Rapamycin & Leucine (BCAAs)
Rapamycin inhbits mTORC1; leucine activates mTORC1. Do you take both? If so, why or why not? A few further questions: 1. Does taking leucine immediately after/during exercise lead to mTORC1 activation only in the muscle groups you're working out (e.g. rather than the brain/liver/etc)? 2. Do the benefits of increased muscle mass outweigh the short-term activation of mTORC1? 3. How long does leucine continue to affect the body (i.e. does taking it only once per week, like rapamycin, lead to long-term effects)? 4. Does leucine modulate the immune system? 5. How does dietary leucine/methionine consumption play into this, if at all? In short, it feels like rapamycin and leucine are tugging the same rope in opposite directions. I'd love to hear any/all thoughts you might have. Thanks in advance!
Uric Acid deep dive might make a good topic for an AMA
I'd like to understand more about managing Uric acid levels. I have struggled with some gout symptoms which have alleviated from a ketogenic protocol. I am wondering about the link between high uric acid levels and cardiovascular risk as well. In one episode I thought Peter mentioned using allopurinol to manage Uric acid levels below a certain level. A deeper dive on what drives uric acid levels (diet, behavior, genetics, etc) in the context of the biochemistry mechanisms might be helpful. In addition understanding what treatments are effective if high uric acid levels have a negative impact on longevity. Pros and cons on short/long term usage of allopurinol +colchicine would be helpful as well as this seems to be a common treatment. Congratulations on the 3 year milestone for the podcast! Love the drive and the qualys.
Compression socks
Came across a thread on medical subspecialty related behavior changes where a lot of vascular surgeons shared that they wear Compression socks every day to avoid things such as venous insufficiency but also, apparently it has been shown to improve athletic performance. What are your thoughts? It seems like a low risk modification.
The Peter Attia patient experience
IT would be interesting for an AMA to walk through the template you use to approach a new patient in your clinical practice. I think this would help all of us in our engagements with our physicians. How do you triage and prioritize risk? I am sure there is a pareto and a set of heuristics applied as you walk down initial assessment of a patient and start down the process of understanding where a person is at, what are their goals, and what to prioritize in terms of treatment (both treatment and preventative)? It would be interesting how you organize the decision making process to help us with our own framework.