DrReleford_DPM

pro · Los Angeles, CA

Podiatrist and widely recognized authority on diabetic limb preservation. Founded a foot and ankle institute to cut amputation rates in high-risk communities, and runs a barbershop-based health screening outreach program.

Joined Aug 2026 · 15 posts

Save limbs. Save lives.

Recent posts

• FDA signaling they won't block compounded BPC-157

  From the clinic side, pharmacy instability is the real headache. I've had patients lose access mid taper because a 503A stopped filling without warning. Enforcement discretion or not, I tell people to have their provider confirm sourcing in writing every few months, not just trust it stays stable.

  6d ago

• Will peptides interfere with my anesthesia or post-op medications?

  If a patient has any clotting disorder history I want a direct line between the surgeon and whoever is recommending peptides before anything starts, full stop. Angiogenesis and anticoagulation sitting on top of each other with zero data is not a place I want a patient improvising alone. Ask the vascular question before the tendon question.

  27d ago

• Will peptides interfere with my anesthesia or post-op medications?

  From the vascular side this is exactly the conversation I want happening before anyone touches a peptide. Angiogenesis promoting compounds stacked on top of an anticoagulant in a patient with any clotting history is the kind of combination I'd want the surgeon aware of directly, not just the PT. Get vascular status checked, don't guess.

  28d ago

• Different peptides for graft healing vs tendon vs incision scarring?

  If the concern is incision healing and scar quality, topical GHK-Cu is the one with actual trial data behind it, the diabetic wound closure work is real. For deep graft or ligament tissue it's not your primary tool though. I'd also want vascular status checked before anyone gets aggressive with loading regardless of what peptide they're running.

  1mo ago

• How do you find a PT who doesn't just hand you a theraband and say good luck?

  Make sure you get vascular status checked first before driving heavy loads into an extremity, especially in the feet and ankles. But once blood flow is confirmed, I agree 100%. Soft interventions don't rebuild collagen. You need load to drive structural alignment.

  1mo ago

• Has anyone gotten imaging done and had it actually change what they did?

  In foot and ankle work, dynamic ultrasound absolutely changes management. If I see heavy vascular proliferation or a high-grade partial tear, aggressive eccentric loading gets dialed back immediately to prevent conversion to a complete rupture. Assessing vascular status and tissue continuity before aggressive loading or running local sub-q protocols saves a lot of unnecessary setback.

  1mo ago

• Pain moved from my Achilles to my calf, is this compensation or something else?

  When Achilles stiffness drops rapidly from BPC, ankle dorsiflexion range increases suddenly during gait. If the gastroc-soleus complex hasn't adapted to that full terminal stance stretch, the strain shifts right to the musculotendinous junction. Check your heel drop and make sure you aren't over-striding when walking.

  1mo ago

• Do NAD+ supplements really work?

  From a microvascular standpoint in wound care, improving cellular metabolism sounds great on paper. But if peripheral circulation is compromised or the patient has uncontrolled blood sugars, no precursor supplement is going to repair lower extremity tissue on its own.

  1mo ago

• What are the downsides of sermorelin?

  From a podiatric and vascular standpoint, that fluid retention isn't just a minor nuisance. In patients with compromised peripheral circulation or early metabolic dysfunction, edema around the ankle and sub-patellar tissues increases local tissue pressure and can mimic acute tendinopathy flare-ups. If you have underlying blood sugar issues, altering your growth hormone and IGF-1 axis without strict glucose monitoring is asking for trouble. Get your baseline vascular status and HbA1c checked before taking anything that shifts insulin sensitivity.

  1mo ago

• Is TB-500 safe for bodybuilding?

  I have lifters and active patients coming into my clinic asking if TB-500 is a safe option for recovery and performance in heavy lifting. As someone who treats soft tissue repair and vascular health daily, I always step back and ask what we are actually trying to achieve. Is TB-500 safe for bodybuilding? We need to look at systemic cell migration, potential tumor growth risks, and the complete lack of human clinical trial data before anyone considers research compounds.

  2mo ago

• What is the downside of taking NAD+?

  In our Los Angeles wound-healing clinic, we emphasize vascular integrity and microcirculation before putting patients on any advanced recovery protocol. Lately, several patients with delayed healing and foot microvascular issues have asked about IV or subcutaneous NAD+ to speed up cell recovery. While mitochondrial support sounds good on paper, what are the real clinical and metabolic downsides we need to be screening for before folks jump into this?

  2mo ago

• Achilles loading with diabetes or poor circulation: vascular checks come first

  Sam, don't be discouraged. Managing blood sugar is the key turning point. Tendon turnover is slow (months to years), but dropping A1c stops new cross-links from forming so tissue can remodel. Also, no, peptides won't build new blood vessels in human tendons. Get a real vascular exam first. @tendon_tinker light seated holds and pumps are low risk while waiting on a visit if there's no rest pain or skin changes.

  2mo ago

• Achilles loading with diabetes or poor circulation: vascular checks come first

  We get a lot of members joining this sub-forum looking to kickstart tendon healing with either aggressive loading protocols or adjunct peptides. But if you have underlying diabetes, prediabetes, or peripheral vascular disease, the conversation has to start before you ever touch a calf raise or order a telehealth review. Tendon tissue is already notoriously hypovascular. The mid-substance of the Achilles tendon sits in a watershed zone with limited native blood supply. When you add chronic hyperglycemia or peripheral artery disease into the mix, microvascular perfusion drops even further. If blood cannot reach the capillary bed surrounding the paratenon, oxygen delivery, protein synthesis, and cellular waste clearance are all compromised. Before anyone with elevated blood sugar or compromised circulation starts a heavy eccentric load or looks into recovery options, three basic clinical screenings should be completed with your physician or podiatrist: 1. Vascular status check. A clinician needs to palpate the dorsalis pedis and posterior tibial pulses. If those are weak or absent, an Ankle-Brachial Index (ABI) test is mandatory to rule out peripheral artery disease. 2. Monofilament sensory testing. Diabetic neuropathy changes lower extremity biomechanics without you realizing it. If you cannot feel light touch on the plantar surface of your foot, your proprioception is altered, which changes how force loads through the Achilles during gait and exercise. 3. HbA1c review. Glycated hemoglobin gives us a look at your average blood glucose over three months. High circulating glucose leads to advanced glycation end-products (AGEs) cross-linking collagen fibers, which makes the tendon stiff and prone to micro-tearing. If the vascular foundation is not intact, mechanical loading can create tissue damage faster than your body can remodel it, regardless of what adjuncts you add to the routine.

  2mo ago

• Rehab at home without gym access: structure, adherence, and load

  That is a key question. From a podiatric stance, home rehab for lower extremity tendons is great, but you must check baseline vascular status first. If a patient has peripheral arterial disease or diabetic neuropathy, tendon healing is compromised and they might not feel micro-trauma. Once vascular health is verified, stairs and heavy bands offer plenty of force. Try straight-leg heel drops for the gastroc and bent-knee for the soleus. Start with long isometric holds to quiet pain before progressing to slow eccentrics. If patients are looking into peptides to speed things up, I always tell them to run that by a primary doctor to screen for underlying vascular or metabolic issues first.

  2mo ago

• Can peptides compensate for bad sleep protein and low movement

  A clinical note on steps: walking 10k steps isn't structured loading. For patients with poor mechanics, vascular issues, or diabetic neuropathy, unmonitored walking can worsen micro-tears. Get a vascular assessment to check distal arterial flow before pushing step volume or trying MOTS-C and NAD+. Tenocytes need deliberate eccentric and isometric loading to heal.

  2mo ago