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Paul Turek

👤 Person
716 total appearances

Appearances Over Time

Podcast Appearances

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

So if there's too much estradiol, the brain senses it's a negative feedback, senses, hey, there's too much of this, so let's make less testosterone. So it will lower your testosterone to have high estradiol. When estradiol is made, it gets metabolized differently than testosterone. It goes to the liver or to fat.

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

So if there's too much estradiol, the brain senses it's a negative feedback, senses, hey, there's too much of this, so let's make less testosterone. So it will lower your testosterone to have high estradiol. When estradiol is made, it gets metabolized differently than testosterone. It goes to the liver or to fat.

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

And aromatases convert it to something else, or testosterone gets converted to female hormone aromatases. So you can get high levels being obese or having liver dysfunction, so alcohol, alcoholic cirrhosis, hepatitis. It'll rev it up and it'll make a lot more estradiol level. And there's some medications that do it too.

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

And aromatases convert it to something else, or testosterone gets converted to female hormone aromatases. So you can get high levels being obese or having liver dysfunction, so alcohol, alcoholic cirrhosis, hepatitis. It'll rev it up and it'll make a lot more estradiol level. And there's some medications that do it too.

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

And that will act and lower your testosterone, which will lower sperm production because you're not watering the plant.

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

And that will act and lower your testosterone, which will lower sperm production because you're not watering the plant.

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

If you see that there's a low count and the testosterone's low, and you could say you need to lose 100 pounds. which is the key secret for everything, right? But you can also give aromatase inhibitors like weightlifters use to keep their levels down. Okay.

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

If you see that there's a low count and the testosterone's low, and you could say you need to lose 100 pounds. which is the key secret for everything, right? But you can also give aromatase inhibitors like weightlifters use to keep their levels down. Okay.

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

So I usually do two semen analyses three weeks apart or more to get a sense of things because it varies quite a bit. So a very important point is that the semen analysis, any feature of that semen analysis vary by 50 to 100%.

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

So I usually do two semen analyses three weeks apart or more to get a sense of things because it varies quite a bit. So a very important point is that the semen analysis, any feature of that semen analysis vary by 50 to 100%.

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

So I do a lot of consulting for the FDA and they do medications in reproductive age men and they're trying to show the semen analysis. They're going to the FDA and they're saying, can you help us interpret this data for the FDA? I said, garbage in, garbage out. I mean, there's so much variability, you really can't say anything. So you have to do at least two samples.

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

So I do a lot of consulting for the FDA and they do medications in reproductive age men and they're trying to show the semen analysis. They're going to the FDA and they're saying, can you help us interpret this data for the FDA? I said, garbage in, garbage out. I mean, there's so much variability, you really can't say anything. So you have to do at least two samples.

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

And it still varies quite a bit. There's inter-observer variability, who does the semen analysis. There's biological variability on what your system's like. So that's the big problem with studies.

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

And it still varies quite a bit. There's inter-observer variability, who does the semen analysis. There's biological variability on what your system's like. So that's the big problem with studies.

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

If they do, they'll do animal models. They won't do human studies, they'll do animal models. They'll do beagles, mice and beagles. And if there's no fertility effects, they don't really look at semen analysis in those. They'll look at fertility effects in the animals. If there's nothing there, then they'll probably not require human studies.

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

If they do, they'll do animal models. They won't do human studies, they'll do animal models. They'll do beagles, mice and beagles. And if there's no fertility effects, they don't really look at semen analysis in those. They'll look at fertility effects in the animals. If there's nothing there, then they'll probably not require human studies.

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

If there's any suggestion of a problem in the animal models, which is a million dollars of work. So if you ask me why I patented the Somatic Colonial Stem Cell, I want an in vitro test for human infertility that we could use instead of animal models, save the animals, save a million dollars, do an in vitro spermatogenesis model and see if there's an effect at all.

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

If there's any suggestion of a problem in the animal models, which is a million dollars of work. So if you ask me why I patented the Somatic Colonial Stem Cell, I want an in vitro test for human infertility that we could use instead of animal models, save the animals, save a million dollars, do an in vitro spermatogenesis model and see if there's an effect at all.

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

Absolutely.

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

Absolutely.