RFK Jr. ep is a no brainer for Brother Attia
RFK jr. said that he's gathering data for his first 100 days, before what I consider will be then launching a nuke into teh pay-offs that have altered the natural course of good scientific medicine. I feel he will do this gracefully though, without fully exposing the entire pay-off system. (ie... he needs results quick & only has 4 years to do it, & so doesn't have time for "he said/she said".) I'd love nothing more than for your team to chime in... before & after this nuke goes off. Ideally it's a gradual & graceful transition, but either way... a complete restructuring of the medical system is about to take place from the US government down, & I'd love to see your (our) team on the forefront of this discussion. What would you advise & share with Mr. Kennedy? ...& what questions do we ask?
Treating Elevated Glucose
When my LDL increased from 107 to 185 (in 6 months) after adding Repatha to my 10mg Rosuvastatin, my cardiologist took me off Repatha and increased my dose of Rosuvastatin to 40mg. Since I had already seen an increase in both fasting glucose and HbA1c when starting the 10mg dose of Rosuvastatin I decided to begin using the Stelo CGM. After 2 months using the CGM I have an average glucose of 107 mg/dl, GMI of 5.9% and Cof V at 14.2%. However, this is using exercise snacks post meals and almost a complete elimination of fruit. At 62 I am pulling all the health levers possible with 15% body fat on Dexa, heavy lifting 4-times a week, Zone 2 4-times a week and HITT twice a week. My question is at what point do I consider adding metformin do reduce my average glucose readings? I should mention my calcium CT score is what has made me so hyper focused on this situation.
Neurofeedback
Hello - The research I have reviewed for the impact of neurofeedback is mixed...mostly not great. Can you share your perspective about the efficacy of neurofeedback? And, what are some alternatives people can consider to neurofeedback? Not sure if knowing the symptoms would help you answer this question, but if so, consider it in the context of rumination, attention span difficulties, memory, and hypervigilience (trauma induced). Thank you!
RPE or HR when completing intervals
I have a concept two bike and an assault bike. As you know, the assault bike will add an arm drive thus increasing my heart rate more so than a concept 2. When doing my intervals, should I focus more on RPE or driving my heart rate higher? I’ve done a Vo2 Max test so I know where my zone is four and five are but I realize that, again because of the arm drive, I can increase my heart rate far more on the assault bike then I can the concept 2. On the concept 2, my heart rate still gets into zone four, the upper I might add, and I feel a great amount of pain at the end of my interval. It’s just that my heart rate does not elevate as much on the assault bike. What would you recommend I focus on or is it a simple combination of both?
HRT as preventative measure for women in early menopause
My question is related to my own case. I am currently 41, in menopause since the birth of my first child at 38yo. I was diagnosed with premature ovarian failure and had to use donor in order to have children. I am currently 7 weeks postpartum with my second child. My menopause symptoms were not too bad, some hot flashes, mild anxiety and congitive issues. I currently have osteopenia, vaginal atrophy and dryness but most of the symptoms I described are gone and after listening and reading all your content on HRT, I am considering it as a prevention for heart disease, dementia, bone loss etc. but I am not clear if it can help as a preventative measure in cases like mine, where it is really too soon to be “without hormones” but the HRT would not be taken to manage menopausal symptoms. Can HRT be beneficial in young patients who go to menopause early in life but they do not need it in order to manage symptoms? Thank you very much
Flexibility
Peter, I definitely could be wrong, but I don't believe I've seen a show dedicated to FLEXIBILITY. I think it is a crucial topic, especially when discussing Stability. I would love to hear more about the science of flexibility, and how one can become more flexible....how to stretch, when to stretch, does eating/inflammation effect one's flexibility, why is one born more inflexible, etc. It's a topic with a lot of mill-of-the-run opinions, but looking for FACTUAL data. Thanks!
Cholesterol
I have had cholesterol levels over 200 (208-257) for 20 years. My Calcium score has been 0 so my GP has not been concerned, I am 5'3" and weight 120lbs. I track my blood pressure regularly and it has not been over 120/80 for the past year. I monitor my diet judiciously and exercise every day (walking, kettlebells, floor work,) I am 75. My family history encompasses obesity (mother, grandmother, sisters) , diabetes (maternal grandmother), cancer (paternal grandfather, uncle), liver disease (mother), thrombosis (father). I have asked my doctor to do the blood test and include your recommendations. THe tests are all normal except for cholesterol of 241, Anything else I should do? Any thoughts?
Approaching conversations with your Doctor & finding a PCP.
