Dr. Peter Attia

Yeah. I'll tell you why I find that interesting, Paul. And I only learned that really in talking to bodybuilders who were taking 500 to 2,500 milligrams of testosterone a week. Because my initial reaction to that was you've already saturated the androgen receptor probably five logs. I mean, not five logs, but like at least one or two logs earlier. But they convinced me, no, no, no.

Yeah. I'll tell you why I find that interesting, Paul. And I only learned that really in talking to bodybuilders who were taking 500 to 2,500 milligrams of testosterone a week. Because my initial reaction to that was you've already saturated the androgen receptor probably five logs. I mean, not five logs, but like at least one or two logs earlier. But they convinced me, no, no, no.

There is a real difference between 500 and 1,000 and 2,500 in terms of muscle mass, which it sounds like you agree with. And I don't understand the physiology of how that's possible. I don't, I mean, how many androgen receptors would you need? You'd have to upregulate them when in fact you'd be downregulating them. So I'm not sure, but the effect is indirect.

There is a real difference between 500 and 1,000 and 2,500 in terms of muscle mass, which it sounds like you agree with. And I don't understand the physiology of how that's possible. I don't, I mean, how many androgen receptors would you need? You'd have to upregulate them when in fact you'd be downregulating them. So I'm not sure, but the effect is indirect.

There's even studies that show, by the way, that high enough doses of testosterone will increase muscle protein synthesis absent the stimulus, absent the lifting stimulus. So it's the potential to recover that is improving.

There's even studies that show, by the way, that high enough doses of testosterone will increase muscle protein synthesis absent the stimulus, absent the lifting stimulus. So it's the potential to recover that is improving.

All right. So now let's talk about the guy who comes to see you. He's been on exogenous testosterone for three years. So he was given poor advice three years ago. He went to some shady back alley website. He was 27 years old at the time. I mean, this is tragically a very common story by the way, right? So this guy has been on 200 milligrams of testosterone a week for the past three years.

All right. So now let's talk about the guy who comes to see you. He's been on exogenous testosterone for three years. So he was given poor advice three years ago. He went to some shady back alley website. He was 27 years old at the time. I mean, this is tragically a very common story by the way, right? So this guy has been on 200 milligrams of testosterone a week for the past three years.

He's now 30 years old. He's met the love of his life. Lo and behold, they can't seem to get pregnant. So he's in your office. During the history, you find out pretty quickly he's been on 200 milligrams of testosterone for three years. Tell me what his sperm analysis looks like. Presumably there are no sperm. I would bet 95% confidence that he would have no sperm in his semen. Okay.

He's now 30 years old. He's met the love of his life. Lo and behold, they can't seem to get pregnant. So he's in your office. During the history, you find out pretty quickly he's been on 200 milligrams of testosterone for three years. Tell me what his sperm analysis looks like. Presumably there are no sperm. I would bet 95% confidence that he would have no sperm in his semen. Okay.

So what are you telling him now? How are you going to solve this problem?

So what are you telling him now? How are you going to solve this problem?

You always have to get it out of it. If they're super jacked, but then they have shriveled testes. Yeah. And they're zero. And they're wondering what, you know, right?

You always have to get it out of it. If they're super jacked, but then they have shriveled testes. Yeah. And they're zero. And they're wondering what, you know, right?

This is the same, by the way, as I'm sure you experienced as a resident in the ER. The people that come in with foreign rectal bodies and abdominal pain That's the one thing they emit from their history. They tell you, you know, this is the last time I ate. This is this, this is this. But then you get the x-ray back and there's like a candlestick in their colon. And then you say, yeah, yeah.

This is the same, by the way, as I'm sure you experienced as a resident in the ER. The people that come in with foreign rectal bodies and abdominal pain That's the one thing they emit from their history. They tell you, you know, this is the last time I ate. This is this, this is this. But then you get the x-ray back and there's like a candlestick in their colon. And then you say, yeah, yeah.

What about this candlestick? And they're like, oh, I totally forgot to mention that. Yes, yes. It was lit when it went in.

What about this candlestick? And they're like, oh, I totally forgot to mention that. Yes, yes. It was lit when it went in.

But not everything.

But not everything.