Creatine supplementation and eGFR
I am a female turning 50 on 12/8/25. I weigh 125 pounds and am lean versus muscular, but generally fit. I try to supplement with 5g of creatine on days that I exercise which is most days but I am not always consistent with supplementation. That being said, I was taking it more consistently in January and November of 2025 and my lab work (below) reflects that. My endocrinologist (seeing for low bone density at age 50) told me after my last set labs (taken before I did a Reclast infusion) to stop taking creatine and retest to see if my creatinine lowers and my eGFR goes back up and then if stopping normalizes my lab results she said that it was my decision to keep using creatine as a supplement. I understand this is not her wheelhouse but I was wondering how long I would need to stop taking creatine for a retest (she did not tell me) and if there is a true concern about a higher creatinine and lower eGFR. I asked my MD about doing a cystatin-c test after listening to one of your podcasts and she said there was no reason to do that test and to stick with the typical eGFR. I may just pay for that if I can get one without an order. I would like to keep on using creatine for muscle and ultimately bone health seeing I already have low bone density for my age, but maybe these results show that I am not good a candidate for the supplement. Curious what your direction would be. Thank you and for all your amazing work! 1/30/25 eGFR 82 creatinine .87 - Labcorp 3/27/25 eGFR 99 creatinine .74 - Labcorp 9/13/25 eGFR 96 creatinine .76 - Labcorp 11/13/25 eGFR 73.4?creatinine .95 - hospital lab
Upheaval in the evidence based lifting
We all just witnessed the downfall of Mike Israetel’s reputation, after his phd thesis was publicly demolished. I personally felt betrayed by many people I used to follow, because the shockwave from the fall of the giant spread far and wide, hitting many other influencers including Layne Norton and Jeff Nippard. In the last weeks I found myself getting down the rabbithole of Lyle McDonald’s content: he sounds harsh and unpolished, very old school, but in a way felt like fresh air. Would you consider having him on the podcast? I think your no bs approach to science would go nicely with someone like him.
Stem cell iv
A 65 y.o. Friend with significant foot neuropathy and back arthritis went to a clinic in Los Gatos CA to an MD with an impressive educational background who removes stem cells from abdominal fat and rejects them via an IV by a specialty method she developed for the cost of 15k. He has had significant improvement and is in contact with several other patients with similar good results. I’m struggling with the lack of research. Dr reports she is being squashed by big pharmaceutical but she changes lives daily. Do you have any thoughts about this systemic delivery of stem cells?
Osteoarthritis
First of all, absolutely love what Peter and the team does there. You truly are AMAZING!!! I've been a long time listener and learner. I would truly appreciate if you could please do a dedicated episode on Osteoarthritis. Perhaps you could include such subtopics as understanding the basics, causes & risk factors, symptoms & diagnosis, treatment options, prevention, pain management, the latest/emerging research, future outlook, etc? I have searched the website and have not found a focused episode on this topic, but would love to hear a deep dive into it as it has significant impact on my family. Thank you.
PCSK9 inhibitor non responder without familial hypercholesterolemia
Please go into this more. I'm intolerant of both statins and ezetimibe and appear to be a non responder of PCSK9 inhibitors (2 months into Repatha). My cardiologists tells me with my E3/E4 genetics, I'm a hyperproducer of LDL however my LDL was below 100 until menopause. I've been on HRT for 5 years. I feel like a case study... Calcium score is zero.
Fructose common pathway for Alcohol Use Disorder, liver damage, and MASLD
The article from Nov 10, 2025, in Nature Metabolism, by the team at University of Colorado Anschutz, and the press publicity about it, seem to indicate that the way to intervene with liver damage from bad diet and treat AUD is by disrupting fructose metabolism - this seems to echo work from Dr. Lustig years ago. Is there more than the mouse models in the recent study to indicate this same pathway is active in humans as a main or predominant target for intervention?
View on managing ASCVD and metabolic risks for people with familial hypertriglyceridemia
For people with familial hypertriglyceridemia, exhibiting low HDL-cholesterol, low LDL-cholesterol (let's say below 60 mg/ dL), apob (let's say between 80 to 100mg/dL ) but high TG between 200-400mg/dL, doctors refrain from giving medications to moderate the apoB or TG levels especially if their lifestyle factors like nutrients and exercise are well managed and their age is below 40. Does Peter have a different view on this matter than other doctors and what is the usual course of actions that Peter takes with his patients that have familial hypertriglyceridemia? More importantly, are there any tips he can provide on how to discuss this with other doctors, who refrain from providing drug interventions (if his view differs)?
