Episode 72 | Dr. Amy Killen | Are Stem Cells The Future of Medicine?
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Kathy Smith: Amy, welcome to the show.
Amy Killen: Thank you so much. That was a fabulous introduction about stem cells. Good job. I feel like that was all the things. You said it so well.
Kathy Smith: I know that we have to keep repeating certain things, because you might hear it. It’s just like with fitness. You hear something and you have to hear it again and again and again. So I wanted to kind of lay the groundwork. Really, start with just the basics. Tell us, what are stem cells?
Amy Killen: Just like you said. Stem cells are sort of the master cells, like the mother cells, almost, in your body, and you have them everywhere. You have them in your skin, your heart, your brain, everywhere, your cartilage. They’re responsible for keeping that tissue alive and healthy. So as you have an injury or as you get sick– say you cut your arm, for instance. The cells in your skin have to get signals from somewhere, have to get new cells to repair that skin. Stem cells are the cells that are capable of replicating themselves, which means making more of themselves in order to repair the tissue.
As you just said, they also send out signals to the cells around them to tell those cells what to do. So they direct the cells around them to repair, and they also can replicate themselves to repair the tissue. So we have to have stem cells everywhere in our body to keep all our different tissues up and running. If we didn’t, we would run out of cells and that organ or tissue would just stop working.
Kathy Smith: Okay, so is the way that I described it pretty accurate that as we age, that the stem cells start to lose their oomph? They’re not as effective, and that’s why these procedures are starting to become so popular? And as we age– let me back up a little bit. A lot of athletes, a lot of people who are using their bodies on a daily basis and pushing them to the max are starting to get stem cells and something called PRP, which I’d like you to describe – even at younger ages. But is that kind of the idea, that our stem cells just aren’t quite doing the job the right way anymore?
Amy Killen: Yeah. As you age, a couple of things happen. It depends on which part of the body we’re talking about, but essentially, you stop having as many stem cells in certain parts of the body. So they’re not as plentiful. Then the ones that are there are not as active. So they’re not capable of creating the regeneration, which is the repair of those organs. It happens slowly as we get older, but every decade, your stem cells in a lot of parts in your body, at least, stop functioning as well.
Kathy Smith: Then you start to harvest or get stem cells and put them back in your body. Let’s go through the process, because I want to talk about my experience, which is a little different than what we’re talking about right here. But let’s talk about the normal experience if you go in and you want to have some procedure here in the United States or at your clinic, let’s say. Where are we going to get the stem cells?
Amy Killen: For my procedures, like I said, I tend to focus on skin, hair, and sexual optimization. Those are kind of my three things. But we can also use stem cells for other things like musculoskeletal pain, like knee pain or back pain. We commonly do that in my clinic as well with my colleague.
For most procedures in the United States, we’re taking stem cells from the patient, from some part of their body, usually from their bone marrow or from their fat – like in the love handle area – getting some stem cells from the fat and their bone marrow either one or both. Then essentially just moving those stem cells somewhere else where we really need them.
For instance, if you have someone who has knee pain, it’s arthritis pain or they had a knee injury and they got some cartilage damage and their own body has not been able to repair it over time, one option is to take stem cells from that same patient from either their bone marrow or from their fat or from both, then concentrate those stem cells and put them back in the same patient’s knee at this really high concentration. Then those stem cells, once they get into the same patient’s knee, send out all of these repair signals and they’re like yelling at the cells around them, “Hey, we’ve got to get back to work. Let’s repair this tissue. Let’s make more cartilage. Let’s get more blood flowing here. Let’s make this knee pain better.” That’s what happens over the course of several months.
Kathy Smith: Is there a difference between how effective bone marrow is compared to fat? Is there a reason to use one over the other?
