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Dr. Flavio Cadegiani: COVID Pandemic Resulted In a Loss of Compassion

[FULL TRANSCRIPT BELOW]“With the exception of the medical boards, all the authorities, or all the [organizations] in Brazil, they never wondered whether we saved lives or not. They just wanted to charge me as guilty.”

Dr. Flavio Cadegiani is one of Brazil’s leading scientists, specializing in endocrinology and sports medicine. He has published 25 peer-reviewed papers on COVID-19, including a landmark study showing a dramatic reduction in deaths and hospitalization in patients given proxalutamide, an affordable, off-label treatment.

“All the real good molecules that are out there, none of them belong to any of these pharma that try to push the vaccines and expensive drugs as treatments,” he says.

After the former president of Brazil began citing his research, Dr. Cadegiani became public enemy #1. Demonized as “anti-science,” he spent months under investigation and was ultimately vindicated by the Brazilian medical boards, which acquitted him unanimously of any wrongdoing in his clinical trials.

“I just can tell you that I used to be a very down-to-earth person, a very anti-conspiracy person. But some of the things that I really believed that did not exist, they actually do,” said Dr. Cadegiani, who considers the smear campaign against him to be a form of “sciencesplaining,” in which activists and members of the mainstream media who are not skilled in the scientific method lecture renowned practitioners such as Dr. Cadegiani about what constitutes “science.”

“When did the system go too far?” he asks. “I think that in COVID, this clearly happened.”


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Jan Jekielek: Dr. Flavio Cadegiani, such a pleasure to have you on American Thought Leaders.

Dr. Flavio Cadegiani: It is my pleasure too. It’s such an honor and privilege to have you here.

Mr. Jekielek: Your medical license was under attack. You were considered to be a very effective endocrinologist, and a very successful one. Some people have even called you Brazil’s greatest living scientist.

Dr. Cadegiani: Yes. They’re just being kind to me

Mr. Jekielek: To the point, you were recently vindicated, and I want you to tell me your story. What happened? Why did you need to be vindicated?

Dr. Cadegiani: It all started back in 2021 when we first announced our results through a presentation, just like all the companies did. By that time, Brazil was facing 3,000 to 4,000 deaths per day.

Mr. Jekielek: This was all because of Covid, of course.

Dr. Cadegiani: Yes, it was all because of Covid. There was nothing before Covid. After we announced the results, our former president, Bolsonaro, started mentioning our research in the national news all over the country, and congratulating the scientists. We’ve never received any support from the government in terms of finance or logistics. We never needed it. But because he started mentioning us, we had automatically become anti-science, because he was considered as the symbol of anti-science in Brazil. Science was being used as a slogan far from its original meaning, and we automatically became anti-science. The molecule we were researching was proxalutamide, a molecule developed in China, but it has nothing to do with Chinese politics.

We were actually looking for any molecule with the anti-androgen effect. They started to call it the new hydroxychloroquine. They started a very aggressive persecution against me, and they denounced me in different medical boards. Medical boards in Brazil are like here in the U.S. They are state by state, and then, there is a central one. They investigated me very thoroughly.

We are now the most analyzed trial in Covid so far. After everything had been analyzed very thoroughly, they were extremely neutral. This was something new, because before we were just being attacked, attacked, and attacked. It’s not that we were protected by anyone. In the end, there was a unanimous decision that there was absolutely nothing to charge us with. I was acquitted unanimously in both states where I was accused.

Many of the doubts regarding our trial were actually fabricated. It includes, for example, the suspicion that we poisoned patients to kill them so it would make false efficacy of the drug. The equivalent of the FDA in Brazil sent the placebo tablets for analysis to the federal police, which came up showing that there was nothing of interest.

Mr. Jekielek: Let me understand a couple of things here. First of all, you’re telling me that they accused you of poisoning the control, basically the placebo?

Dr. Cadegiani: Yes. There is no other reason why they would send the placebo tablets for analysis.

Mr. Jekielek: Because then you would’ve artificially inflated your-

Dr. Cadegiani: Yes, and I only learned this afterwards. I would have artificially increased the mortality rate in the placebo group, so that would show a difference. But that shows complete lack of knowledge on basic epidemiological data, because the mortality rate in the placebo group during the study was even a bit lower than in the same regions during that period. It makes no sense at all.

Mr. Jekielek: When you talk about we, you’re talking about your research group?

