What is the optimal training and nutritional intake timing during Menopause?
Dr. Attia, your work emphasizes Zone 2 cardio and intermittent fasting for metabolic health and longevity, which can benefit women in menopause. However, Dr. Stacy Sims argues that moderate-intensity cardio, like Zone 2, may increase cortisol and exacerbate menopausal symptoms in active women, and she advises against fasting due to potential hormonal stress. Could you clarify the evidence supporting Zone 2 cardio and intermittent fasting for menopausal women, particularly how these strategies can be tailored to minimize cortisol-related risks and align with their unique physiological needs during this phase?
Obicetrapib progress
Was wondering if you can have John Kastelein on again to talk about Obictrapib progress. Just had a good study on lowering Alzheimer's markers. This CTEP inhibitor is super interesting for both CV and more importantly dementia/Alzheimer's. Would love to hear more about it as an episode, on AMA, or you reviewing the data as this drug progresses to market. Thanks.
Ep# 355 – Skincare strategies with Tanuj and Suzan
As a 46-year-old male struggling with adult acne, I paid especially close attention to Suzan and Tanuj’s recommendations on treating acne. My takeaway from episode 355 was Accutane is really the method-of-choice while antibiotics are to be avoided. If I recall correctly, the chief concern with antibiotics are adverse impacts to the microbiome. I really want to better understand the risk-reward profile of each of these treatments. As a patient, why would I appeal to my dermatologist to stop prescribing antibiotics and instead switch to an drug that dries out the skin/lips, causes nosebleeds, muscle and joint pain, prohibits patient from consuming alcohol, causes birth defects (in women), and may result in suicidal thoughts? Are the impacts to gut health (from antibiotics) significant enough that it would warrant switching to a drug with such an extensive list of side effects (Accutane)?
CT colonography?
Hi, I just listened to AMA #56 about cancer screenings and heard Peter say he doesn't recommend CT conolographies. He said he would explain why later in the podcast, but I didn't hear any further explanation. Will you please explain why he doesn't recommend CTCs? The sensitivity data reported by Dr. Pickhardt seems very positive, and the benefits of avoiding sedation and reducing the risk of perforation also seem very positive. Finally, would your view of CTCs be different for patients with sharp angulations in their colons for whom previous colonoscopies have failed? Thank you!!
More discussion about oral birth control
For women in their 30s, 40s, 50s who are athletes, or are very focused on strength building and VO2 max, could you speak more about the benefits and risks of regular old oral birth control? I seem to be hearing it spoken of negatively by many people in the public eye these days and I want to make sure I understand why and whether it applies to me. I have listened to most of the full length Drive podcasts and have listened to your podcast with Rachel Rubin multiple times. I really really appreciate how you both give so much attention to HRT. In perimenopause most PCPs and Ob/Gyns out here are still recommending OBC, probably bc they dont know how to do HRT. And it does have the advantage of preventing pregnancy which is a concern for many of us still. OBC also has the convenience of being a daily pill. I am in perimenopause at 43 and weighing all the options. The steadiness of going back on OBC, which I was on for many years, does appeal. Does it knock down our testosterone? Is it negative for sport performance? For bone health? Sounds like it has more of a clotting risk than HRT, but so does unwanted pregnancy! Would love more from Dr. Attia on OBC and maybe weighing the convenience of going back on OBC versus a complicated pursuing of HRT since that's a choice we are being asked to make out here as patients. Thank you infinitely for your attention to HRT and for trying to right the medical wrong of the past few decades.
Airway dentistry: Airway impact on overall health including sleep
Hi, would be tremendously interesting if you could have a podcast episode focused on airway dentistry / dental sleep medicine. There is a lot of evolving clinical evidence of the criticality surrounding the development of the face and mouth structure and its impact on airways, sleep and overall health and would be tremendous to learn more about this via your podcast. Example of experts seems to be e.g. Audrey Yoon at Stanford. Would also like to give a big thank you for the great work you are doing! Keep it up! Best regards, Eskil Nilsson
Why Bryan Johnson stopped rapamycin
Bryan Johnson stopped taking rapamycin after 5 years citing side effects (https://blueprint.bryanjohnson.com/blogs/news/i-stopped-taking-rapamycin?srsltid=AfmBOoolJ1QVD19wZVWJx7jXwMEWgZASyvu1DE87sEBSo-JxCfPopTyH). Could you comment on this and update on the latest studies of rapamycin for humans and dogs?
anti-cholinergic medications in the past
Anything I can do to compensate for having taken an anti-cholinergic medicine daily for 7 years for migraine prevention? With the resent study on Benadryl showing a link to dementia, I have heard that anticholinergics may all have that same risk. Wondering If I can do anything now to make up for having taken that medication.
Emotional health/living a life worth living
All the studies state that having quality relationships is the key to emotional health/longevity/living a life worth living. As an introvert who is not partnered and has no children it is kind of stressful to keep hearing this recipe. Are these studies designed to frame the emotional health question within the context of a traditional family? Assume if one doesn't feel lonely, then one isn't lonely? If there is literature specifically on single people/introverts on what constitutes loneliness, emotional health etc it would be great to summarize.
Managing LP(a)
Thanks to your podcast and your book, I’ve been making some serious life changes over the past year (and have roped my husband in too!). I’ve since learned that I have high LP(a). Will lowering saturated fat to under 5g daily (in conjunction with good daily exercise and a statin) have a substantial impact on moving apoB into those lower recommended ranges? If not, I’m thinking I may be asking my pcp to increase my statin (currently at 20mg) and I worry about pushback from them….. Thank you for all you and your team do! You are making a difference in our lives and we really appreciate your work!