Amy Killen: That’s a big debate right now. When you go into stem cell circles and talk to different doctors, they all have their own distinct opinion. In our office, we tend to use, for musculoskeletal again, like knees, elbows, wrists, all those kinds of things, we tend to use bone marrow and fat cells together. Dr. Adelson found that the bone marrow cells work pretty well for almost everyone. So they’re pretty consistent. But that the fat-derived stem cells which are more plentiful in number, they tend to more often have sort of excellent results. They don’t work for everyone all the time, but when they do, the results are really good. So he puts those two together for most of his procedures when he’s treating pain, like neck pain, back pain, knee pain, ankle pain. He puts the two together and gets a really consistent response with some really excellent responses as well.
Kathy Smith: So it’s like getting the best of both worlds.
Amy Killen: Yes.
Kathy Smith: What about with some of the procedures that you do with the hair, the skin? I know a lot of people are talking about the amazing results you’re getting with the rejuvenation of the skin on your face. Where are you deriving the stem cells for those procedures?
Amy Killen: For my procedures, there are a couple of different options. One is just to use platelet-rich plasma, which you mentioned earlier – PRP or platelet-rich plasma. It comes from the patient’s own blood. We just get a little bit of blood from the patient, draw it from the arm. Then we centrifuge it or spin it and we concentrate the platelets, which are like the healing part of the blood. They have all these growth factors in there, and then we inject just those concentrated platelets into the skin. That’s been around for a while. That’s the vampire facial or vampire facelift maybe you’ve seen somewhere on social media. That’s a great starter way to do it, and it does do some of the same kinds of things that the stem cells do but just to a lesser degree.
The next step up from there is using what I call exosomes, which are the messaging component of the stem cells that we’re able to buy from a lab, and they come from umbilical cells. Essentially, they come in a frozen vial and I can use those. They have a similar effect, we think, to using actual stem cells, but they’re less invasive for the patient. The next option is using the patient’s actual stem cells, which I tend to use the patient’s fat-derived stem cells from their love handles with a mini liposuction, get the fat cells, and concentrate them and put them in.
Some patients want all of it. They want kind of the kitchen sink. So we’ll put all the things together and use those. That’s pretty common actually with our patients where I’m using stem cells from their fat plus these exosomes, sort of messenger bubbles, plus the PRP.
Kathy Smith: Does harvesting the stem cells from the fat or the bone marrow, does it hurt?
Amy Killen: That is an excellent question. It does hurt a little bit. What we tend to do now because a lot of times we’re doing these bigger cases anyway where we’re doing multiple injections. Maybe the person wants their knee injected plus they want their back injected plus their face and their hair. We tend to put them to sleep. So we have an anesthesiologist. We do moderate sedations so they’re still breathing on their own, but they’re very comfortable and not feeling pain. We tend to do sedation for most of these now because we found that the patients love it. They wake up and they feel good and they have no memory of any pain, which it seems to help them heal better and faster and even have a better response to the therapies, which is interesting.
If we’re getting your stem cells from your bone marrow or fat in our clinic, we tend to sedate you. Some clinics don’t. They keep you awake and that works well for them as well.
Kathy Smith: So everything we’ve talked about up until now is where you’re taking stem cells from your own body and then injecting them back into your own body. There’s this other approach, which is much more controversial, where you’re taking stem cells from different areas. There’s a lot of talk now about the umbilical cord. Back in the 1980s, there were headlines all over the place about the idea that they were using embryonic stem cells, and I think people had the wrong idea of where those were coming from. But it created a lot of controversy.
Now, we’re going into this idea of umbilical cord stem cells, but there’s still controversy about it. Can you explain what the pros and cons are of that approach?
Amy Killen: First of all, I’ll just say that embryonic stem cells, which you eluded to, are not used in clinical practices right now, because they do come from an embryo, which is like a five-day old embryo. You have to get the stem cells from it, and the embryo does not survive that. A lot of people had a lot of ethical concerns about that. The other problem with those kinds of cells are they tend to form tumors in patients. We don’t want to do that. So the embryonic stem cells are very different than what we’re doing now with stem cells.
