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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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.
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.
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.
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 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.
And their capacity to do that was reduced by 50% after such a short intervention. So I think sleep restriction and unhealthy sleep is a very underappreciated cause of metabolic health and weight gain. And then by extension, these other things we're talking about.
Yeah. I mean, look, I've said this before and I'm not the first to say this, so I'm paraphrasing others, but if you really stop to think about it, sleep doesn't make a lot of sense from an evolutionary perspective. Right. Like if you go back in time a few hundred thousand years, why would we have spent a third of our life unconscious? It didn't serve our purpose.
You can't mate, you can't hunt, and you can't defend yourself. So you have to believe that if we could have evolved out of it, we would have done it. And we didn't. So that means that whatever it's doing, it must be really important. I mean, core essential to our existence. While I will completely acknowledge that different people have a different necessity or requirement for how much they sleep,
I still think that many people underestimate how much they need.
Well, they're very similar to the types of things you're thinking about, and I love how you've got specific examples. So I really like playing with my kids, right? So I can imagine that in my marginal decade, I'll have grandkids that are the age of my kids, right? Yeah. And, you know, maybe a bit older, but as I'm even getting towards that marginal decade.
Okay, so playing sports is really, really fun. I really like playing, especially because when I grew up, like I played hockey because I grew up in Canada, and then I immediately went into kind of boxing and martial arts, and those became my life. So now playing sports that I didn't play much as a kid is really fun. Like I'm really enjoying baseball. I'm really enjoying soccer. And –
And so when you play these things, you realize this is not an easy thing to do when you get old. Like to sit in the goal and actually like stop a ball when a kid is blasting at you full stop, you have to be able to move around. So again, like I would love to be able to play soccer, throw a football, throw and hit a baseball as long as possible.
You can get into movements that are much simpler, but if I can do all of those things, I'm in great shape. Now, of course, to be able to do that, I also need to be able to do a lot of things that many people also can't do in their marginal decade, like sit on the floor, get up off the floor under their own power, walk up X number of flights of stairs, having the strength to do that.
I like doing that. certain things. Like I like archery a lot. So it's, you know, I want to be able to pull a bow back, obviously not at the same poundage as the current bow that I pull back, but I would still like to be able to pull a 50 pound bow back in the final decade of my life.
No one in the final decade of their life ever said, I wish I had less strength and I wish I had less endurance. So you cannot be too strong and you cannot be too fit. The only time that one would throttle back on the pursuit of those is A, if doing so is coming at the expense of something else, either with respect to your health or your life.
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