Peter, if you weren’t a doctor and were picking up useful medical knowledge from a podcast, how would you approach nudging your doc about receiving lipid treatment when they don’t look at ApoB, and hand wave your high LDL because your HDL is high. Also, how might you go about finding a new PCP who is bought into pursuing preventive care?
Insulin resistance in Type 1 Diabetes
I would like to understand the role of insulin resistance in Type 1 diabetics. My 19 year old son was recently diagnosed and we are in month 4 with an A1C still over 10. I’m told it takes time to get control with a. We diagnosis but I don’t feel like there has been enough emphasis on the importance of control and what may be contributing (ie resistance). I also know some with T1D on GLP meds. Would love an overlay in depth update on this disease.
Sex differences in responses to calorie restriction
What do we know about the differences in male and female responses to calorie restriction? Are there specific methods for reducing calorie intake that are particularly suited to reducing BF% in females vs males? What strategies would be indicated for weight loss in an adequately-muscled, over-nourished (overweight but non-obese), insulin-sensitive, pre-menopausal woman vs a man of the same age and characteristics?
Exercise after 70
Just saw a Jordan Peterson video that said endurance exercise after 70 might be counterproductive. That strength building is much more beneficial, with less or moderate endurance emphasis. What is you take on this? I’m 77 and try to do about 15 minutes on the rowing machine 3 times a week. I get my HR up to around 130-135. I’m type 2 diabetic, hypertension, two artificial hips, among other things. 168 lbs, 5’9”. Still working desk job.
Fasted Training: Boost or Bust?
I struggle to find clear evidence on whether fasting before exercise is beneficial. My routine includes: 4x per week – 45 min of Zone 2 cardio (elliptical) + 75 min of strength training 1x per week – 30 min VO2 Max swimming 1x per week – 1 hour of Zone 2 swimming I'm comfortable training fasted on cardio-only days, but conflicting information surrounds strength training. Could training in a fasted state harm performance, impact health, or be counterproductive? Or is it a viable approach? Additionally, when pre-feeding before cardio and strength training, should I prioritize carbs for fuel? Or would a combination of healthy fats, MCTs, and protein be more effective? What’s the optimal timing for this pre-workout meal? Currently, I eat breakfast at 9:00 AM, start cardio at 10:15 AM, and begin strength training at 11:15 AM. Given this schedule, what’s the best approach for fueling? I train hard for my age (47), rating my effort at about 8/10, though I’m not a competitive athlete. I’d appreciate any insights. Thanks!
Updated guidelines on CRC screening?
Last post on CRC was in 2022. What is the update on CRC screening both in terms of techniques (colonoscopy, colonoscanner, stool, blood?, etc...), and recommendation on age, balancing risk/rewards. Would love a guest episode on this as complete as the amazing episode on prostate!
Enclomiphene as a TRT Option
Hi Dr. Attia, Thank you for all the work you do — I’ve been a longtime listener and truly appreciate your focus on metabolic health and longevity. I’m 43 and have been working hard to reduce mild insulin resistance (based on my A1c and CGM data) through many of the practices you recommend: strength training 3x/week (1–1.5 hrs), Zone 2 cardio 4x/week (with Morpheus HRM and lactate testing), careful dietary management (low glycemic, carb/protein balanced, minimally processed foods), and regular monitoring with DEXA and Function Health labs. Despite these efforts, I’ve noticed age-related declines in strength and energy. My testosterone hovers around 400, and I’m curious whether increasing it to a higher normal range (800–900) could help optimize my healthspan. However, I’m hesitant to commit to lifelong injections, which is why enclomiphene has caught my attention as a potentially safer, more natural way to boost endogenous testosterone. I know enclomiphene isn’t FDA-approved and long-term data is limited. But before considering injections, I wonder if this could be a viable approach to assess whether higher T levels improve my quality of life. Given my context — family history of early-onset type 2 diabetes (mother), and ongoing efforts to mitigate insulin resistance — do you see enclomiphene as a reasonable option? Thank you for any insights you can share. Best,
Have you ever heard of Function Health, and if so, what do you think of it?
Function Health is a company which offers 100+ annual biomarker tests for an annual fee of $499. I have no idea what many of these tests are, and I am wondering what you think of the value of their program, if you have ever even heard of it.
Indoor rock climbing/bone density
I have been rock climbing for the last year and a half. I try to fit it in twice per week. It is very enjoyable and I have seen an increase in my strength, especially grip strength. Is there research that shows any benefit for overall bone density? I would think by loading the body in this way, can only increase bone density at any age.