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    #275 - AMA #52: Hormone replacement therapy: practical applications and the role of compounding pharmacies

    enOctober 16, 2023

    Podcast Summary

    • Challenging the Stigma of Hormone Replacement TherapyHormone replacement therapy is a valuable option for perimenopausal and postmenopausal women in improving their health, and it is essential to promote informed discussions and support for its use.

      Hormone replacement therapy (HRT) has been unfairly demonized in the mainstream medical community. The misinterpretation of the women's health initiative has led to a gross injustice for perimenopausal and postmenopausal women seeking hormone therapy. This topic is not only relevant for women but also for men who care about women's health. It is important to pay attention to discussions on HRT as it can help not only women but also those who support them. Additionally, the conversation around HRT also sheds light on the use of compounding pharmacies, which can be beneficial for those in need of custom prescriptions. Overall, this discussion aims to provide practical applications and insights for the use of HRT in women's healthcare.

    • Diagnosing Menopause and Tracking Hormone LevelsBlood tests, particularly measuring FSH and LH levels, can indicate the onset of menopause or provide insight into inconsistent periods. It is important to note that women still having periods are not in menopause.

      To confirm the onset of menopause, a clinical diagnosis requires 12 months of amenorrhea without any other obvious cause. However, there are blood tests that can indicate the approaching menopause or be useful in cases of inconsistent periods. The main hormone to look at is follicle stimulating hormone (FSH), which provides a sense of where a woman is in her trajectory towards menopause. FSH levels can be measured along with luteinizing hormone (LH). It is important to note that women who are still having periods, even if they are infrequent due to factors like the use of an IUD, are not considered to be in menopause yet. To gain a better understanding of female reproductive hormones and their changes throughout a cycle, watching the provided video on the subject can be helpful.

    • Measuring hormone levels for menopause diagnosis and fertility planning.FSH and LH levels around 20-25 indicate menopause, but diagnosis considers symptoms. AMH levels help with reproductive planning.

      Measuring FSH, LH, and estradiol levels on day 5 can provide valuable information about menopause. When FSH and LH levels rise to around 20 or 25, it indicates that a woman is in menopause. However, it's important to note that menopause is not solely diagnosed based on these hormone levels, but also takes into account other symptoms and medical evaluations. The most common symptoms experienced by women before menopause include hot flashes and night sweats. Other symptoms, such as vaginal dryness and loss of bone density, may occur later. Additionally, for those concerned about fertility, the anti-malaria hormone (AMH) can be indicative of ovarian reserve. Knowing AMH levels and their rate of decline can provide insights for reproductive planning.

    • Hormone Levels and Menopause: Understanding the ImplicationsMonitoring hormone levels, such as FSH, LH, and AMH, can help predict the timing of menopause and guide decisions on fertility and hormone replacement therapies.

      The levels of FSH, LH, and AMH play crucial roles in understanding menopause and its implications. Five years before menopause, FSH and LH are low, while AMH is high. As menopause approaches, AMH levels drop suddenly within a year or two, while FSH and LH rise. This graph displays these changes in hormone concentrations. Studies suggest that an AMH level below 0.2, combined with being over 40 years old, indicates a high probability of entering menopause within the next five years. FSH is also valuable in determining the timing of menopause. On the other hand, an AMH level above 1.5 suggests that menopause is at least six years away, making it helpful for those considering fertility options. Understanding these hormone changes can aid in managing menopausal symptoms and deciding on hormone replacement therapies.

    • Exclusive Member Benefits: Accessing a Wealth of Knowledge and ResourcesBy becoming a member, gain exclusive access to comprehensive show notes, monthly Q&A episodes, premium newsletters, private podcast feed, and valuable highlight reels. Peter values providing more value than the subscription price.