The umbilical cord stem cells or placental-derived stem cells are from healthy C-section babies that the mother donates the placenta and umbilical cord to science, to a lab. Then the scientists are able to go in and isolate the stem cells from that cord that are young stem cells. So they’re still considered to be adult stem cells just like you have in your fat or your bone marrow. Obviously, they’re coming from an infant, but they still act like adult cells. They’re just more youthful.
That’s something that is being done in the United States and out of the country. In the U.S., there are quite a lot of regulations from the FDA, from the government and restrictions as far as what we can do with these umbilical cord cells. They’re still being used, but I’m not sure how long they’ll be used. There’s quite a bit going on with that with the FDA coming down on people for using different types of products. Certainly, outside this country, people are using these products and sometimes having excellent results with them.
Kathy Smith: When you use stem cells from an umbilical cord, those are going to be injected in an IV or something. Full disclosure here – about two months ago or a few months ago, I actually went down to Costa Rica to a medical center to have this done. I had researched it a lot and as we’re going through this discussion now, I had heard about the benefits, especially as you age, of having younger stem cells in your body. Can you explain to the listeners like when you have an IV, where do the stem cells go? You’re not injecting into a disc or you’re not injecting into your knee. So where are the stem cells going, and what is an expected result?
Amy Killen: The stem cells are just going into your blood stream. They go into the blood vessels and they cruise around your blood vessels. If they’re actual stem cells, a lot of them will get caught in the lungs, because the lungs are the first place that they tend to go. So they may stay there. But stem cells have what they call the ability to home, which is basically, they can go to areas of inflammation, areas that are maybe in distress in your body. So we use IV stem cells– and by we, I mean the medical community as a whole– uses IV stem cells sometimes for all kinds of things that have sort of systemic – so system wide, body wide problems.
For instance, autoimmune disorders. These are things like multiple sclerosis or rheumatoid arthritis or some of these things where the whole body is inflamed and the body’s fighting itself and there’s a lot of stuff going on. We can use IV stem cells – and they’re being studied quite a bit for treating these disorders, because these stem cells go in and they actually change the way the patient’s immune system is behaving. They can speak to the patient’s own cells and change the way the immune system is behaving and improve the symptoms of some of these diseases versus maybe you don’t have that, but maybe you’re pretty healthy. The idea behind using them in that case is, again, you don’t have as many stem cells as you get older. So there’s the theory that by giving people more youthful stem cells with all of their youthful signals that maybe you can restore or replenish the supply of stem cells and turn back the clock to some degree.
There’s still a lot of research in this field. We don’t know for sure how it’s going to work or the best way it’s going to work, but it seems to be that it’s leading in that direction of maybe being helpful even as a sort of anti-aging protocol.
Kathy Smith: Yeah. There are a lot of headlines. And the headlines are pretty extraordinary. They range from miracle cures and recently we learned of a second HIV patient in remission after stem cell treatment. Then you also read other articles about stem cells causing major issues in the body.
So it’s an exciting time, but it feels to me, going through it, a little bit of the wild, wild west. So it’s important to ask questions, to do your homework, and to continue the research obviously to understand this a little better.
But it’s interesting from my side. I have to say when it comes to the IV approach, one of the things that I heard from different people are, “How many stem cells are you getting? What’s the concentration? Have they been expanded? Once they get put back into your system, have they been frozen the right way? Have been thawed the right way, and are they still alive?”
That’s not really a specific question that you have to answer, but in general, how would you recommend somebody really make sure they’re doing due diligence besides coming to Park City. Because I know you guys are at the top of your game and you’re very cautious. You’re the best of the best. But what kind of recommendations would you have for people?
Amy Killen: It’s really difficult. I feel for everyone out there, because honestly, even though I am actually traveling around the world right now as part of a documentary project to look at the different ways that different countries and different providers are using stem cells, because it’s so different than what we’re doing in the U.S. But even with that knowledge, it’s hard to look at someone’s profile online and see if they’re doing it right or not.
