Dr. Bikman’s lecture this week explores the metabolic roles of bilirubin, a molecule typically associated with liver disease and jaundice but now emerging as a key player in metabolism, oxidative stress, and fat regulation.

Bilirubin is produced from the breakdown of red blood cells and is transported to the liver, where it undergoes conjugation to become water-soluble and is then excreted into bile.

While historically viewed as a waste product, recent research suggests that bilirubin plays a significant role in protecting against oxidative stress and inflammation, and may even contribute to metabolic flexibility and fat metabolism.

One of bilirubin’s most fascinating properties is its potent antioxidant effect. It neutralizes reactive oxygen species (ROS), helping to reduce oxidative stress—a key driver of chronic diseases, including insulin resistance, cardiovascular disease, and neurodegeneration. Bilirubin also acts as an anti-inflammatory agent, inhibiting key inflammatory pathways such as NF-kappa B, which is involved in obesity-related inflammation. Interestingly, individuals with Gilbert Syndrome, a genetic condition that causes mildly elevated bilirubin levels, have been shown to have a significantly lower risk of cardiovascular disease.

Beyond its antioxidant and anti-inflammatory roles, bilirubin also influences fat metabolism. Studies suggest that bilirubin enhances mitochondrial function and thermogenesis, particularly in brown and beige fat, by increasing UCP-1 (uncoupling protein 1) expression, which helps the body burn fat more efficiently.

Ben concludes by discussing ways to naturally increase bilirubin levels. Since bilirubin is excreted in bile, diets higher in fat may enhance enterohepatic recycling, allowing more bilirubin to re-enter circulation and exert its beneficial effects. While excessive bilirubin can be toxic, modestly elevated levels, as seen in Gilbert Syndrome, appear to provide metabolic advantages.

This growing body of research challenges the outdated view of bilirubin as a mere waste product and suggests that it may be a crucial player in metabolic health.

Show Notes/References:

For complete show notes and references referred to in this episode, we invite you to become a Ben Bikman Insider subscriber. As a subscriber, you’ll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben, ad-free Metabolic Classroom Podcast episodes, show notes and references, Ben’s Research Reviews Podcast, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. Learn more about becoming an Insider on our website: https://www.benbikman.com

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Dr. Bikman’s Metabolic Classroom lecture this week explores peptides and their effects on metabolism, fat loss, muscle growth, and overall health.

Ben begins by defining peptides as short chains of amino acids that act as signaling molecules in the body. While some peptides occur naturally, others are synthetically developed for therapeutic purposes. He explains that peptides are gaining popularity in fitness, anti-aging, and metabolic health, influencing fat loss, muscle repair, insulin sensitivity, and even skin regeneration. He also introduces collagen peptides, highlighting their unexpected metabolic benefits, including their influence on GLP-1 and gut microbiome health.

Ben then categorizes peptides based on their primary functions. For fat loss, peptides like CJC-1295 and Tesamorelin work by stimulating growth hormone and IGF-1, promoting fat breakdown while preserving muscle mass. Another peptide, Melanotan-2, originally known for increasing melanin, has been found to suppress appetite by affecting the melanocortin system. He also discusses peptides like Ipamorelin, which help enhance muscle recovery and growth by selectively increasing growth hormone secretion without affecting other pituitary hormones.

In the anti-aging and skin health category, Thymosin Beta-4 stands out for its ability to enhance wound healing and tissue repair. Dr. Bikman also highlights the unexpected metabolic role of collagen peptides, explaining how they can increase GLP-1 levels, improve insulin sensitivity, and even activate AMPK, a crucial metabolic regulator involved in fat breakdown and cellular repair.

Finally, he touches on how peptides are administered—most commonly via subcutaneous injections, though some peptides can be absorbed sublingually or applied topically.

He cautions that not all peptides are created equal, warning against low-quality or counterfeit products. Ben emphasizes the need for high-quality sourcing and careful monitoring, as some peptides affect hormone levels and require medical supervision.

Dr. Bikman concludes that peptides hold immense potential for metabolic health, fitness, and longevity, but should be used wisely and responsibly.

Show Notes/References:

For complete show notes and references referred to in this episode, we invite you to become a Ben Bikman Insider subscriber. As a subscriber, you’ll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben, ad-free Metabolic Classroom Podcast episodes, show notes and references, Ben’s Research Reviews Podcast, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. Learn more about becoming an Insider on our website: https://www.benbikman.com

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Learn more about becoming an Insider: https://www.benbikman.com

In this week’s lecture, Dr. Bikman explores the metabolic origins of acne, challenging the conventional view that acne is purely a skin issue. While acne is often attributed to excess oil production, clogged pores, bacteria, and inflammation, Ben highlights how metabolic factors—especially insulin—play a significant role.

Insulin directly stimulates sebaceous glands, increasing oil production, and also triggers the release of androgens (such as testosterone), further worsening acne. Additionally, insulin resistance promotes inflammation and hyperkeratinization, both of which contribute to acne severity.

He explains that puberty naturally induces a state of insulin resistance, which helps drive growth and development. However, when combined with modern high-carbohydrate diets, this physiological insulin resistance can be exacerbated, leading to severe acne in some teenagers. He also discusses the role of insulin-like growth factor 1 (IGF-1), which is stimulated by high insulin levels and is known to increase sebum production and accelerate skin cell turnover, worsening acne conditions.

Ben then presents compelling research on metabolic-based acne treatments, including the use of metformin, an insulin-sensitizing drug that has shown promise in reducing acne, particularly in conditions like PCOS. He also highlights dietary interventions, particularly low-carbohydrate and ketogenic diets, which have been found to significantly reduce acne severity by lowering insulin and improving skin health. One study found that young women on a ketogenic diet saw a 33% reduction in acne severity and a 50% improvement in skin quality within just 45 days.

He concludes that acne is not just a cosmetic issue but a metabolic condition that can be managed through dietary and lifestyle changes. While conventional acne treatments address symptoms, tackling insulin resistance through proper nutrition provides a long-term solution. He encourages those struggling with acne to focus on cutting out refined carbohydrates, prioritizing protein, and embracing healthy fats to regulate insulin levels and improve skin health.

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