Dr. Cadegiani: Our research group. Yes, but I was the leader, I was the principal investigator. All the trials were under my name, so I am the man responsible. In northern Brazil, in the Amazon, I had a group, and in southern Brazil I had another group.

We had two phases of the study. The first one, in order to avoid someone saying that it was too good to be true, we extended as we were allowed to, as per the rules provided during the pandemics, and we have all this documented, we extended it to southern Brazil. These findings in southern Brazil were extremely similar to those in northern Brazil.

This study was double-blind, so neither the system doctors nor the patients knew who was taking placebo and who was taking the proxalutamide, the active drug. More than 95 to 97 percent of the time, the doctors were right regarding their guesses whether the patients were taking one or another one.

Mr. Jekielek: Because it had some efficacy, basically?

Dr. Cadegiani: Yes. The change in the course of the disease was actually dramatic. There was a city called Tapaua that, by logistics, received more active drug than placebo. In this hospital in the middle of the Amazon an average of 13 to15 people were dying per day. After the study started, it changed to 13 to 20 people being discharged alive per day. That was dramatic. I went there every five days, and the second time I was there, I couldn’t believe my eyes. It is very hard to say that this was not real.

Mr. Jekielek: How big was the study or both phases of the study?

Dr. Cadegiani: In both phases, there were almost 800 patients enrolled.

Mr. Jekielek: I’ll also mention, you didn’t go into this as an activist for this molecule. You were just doing an exploratory study.

Dr. Cadegiani: Exactly. Actually, I was an activist to save lives, regardless. We wanted to prove and demonstrate the androgen theory. We first observed that men were disproportionately affected compared to women matched with the same age, same body mass index, same body weight, and same comorbidities. We noticed that there was something inherently related to sex. Shortly afterward, we discovered that men with alopecia, bald men, were more severely affected than men with normal hair.

It matched with a molecular discovery in March 2020 that SARS-CoV-2 needs to be prepared by a protein called TMPRSS2. With this protein, the only endogenous regulators are androgens, which are hormones with testosterone action. But it doesn’t mean that higher the testosterone, the worse it is, otherwise young men would be the most affected. It is more about the balance between dihydrotestosterone, which is DHT, and testosterone. By the way, finasteride or dutasteride also have some action for Covid, and their action is to block the conversion from testosterone into DHT, and it’s used for baldness.

After this, we also found that women with polycystic ovarian syndrome, PCOS, were also more severely affected than women without PCOS. Our finding was from back in 2020, in my clinic, which was further confirmed by the UK Biobank data. It showed that hyperandrogenism, excessive androgen activity and sensitivity, and age were the most important predictors of COVID severity.

We must understand that unlike other viruses, Covid-19 had a very wide variety of severity. Within the same variant, it goes from asymptomatic to a deadly virus. It depended more on the host than on the virus. Understanding this, we needed to focus on host factors, rather than on the virus.

Mr. Jekielek: You’re one of the first endocrinologists on the show talking about Covid. The lens you look through is somewhat unique, compared to many of the doctors.

Dr. Cadegiani: Exactly. With Covid, the other factor is ACE2, a protein through which SARS-CoV-2 enters a cell. ACE2 is regulated by a system called renin-angiotensin-aldosterone, which is basically what causes hypertension. These are dysregulated in metabolic and inflammatory diseases, which may explain why obesity and diabetes are also important risk factors.

It calls me to understand that endocrinology should have paid more attention to this. In August 2020, I published a review of the potential drug classes that could be helpful for Covid-19. Two-and-a-half years later, a meta-analysis was published showing that the exact same drug classes were protective. That means that what I predicted back in August 2020 was further verified, not that they were used for Covid, but for chronic users.

Covid made doctors think we were supposed to think about the pathophysiology of the disease in order to understand how to treat it. What causes disease is complex with multiple targets. It is unlikely that one single molecule like ivermectin alone will be 100 percent effective. Of course, studies will never show 100 percent effectiveness. We should have conducted trials with combinations.

It’s funny because you do see Paxlovid is a combination of two different antivirals. There are other monoclonal antibodies that were combined. So why, when we proposed drugs, did we not combine different drugs? There are several other flaws in these trials on ivermectin I could mention here, but basically it seems that we were prohibited to think about the disease. Where is the medical rationale? Why didn’t we learn the basics in the clinic, so at the right we could go where it was needed most?