At our office, we just treat very specific things. We only treat musculoskeletal pain and then do the aesthetics and sexual health. We’re not treating other diseases and making any claims about those things. I think that it’s best to do a lot of research about this with a specific doctor. For instance, if you’re getting stem cells for dementia, for instance, which is being done in Japan as well as some clinical trials here in the United States, who is doing the stem cells? Is it someone who has a knowledge of dementia? Is it a neurologist? Is it a neurosurgeon? Is it someone who has worked with dementia and has experience with that particular field? What is their experience with that field and with stem cells versus some random person on the street, some doctor on the street who’s giving stem cells and saying it’s for everything?
I think finding a specialist in the different areas is probably the best way to do it or at least someone who’s been doing that for a long time and really knows what they’re doing.
Kathy Smith: So it’s really about almost that same adage that we used to use in fitness. If it seems too good to be true, it’s probably too good to be true in the sense that if you’re getting a bargain price and they’re promising results overnight or whatever, you’ve got to look a little further and dig a little deeper.
But if you go into the right place, you’re getting it done, let’s talk about some of the results you can get. Because that’s what I think is so fascinating. Let’s switch over to some of the things you do and I know our listeners are excited to hear about. Let’s start with sexual vitality. I want to focus on women, because we had Ben Greenfield on the show. He told us everything that you did, how you helped him with the p shot. For people that haven’t heard that episode, if you go to the Ben Greenfield episode, it was about his penis. He’s very open about telling the story.
I think what’s sometimes ignored in this field and it’s because we hear a lot of guys talking about it is the female side of this. I am excited about it, because as we know, after menopause and honestly with aging and having babies, things start to change in your vagina. The skin thins and there’s stretching, the labia starts to shrink a little bit or maybe a lot depending on your age.
Besides all of the great sexual things I want to talk about, what about vaginal health in general? How can what you call the o shot help this area?
Amy Killen: First of all, I totally agree with you. I think that women’s sexual health doesn’t get nearly as much attention as it should and not as much as men’s sexual health, which I think is a shame.
I try to use several different technologies and things together for women’s sexual health. Certainly, the hormonal aspect is very important. As you mentioned, post-menopausal women with lack of estrogen and testosterone tend to have big changes in the vaginal flora. You have thinning of the vagina and you have loss of lubrication and loss of elasticity and all kinds of things. So I do think that looking at hormones and maybe even replacing hormones can be important – unless you have a reason not – to in really restoring this area.
The things that I do with the o shot– the o shot is traditionally an intervaginal injection which means an injection into the vagina kind of into the area of the g spot, which is on the front part of the vagina. I do injections there, maybe a couple. Then I also inject into the clitoris directly. And I use a numbing cream.
Kathy Smith: I was going to say, “Oh!”
Amy Killen: When I say that, it’s like “Aah!” But it’s actually not as uncomfortable as it sounds. We use a numbing cream. It’s pretty comfortable. In these areas, even with a couple of simple injections, a lot of women will say that they have improvements in everything from just pleasure and sensation and orgasm pleasure to improvements in lubrication. Because we’re actually bringing more blood flow to the area, which is responsible for lubrication. I’ve had patients tell me they’ve had improvements in tightness. And a lot of patients will also have improvements in stress urinary incontinence, which is when you jump or laugh and you kind of pee a little bit, and you don’t really have control over it – after you have babies especially.
That’s something that just by giving you some extra support in the urethra, which is the tube where your urine comes out. These simple procedures can sometimes make a big difference. These are just literally injections with a needle that’s a very tiny needle. It’s not surgery. You’re awake. It’s not a big deal. You’re at low risk. So I will pair that often with the hormone replacement or even vaginal lasers, which can also be really great in this population to try to really give patients back their sexual health.
Kathy Smith: Okay. I know that you’re big in using different modalities. You mentioned hormone replacement. You’ve mentioned the stem cells. I don’t know if it would be for this area, but one of the things I’ve heard you talk about is like a pulsar or a pounding.
Amy Killen: Oh, yeah. The Gainswave or the shockwave therapy?
Kathy Smith: Yeah, the shockwave therapy. Is that for men, or is that for women also?
