#2469 - Brigham Buhler

What It Covers

Brigham Buhler joins Joe Rogan to detail the regulatory battle over peptides and compounded medications, explaining how FDA classification decisions from the prior administration created a black market affecting 4 out of 5 peptide users, while outlining how the current HHS leadership under RFK Jr. is working to restore clinical access and build a preventative, cash-pay healthcare model.

Key Questions Answered

• •Testosterone & Prostate Cancer Myth: The fear linking testosterone therapy to prostate cancer traces back to a single 1930s study involving three patients — one dropped out, one was chemically castrated. No study since has confirmed the correlation. The FDA under current leadership is actively working to remove black box warnings on testosterone and hormone replacement therapy for both men and women, reversing nearly a century of medical dogma.
• •Peptide Black Market Reality: Banning peptides did not eliminate their use — it pushed 4 out of 5 peptide prescriptions into gray and black market channels with zero clinical oversight. Products purchased online frequently have no dosing instructions, no reconstitution guidance, and independent testing shows many are incorrectly dosed, sometimes at 2x the intended concentration, creating serious risk of muscle wasting and other adverse events without any clinician in the chain of custody.
• •FDA Drug Safety Track Record: 60–80% of drugs that successfully complete the FDA approval process later require a major label change or recall. Additionally, roughly 90% of products used in operating rooms were approved through the 510(k) pathway with no human safety studies. Off-label prescribing is standard clinical practice. These facts undermine the argument that peptides are uniquely dangerous for lacking large-scale human controlled trials.
• •NIH-to-Pharma Pipeline: A significant portion of pharmaceutical drugs originate from NIH-funded phase one trials, meaning taxpayers fund early-stage drug innovation. Pharmaceutical companies then license those molecules, run them through FDA approval, and hold exclusive patents for decades. This structure allows companies like Eli Lilly — whose market cap reached $800 billion after GLP-1 drugs — to claim financial harm from compounders while having built their valuation on publicly funded research.
• •Compounding vs. Big Pharma Scale: During the GLP-1 drug shortage, the entire compounding sector produced approximately $1.5–2 billion in compounded weight loss medications to meet FDA-acknowledged patient demand. Eli Lilly alone grew its company value sevenfold. Buhler argues the $7 billion harm figure cited by pharmaceutical lobbyists to legislators is inflated and includes black market activity, misrepresenting the actual scale of licensed compounding pharmacy competition.
• •Gene Sequencing as Predictive Medicine: Fewer than 1 in 1,000 people have had their genome sequenced, yet gene data can identify predispositions to infections, gut acidity, bone density, and tendon resilience before symptoms appear. Buhler's team is integrating full gene sequencing into the WasteWell app alongside DEXA scans, VO2 max, and real-time wearable data to build personalized health models that can project chronic disease risk years before clinical onset.
• •State-Level Regulatory Strategy: Texas, Florida, Utah, and Arizona have passed or are advancing Compassionate Use legislation that allows clinics to administer biologics and stem cell therapies within state borders, independent of federal FDA restrictions. Florida's approach generated $300 million in medical tourism revenue. Buhler is actively working with Texas legislators to expand this framework to include peptides and biologics, creating a state-level regulatory pathway that can later be mirrored federally.