What is "symptomatic" in relation for deciding its time for HRT?
As a 48yo man who has lower T levels (free T over the years from 40-80, even with weightlifting 4x or more times a week). While my HBP/statins/thyroid are controlled with the lowest doses of meds, I have often wondered if supplementation was something to consider for those conditions and overall health. However, Peter qualifies in most of his podcasts he would only recommend it if the patient is "symptomatic". What does he mean by that as the symptoms are very generic? How do you judge "fatigue" if sleep is okay, but you have multiple jobs/projects/family issues to deal with? If there is no issue with libido...is a slowly losing battle with weight gain and an unexplained increase in fasting blood sugar over the last couple years (up to 115 now) "symptoms"? So, I wonder if things are tracking in the wrong direction and I'm seeing an underlying smoldering before the fire….but does these constitute “symptoms”? It has become more relevant because my 47yo wife's OB has told her she would only think of prescribing HRT if she develops "symptoms". Her health is good (no meds), and she'll say she feels fine, but she is a high achieving, push through it, kind of woman...so definitely could be ignoring things as "normal stress". Not to mention the underlying changes that could occur before she “feels something”. My feeling from your podcasts is that waiting for dramatic hot-flash kind of symptoms is sort of too late and a semi-annual hormone screen for her may not give a true reflection of her overall status.
Question about Dizziness and Vertigo caused by new supplements
Hello Dr. Attia: I have recently experienced bouts of vertigo and dizziness over several days, causing presumably by new supplement that I began taking. The new supplements were Red Beet Powder (1 g/daily) and Rhodiola Rosea (100mg/daily). I had also been taking Coco Flavanols (750 mg/daily -- Cocoa Via). After the first couple of days I stopped taking the Rhodiola Rosea and the Cocoa Via, as Rhodiola Rosea has dizziness indicated as a side effect, and coco flavanols are indicated to reduce blood pressure. Within a week or so, both the vertigo and the dizziness subsided and I stopped these for several weeks For some reason after several weeks I decided to take 333mg of Red Beet powder as a pre-workout activator and 1 Rhodiola Rosea -- and after just 1 day both my vertigo and dizziness returned. After elimination of these completely, both subsided after about a week. I am amazed that such a small dose when I reengaged with these 2 could cause this much of an impact. To date now I have eliminated all 3 supplements, but in your podcast and others I see that Red Beet Powder is a highly recommended supplement for both blood pressure reduction and pre-workout activation. Is this vertigo and dizziness being caused by the high nitrites/nitrates in the red beet powder or is it caused by the reduction in blood pressure. My blood pressure is consistently at about 120/80. Thank you
HRV increases and how best to balance higher cardio with high volume strength
I have seen an increase in my HRV (measured with Morpheus), going from a weekly average of 54 to 61 to 65 to 81 (in 3-4 weeks). My HRV has been 80+ on 5 of the past 7 days, whereas previously I was averaging in the 50s and occasional blips in the 70s. I do both high volume weights and green threshold intervals (Norwegian 4x4s) -- sometimes followed by a 1-2 minute max interval. I've tried to prioritize cardio and I have recently added more frequent 4x4s as well as a few 12 minute VO2 max runs -- while still doing strength high volume. For continued HRV maintenance/improvement, should I reduce my strength? Will the high volume/high weight strength training be contradictory to my cardio, with respect to the volume and strength of my heart? I do try to do cardio first anytime I have squats or deadlifts planned, and I do prioritize my recovery. Other than that, do you have any guidelines or protocols on how to best execute this tradeoff between strength and cardio focus, while trying to maximize for cardiological benefits (and higher HRV? I'm also trying to improve my VO2 Max, but I have seen only minimal improvements even with more 4x4s and VO2 Max test runs. I'm very happy though with my HRV improvements. I am 64 years old.
Optimizing protein intake for vegetarians
It would be great if Peter does a deep dive helping a growing number of vegetarians to optimize their protein intake strategies. I personally would love to move to a more vegetarian diet (driven by a sustainability conscious mindset), but my daily protein target is 160-170 grams. This makes it rather challenging to meet the daily target without over relying on protein shakes, avoiding meats and mitigating the risks of malnutrition. I personally wouldn't mind to arrive at 80% vegetarian diet and meeting my protein daily target with it.
Mice Don’t Go Through Menopause
For a lot of the studies you site, especially in longevity, mice are used in the studies; however, female mice don’t go through menopause. How does any longevity study translate to women when menopause is such an important factor in how women age. Aside from HRT being a critical component to health-span for women, the other therapies may or may not be helpful. I don’t know, mice don’t go through menopause. (I know that exercise, diet, and sleep are critical components, but what else?)
MTOR - yes or no????
Hi Dr Attia - I’m kinda confused as to whether us older folks are better off suppressing or stimulating MTOR. On one hand Rapamycin suppresses MTOR and seems to prolong life in just about every animal trial done to date. But suppressing MTOR also decreases your body’s ability to gain or maintain muscle mass, which is of critical importance for us senior citizens (I’m 65). So I’m wondering which is the best way to go - Rapamycin to suppress MTOR, or a supplement like the DL185 peptide to increase MTOR and therefore muscle mass???