Mr. Jekielek: How did you predict these compounds would be effective, as was shown in this meta-analysis?

Dr. Cadegiani: It was based on their mechanism of action, as simple as that. It was based on how they act, directly and indirectly. Based on our current knowledge, I said, “Let’s look at anti-diabetic drug classes and drugs for fatty liver disease. These other drugs for estradiol replacement therapy would be beneficial as well.” It was according to their mechanism of action, and it wasn’t so hard to predict.

Mr. Jekielek: Please tell me about who you are, and how you came to be running this research team.

Dr. Cadegiani: I am a trained doctor, and I had my residency in internal medicine. Afterwards, I had my training in endocrinology and took my board certification in endocrinology. Then, I started with something which is not very common in the U.S., a double career. I started my own private practice with a clinic, and my research career with my MS, and then, my PhD in clinical endocrinology.

Both were successful, thankfully. I never wanted to stop both, even after my PhD. After I obtained my PhD degree, naturally, I wanted to extend my research. There is something that I always tell people. A PhD is a doctor of philosophy, so we are supposed to be thinkers. I started a new area of study, sports endocrinology, from the perspective of the endocrinologist, which is completely different from the perspective of other areas.

My research was pretty new. We published more than 12 papers from my PhD. I published a book afterwards on overtraining syndrome. I also discovered a new phenomenon called hormonal conditioning. We have cardiovascular conditioning, we have musculoskeletal conditioning, and we discovered that our hormones also get conditioned, even to stimuli not related to exercise. Those who are physically active tend to respond better. This may explain why athletes that do not under-eat and who are healthy, tend to respond better to infections, to cancers, and several other diseases.

We filled in some of the gaps. My tutor, a great guy, did not know anything because nobody knew anything about the subject. But he was there to guide me and he did an amazing job. I’ve always been a thinker and a questioning person. When it came to Covid, it wouldn’t be any different. I don’t think there is truth or beauty in absolutism, which doesn’t mean that I will be a hyper-relative person. It means that absolutism brings you a non-rational answer, a more visceral answer.

In early 2020, we heard about the compassionate use of drugs, which means, why do we not have therapeutic options? Let’s use what we have on hand, what we have in terms of evidence so far, but that was lost. The loss of compassionate use came together with the loss of compassion for others, which started happening in May to June 2020. There were expressions that killed me like, “There’s no evidence.” Goodness, no evidence. Everything is evidence. They could have said, “There is insufficient evidence to put this into practice.”

I published 25 peer-reviewed papers on Covid, indexed in PubMed. In one of the papers I published, we conducted an observational study, for which they tried to pretend I was a fraud. They were never able to prove it. That came back in July 2020, when we just followed patients. Those who were not treated were so much worse than those who received a type of treatment like ivermectin, ethosuximide, or hydroxychloroquine. Then, it became ethically questionable to conduct trials with no active standard of care. And that is published.

We saw something called clinical equipoise. What is that? For example, when you have an acute lung edema, there are no randomized, clinical trials testing furosemide, because we already know that it saves lives, and you won’t test it. This is clinical equipoise—it’s so clear and there is so much strong plausibility that nobody will use a few people to test whether this works or not.

This would be basically the same, because none of these drugs were actually harmful in their correct dosage. We demonstrated that it was unequivocally wrong to conduct trials with pure placebo without any type of active support. In all of our trials, there were drugs and we just added proxalutamide or dutasteride or spironolactone.

This was a learning back from 2020 they were pretending not to see, which really shocked me. But we may be able to revisit all these findings later when we calm down, because we really need deep reforms in the health system, the regulatory system, and the scientific system. Who controls science? It’s the journals and the editors, and basically they shape science according to what they want to publish or not publish.

I was just rejected for a paper on ivermectin with no weaknesses in the methodology, but based on the fact that they don’t want controversy about ivermectin. We are not able to publish certain things, not because it’s not good, but because they don’t want to publish it. There won’t be science on ivermectin if they do not allow us to publish. They are shaping science. They are true controllers, and who controls them?

Mr. Jekielek: Please tell me about this paper that you submitted. Methodologically, they said it looks good.

