Peter Attia, M.D.

But all of that said, is there a case to be made that we should not be replacing testosterone in men because it turns us backwards in terms of this aggression and it's more likely to make that 55-year-old guy want to find himself the 20-year-old girlfriend?

No, no, I'm asking the opposite question.

I'm saying, given everything we've just learned about testosterone, is there a negative consequence to taking a 55-year-old guy and restoring his testosterone to what it was when he was 18?

Why you should restore it back to when he's 18?

It totally depends on the symptoms would be my take.

So if a guy is having difficulty putting on muscle mass, if he's complaining of something, see, there are some guys who say, I'd like to have sex once a week and my wife would like to have sex once a week.

And that's what we do.

And that's fine.

Conversely, there are other guys who say, my wife wants to have sex every day and I want to have sex once a month.

Now this is a problem.

But if my testosterone is what it was when I was 18, I'd like to have sex every day.

My wife would like to have sex every day.

Now we're happy.

There isn't a formula here, but that's one example of how you're trying to match the symptoms and what the patient is saying to what you can do.

There are some guys who have no difficulty putting on muscle mass despite having a testosterone of the 20th percentile.

It might be that their genetics are such that that was the case, or they put on a lot of muscle mass when they were younger and it's just easier to maintain it.

There's certainly evidence that insulin resistance can be ameliorated by correcting hypogonadism.

So there are reasons to consider doing it.

What I'm trying to get at is, are there negative consequences of doing it from a behavioral standpoint?

And I'm not talking about roid rage and things like that, which has largely been debunked outside of, again, these edge cases where people are taking super physiologic doses.