:

• Production of sphingomyelin and phosphatidylcholine, which are needed to maintain cell membrane integrity.
• Production of acetylcholine, which is one of the major neurotransmitters in the body.
• Modulation of gene expression and cell membrane signaling.
• Early brain development in fetuses. 

Cyanocobalamin

Otherwise known as vitamin B12, cyanocobalamin derives its name from the fact that it has a cyanide group attached to its molecule and also contains the mineral cobalt. It is essential for cellular energy production as well as DNA synthesis. It is an essential water-soluble vitamin and must be obtained from food or as dietary supplements. Some good food sources of vitamin B12 are meat, fish, milk, eggs, and cheese, among others. Some of the roles that cyanocobalamin serves in the body include:

• Cofactor for methionine synthase and L-methymalonyl-CoA mutase.
• Synthesis of methionine from homocysteine.
• Regeneration of tetrahydrofolate from 5-methyltetrahydrofolate.
• 
  

Contraindications: 

There are certain clinical conditions under which Lipo-B should be avoided or administered with caution. Some of these conditions include:

• Hypersensitivity: Lipo-B (MIC) is absolutely contraindicated in individuals who have a demonstrated hypersensitivity to any components of the product.
• Acidosis: This can be worsened by methionine administration.
• Liver disease: This may impair the metabolism of the product components.
• Hereditary optic nerve atrophy (Leber’s disease): Individuals with Leber’s disease may experience a worsening of their symptoms if administered products containing cyanocobalamin.

LIPO C Injection 

Methionine 15mg/ Choline Chloride 50mg/ L-Carnitine 50mg/ Dexpanthenol 5mg

Home - weekly self-injections:  dosing 1ml SQ week

10ml vial with syringes $110 

30ml vial- $285

Lipo-C injection contains a mixture of compounds that may aid in the reduction of adipose tissue (fat). The mixture of compounds individually may be effective, however in combination they may exhibit more lipotropic activity than when administered alone in a synergistic fashion. Injection of this mixture of lipotropic compounds may be more effective than oral supplementation, this is due to the increased bioavailability of parenteral exposure.

These lipotropic agents are structurally and functionally closely related to the B-vitamins, or are involved in the homeostasis of energy production from fat. These compounds are often employed together in the hope of potentiating fat-loss, thus while the Methionine Choline mixture and B vitamin(s) are often injected separately, they are part of the same overall injection cycle. The non-vitamin compounds that are injected into the body stimulate the liver into optimizing the process of metabolism, elevate the movement of and utilization of fat, and provide the needed metabolic environment of the body for a fatty acid (fat) mobilization and utilization.

Lipotropic compounds are used on the potential for release of fat deposits in some parts of the body. They sometimes go by the names Lipo-Den, Lipo-Plex, Lipo Shot, or MIC Injection.

 The lipotropic agents included in this injection are:

Methionine helps the liver maintain the optimal ability to process fatty cids. Methionine is a major constituent of S-adenosylmethionine which has been shown to be associated in genetic regulation and activation of certain genes. Methionine contributes to methyl donation to histones that activate certain genetic processes that may be involved in the increase in lean tissue. Although indirectly linked to lipolysis, it is believed that the increase in lean tissue increases resting metabolic rate, therefore increasing the overall required calories that must be obtained from storage or dietary intake. Methionine, via S-adenosylmethionine, has been shown in animal models to increase CNS activity, therefore increasing the caloric requirements required by the CNS. The downstream effects of this may ultimately lead to increased caloric requirements for the entire organism. Although studies have not been replicated in humans, there may be an association due to the similarity in pathways shared between organisms.

Choline is a simple molecule usually classified as a B vitamin. The B vitamin class is usually involved in the generation of energy and support of metabolism. Choline is an important precursor to the neurotransmitter acetylcholine. This neurotransmitter is involved in a host of activities, one of which includes muscular function and contraction. Acetylcholine is a fundamental neurotransmitter that enables the communication between neurons. Increased neural communication results in increased CNS activity which ultimately leads to increased energy expenditure. Energy expenditure requires nutrient input, either from stored energy (fat), or dietary nutrients. Choline exist in a delicate balance and homeostasis with methionine and folate. When these nutrients are not in balance adverse health effects may be present. Along with the increase in CNS activity comes increased cognitive ability, reported by many users. Choline may be effective as a nootropic, or a substance with ability to increase cognition. Increased neural cognition is thought to be due to choline’s role as a precursor to acetylcholine.