Dr. Cadegiani: Yes, they were not able to criticize it. They would be very ready to criticize everything. They were not able to find any flaw to give as an excuse. They just said, “We don’t want to publish it because it is too controversial.” It’s not even based on scientific standards anymore. I am an editor for BMC Endocrine Disorders, and I’ve never seen this. But even in the BMC series, which is part of Nature, I tried to publish another paper. It’s called BMC Infectious Disease, but they asked me not to do it because of these controversies.

The most prestigious journal on the planet, the New England Journal of Medicine, its editor-in-chief, Eric Rubin, rejected my paper on proxalutamide after reviewers had accepted it, because they were not able to analyze the data. They need to analyze the data to check the veracity, and they do not have the capacity to analyze the data, which actually means they do not analyze the data they publish.

Mr. Jekielek: Let me jump in here. They said, “We don’t have the capacity to analyze the primary data.” But you’re saying they don’t have the capacity to do that for any study or just your study?

Dr. Cadegiani: No, they don’t have the capacity to analyze the data for any study. If they do not have the capacity to analyze our results, of course, they cannot analyze other studies as well. They just believe the results presented to them. With a journal like the New England Journal of Medicine, my previous impression was that they were obliged to analyze the data from a statistical perspective to check whether it was true or not.

How come they do not analyze what they publish? This comes along with the Surgisphere fraud that was published in both the Lancet and New England Journal of Medicine almost simultaneously, which is also strange. How was the review process? How did they accept the papers?

Mr. Jekielek: Remind us quickly about the Surgisphere fraud.

Dr. Cadegiani: Coincidentally, after the vaccines had been launched, after the acceptance of the speed-up of the process going into the approval, Surgisphere was a group that published negative data on hydroxychloroquine in one, and negative data on other drug classes in another one, clearly aiming to suppress any early treatment, because for the emergency approval of the vaccines, there could not be any therapeutic option.

I’ll give you other examples. With Pfizer, why did they only start these Paxlovid trials after the approval of their vaccines? They already had the molecules. Why didn’t they start the trial back in early 2020? I’ll tell you more. There’s another drug, enzalutamide. They finished their study in November 2020 with dubious results, where it might be good in terms of mortality rate, or might be bad in terms of hospitalization length.

The study was completely flawed. The editor-in-chief was never able to respond to one single question from my questions, and I’m very doubtful. I really wanted clarification. They could have gone both ways with the study. They could have used it to try to prove enzalutamide, or they could have killed it. They decided to kill it because Paxlovid was here. They held it for more than one year until they started to submit this paper, which means that they were on hold.

Mr. Jekielek: Basically until the emergency use authorization of the vaccine.

Dr. Cadegiani: Yes, and to check whether they would be more benefited from Paxlovid or enzalutamide.

Mr. Jekielek: Right. Fascinating.

Dr. Cadegiani: Everything makes a lot of sense. I haven’t found any other plausible explanation for any of this. We had a very orchestrated campaign, and those with limited IQ, and even researchers and those with PhDs just repeated what the media said. Obtaining a PhD does not mean that you’re smart or brilliant at all. There were those who were afraid to speak out or just wanted to virtue signal. They were just repeating. They were prohibited from thinking and prohibited from questioning.

There was a massive campaign. They basically did collective gaslighting on the treatments and on those who dared to speak out. If you have just a minimal sense of perception, you don’t need to be that smart on this. You are able to notice this, unless you have some interest behind it.

Mr. Jekielek: One of the things I’ve noticed throughout the pandemic, there were some issues where the media was very, very active in pushing a very specific view by repeating the same idea again and again. This happened with a few things during Covid and some other things before. I met people who believed what the media was saying, but that was the only area where they had a blind spot. It’s almost like they were brainwashed. I don’t know if you saw anything like that.

Dr. Cadegiani: We do see various colleagues who are extremely skilled in basically everything. They have great opinions and a sense of criticism, but when it comes to these vaccines and the treatments, they seem to be blocked. I would say instead of brainwashed, they were brain frozen. They created a whole sociological movement. If you’re from academia, it’s very hard for you to accept this concept of different ideas and different voices speaking and bringing in their hypothesis. Science is not one person, and science is not a religion. Science is the collective of ideas and findings.

Science is now being used as a slogan, more like politics than the original scientific meaning. I am a scientist. Because my opinion is different from those more popular with the mainstream media, it doesn’t mean that I’m no longer a scientist, or a science liar. I’m not one of their scientists with no skills in science telling me what science is. That is basically scienceplaining, I would say. This is complete gaslighting.

