What's the deal with stem cell therapy?

21:06Emily Oster: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. OK, 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. pyrofacial, you start with something real. A stem cell is 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.

21:49That's why it's a stem. It's a stem to branch into multiple different kinds of cells, like a plant. Yes. 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. Yeah.

22:10Emily Oster:I mean, they can be miraculous in real medicine applications. But let me – can I like walk you through one? Yeah, totally. Like sickle cell disease? Okay. Yeah. Sickle cell disease is a genetic condition that is a genetic mutation, 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 there are two FDA-approved therapies for sickle cell disease that are curative now, and they both come from stem cells.

22:47Emily Oster: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 like 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.

23:28Emily Oster: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 non-sickling 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 now no white blood cells, virtually no red blood cells. No immune system. No immune system. They are in the hospital. 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.

24:15Emily Oster: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. 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. Many different, but not all different. And 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.

24:56Emily Oster: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 drive stem cells can turn into white cells and red cells and platelets. And that's about it. That's so cool. That's three different kinds of cells, but it's not every type of cell. And so the other thing that people will be familiar with, I think sort of 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.

25:31You start with two cells, four cells, eight cells, and that embryo can turn into anything. There is a lot of controversy, which I just want to put aside, around the 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?

25:53Emily Oster: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 implied. 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.

26:33Emily Oster: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, like, you know, out of an entire harvest, you go like four or three. I mean, very small numbers of cells.

27:17And 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. Time, expense, effort. Yeah. But it's not like you just pick up a bunch of cells and, you know, 95 percent of them are stem cells and it's no problem to find.

27:32Emily Oster: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.

28:08Emily Oster:You are allowed to do that. Hence vampire facials. OK. And also fat grafting. That's how you get like fat from your ass into your face. 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.

28:43Emily Oster: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 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 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.

29:23Emily Oster:To give you a sense for like those therapies we talked about like for sickle cell and stuff, you want about one to two million cells per kilogram of body weight. That's the dose. So 75 kilogram, man, you're talking, you know, 7 ,500 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 three million, three, three stem cells. in fat 1.7 percent 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 uh they didn't look similar to each other there was a lot of differences and when they did more advanced testing they found actually zero percent of the cells they found were stem cells when they came from fat and so So what we have in these regenerative medicine clinics is attaching a real scientific term to make something sound fancier than what it is.

30:22Emily Oster:It's like if I invented like quantum cola, right? And I'm like, 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. Yeah, I mean, I think 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 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?

31:08Emily Oster:We'll get to that as we kind of dig into 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 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.

31:43Emily Oster:Here, I 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. 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. Yeah. I mean, that's that's a lot of money.

32:20Emily Oster: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. is like, of course it can cure my knee osteoarthritis. Okay, so that gets us to a place where we sort of say these regenerative medicine clinics, there's kind of, it's not stem cells. So then the question is like, okay, but is it, is there any evidence that these kinds of things, that whatever is happening there works in some other sense, whether it's because of the three stem cells or because of something else?

32:55And 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 knees. I love studying knees 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 shit 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?

33:32Like, 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 knees, you know, waving your hands over them, saying this shaman words would affect your knee because that's how knees are.

33:57Emily Oster:It's subjective. The best study on this, in my opinion, was in the British Journal of Sports Medicine. That's a very - Very good journal. Very good journal. One of my favorites. Oh, good. 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, I'm putting stem cells in quotes. It's some fat that they took. Snitch a few good fat, maybe had some cells. Don't know. Could be anything. 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.

34:39Emily Oster:So I 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. Yeah. But saline costs three cents and stem cell fat costs$10 ,000. Like people are charging, I mean, maybe less than that. Also, just to be clear, it's not that the saline helped. It's just the placebo effect helped. 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.

35:13Emily Oster:Exactly. Exactly. Exactly. Meta-analyses, which are combinations of trials, sort of confirm this general thing, which says, for example, there is a meta-analysis from the Orthopedic Journal of Sports Medicine, not quite as good as the British Journal, but that's fine. 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. That's the penis injection.

35:47Emily Oster:Oh, that's what they were using in the Olympics. That's what ski jumpers were putting in their penises in the Olympics. See, you've got to listen to all the episodes of this podcast to go back to know what hyaluronic acid is. But if you did, you would know it has many uses. Fake knee, fake fixing your knee and making your penis big so your ski jumping suit is looser and you can go farther. There you go. Do you think that it would fix the rotator cuff? I don't know if it might. I'd feel more comfortable, I think, injecting hyaluronic acid into my rotator cuff than my fat cells, probably. I thought you were going to say I'm injecting into your penis.

36:23Okay, let's move on.

36:25Emily Oster:I haven't ruled that out yet. No. Okay, so knees are one example. But I think what is true in these studies is that at least in these medical study settings, there wasn't any downside to, again, this is like studies being done. actual doctors in actual doctoring environments. I think the piece that is more worrisome is all of the kind of wellness face, et cetera, stuff. And so there my read is there is again, no evidence that anything about this would improve your face. Yeah. No good evidence. 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?