      Peter Attia is committed to providing valuable content without relying on paid ads. He achieves this through the support of his members, who receive exclusive member-only benefits. These benefits include comprehensive podcast show notes, monthly Ask Me Anything episodes, a premium newsletter with in-depth research, access to a private podcast feed, and a highlight reel of previous episodes. By subscribing, members gain access to a wealth of additional knowledge and resources beyond what is available for free. It's clear that Peter's goal is to ensure that the value provided to members far exceeds the price of the subscription. However, it's important to note that the information shared is not a substitute for professional medical advice, and users should consult their healthcare professionals for any specific medical conditions.

    Recent Episodes from The Peter Attia Drive

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    In this “Ask Me Anything” (AMA) episode, Peter provides insights on a broad range of important topics. He delves into the prevention of cognitive decline, the link between cardiovascular disease and Alzheimer's disease, and methods to lower blood glucose, insulin, and apoB. He also addresses nutrition-related queries, exploring the impact of dietary habits on weight loss and longevity, how a person can identify the best diet for themselves, and common nutrition myths. Additional discussions include optimal blood pressure, daily step goals, the benefits of standing versus sitting desks, and much more.

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    View the Show Notes Page for This Episode

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    The Peter Attia Drive
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    View the Show Notes Page for This Episode

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    Dena Dubal is a physician-scientist and professor of neurology at UCSF whose work focuses on mechanisms of longevity and brain resilience. In this episode, Dena delves into the intricacies of the longevity factor klotho: its formation and distribution in the body, the factors such as stress and exercise that impact its levels, and its profound impact on cognitive function and overall brain health. Dena shares insights from exciting research in animal models showing the potential of klotho in treating neurodegenerative diseases as well as its broader implications for organ health and disease prevention. She concludes with an optimistic outlook for future research in humans and the potential of klotho for the prevention and treatment of Alzheimer’s disease.

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    View the Show Notes Page for This Episode

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    The Peter Attia Drive
    enMay 20, 2024

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

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    In this “Ask Me Anything” (AMA) episode, Peter delves into the often misunderstood concept of inflammation. He first defines inflammation and differentiates between acute inflammation and chronic inflammation, the latter of which is linked to aging and a plethora of age-related diseases. Peter breaks down the intricate relationship between chronic inflammation, obesity, and metabolic health, and highlights the signs that might suggest someone may be suffering from chronic inflammation. From there, the conversation centers on actionable advice and practical steps one can take to manage and minimize chronic inflammation. He explores how diet plays a crucial role, including the potential benefits of elimination diets, and he examines the impact of lifestyle factors such as exercise, sleep, and stress management. Additionally, he discusses the relevance of food inflammatory tests and concludes by examining the potential benefits and drawbacks of drugs and supplements in managing inflammation.

    If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #59 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

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    The Peter Attia Drive
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    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

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    In this special edition celebrating 300 episodes of The Drive, Peter discusses a variety of popular topics and health interventions and classifies them based on their level of evidence and relevance using the following categories: proven, promising, fuzzy, noise, and nonsense. Peter first delves into the topic of geroprotective molecules, covering rapamycin, metformin, NAD and its precursors, and resveratrol. Next, he explores the significance of metrics like VO2 max and muscle mass, as well as emerging concepts like blood flow restriction and stem cells. The conversation extends to nutrition, addressing questions surrounding long-term fasting, sugar consumption, sugar substitutes, and the contentious role of red meat in cancer. Peter not only provides his current stance on each topic—most of which have been covered in great detail in the previous 300 episodes—but also reflects on how his opinion may have evolved over the years.

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    • The idea that sugar substitutes are dangerous [1:22:15];
    • The debate on red meat and cancer [1:28:45]; and
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    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

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    This is a special episode of The Drive with Peter’s friend and fellow car enthusiast Dax Shepard. In this podcast, which commemorates the 30th anniversary of the death of Brazilian Formula One legend Ayrton Senna, Dax sits down with Peter to better understand what made Senna so special and why Peter remains an enormous fan. This conversation focuses on Senna’s life, the circumstances of his death, and his lasting impact and legacy on the sport of F1.