The supplementation of choline has been shown to reduce serum and urinary carnitine. The reduction of carnitine in these fluids may indicate carnitine has been partitioned in tissues that utilize it as a fatty acid mitochondrial transport. When carnitine is used in the mitochondria it transports fatty acids to the location which they are broken down and used as energy. It has also been reported that molecular fragments of fat have been found in urine after carnitine and choline supplementation, which may be due to incomplete fatty acid oxidation and the removal of the subsequent byproducts. This means, choline supplementation may increase the utilization of carnitine and increase the removal of fatty acids, even though all fatty acids are not burned as energy. The fragments of fatty acids not burned as energy are extruded in the urine as molecular fragments.

Methionine, which helps the liver maintain the optimal ability to process fatty acids. Choline, which stimulates the mobilization of fatty acids and prevents their deposition in a given part of the body and, Inositol, which aids in the transport of fat into and out of the liver and intestinal cells, acts synergistically with choline, exhibiting more lipotropic activity than when administered alone.

As soon as the effect of all 6 of these substances wears out, the body gradually begins returning to its normal rate of fat and general metabolism.

Typically, these compounds are administered in concert. Injections can be administered up to twice a week. B12 is purported by its users and practitioners to help speed up overall metabolic processes and create a greater feeling of overall energy & well-being. Because these lipotropics are structurally and functionally closely related to the B-vitamins, they are often employed together in the hope of potentiating the potential for fat-loss, thus while the mixture and B vitamin(s) are often injected separately, they are part of the same overall injection cycle. The non-vitamin compounds that are injected into the body stimulate the liver into optimizing the process of metabolism, elevate the movement of and utilization of fat, and boost the metabolic power of the body for a while.

Other compounds are included as an attempt to further potentiate these effects:

• L-Carnitine
• Dexpanthenol (Vitamin B5)

Weight loss Bundle: The Weight Loss Bundle will contain 3 medications along with the syringes

needed to inject: 

Sermorelin/Glycine 4mL vial

MI B12 + Carnitine 4mL vial 

Thermo Suppress, 0.3cc - 2 packs, and 0.5cc - 1 pack.

• Bella 3 (Bupropion HCl 65 mg / Caffeine 20 mg / Oxytocin 100 IU / Topiramate 15 mg / Naltrexone HCl 8 mg / Methylcobalamin 1 mg) Capsules

• Bella Decaf (Bupropion HCl 65 mg / Oxytocin 100 IU / Topiramate 15 mg/ Naltrexone HCl 8 mg / Methylcobalamin 1 mg) Capsules

• Bella Plus (Bupropion HCl 65 mg / Caffeine 20 mg / Metformin 250 mg/ Oxytocin 100 IU / Topiramate 15 mg / Naltrexone HCl 8 mg / Methylcobalamin 1 mg)  Capsules

• Bella Plus Decaf (Bupropion HCl 65 mg / Metformin 250 mg / Oxytocin 100 IU / Topiramate 15 mg / Naltrexone HCl 8 mg / Methylcobalamin 1 mg) Capsules

Caffeine is a naturally occurring xanthine derivative used as a CNS and respiratory stimulant, or as a mild diuretic. Other xanthine derivatives include the bronchodilator theophylline and theobromine, a compound found in cocoa and chocolate. Caffeine is found in many beverages and soft drinks. Caffeine is often combined with analgesics or with ergot alkaloids for the treatment of migraine and other types of headache. Caffeine is also sold without a prescription in products marketed to treat drowsiness, or in products for mild water-weight gain. Caffeine was first approved by the FDA for use in a drug product in 1938. Clinically, it is used both orally and parenterally as a respiratory stimulant in neonates with apnea of prematurity. Caffeine reduces the frequency of apneic episodes by 30—50% within 24 hours of administration.1 Caffeine is preferred over theophylline in neonates due to the ease of once per day administration, reliable oral absorption, and a wide therapeutic window. A commercial preparation of parenteral caffeine, Cafcit®, was FDA approved for the treatment of apnea of prematurity in October 1999, after years of availability only under orphan drug status (e.g., Neocaf). The FDA has continued the orphan drug status of the approved prescription formulation.