37:21Emily Oster:Like even if I inject saline into my wrinkles and stuff, at least temporarily until the saline gets absorbed, 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 3 ,000 different options of which stem cell regeneration, regenerative therapy clinics is just one.

38:11Emily Oster: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, 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. We can show all the data that shows that it doesn't work any better than placebo, but you hear something like this online and it sticks in your head.

39:01Emily Oster:So let's play that for a second. He was 92, and he was doing all the old man stuff. You know, his hip was killing him, and he was like, he had multiple problems. I mean, he wasn't in good shape at all. 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. So what was his response to this IV treatment? It was like he got a new lease of life. fixed all his inflammation and pain and he started walking again and his kidneys were good and his heart he had a prolapse valves in there and they healed and uh his um cognitive powers improved his eyesight improved whoa 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.

40:01And what he's saying sounds amazing. I mean, it sounds like we basically, it's too good to be true. But I think it connects. This is why this, you know, 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, it 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.

40:43And 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. Yeah. 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.

41:20You'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.

41:27Emily Oster: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 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.

42:00Emily Oster: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.

42:40Emily Oster: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, you know, it's particularly we're talking about knee osteoarthritis and things like that. You can sort of say, oh, well, OK, yeah, cartilage. 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 there are just biological limitations to how this could work.

43:13Emily Oster: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 they're next to. Not true. In fact, very few stem cells do anything when they're in the body in terms of differentiating further.

43:53Emily Oster: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?

44:31Yeah. 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 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. psychosal anemia under these like 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.

45:11And 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 don't we're not just gonna make you look younger. This isn't Botox. You know, we're going to like Like put young cells in. We're going to actually make you younger. And that's, of course, impossible, but very compelling.

45:33Emily Oster: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. 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.

46:16Emily Oster: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 whatnot. And I see a study of stem cell therapies for multiple system atrophy. And 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 report on clinicaltrials.gov, and the first red flag I had is that they have to list the conditions that they're testing the stem cells for.

46:57Emily Oster: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 one is testing that many things. No one treatment is doing all of those things. 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'd like test it on one thing so you know what's going on.

47:34Emily Oster: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 mdstemcells.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 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?

48:15Emily Oster: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 they, you know, They're like a 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. 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 actually used to have a license in Connecticut.

48:51Emily Oster: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 people. 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 put some fat cells up her nose or whatever?

49:29Emily Oster:But the fact is these things live in the same space. And although 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. 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 clinicaltrials.gov, which is not some scammer 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.

50:20That'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 is 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, 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.

50:55People are being told, you know, you should get stem cell therapy instead of chemotherapy, immunotherapy, something that might actually address your problems. And so it is 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 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.

51:27And I will say, uh, 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.

51:54Emily Oster: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?

52:29Emily Oster: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 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 sell it all you want. That's how capitalism works. but research isn't medicine. And, uh, 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 do both at the same time.

53:10Emily Oster: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. 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 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. If you are a person with sickle cell anemia, this is, of course, a kind of therapy that you will be discussing with your doctor.

53:56But if you are thinking about using stem cells or some kind of stem cell clinic for something in your health, do not do that.

54:06Emily Oster: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, what they're injecting is safe. They're charging you an arm and a leg for stuff that isn't really there. Smash or pass, stem cell therapy. Yeah. When it comes to regenerative medicine clinics, I'm a hard pass on this. How about you, Emily. I am a hard pass except for sickle cell anemia and a few cancers.

54:47Emily Oster:It's like cancers. Yes. Right. Real stem cells are great. It's just, this is fake. All right. That's it for stem cells. So your mailback question of the week after the break. Iveam is built for losing weight and moving forward. Iveam is built for feeling your best and seeing results. Iveam is a medical weight loss program built for you. Their approach is individualized virtual integrative medicine. 99.2 % of patients who completed the IVM weight loss protocol achieved meaningful change, dropping an average of 45 pounds. IVM built for your wellness journey. IVM built for real life. When you sign up right now, you can get a one month free trial.

55:29Start your personalized plan in minutes by visiting IVM health.com. That's IVM health.com subscription required medication labs and supplements not included results based on patients who completed the full i-veam protocol over 68 weeks individual results vary not all patients are eligible prescription medications may carry risks and should be used only as

55:57Emily Oster:directed by your provider tyler reticure from 2311 racing another checkered flag for the books Time to celebrate with Chumba. Jump in at Chumbacasino.com. Let's Chumba. No purchase necessary. BTW Group. Void where prohibited by law. CTNC 21 Plus. Sponsored by Chumba Casino. What if your soda actually did something for you? Introducing Sky Pop Protein Soda. With 10 grams of complete protein, zero sugar, and 45 calories, Sky Pop Protein Soda offers four delicious flavors with big taste and real benefits. It's light, refreshing, and ready for wherever your day takes you. It's Anytime Protein that helps you reach higher.

56:36Skypot Protein Soda. Reach for the sky. Get your Skypot Protein Soda now at Target or Walmart.

