Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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Appearances
Can't get low-dose naltrexone there. You mean it has to be compounded at 4.5, you're saying? You're right.
So it's basically a free drug.
Yeah. I'm very curious to see if anybody has looked at LDN in any of the neuroinflammation stuff. We see the relationship between herpes simplex virus and Alzheimer's disease, between shingles, especially ocular variants of it and Alzheimer's disease. We know that there is some relationship between inflammation and this disease. And we know that that's obviously not all paths cross through that.
There are lipid mediated paths, metabolic paths, vascular paths. I think it would be very difficult to make the case there's not an inflammatory path towards that condition. And so interesting to think about.
What's the evidence for the inhibition of the toll-like receptor? Is that in vitro? Yeah, it is in vitro.
Why do you think you see? I mean, that's an interesting one.
Yeah. So when we met 25 years ago, how big was the department at Stanford in pain?
I'll finish the story of how we met. So I'm in this state of total hell. In addition to all the stuff I mentioned about this incredible pain, I couldn't even stand up, literally couldn't stand. And if I did, I had to be hunched over. And so at the time I was dating an anesthesiology resident and she was the one that said, hey, we just need to get you in this pain clinic.
We got to break some stuff. This is going nowhere. You're circling the drain here, kid. I think she was in her last year of anesthesiology. So I think she was doing a rotation through pain, maybe. That's probably how she weaseled me in there. So I come and see you in clinic. By the way, at this point, my mom had flown down from Toronto to take care of me.
It's not like I could drive or do anything. So my mom drives me into the hospital. Come in and see you. You hear the story. We'd ruled out anything that required any more surgical intervention. In other words, I'd undergone another MRI. I'd had a flexion extension film. I wasn't surgically unstable. And in fact, where the original injury was didn't even seem to be what was driving the pain now.
So you said, look, the first thing we're going to do is we're going to give you an IV lidocaine drip to see if we can just calm these sodium channels down.
So you said, well, how much do you weigh? I said, I weigh 80 kilos. You said, okay, we're going to give you 400 milligrams of lidocaine intravenously. And I said, Dr. Mackey, I just took my boards a year ago. That's a toxic dose. You said, don't worry, we're going to do it in a cardiac monitored room. You will be on an EKG and we will be able to defibrillate you if you have an arrhythmia.
So I said, go for it. So in 20 minutes, I got 400 milligrams of lidocaine, didn't touch the pain. Tried something else, didn't touch the pain. By now it was eight o'clock at night. Oh, wow.
And you said, okay, the only thing left to do at this point is to go in there and do a series of injections at every single facet joint, every single dorsal root, every nerve root, every dorsal root ganglia, the entire length of your spine. I will not be able to diagnose what is wrong because I'm basically going to stop all the pain, but then we will chip away at this over the coming months.
And I said, great. Can we do it now? You said, no, it's eight o'clock at night. We don't have an anesthesiologist. I'm the only one here. I said, you're an anesthesiologist. You said, yes, but I'm the one that's doing the procedure. So I said, well, why can't we do that? And then you said, well, we won't be able to give you any sedation. And I'm about to stick 45 needles in your back.
And I said, I don't care. That's how much pain I am in right now. So we go into the OR and you proceeded to put, I think, hydrocortisone, bupivacaine, and you lit me up, up and down the back. And two hours later, I stood up for the first time in three months. I was completely pain-free. This was remarkable. So we get home, it's midnight. I say to my mom, I'm not going to bed.
I'm going to go for a walk because like I hadn't walked in three months. And you know the campus loop of Stanford? Yes. Yeah. I walked it until the morning. It's a four mile loop.
I just walked around and around and around till nine o'clock in the morning, came back home, went on to develop plantar fasciitis because when you don't walk for three months and then you don't stop walking, but put that aside. And you told me, look, you're going to probably feel okay for a few days and then the pain is going to come back.
Well, it actually turned out to be two weeks that I was pain-free. And then the pain came back. And over the next three or four months, you repeated comparable procedures repeatedly. but with more and more precision, i.e. narrowing in at what the problem was. And if my memory serves me correctly, it was mostly in the T12 L1 area.
And I think the ultimate diagnosis was, look, you lost so much disc space at L5 S1 through the multiple surgeries. If you look at my MRI today, I basically don't have a disc at L5 S1. that you've now developed this facet arthropathy that far up. And that's where those nerve roots are going into kidneys and testes.
Showing 1161–1180 of 5,258 · page 59 of 263
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