One way to figure out what real orthobiologics look like is to review some of the stuff I get sent. This week an educated patient left a comment on one of my posts. This lead to a several day investigation into the clinic in hopes that I could educate more patients about how to avoid therapies which are advertised as one thing, but the reality is quite different. Let’s dig in.
The Comment that Was Left
“I went to a seminar recently in Edmonton, Alberta, Canada. They gave a number of talks in the Edmonton Area. The talks were given by a paid professional speaker about stem cell treatments. The place they were promoting was “Montana Regenerative Medicine & Anti-Aging Institute.” They have no website. I looked before I went. There is no doctor connected to this place. The brochure they handed out shows a Nurse Practitioner and a couple of office staff people. The speaker admitted that a Nurse Practitioner does the injections. When questioned by me in front of the audience, he said Nurse Practitioners have the same training as doctors. I said no they don’t. I am a Nurse Practitioner. They were offering a discount for booking that day and throwing in extra amniotic stem cells along with an injection and even an IV infusion of stem cells, all for about $4000. I would never go to such a place but what worries me is guidable people who do not know or do not do their research. They scheduled to come back to the Edmonton are again now to offer lots of talks by the professional speaker. I am very concerned about such places…It is a pressure sales tactic.“
Let’s digest this a bit. This patient went to a seminar. That may or may not be bad, depending on what’s said. In this case a Montana clinic was using a professional speaker to advertise a nurse practitioner providing “stem cell” injections. This was a high pressure, “money off if you buy right now” type event.
More Research on Montana Regenerative Medicine & Anti-Aging Institute
A quick google search shows that it appears this is an endocrinology office? However, further searches show that two nurse practitioners work there. There isn’t much of a website as very little can be found there. but I did notice these parts of their web-site:
So we will certainly explore how much science there is to support what they do.
Here we see lots of mentions of “stem cells” and in particular “mesenchymal stem cells”. So we will also need to investigate if they’re offering stem cells or something else.
What’s Being Claimed vs. What’s Reality?
We have a clinic that says it’s science-based and a patient who went to a “stem cell” seminar and a website that uses the term stem cell many times. To investigate further, I had one of our staff experts call to see what they were doing:
- The injections are only performed by the nurse practitioners
- No imaging guidance is used, so these are blind injections
- They only use exosomes, so no stem cells are used
What Are Exosomes?
Exosomes are little packets of chemicals that are excreted by cells. They’re how most cells in the body communicate. To understand this better, see my video below:
Hence, exosomes are NOT stem cells, but how stem cells and other cells communicate. They can be seen in cultures where stem cells or other cells are being grown. You can then take the media from that culture (the fluid in which the stem cells grow) and then run it through a special centrifuge to concentrate the exosomes. You can bottle and sell this stuff, but there’s one problem. Since this product is made using the culture of cells, it’s illegal to sell without a drug approval. That hasn’t stopped many companies from selling vials of exosomes and many clinics from buying and using exosomes.
So if we use a construction site metaphor, the stem cell is the general contractor and the exosomes are the orders he or she barks out. Those orders change drastically based on the scenario at the construction site, what needs to be done, what’s working and not, etc… Hence, injecting exosomes without stem cells doesn’t make a ton of common sense. A bit like tape-recording the orders of a GC on one construction site and then playing them back (without the GC) at another different site. This is why we throw away trillions of exosomes every month at our licensed Grand Cayman clinic where they can culture stem cells.
Claim 1: This Treatment is Backed by Science
So what science exists that exosomes will help or cure some of the conditions discussed on the website of Montana Regenerative Medicine? As of today, I can’t find a single human study on any common problem like knee arthritis or shoulder rotator cuff tears where exosomes were used. Not a safety study nor a study showing if this works or doesn’t work. So much for “Backed by Science”.
Claim 2: Mesenchymal Stem Cells are Used
As discussed above, we confirmed via phone that no mesenchymal stem cells or other stem cells are used. The clinic staff stated that they used to use umbilical cord tissue (which contains no live and functional MSCs), but now they only use “exosomes”. Again, these are not stem cells and there are no clinical publications showing that this approach is effective.
Standard of Care?
First, I have written many times that mid-level providers like nurse practitioners and physician’s assistants should not be offering investigational care that is not yet standard of care. Second, as revealed here, this clinic uses blind injections which would be the lowest level of care possible on our quality scale of orthobiologic injections:
Basically, “Level 0”.
This clinic doesn’t have much of a digital footprint, so all that comes up in a Google search is a very sparse website and a few standard clinic review sites. Hence I clicked on the HealthGrades reviews, more to find out additional information about the clinic. However, that’s when things got weird. I looked at the reviews and they were all 5-star in the first 5 pages except for 1 that was one star and one 4 star. In addition, none of these 112 reviewers had a profile picture and many were very generic. To get a sense of how this stacked up against the best “over the top” fancy hotel that I have ever stayed at where even my teenage kids commented on the stellar service (the first time ever they made that comment), I compared the two. On the left below are the first 50 reviews for Montana Regenerative and on the right are the reviews for the best hotel ever. Note the distribution of reviews on the right. They look skewed towards 5-stars, but there are clearly some 4, 3, 2, and 1-star reviews. Now, look at Montana regenerative on the left. 48/50 reviews I checked were 5 stars. In fact, the lady that left the one-star review also commented that the other reviews looked fishy. So is this clinic buying reviews from a click farm? Is that part of the same marketing package that includes someone giving lectures in Canada? I can’t say for sure. Perhaps the service is that good?
Another Disturbing Trend?
Given that there are hundreds and now possibly thousands of clinics advertising for things they don’t really offer, I try to pick clinics that represent a specific type. In this case, one that uses aggressive sales tactics in a seminar (likely through a third party who has little idea of what this clinic really does), then uses mid-levels instead of physicians, and who claim that they have science and stem cells on their side, but neither one of those claims is true.
The upshot? So was our patient that commented right? My review shows that there are quite a few issues here. The first is that what the website says is being offered isn’t being offered. Second, are the obvious aggressive sales tactics that our patient experienced. Finally, there is no science supporting that you would want to get exosome therapy at this point.