Amy Killen: It can be. It’s been used most often for men. Gainswave is this protocol name, but the actual general generic name is low-intensity shockwave therapy, which is basically used as high-intensity sound waves that are going to restore a lot of the blood flow. We’ve used it quite a bit for men with erectile dysfunction or just want to have improved blood flow and firmer erections.
We’re starting to use it for women and seeing good results with that as well. Again, it’s no risk, super easy, 20-minute outpatient kind of thing, where basically we’re just improving the blood flow to that area with this device that uses sound waves. It’s pretty cool. We haven’t been doing it very long yet, but we are seeing some good results with that.
Kathy Smith: What kind of results are you seeing?
Amy Killen: The same kind of thing as the o shot. Basically, we’re improving blood flow. Before you have sex, improved blood flow is part of it so your clitoris gets engorged and then you also have lubrication which is coming from improved blood flow. So getting blood down to that area is really important for women in order to be able to enjoy the experience. So we can actually increase blood vessel formation and blood flow with some of these different techniques.
Kathy Smith: So let’s go from down below to up above. Let’s go back to the face. We started with the face, and you mentioned some of the things with the PRP, with the vampire facial that you mentioned then going into maybe stem cells. How does it compare with some of the laser things that have been done? To me, it sounds a bit like you’re aggravating the skin. You’re injuring the skin in some way. And that injuring then is causing your body to have to create the healing process which is going to increase collagen and is going, I guess, get stem cells there to heal it. And if you’re introducing stem cells, I guess it just heals a little better and faster and whatever. But is it kind of a little bit of the same concept of a laser where you’re going in and injuring some of the skin?
Amy Killen: In some ways, yes. You can actually also pair a lot of these treatments with laser treatments – like with CO2 lasers and those kinds of things. The end results are excellent. With both of those treatments, different types of lasers obviously are used, but you’re trying to increase the person’s own production of collagen and elastin and hyaluronic acid, which are the main components of skin that go down as we get older.
So it works in some of the same kind of ways. Some things are a little bit different. I think that lasers, some of them are focused more on specific things like tightening or removing the pigment from the skin, removing the dark spots from skin. Every laser has a different type of indication and so it’s used differently.
With the stem cells and the PRP, I tell patients what they should expect. And what I see is that it just, over time, it creates this much more youthful skin. So you have improvements in all kinds of things from texture and tone to color to age spots get better, scarring can get better, fine lines can get better. Certainly, it can help some with general tightness. Although, it’s not the same as a facelift either.
Some patients, if you have a lot of sagging and aging skin from that, then maybe a facelift is something that you need, if you decide you want it, that’s going to be the only thing that actually pulls that skin really tight if it’s gotten to that point.
For most people who are looking for something relatively gentle, they still want to look like themselves, they don’t want to look crazy and have a bunch of other random things in their face, but they want to look youthful and they want to look refreshed, then I think the stem cells are a great way to go.
Kathy Smith: How much does it cost approximately?
Amy Killen: It depends on what you’re doing and what you’re injecting. The PRP only treatments can range from about $1500 or $2,000 up to, if you’re adding in stem cells or exosomes, it can be several thousand dollars. Again, kind of depending on exactly what cells you’re putting into the face.
Kathy Smith: How often would you recommend doing it?
Amy Killen: With the PRP, I love to do PRP even on myself a couple of times a year if I can – two or three times a year. Of course, I have access to the stem cells and the exosomes. I’ll try to do exosomes on myself about once a year. Obviously, not everyone has access to all of these things, so I tell people, “If you can do maintenance with just PRP or even with just micro-needling by itself which is the little device that goes in and out with little needles that go in about two millimeters, then do the bigger procedures maybe once every couple of years or once every five years. Part of it depends on what else you’re doing for your skin.
Are you wearing sunblock or some kind of shade when you go outside? Because that’s the number one cause of aging is the sun. Are you using a good skincare line? Are you eating a healthy diet? What you put in your body is so important for your skin.
So if you’re taking care of your skin in general, then these kinds of therapies that I do are going to last a lot longer.