HRT for women over 60
For women in their 60s who were denied HRT because of the flawed women's health initiative study, could starting hormone therapy now (10+ years post-menopause) confer some of the same heart and bone health and cognitive benefits? The research seems mixed, and suggests it’s okay for women who have no risk factors - but is that interpretation also flawed? For women who eat well, maintain a healthy weight, and exercise regularly (including weights) but still are starting to see their cholesterol, A1c and blood pressure creep up above normal, while Dexa scans and brain fog get worse, could HRT still be protective and potentially slow or reverse these trend lines? If a patient over 60 with elevated LDL (low 100s) and blood pressure is able to improve her cholesterol and bp to normal with medication, would HRT then be potentially safe for her? Given the elevated DVT risk suggested in the research, would the answer change if we know the patient does not have the factor V Leiden gene? What other tests might need to be run to help make the decision? What type of HRT at what dose would provide the best benefit-risk?
Protein
Can you post several days worth of your actual meals to give us a sense of how you are getting in your protein daily? Not looking to copy a nutrition plan. Looking for examples of how you specifically achieve your protein intake. Alternatively, can you recommend how someone can achieve daily intake if they are on a budget? Thank you!
Muscular/ structural flexibility: how important, how to practice it, pitfalls..
Where does structural flexibility fit into Peters framework for health? In sports and in PT flexibility of major leg muscles,, shoulders hips..has always been emphasized. How does Peter think about it: when is it helpful or harmful, does he stretch himself?
Integrating Genetic, Glycan, and Inflammatory Biomarkers: Can Precision Testing Extend Both Lifespan and Healthspan?
As both a technology executive and an amateur endurance (mountain bike) and combat sports athlete (BJJ), I’ve been working to optimize my longevity and performance through evidence-based interventions. I currently rely on a series of advanced diagnostic tests, including GlycanAge, 23andMe (genetic data), a sports genetics and nutrition analysis, and ImuPro (type III food allergy and inflammation profiling). My question is: How effective and reliable are these genetic and immunological tests — such as 23andMe, Glycanage, ImuPro, and DNA performance analyses — in guiding interventions for longevity (lifespan and healthspan)? Specifically, how valuable is their insight into traits like inflammation markers, caffeine metabolism, medication response, and micronutrient deficiencies (magnesium, zinc, etc.)? In your view, how should these datasets be integrated — or weighed — in a comprehensive longevity protocol for someone who trains and competes regularly, but supplements only when clinically indicated by diagnostic evidence? And are there other, more validated or emerging genetic or molecular assays you would recommend that could meaningfully impact long-term health outcomes? THank you
Integrating Genetic, Glycan, and Inflammatory Biomarkers: Can Precision Testing Extend Both Lifespan and Healthspan?
As both a technology executive and an amateur endurance (mountain bike) and combat sports athlete (BJJ), I’ve been working to optimize my longevity and performance through evidence-based interventions. I currently rely on a series of advanced diagnostic tests, including GlycanAge, 23andMe (genetic data), a sports genetics and nutrition analysis, and ImuPro (type III food allergy and inflammation profiling).
Integrating Genetic, Glycan, and Inflammatory Biomarkers: Can Precision Testing Extend Both Lifespan and Healthspan?
As both a technology executive and an amateur endurance (mountain bike) and combat sports athlete (BJJ), I’ve been working to optimize my longevity and performance through evidence-based interventions. I currently rely on a series of advanced diagnostic tests, including GlycanAge, 23andMe (genetic data), a sports genetics and nutrition analysis, and ImuPro (type III food allergy and inflammation profiling). My question is: How effective and reliable are these genetic and immunological tests — such as 23andMe, Glycanage, ImuPro, and DNA performance analyses — in guiding interventions for longevity (lifespan and healthspan)? Specifically, how valuable is their insight into traits like inflammation markers, caffeine metabolism, medication response, and micronutrient deficiencies (magnesium, zinc, etc.)? In your view, how should these datasets be integrated — or weighed — in a comprehensive longevity protocol for someone who trains and competes regularly, but supplements only when clinically indicated by diagnostic evidence? And are there other, more validated or emerging genetic or molecular assays you would recommend that could meaningfully impact long-term health outcomes? Thank you
Repatha effect on body composition
Hello, Background: I am a 120lb, low body fat, 59yo F with rather significant ASCVD and have been taking Repatha (after experiencing near rhabdomyolysis with Atorvastatin) since July 2025. I have also been taking hormone therapy since December 2024 in an effort to delay further bone loss. I have been a lifelong moderate exerciser (running, biking) and added consistent weight training in the Fall of 2024. I purchased a HUME body scanner in March 2025 to better track my progress. It reflected consistent increases in muscle mass and slight decrease/constant body fat month to month UNTIL July 2025, when I started Repatha. Since then, the numbers have inverted (body fat up, muscle mass down) each time I step on the HUME. In fact, it seems that my strength is actually decreasing despite rest days, not being “overtrained”… Is there a correlation between Repatha and body composition? I am beginning to feel defeated due to the fact my ApoB was 113 without Repatha and I clearly need something. My physicians are not concerned about body composition and have no answers. Thank you.