Dehydroepiandrosterone (DHEA) is a C19 steroid also known as 5-androsten-3 beta-ol-17-one. DHEA and DHEAS (an active, sulfated form of DHEA), are endogenous hormones secreted by the adrenal cortex in primates and a few non-primate species in response to ACTH. DHEA is a steroid precursor of both androgens and estrogens, and thus is often called 'the mother hormone'. Endogenous DHEA is thought to be important in several endocrine processes, but current medical use of DHEA is limited to controlled clinical trials. In 1997, Pharmadigm, Inc. received an orphan drug designation to enroll patients with thermal burns who require skin-grafting into trials using injectable DHEAS, known as PB-005. Researchers continue to investigate the role of both endogenous and exogenous DHEA in CNS, psychiatric, endocrine, gynecologic and obstetric, immune, and cardiovascular functions.2

Exogenously administered DHEA is sold as a nutritional supplement in health and drug stores and many older individuals are using it to 'maintain the vitality of their youth'. There is currently no objective, well-controlled, large-scale, scientific evidence to back claims that taking DHEA combats the signs or symptoms of aging, diabetes, neurologic disease, sexual dysfunction, or heart disease Some athletes abuse DHEA believing that it can enhance the body's synthesis of testosterone; the potential action of DHEA as an anabolic steroid has lead to the prohibition of supplementation in competitive sport, even though evidence of anabolic effects in athletes is lacking. DHEA is also abused by athletes in an attempt to normalize the testosterone: epitestosterone ratio. However, the sensitivity and specificity of currently available testing for athletic 'doping' can readily identify the presence of banned substances, including testosterone. Because of DHEA's complex physiologic actions, more than 500 scientific articles investigating it have been published since 1993. Many of the short-term trials of DHEA to date have lacked the rigor and statistical applications needed to support therapeutic claims. Most claims will need to be confirmed by large-scale, properly conducted, and controlled studies. In 1984, the FDA banned the non-prescription (OTC) sale of exogenous DHEA due to concern over hepatotoxicity (hepatitis and hepatic tumors) as noted in animal studies. The FDA formally relegated DHEA to a Category II OTC ingredient at that time (i.e., not generally recognized as safe and effective). However, in 1994, the passage of the US Dietary Supplement Health and Education Act (DSHEA) allowed DHEA to be marketed as a nutritional or dietary supplement.

Inositol has shown clinical benefits in treating disorders associated with metabolic syndrome. Inositol supplementation has been effectively used to accelerate weight loss, reduce fat mass, improve serum lipid profiles and upregulate the expression of genes involved in lipid metabolism and insulin sensitivity in women with polycystic ovarian syndrome. Myo-inositol alone or in combination with D-chiro-inositol significantly reduced weight, BMI, and waist-hip circumference ratios in overweight/obese women with PCOS. Weight loss, reduction in fat mass and increase in lean mass were accelerated when inositol supplementation was accompanied by a low-calorie diet. In addition, inositol supplementation was associated with lower rate of gestational diabetes and preterm delivery in pregnant women. Currently, research is being performed to assess whether inositol may be used in treating various cancers.

Methionine is a sulfur-containing branched-chain amino acid. A precursor for cellular methylation reactions, methionine plays an important role in lipid metabolism, polyamine synthesis, immune function, heavy metal chelation, and maintenance of redox balance. Conversely, dietary methionine restriction in rodents increased energy expenditure, improved insulin resistance, and enhanced lipolysis and fatty acid oxidation in adipose tissue.

The lipotropic effects of methionine may be attributed to its metabolite S-adenosyl methionine (SAM). SAM is synthesized from methionine via an energy-consuming reaction. SAM administered orally or by injection has been investigated as a treatment for liver diseases, osteoarthritis, and depression. The benefits bestowed by SAM may be due to its role as a methyl donor in biochemical processes governing lipid homeostasis, DNA stability, gene expression, and neurotransmitter release.

