Paul Turek

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358 appearances 1 recordings 1 series first heard Jun 2025 last heard Jun 2025

Paul Turek’s voice in public audio — every appearance, attributed to the second.

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The Peter Attia Drive · #351 ‒ Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D. · 2 Jun 2025 podcast

So exercise, acupuncture, massage, or yoga. I mean, for men, I say physical activity is the best thing for sex. So as an aside, during COVID, I had two groups of men. They said, what do I do? My life's a mess. You know, everyone's life's a mess. So half of them had drinks at five o'clock, started drinking a lot. And the other half went out for runs or got a Peloton, which most of the country did.

That's a great story, the Peloton story. And then about six months later, these guys realized it's not working. And they started shifting over to exercise. So I was very proud of them. These guys I was really happy with, like nice, because that's the best way to handle stress is when you have no control over things. go for a run, go for a walk, get out there. So good for you.

It's decompressing, get your mind off something, anything, surfing, whatever. They don't do that. So I said, well, let's do this. I think what's happening is this. I think it's just stress. Maybe try traveling less or whatever. And then I'll give them Clomid. I'll say, let's try this for three to six months and let's see how you feel. Sometimes it's sexual health issues.

Erections aren't typically that dependent on testosterone. Typically, it's other things. I'll give you the benefit of the doubt. Maybe you were higher before and we don't know that, but let's do something pretty safe and easy and I'll double your testosterone or triple it. Let's see how you do. And then I'll check in with them at three and six months. How are you feeling? I feel great.

Or, hey, it's not working. I feel the same. It's like, well, it's not testosterone related. Whatever the symptom is you're having, you wouldn't have it with a testosterone. We know levels of testosterone above which you should not have symptoms. We know libido, we know erections, we know fertility, things like that.

I don't know. Erections, I would say the best study is about 290. Yeah.

You're convincing them. And then what about libido? Libido, I'd say 350 is sort of a range. It's pretty sensitive and it's harder to call. Libido is driven by so many different things. Fertility, I'd say 300 is a good one.

I think there's myths around testosterone and those are some of them, but it's sort of a Morgan Taylor and equilibrium story where if you're low- You have symptoms and you're low. Those symptoms will get better when you go up. But then there's a point where it flattens out. There's no increase or improvement in symptoms. Sexual health symptoms are classically ascribed to that.

There also is a linear relationship between testosterone, and that would be blood and muscle. So more is better for making blood, doping, and also blood doping, and also for muscle. Absolutely linear.

Effect of testosterone muscle mass is indirect. It's not that you're going to do it and create mass. You don't just create mass. what it allows you to do is recover from injury. So if you push the system and you need two days to recover, you can go to one day, you can push it again harder. So that's what testosterone does in the primitive world.

I'm not sure that's receptor-driven at all. It might be several pathways going on that are logarithmically better but it allows you to push the system and go back and then push it again. And that's how you build muscle.

So it's funny because a lot of guys come in and they look good. When I examine, I'll say, are you taking anything? Because they never put it on their medications, right? They never write it out on the history.

So I will look them in the eyes. So are you taking testosterone? And I'll look them in the eye until they answer. And if they look down and they don't say anything, I know they're on it. If they look me in the eye and say no, then I know they're not. But they'll always look away. It's this verboten thing.

Yeah, yeah, yeah. So my theories about this is why is he taking it? So if he's taking it for anabolics and, you know, he probably has a pretty good idea. I want to give you a little research we're doing on the lifespan of anabolic steroid users. So remind me at the end of the story, give you a little brief about what I know about that. So how he takes it matters.

So if he's been in constant use injectables, that's the most suppressive of fertility. And if you turn a gland like a testicle off long enough, it's off. So I gave a lecture to the Antigran Society on recovering men from hypogonadism in young men. And I asked them a question at the end. My whole procedure comes from steroid users.

I take notes when the anabolic guys come see me because they're really smart and they know a lot about reactions, biology. Yeah, it's incredible.

But it's a science. Some of them are PhDs. I took notes for years and it came up my approach along with what I know. So it's very much in concert with concert with them. So everything I say is built on a large experience and it's called getting off the juice, the blog. And I have people read that blog, do it and say, get about 80% of the way. And then call me and say, I need help here.

Now I'm here. We'll link to this in the show notes for sure. Getting off the juice. And there's a PowerPoint in it. So the recovery is usually possible in young men, but it depends on how much they took, how long they took it, and how they took it. If they do it like a cycling effort, that's the best.

So if you cycle steroids, you recover the pituitary, you get back to normal, and then you hit it again, that's actually quite smart. Constant use is not. Constant use for longevity or whatever is not a good idea for fertility. So that's going to be much more suppressive. Injections are worse than orals or any gels.

So the next thing is how long, so I asked the Endocrine Society, since I answered all their questions, I said, I have a question for you. Can you turn a testicle off like in a thyroid or an adrenal gland if you suppress it enough? Can you turn it off for good? And they said, yeah, that's an important question of ours. We can do that.

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