    We discuss:

    • Peter’s interest in motorsports began as a child [2:30];
    • The drama and dangers of F1 [6:00];
    • What made Senna special [13:00];
    • What Senna meant to Brazilians [24:00];
    • The cause of the fatal crash [28:15];
    • Why Peter is obsessed with Senna [40:30];
    • Being the best versus having the best record [43:30];
    • Senna’s unique driving style and incredible intuition about automotive engineering [46:30];
    • Back to the day of the dreadful race [53:00];
    • What Peter believes caused the crash [1:02:45];
    • Views on dying young, in the prime of life [1:13:00];
    • Senna lives on in his foundation and in safety changes adopted by F1 [1:21:00];
    • Statistics aren’t enough for fandom, and why people like who they do [1:24:15];
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    • Senna’s driving superpower [1:30:30];
    • The fastest drivers currently in F1 [1:38:30];
    • Current F1 obsessions [1:45:00];
    • How hard it is to do what the top F1 drivers do [1:50:15];
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    • Awesome Senna mementos from Etsy [2:01:15];
    • What makes specialists interesting, and Max’s devotion to F1 [2:10:15];
    • What Senna might have done if he had not died that day [2:14:00];
    • Michael Schumacher and Max Verstappen are also top F1 drivers [2:17:30];
    • Interlagos in Sao Paulo Brazil is always an incredible experience [2:18:45]; and
    • More.

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    #299 ‒ Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

    #299 ‒ Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

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    Luc van Loon is an internationally renowned expert in skeletal muscle metabolism. In this episode, Luc starts with an exploration of the roles of insulin and triglycerides in endurance exercise, highlighting their impact on skeletal muscle metabolism, and he offers profound insights into the significance of protein in this context. He elucidates how different protein types and forms influence muscle protein synthesis rates, exploring the nuances of protein absorption, digestibility, amino acid quality, and their implications for performance and recovery. Delving deeper, he differentiates between animal and plant protein sources, unraveling the distinctive properties of various protein types, from the differences between whey and casein to the emerging trends in collagen protein supplementation. Moreover, Luc dissects the intricate connections among physical activity, lean muscle mass, muscle protein synthesis induced by resistance training, and dietary protein.

    We discuss:

    • Luc’s background and insights about fuel selection during exercise [3:30];
    • Fuel utilization during endurance exercise [9:30];
    • Fat metabolism, intramuscular lipids, and the nutritional dynamics of endurance sports [17:15];
    • The optimal window for replenishing intramuscular fat stores and glycogen post-exercise [25:15];
    • Luc’s interest in protein metabolism and exploration of amino acids' dual role as building blocks and signaling molecules in driving muscle protein synthesis [32:15];
    • How protein metabolism differs between sedentary individuals and those engaged in predominantly strength training or endurance training [38:45];
    • The basics of how proteins are digested and absorbed, and how muscle protein synthesis is measured [50:30];
    • How factors like food texture, cooking methods, and protein composition impact muscle protein synthesis, and the importance of protein distribution throughout the day [59:45];
    • Differences in whey and casein proteins, and the ability of ingested protein to stimulate muscle protein synthesis [1:03:30];
    • Dietary protein distribution and quantity for the maximization of muscle protein synthesis [1:09:00];
    • Muscle loss with age and inactivity and the importance of resistance exercise to maintain type II muscle fibers [1:17:15];
    • Differences between whey and casein proteins, and the importance of both quantity and quality of protein sources [1:28:30];
    • Optimizing muscle protein synthesis: exercise, timing of protein intake, protein quality, and more [1:37:00];
    • How to preserve muscle while trying to lose weight [1:46:00];
    • Anabolic resistance and overcoming it with physical activity [1:55:45];
    • Importance of protein intake and physical activity in hospitalized patients [2:06:30];
    • Reviewing the efficacy of collagen supplements [2:13:30];
    • Plant-based diets: how to ensure a balance of amino acids, and other considerations [2:20:30];
    • Future research: understanding protein metabolism in the brain [2:23:45]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

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