Methylcobalamin, or vitamin B12, is a B-vitamin. It is found in a variety of foods such as fish, shellfish, meats, and dairy products. Although methylcobalamin and vitamin B12 are terms used interchangeably, vitamin B12 is also available as hydroxocobalamin, a less commonly prescribed drug product (see Hydroxocobalamin monograph), and methylcobalamin. Methylcobalamin is used to treat pernicious anemia and vitamin B12 deficiency, as well as to determine vitamin B12 absorption in the Schilling test. Vitamin B12 is an essential vitamin found in the foods such as meat, eggs, and dairy products. Deficiency in healthy individuals is rare; the elderly, strict vegetarians (i.e., vegan), and patients with malabsorption problems are more likely to become deficient. If vitamin B12 deficiency is not treated with a vitamin B12 supplement, then anemia, intestinal problems, and irreversible nerve damage may occur.

Naltrexone is an oral opiate receptor antagonist. It is derived from thebaine and is very similar in structure to oxymorphone. Like parenteral naloxone, naltrexone is a pure antagonist (i.e., agonist actions are not apparent), but naltrexone has better oral bioavailability and a much longer duration of action than naloxone. Clinically, naltrexone is used to help maintain an opiate-free state in patients who are known opiate abusers. Naltrexone is of greatest benefit in patients who take the drug as part of a comprehensive occupational rehabilitative program or other compliance-enhancing program. Unlike methadone or LAAM, naltrexone does not reinforce medication compliance and will not prevent withdrawal. Naltrexone has been used as part of rapid and ultrarapid detoxification techniques. These techniques are designed to precipitate withdrawal by administering opiate antagonists. These approaches are thought to minimize the risk of relapse and allow quick initiation of naltrexone maintenance and psychosocial supports. Ultrarapid detoxification is performed under general anesthesia or heavy sedation. While numerous studies have been performed examining the role of these detoxification techniques, a standardized procedure including appropriate medications and dose, safety, and effectiveness have not been determined in relation to standard detoxification techniques. Naltrexone supports abstinence, prevents relapse, and decreases alcohol consumption in patients treated for alcoholism. Naltrexone is not beneficial in all alcoholic patients and may only provide a small improvement in outcome when added to conventional therapy. The FDA approved naltrexone in 1984 for the adjuvant treatment of patients dependent on opiate agonists. FDA approval of naltrexone for the treatment of alcoholism was granted January 1995. The FDA approved Vivitrol, a once-monthly intramuscular naltrexone formulation used to help control cravings for alcohol in April 2006, and then in October 2010, the FDA approved Vivitrol for the prevention of relapse to opioid dependence after opioid detoxification.

Yohimbine is an oral alpha-2 blocker that is chemically related to reserpine. It is an alkaloid found in the bark of Rubiaceae and related trees, but can also be found in Rauwolfia serpentina. Yohimbine has been proposed as a treatment for erectile dysfunction (ED), however only limited evidence exist. According to ED treatment guidelines, only one small study in the published literature used acceptable efficacy outcome measures; therefore, conclusions about the clinical efficacy of yohimbine have not been established and its use in the treatment of ED is not recommended. Further, associated adverse events such as elevations of blood pressure and heart rate, increased motor activity, irritability, and tremor may limit its use. Yohimbine has been available since before 1938.

• Lipo Burn 1 (Caffeine 50 mg / Theanine 100 mg / Yohimbine HCl 5 mg) Capsules

• Lipo  Burn 2 (Caffeine 25 mg / Chromium Picolinate 0.025 mg / DHEA 10 mg /  Inositol 25 mg / Methionine 25 mg / Methylcobalamin 0.5 mg / Naltrexone  HCl 8 mg / Yohimbine HCl 2.5 mg) (Slow Release) Capsules

• Lipo Burn 5 (Chromium Picolinate 0.025 mg / DHEA 10 mg / Inositol 25 mg / Methionine 25 mg / Methylcobalamin 0.5 mg / Naltrexone HCl 8 mg / Yohimbine HCl 2.5 mg) Capsules