#276 ‒ Special episode: Peter answers questions on longevity, supplements, protein, fasting, apoB, statins, and more

10/23/23 • 79 min

3 Listeners

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In this special episode of The Drive, Peter discusses a variety of topics, breaking away from the typical deep-dive format to explore a wide range of common questions submitted by listeners. Peter tackles subjects like the viability of living to 120 and beyond, addressing some of the optimistic theories regarding achievement of this remarkable feat. Peter then shares his drug and supplement regimen while emphasizing how individualized these protocols need to be. The conversation also touches on lowering apoB, the long-term use of statins, the myth of good vs. bad cholesterol, the complexities of nutrition research, the quest for the ideal diet, and Peter's strategies for hitting daily protein goals. Peter finishes with a discussion about his favorite health-tracking wearables, the role of CGM in non-diabetics, and more.

We discuss:

Overview of topics and previous episodes of a similar format [2:45];
The viability of living to 120 and beyond: some optimistic theories [4:45];
The potential of mTOR inhibition as a mid-life intervention, and longevity potential for the next generation [13:30];
A framework for thinking about geroprotective drugs and supplements in the context of a lack of aging biomarkers [17:00];
Supplements Peter takes and how his regimen has changed in the last year [26:15];
Pharmacologic strategies to lower ASCVD risk, the limitations of statins, nutritional interventions, and more [36:15];
Misnomers about cholesterol [48:00];
Why nutritional research is so challenging, some general principles of nutrition, and why Peter stopped doing prolonged fasts [50:45];
Optimizing protein intake [59:45];
Wearables for sleep and exercise, continuous glucose monitors (CGM), and a continuous blood pressure monitor on the horizon [1:04:45]; and
More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube

View the Show Notes Page for This Episode

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We discuss:

Overview of topics and previous episodes of a similar format [2:45];
The viability of living to 120 and beyond: some optimistic theories [4:45];
The potential of mTOR inhibition as a mid-life intervention, and longevity potential for the next generation [13:30];
A framework for thinking about geroprotective drugs and supplements in the context of a lack of aging biomarkers [17:00];
Supplements Peter takes and how his regimen has changed in the last year [26:15];
Pharmacologic strategies to lower ASCVD risk, the limitations of statins, nutritional interventions, and more [36:15];
Misnomers about cholesterol [48:00];
Why nutritional research is so challenging, some general principles of nutrition, and why Peter stopped doing prolonged fasts [50:45];
Optimizing protein intake [59:45];
Wearables for sleep and exercise, continuous glucose monitors (CGM), and a continuous blood pressure monitor on the horizon [1:04:45]; and
More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube

Previous Episode

#275 - AMA #52: Hormone replacement therapy: practical applications and the role of compounding pharmacies

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In this "Ask Me Anything" (AMA) episode, the discussion zeroed in on the practical application of hormone replacement therapy in women. Peter walks through the signs, symptoms, and hormonal changes in women approaching – and going through – menopause. He provides an overview of the FDA-approved HRT formulations and explains how women might go about choosing the right option for themselves. Peter also describes the significant changes in testosterone levels in women over time and the options, as well as the considerations and challenges of testosterone replacement therapy (TRT) for women. Lastly, Peter highlights the necessary role of compounding pharmacies in HRT, underscores concerns regarding the quality and sterility of compounded drugs, and offers guidance on locating a trustworthy pharmacy.

If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #52 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

Why hormone replacement therapy is such an important topic [2:00];
The onset of menopause: symptoms, blood tests, and when to consider HRT [6:00];
Tests that may provide indications of perimenopause and their implications for fertility [9:15];
Vasomotor symptoms: hormonal changes that cause hot flashes/night sweats, and HRT therapies that can help [13:45];
The role of estrogen in menopausal HRT [17:30];
The limited role of progesterone in HRT protocols [25:15];
What is a “bioidentical” hormone? [28:30];
Overview of the FDA-approved HRT formulations [31:45];
Determining HRT dosing and considerations for perimenopausal women [37:45];
Choosing the right HRT formulation: pros and cons [43:30];
Examining the link between certain forms of estrogen and breast cancer [46:45];
Changes in testosterone levels in women over time and why it matters [50:00];
Recognizing low testosterone in women: common symptoms and diagnosis [53:45];
Testosterone replacement therapy for women: options, considerations, and challenges [57:30];
The long-term use of testosterone in women: examining the limited data [1:00:15];
What is a compounding pharmacy? [1:09:30];
Reasons to opt for a compounding pharmacy over a pharmacy that adheres to stricter regulations [1:16:00];
The tragic incidents that heightened concerns about compounding pharmacies [1:20:45];
Tips for finding a reputable compounding pharmacy [1:27:45]; and
More.

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Next Episode

#277 ‒ Food allergies: causes, prevention, and treatment with immunotherapy | Kari Nadeau, M.D., Ph.D.

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Kari Nadeau is a physician scientist with expertise in treating food allergies. In this episode, Kari first explains the fascinating workings of the immune system, exploring how it adeptly defends against bacteria and viruses but how the same system can lead to food allergies. She proceeds to explore the complexities of food allergies, detailing their typical developmental patterns, underscoring the significance of preventative approaches like early exposure, and highlighting the potentially life-threatening nature of severe food allergies. Kari illuminates the latest advancements in immunotherapies that not only mitigate allergy severity but also hold the potential to completely cure the patient. Additionally, Kari shares her concerns about the increasing levels of air pollution, elucidating its adverse effects on health while providing valuable suggestions for reducing exposure.

We discuss:

Kari’s motivation to study food allergies [4:00];
Overview of the immune system and the family of immunoglobulins [9:00];
How our immune system fights viruses, bacteria, or fungi, and some exceptions to the rule [13:00];
Why our immune system is generally better at fighting viruses than bacterial infections [18:45];
Differentiating a food sensitivity from a food allergy, and a discussion about celiac disease [25:30];
How food allergies develop, why they can be lethal, and factors contributing to the uptrend in food allergies [35:45];
The role of environmental factors in the onset of food allergies and strategies for prevention [50:15];
How immunotherapy helps to overcome, and even cure, food allergies [1:04:15];
Can immunotherapy work for environmental allergens like pollen? [1:24:00];
Air pollution: impact on health and tips for reducing your risk [1:25:30];
Resources for those wanting to learn more or find clinical trials related to food allergies [1:40:45]; and
More.