The role of testosterone in males and females, performance-enhancing drugs, sustainable fat loss, supplements, and more | Derek, More Plates More Dates Pt.2

Peter Attia

Feb 26, 2024

Episode description

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Derek is a fitness educator, the entrepreneur behind More Plates More Dates, and an expert in exogenous molecules commonly used and misused by bodybuilders and athletes. In this episode, Derek returns to the podcast to explore the impact of exogenous molecules on male and female health. He covers testosterone, DHT, DHEA, progesterone, clomiphene (Clomid), hCG, and various peptides, alongside updates from the FDA affecting peptide use. Additionally, he addresses the recent hype around increasing muscle mass through myostatin inhibition via follistatin gene therapy and supplementation. Additionally, Derek discusses the various strategies that bodybuilders use for losing fat while preserving muscle, including insights on weight loss drugs.

We discuss:

  • Testosterone and DHT: mechanisms of action, regulation of muscle growth, and influence on male and female characteristics [2:15];

  • TRT in women: the complexities and potential risks associated with testosterone use in women [9:00];

  • DHEA supplementation: exploring the benefits and risks for women, and the differing effects on men vs. women [22:00];

  • The role of progesterone in both men and women, pros and cons of supplementation, the importance of tailored doses, and more [28:00];

  • Measuring levels of free testosterone [37:15];

  • The trend towards earlier interest in TRT, and the risks of underground sources of testosterone [42:00];

  • The complexities and considerations surrounding the use of Clomid, E-Clomid, and hCG in TRT [46:00];

  • Low testosterone: diagnosis, potential causes, treatment options, and other considerations [53:45];

  • Growth hormone-releasing peptides: rationale and implications of the recent FDA categorization as high-risk substances [1:03:45];

  • Follistatin gene

Episode description

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Derek is a fitness educator, the entrepreneur behind More Plates More Dates, and an expert in exogenous molecules commonly used and misused by bodybuilders and athletes. In this episode, Derek returns to the podcast to explore the impact of exogenous molecules on male and female health. He covers testosterone, DHT, DHEA, progesterone, clomiphene (Clomid), hCG, and various peptides, alongside updates from the FDA affecting peptide use. Additionally, he addresses the recent hype around increasing muscle mass through myostatin inhibition via follistatin gene therapy and supplementation. Additionally, Derek discusses the various strategies that bodybuilders use for losing fat while preserving muscle, including insights on weight loss drugs.

We discuss:

  • Testosterone and DHT: mechanisms of action, regulation of muscle growth, and influence on male and female characteristics [2:15];

  • TRT in women: the complexities and potential risks associated with testosterone use in women [9:00];

  • DHEA supplementation: exploring the benefits and risks for women, and the differing effects on men vs. women [22:00];

  • The role of progesterone in both men and women, pros and cons of supplementation, the importance of tailored doses, and more [28:00];

  • Measuring levels of free testosterone [37:15];

  • The trend towards earlier interest in TRT, and the risks of underground sources of testosterone [42:00];

  • The complexities and considerations surrounding the use of Clomid, E-Clomid, and hCG in TRT [46:00];

  • Low testosterone: diagnosis, potential causes, treatment options, and other considerations [53:45];

  • Growth hormone-releasing peptides: rationale and implications of the recent FDA categorization as high-risk substances [1:03:45];

  • Follistatin gene

Mindsip insights from this episode:

Rely on accurate LCMS tests for hormone assessment

An example showed a standard estradiol test was over double the result of the more accurate LCMS test (41.3 vs 18.3), potentially due to supplement interference.

Inject L-carnitine to enhance bioavailability and avoid TMAO

L-carnitine is often injected because its oral bioavailability is only 10-15% and injection bypasses the gut's conversion to the potentially concerning compound TMAO.

Transform protein shakes into satisfying ice cream with Ninja Creamy

The Ninja Creamy machine is a popular gadget for turning protein shakes into a highly satiating ice cream, helping to manage cravings during a diet.

Manage free DHT levels to reduce anxiety on TRT

Men on TRT often have disproportionately high free DHT due to lowered SHBG, which can lead to a perpetually anxious or 'keyed up' state.

Unmask fitness photo fakes through lighting and posture manipulation

Fitness 'before and after' photos are easily faked on the same day by manipulating lighting, muscle pump, food-induced bloating, posture, and even facial expressions.

Understand Clomid limitations in raising testosterone levels

Clomid may fail to raise testosterone in men with very low estradiol because there isn't enough estrogenic negative feedback to inhibit in the first place.

Monitor voice changes with decibel recorder during androgen use

Some female bodybuilders use a decibel voice recorder to monitor for irreversible voice changes when using androgens.

Restore testosterone levels with DHEA during birth control use

A study showed that 50mg of DHEA per day can fully restore total and free testosterone levels in women whose hormones are suppressed by combined oral contraceptives.

Balance anxiety on TRT with progesterone supplementation

Some men on TRT use 50-200mg of progesterone to help balance the sympathetic drive and anxiety from perpetually high free androgen levels.

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