Mr. Jekielek: Scienceplaining, is that what you said?

Dr. Cadegiani: Scienceplaining, yes. They’re trying to explain what science is to a scientist.

Mr. Jekielek: I haven’t heard that before. That’s funny.

Dr. Cadegiani: I just invented it. It is a collective gaslighting process. It’s not easy to have your voice silenced and to be persecuted all the time. Their true freedom is gone. I can tell you by my own experience, they were never concerned about life. For example, with the exception of the medical boards, all the authorities in Brazil never wondered about whether we saved lives or not.

They just wanted to charge me as guilty. They had that desired outcome. They discarded absolutely everything that could favor me. They just made falsehoods in their arguments in order to create a story. This was so bad that the federal police invaded my house and my clinic last August trying to find something.

This was very like the mechanism of phishing, as we say. They invented the story. They truly invented the story saying there was a worldwide drug dealer, or something like that. But, that was very unlikely. They were trying to find tablets from a drug dealer for treatments for Covid-19.

They invaded my house in order to find those tablets of proxalutamide or whatever they felt like looking for. They took my computer, they took my mobile, and they still haven’t given them back. I had to get new ones. This is completely abusive. They went really hard on me on this, but I’m not making myself into a victim at all. I do not regret anything I have done for these patients and all the lives we saved.

Answering them, we did save a lot of lives. They know we saved lives. It is clear, and it’s pure mathematics. They could have said, “They may have saved lives, but they didn’t follow this or that rule.” They were not able to tell us which rule we did not follow, because we followed all the rules strictly. They were not concerned about saving lives at all. They didn’t care. In their statement while trying to attack me, they said, “The rules mattered more than lives.” I needed to read that ten times to believe that it was actually written.

Mr. Jekielek: They wrote that?

Dr. Cadegiani: Yes, “Even if the objective is to save lives, rules are more important than those lives.” I couldn’t believe that. This sequence of persecution involved several different agencies and they were connected to each other. Can I call them the mafia, although they’re supposed to be official government agencies? They were very connected. They were illegally using authority, and they made unprecedented decisions.

I’ll give you an example. They suspended my research on September 3, 2021, based on a late meeting on September 1. In Brazil, every meeting in public service needs to be documented. But this one was not documented. Then, we discovered that they communicated the decision on August 27. They are not able to explain how a decision supposedly came from one meeting, but the decision was actually made before the meeting.

Mr. Jekielek: That sounds suspicious.

Dr. Cadegiani: A little bit suspicious, right? But because they think they’re protected by the mainstream media, they think they can do anything. But I can tell you, the check comes for everyone.

Mr. Jekielek: Here’s a question. Why do you think the medical boards that vindicated you in multiple states were different?

Dr. Cadegiani: Yes, in two different states. In the end they focused on two different states.

Mr. Jekielek: The north and the south.

Dr. Cadegiani: They were just neutral. They went through a very thorough analysis of the data of what we did. They gave us the true right to defend ourselves, unlike the other places. We showed that everything that was being said about the study was absurd. A person that had no capacity, no ability, and no competence to evaluate our study spread the words illegally. He could not have spread the words outside, it was confidential. It was made up with a paid news article in the British Medical Journal. They were paid to write an article against me.

Mr. Jekielek: Using this leaked information?

Dr. Cadegiani: Exactly. They could have used it, and we told them that. They ignored it completely. It’s very weird how they acted. The British Medical Journal acted quite unethically. They did not pay attention to what was obvious. Now, we are going to send them the documents. Because the medical boards are the ones who are in charge, and who evaluate the medical ethics behind the research. They just gave me the chance to defend myself. As I said, they were neutral and impartial. All we needed was someone to hear me and to understand what happened.

Because there was no such material or real arguments that could be sustained against that very first defense of mine. These other authorities kept changing their narrative with the arguments I brought. They kept changing all the time, with something different, something new, something they invented out of nowhere. When we asked them to specify, they were not able to. They wanted me to send the patient data. They wanted me to send the results, the names of patients and all the identifications throughout the internet, which could have been stolen and published and leaked.

Those who are investigators know the importance of maintaining the confidentiality of these patients. I offered to go and show them. They did not accept. They did not understand the importance. They acted very unethically by telling me that the study was irregular,