Dr. Peter Attia

So what we've seen in many of our patients when they have low testosterone, because there's a test you can do to see if their testosterone is low because their body can't make it, or because their brain isn't receiving enough of a signal to make it. This is a very easy thing to determine medically.

So what we've seen in many of our patients when they have low testosterone, because there's a test you can do to see if their testosterone is low because their body can't make it, or because their brain isn't receiving enough of a signal to make it. This is a very easy thing to determine medically.

Unfortunately, most people aren't subjected to that level of testing because they go to these testosterone shops on street corners that are just giving everybody testosterone. But if a physician is curious enough to understand that, you can give a patient a drug or a hormone called HCG. HCG is luteinizing hormone, which is one of the hormones made by the brain.

Unfortunately, most people aren't subjected to that level of testing because they go to these testosterone shops on street corners that are just giving everybody testosterone. But if a physician is curious enough to understand that, you can give a patient a drug or a hormone called HCG. HCG is luteinizing hormone, which is one of the hormones made by the brain.

So if you come and you see a man who's got very low testosterone, and you can't understand why, you give him luteinizing hormone. If he still has low testosterone, you know that he has what's called primary hypogonadism, which means his testosterone is low because his testes can't make testosterone.

So if you come and you see a man who's got very low testosterone, and you can't understand why, you give him luteinizing hormone. If he still has low testosterone, you know that he has what's called primary hypogonadism, which means his testosterone is low because his testes can't make testosterone.

Conversely, if you give the man luteinizing hormone and all of a sudden his testosterone goes up, he has secondary hypogonadism. I mean, you could mix the primary secondary there, but really the terminology doesn't mean anything. What matters is he can make testosterone, but... for some reason, his brain isn't giving his body the signal to do it.

Conversely, if you give the man luteinizing hormone and all of a sudden his testosterone goes up, he has secondary hypogonadism. I mean, you could mix the primary secondary there, but really the terminology doesn't mean anything. What matters is he can make testosterone, but... for some reason, his brain isn't giving his body the signal to do it.

And that's a classic finding in a person who's under high stress and or not sleeping well. So that's a long-winded answer to your question, but I think that those are probably the greatest contributors to this.

And that's a classic finding in a person who's under high stress and or not sleeping well. So that's a long-winded answer to your question, but I think that those are probably the greatest contributors to this.

Now, people have talked a lot about what about microplastics, what about other environmental factors, what about other factors in nutrition beyond just the ones that would contribute to excess body fat. The evidence there is less compelling, but I don't think we should discount it. But I think that if those things are playing a role, it is probably much smaller than what we just talked about.

Now, people have talked a lot about what about microplastics, what about other environmental factors, what about other factors in nutrition beyond just the ones that would contribute to excess body fat. The evidence there is less compelling, but I don't think we should discount it. But I think that if those things are playing a role, it is probably much smaller than what we just talked about.

worse food choices for sure and i was like is that like dopamine dysfunction no it's probably more due to insulin signaling so um we know from really good experimental studies that when you sleep deprive people they become insulin resistant And the more insulin resistant a person is, the less they're able to access their stored energy.

worse food choices for sure and i was like is that like dopamine dysfunction no it's probably more due to insulin signaling so um we know from really good experimental studies that when you sleep deprive people they become insulin resistant And the more insulin resistant a person is, the less they're able to access their stored energy.

So higher insulin resistance means greater difficulty accessing stored energy. So if you wake up and you have successive days of poor sleep and you're becoming somewhat insulin resistant, you're going to want to eat more because you're not able to access your own natural stores of fat, which is where we want to go for energy.

So higher insulin resistance means greater difficulty accessing stored energy. So if you wake up and you have successive days of poor sleep and you're becoming somewhat insulin resistant, you're going to want to eat more because you're not able to access your own natural stores of fat, which is where we want to go for energy.

So if you look at one experiment that was done out of the University of Chicago, they took healthy subjects, young subjects, and sleep deprived them for hours. somewhere between 10 and 14 days. So not a huge period of time. And they only let them sleep four hours a night, which by the way, I know a lot of people who are doing that for years at a time.

So if you look at one experiment that was done out of the University of Chicago, they took healthy subjects, young subjects, and sleep deprived them for hours. somewhere between 10 and 14 days. So not a huge period of time. And they only let them sleep four hours a night, which by the way, I know a lot of people who are doing that for years at a time.

In that 10 to 14 day period of time, their insulin resistance was worsened by 50%. In other words, they do an experiment called a euglycemic clamp where they inject them with glucose to see how effectively they can put glucose into their cells. That's the hallmark of insulin sensitivity is how well you can put glucose into your muscles when it's infused in you.

In that 10 to 14 day period of time, their insulin resistance was worsened by 50%. In other words, they do an experiment called a euglycemic clamp where they inject them with glucose to see how effectively they can put glucose into their cells. That's the hallmark of insulin sensitivity is how well you can put glucose into your muscles when it's infused in you.