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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.

I shoot for the normal range of 500 to 1,000. I'm not an anabolic guy. I'll melt it today.

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

I shoot for the normal range of 500 to 1,000. I'm not an anabolic guy. I'll melt it today.

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

Well, it's HCGs that's driving the T. We're just trying to protect it. If you said, what do you give on isolation as monotherapy? Yeah, what would you give for a Clomid monotherapy? 12.5 to 25, typically, depending on how sensitive the system is. And do you prefer Clomid and Clomiphene? So it's very interesting. Clomiphene's really good. It's an interesting FDA story.

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

Well, it's HCGs that's driving the T. We're just trying to protect it. If you said, what do you give on isolation as monotherapy? Yeah, what would you give for a Clomid monotherapy? 12.5 to 25, typically, depending on how sensitive the system is. And do you prefer Clomid and Clomiphene? So it's very interesting. Clomiphene's really good. It's an interesting FDA story.

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

So Clomid is not approved for men. And clomiphene isn't either. Clomid's approved for women and clomiphene's not approved for either. Clomiphene's compounded. Clomid is available for 50 years. So a lot more data. And once a cis isomer was a trans isomer. So they're different. And the estrogenic effects are slightly different. So I have enormous experience.

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

So Clomid is not approved for men. And clomiphene isn't either. Clomid's approved for women and clomiphene's not approved for either. Clomiphene's compounded. Clomid is available for 50 years. So a lot more data. And once a cis isomer was a trans isomer. So they're different. And the estrogenic effects are slightly different. So I have enormous experience.

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

I have 560 men on clomid and I have fewer in clomiphene. But it was developed for older men to preserve their testosterone levels as they age because the signaling tends to get weaker. The pituitary tends to get lazier. And this is to keep your testosterone levels up more physiologically than taking testosterone. So it went through some very good randomized trials that were published.

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

I have 560 men on clomid and I have fewer in clomiphene. But it was developed for older men to preserve their testosterone levels as they age because the signaling tends to get weaker. The pituitary tends to get lazier. And this is to keep your testosterone levels up more physiologically than taking testosterone. So it went through some very good randomized trials that were published.

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

This was clomiphene? And clomiphene citrate. And they were done by reputable people in the field. and published, and then it went to the FDA for approval for secondary hypogonadism, sort of age-related changes, not primary testicular failure, in age-related androgen deficiency of the aging male or Adam. FDA sat on it for a couple of years and said, nope. What? Good question.

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

This was clomiphene? And clomiphene citrate. And they were done by reputable people in the field. and published, and then it went to the FDA for approval for secondary hypogonadism, sort of age-related changes, not primary testicular failure, in age-related androgen deficiency of the aging male or Adam. FDA sat on it for a couple of years and said, nope. What? Good question.

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

So it's published, they're good trials, it's safe, it's as good as Clomid, and they didn't approve it. And I think it's hard to know, but I think the reason was that there's such an uproar about testosterone in America right now, and the FDA doesn't like what's happening. What happened is you can advertise your drug to the consumer now,

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

So it's published, they're good trials, it's safe, it's as good as Clomid, and they didn't approve it. And I think it's hard to know, but I think the reason was that there's such an uproar about testosterone in America right now, and the FDA doesn't like what's happening. What happened is you can advertise your drug to the consumer now,

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

So you know all the biological response modifiers for psoriasis, all those drugs go on and they give you five seconds on the benefits and the lesions go away and then 25 seconds on side effects, right? So you can do that. If you do that with testosterone, what you hear is, do you fall asleep after dinner? Are you not as athletic as you used to be? Are your erections not as good as they used to be?

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

So you know all the biological response modifiers for psoriasis, all those drugs go on and they give you five seconds on the benefits and the lesions go away and then 25 seconds on side effects, right? So you can do that. If you do that with testosterone, what you hear is, do you fall asleep after dinner? Are you not as athletic as you used to be? Are your erections not as good as they used to be?

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

There's 10 questions in the Adam questionnaire and everyone who ages- Every guy's going to be like, yeah. Everyone who ages has those issues, right? So it's a no-brainer if they go on TV, they're going to want this stuff. So the cat's out of the bag. They're stuck.

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

There's 10 questions in the Adam questionnaire and everyone who ages- Every guy's going to be like, yeah. Everyone who ages has those issues, right? So it's a no-brainer if they go on TV, they're going to want this stuff. So the cat's out of the bag. They're stuck.

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

And so now when any testosterone trial comes back, they're going to point out, the FDA makes sure that we point out the dangers of testosterone replacement. So this is part of that energy, which is, you know, we don't want another testosterone.

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

And so now when any testosterone trial comes back, they're going to point out, the FDA makes sure that we point out the dangers of testosterone replacement. So this is part of that energy, which is, you know, we don't want another testosterone.

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

They're really safe drugs. My effect is someone comes in who's young, who maybe wants kids, hasn't had them, And they have a low testosterone of 220. You measure their LH, which no one does. It's low. Secondary hypogonism. So it's not a testicle failing. It's a signaling issue. And that's probably stress. So I said, get rid of your stress. And they say, how do I do that?

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

They're really safe drugs. My effect is someone comes in who's young, who maybe wants kids, hasn't had them, And they have a low testosterone of 220. You measure their LH, which no one does. It's low. Secondary hypogonism. So it's not a testicle failing. It's a signaling issue. And that's probably stress. So I said, get rid of your stress. And they say, how do I do that?