56:44Emily Oster:Hey, it's Ryan Seacrest for Jewel Osco. It's stock up savings time now through March 31st. Spring in for storewide deals that earn four times a point. Look for in-store tags to earn on eligible items from Lindor, Chips Ahoy, Gatorade, Host, Ziploc, and Zoa. Then clip the offer in the app for automatic event-long savings. Stack up those rewards to save even more. Enjoy savings on top of savings when you shop in-store or online for easy drive-up-and-go, pickup or delivery. Restrictions apply. See website for full terms and conditions. We're in the laundry room where Mike just finished two loads of laundry after working all day, multiple carpools, and a grocery pickup.

57:21Emily Oster:Mike, how'd you do it? Grand Appliance, they installed a pair of GE Profile all-in-one washer-dryer combos. I load them, hit start, head to work. When I come home, two loads, ready to fold. I got to say, Mike, that's efficiency. Game-changing efficiency. There it is, another assist from Grand Appliance. Learn about GE Profile Innovation at your local Grand or GrandAppliance.com.

57:45Emily Oster: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. I take magnesium for sleep, Perry. Oh, okay. Cool. What do you think? 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?

58:26based on the data.

58:28Emily Oster:I read the data the same way. I think there's 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. Yeah, 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. That is not correct. I am looking at my WHOOP recovery analysis here on my phone. And it tells me my magnesium supplement is plus 1%. And it's not statistically significant in contrast to other things like not drinking, which is a plus 8%.

59:08Okay. Yeah.

59:10Emily Oster:I can take magnesium, but I'm not going to give up alcohol. Jeez. Please. It'd be ridiculous. 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 data is not large. I'm surprised we haven't seen larger randomized trials on this, but I guess the point is that 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 trial. Yeah, that's probably why. Dr. Hap put on, don't overdose. Take the recommended dose.

59:45Emily Oster:There is magnesium toxicity at super high doses, so don't go crazy. 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. Let us know, Emily's dad. Hi, dad. That's it for us today. Stick with us next week when we will ask, what's the deal with creatine? Wellness Actually is produced in association with iHeart Media. 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.

1:00:27Emily Oster: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 wellnessactuallypod. And don't forget, we want to hear from you. Head over to wellnessactually.fm and leave us a question for our mailbag. Or suggest a topic for a future show. We'll let the influencers have the last word. You did the labrum surgery? No. Rotator cuff? No surgery. I put out a full-length rotator cuff tear. Okay. And they used exosomes, and it was gone. The next MRI I have, the tear was gone.

1:01:03Emily Oster:Yeah. It just seals up.

1:01:15IVM is built for losing weight and moving forward. Iveem is built for feeling your best and seeing results. Iveem is a medical weight loss program built for you. Their approach is individualized, virtual, integrated medicine. 99.2 % of patients who completed the Iveem weight loss protocol achieved meaningful change, dropping an average of 45 pounds. Iveem, built for your wellness journey. Iveem, built for real life. When you sign up right now, you can get a one-month free trial. Start your personalized plan in minutes by visiting iveamhealth.com. That's I-V-I-M health.com. Subscription required medication labs and supplements not included.

1:01:58Results based on patients who completed the full iVeam protocol over 68 weeks. Individual results vary. Not all patients are eligible. Prescription medications may carry risks and should be used only as directed by your provider.

1:02:15Emily Oster:Tyler Reddick here from 2311 Racing. Victory Lane? Yeah, it's even better with Chumba by my side. Race to ChumbaCasino.com. Let's Chumba. No purchase necessary. VGW Group. Void where prohibited by law. CTNCs. 21+. Sponsored by Chumba Casino. You know that moment around 2 p.m. when you realize you haven't eaten protein, but you also don't want a heavy shake? I have a solution. Sky Pop Protein Soda. It tastes like soda. It's light, bubbly, refreshing. but with 10 grams of complete protein, zero sugar, and only 45 calories. So I don't have to think about it. I'm just packing lunches, answering emails, doing everything, and I just grab one to go.

1:02:51It really does feel lighter than those big functional drinks, and you're still getting real benefits and not something you've forced yourself to drink. Sky Pop Protein Soda. Reach for the sky. Get yours now at Target or Walmart.

1:03:02Emily Oster:Hey, it's Ryan Seacrest for Jewel Osco. It's stock up savings time now through March 31st. Spring in for storewide deals that earn four times a point. Look for in-store tags to earn on eligible items from Lindor, Chips Ahoy, Gatorade, Host, Ziploc, and Zoa. Then clip the offer in the app for automatic event-long savings. Stack up those rewards to save even more. Enjoy savings on top of savings when you shop in-store or online for easy drive-up-and-go, pickup-or-delivery. Restrictions apply. See website for full terms and conditions. We're in the laundry room where Mike just finished two loads of laundry after working all day, multiple carpools, and a grocery pickup.

1:03:39Emily Oster:Mike, how'd you do it? Grand Appliance, they installed a pair of GE Profile all-in-one washer-dryer combos. I load them, hit start, head to work. When I come home, two loads, ready to fold. I gotta say, Mike, that's efficiency. Game-changing efficiency. There it is, another assist from Grand Appliance. Learn about GE Profile innovation at your local Grand or grandappliance.com. This is an iHeart Podcast. Guaranteed human.