Kathy Smith: And add exercising to that list obviously.
Amy Killen: Absolutely. Yes.
Kathy Smith: Especially the yogas and the inversions, but also the strength training. I find that when I strength train, it releases different hormones into your body. Those hormones go a long way systemically in helping your entire body feeling more youthful and look more youthful.
Getting back to the skin on the face. You’re going through these different treatments and then go up to the hair. I know that you talk to men quite a bit about this, but females, especially after a certain age are talking about thinning hair. Does the procedure help that?
Amy Killen: Yeah, definitely. With males and females with various different types of hair loss, we can see improvements in both improving the number of hairs, so increasing the number of hairs as well as increasing the density of each hair or the thickness of each individual hair.
Hair loss in women is tricky, because it can be all different things. It could be their thyroid that’s out of balance. It could be stress. It could be they just had a baby. It could medication that they’re taking. There are so many things that cause hair loss in women that we ask a lot of questions first to figure out what it’s from. You want to correct whatever it is obviously as well. But sometimes hair loss is the same kind of hair loss that men have, which we call androgenetic alopecia, which is essentially a hormonal problem at the hair follicle. That’s pretty common in women. There are also some autoimmune disorders that cause hair loss as well.
But the protocol’s the same. I inject these regenerative things – the PRP, the stem cells – into the scalp around the hair follicles, not very deep, just superficial injections. Then I, oftentimes, will do the micro-needling on top which is a little device that goes in about two millimeters that I put the topical stem cells on. I see some great results with women just as I do with men.
Kathy Smith: What do you think is– I wish I could keep you on the show by the way forever, because there’s so much to talk about. But we touched on the different areas I want to touch on, which is sexual vitality, vaginal health. We talked about skin, hair. We didn’t have much time to get into pain; although, you covered it in the beginning. I do understand from reading the material at your website that you deal with a lot of people, especially from around the world and from around the United States, but especially here in Park City, because we have so many athletes– but knee pain, joint pain, back pain, shoulder pain and are getting terrific results with it.
This is an exciting time for you. I’m just wondering, what are you thinking is the future of all this stem cell therapy? Where are we going? What are you hoping that happens within the next five years, 10 years, 15 years? And will there be a time where regular medicine is really going to be all about this regeneration and this idea that our kids and our grandkids how when they go to the doctor, they’re going to go to the doctor and say, “My liver isn’t so great,” and they’re going to be able to get in there and regenerate the liver through stem cells. Is that the future of medicine?
Amy Killen: I definitely think that stems cells is the future of medicine. We’re already there in some degrees, but it just needs to become more accessible from a regulatory standpoint as well as from a financial standpoint to the masses. But at some point, in the not so distant future, we won’t rely on pharmaceuticals as much. If we can treat someone’s pain by actually repairing the tissue, repairing the knee, and getting it back to full working order, then they don’t need opiates. So all of a sudden, the opiate crisis is not happening or they don’t need other expensive medications. If we can do this in various parts of the body and for all different diseases, then all of a sudden, we’re not relying on drugs to kind of patch us up and get us through. We’re also not relying on surgeries as much.
So I do think that in the next five years, maybe 10 years, you’ll go to your doctor and he or she will be able to probably, off the shelf essentially, grab different stem cell protocols and therapies and treat your problem with those stem cells. Maybe they’re growth factors or different things, but essentially, regenerate and repair your tissue in real time so maybe you don’t need to be on protracted, long medical pharmaceuticals and such.
Kathy Smith: Isn’t that exciting? Oh, my gosh. You have to be kind of pinching yourself in some ways. You’re really at the beginning of this, and you are such a leader in this field. So hats off to you. I can’t wait. I’m going to come by. I think I’m going to come in for – even though it sounds like it hurts – a little of that vampire treatment here.
Amy Killen: Yes. Come in for sure.
Kathy Smith: I’ll see you around town. I really appreciate you being on the show. You’re just a doll for coming on. Thank you so much.
Amy Killen: Thank you, Kathy.
