Low testosterone: diagnosis, potential causes, and treatment options | Peter Attia and Derek MPMD

This clip is from episode 291 ‒ The role of testosterone in males and females, performance-enhancing drugs, sustainable fat loss, supplements, and more with Derek, More Plates More Dates. 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 clip, Derek and Peter discuss:

- What can impair pituitary function?
- Are there guys that can recover after 10 years of TRT?
- What can you do to maximize testosterone production?
- And more

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About:

The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.

Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.

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[MrStreetninja]

The craziest part to all of this is that Derek is self-taught in everything.

[paulsacramento]

Under recovery is a term that is NOT used enough. It isn't about how much you train, it's if you have sufficient recovery so that you are note in a chronic state of cortisol.

[GARZA_ICMG]

I recently went thru a weight loss journey, test was at 632 at 256lbs, down to 479 after dropping to 196. I went through overtraining and a loss of libidos after the weight loss. I have since got back up to 211lbs no longer in a deficit and now my test is at 732 @33yrs old. Only taking protein, creatine a multi a d3/k2 supplement! I’m feeling great now

[Ziggle-kykv]

A book that changed my life in ways that I never could imagine is "Secret Testosterone Nexus of Evolution".Drop whatever you're doing right now and go find that book. Trust me after I implemented things from the book my testosterone levels went beast mode

[superawesomefuntimego]

I just turned 50 and have been battling with insomnia, poor sleep, constant fatigue, lack of mental clarity, 0 sex drive (sex maybe once or twice a year), increased weakness for the past several years. I have had multiple blood tests performed and sleep studies, but my doctor has never offered to test my testosterone levels. I work out and mountain bike regularly, but my energy is a shell of what it was even 5 years ago and it is a battle each time. My FTP is down 20-25% despite still riding similar mileage and elevation. I am wondering if my next step is to actively request a test for low testosterone?

[TheJustina]

Half of what is said on this podcast sounds like a foreign language that I do not know how to speak…. Yet I still love it.. haha

[ericmckelvey]

How do you find a worthwhile endocrinologist?

[barkleyhunt]

insane how Derek absorbs this information. Just shows there are very smart people out there who are not M.D's. Thank you Peter for looking past this and seeing his knowledge for what it is. he's a pro and has helped so many. Rogan respected him early on too.

[nikobt]

In my opinion, Dr. Attia's line of questioning and closing commentary on replacement therapy are telling. The comments are as well. I hope people considering this path educate themselves appropriately.

[barrysmith]

“Understanding this before you go down the rabbit hole” may sound like good advice though I defy you to find where you can get quality and correct Testosterone advice. I discovered that my dr had increased my weekly dosage by 25 % without conferring with me. What I thought was my combat PTSD was returning was in reality a continuing weekly over dosage of testosterone. Many of the symptoms are the same. I got tested to confirm my suspicions and my new reading was no longer in the 850 range. In 8 short weeks it was now 1247! After many conversations with many so called experts I finally got the truth from my pharmacist that indeed I was overdosing. Yes ….I’m not going back to that doctor ever. I only found this out because I give my own shots to myself.

[rickyfulbrook]

I just found out I have low t and as a fit 35 year old trying to bulk this is completely crushing. I mean I've always known test levels are lower than ever before in men and that they get lower with age. I've always looked after myself I'm in good shape and I get plenty of sleep. Turns out I don't even have average levels for my age. I'm just getting sick of sucking at life.

[BillMan]

My free T was below Normal range. My total T was around 325. Felt Terrible. Started 100ml test CYp a week. GAME CHANGER. Just do it

[mikeydiker]

How do you find a local doctor or provider that specializes in TRT? I'm having a hell of a time finding someone locally to me.

[whoknew]

Have been on trt 0.5 cyp a week for lil over a year with no problems.however the had problems with my refill missed like 3 weeks and all hell broke lose..started getting crazy anxiety i never had prior brain fog overall feeling terrible.my test had crashed i suppose did my bloodwork but it was fine around 600 test estradiol was 39 tho..restarted treatment anxiety and panic attacks went away but still feel terrible especially in the mornings not sure why?Almost regret starting trt just wanna feel good again.

[scatdaddy]

Great discussion. Much deeper than the “ your numbers are low use hrt “

[DanMaul-ipis]

I recently had my testosterone tested. It came back at 86. I’m 42, 185lbs, in decent shape. Can run a 5k tomorrow if needed.
But taking testosterone scares me. I don’t like being dependent on pharma. But I feel off. Always tired, fatigued. Many issues. But not sure I want to to take fake test

[jonasleonas]

Got stuck, as cant find a problem for my 35y old Primary Hypogonadism. Training every 2nd day, eating healthy calculating calories... Have all the low t symptopms... T levels of total> 150 Free T also way bellow normal. LH, FSH, Prolactin, SHBG, TSH, are fine in normal range, DNA kariotype is fine as I dont have XXY or anything like that. Waiting for Iron, Progresterone, Estrogen results, but what next if they are in normal levels?

[Poppy_love]

When regular Doctors talk about normal hormone levels what they don't tell you is they mean the regular hormone levels for your sex and age. Not the hormone levels as they were in your peak age. So if you want to supplement for longevity or even just to feel younger you need to get your hormone levels back to their peak!

[petersoar]

Hey, so, recently I got my total testosterone tested and it was 323ng/dl. As someone who has recently benched 400lbs and deadlifted 580lbs and just generally doesn’t have a bad time in the gym at all, what gives??

[RunningWithSauce]

Nobody is addressing the elephant in the room. In the first world, we are seeing a consistent drop in Testosterone for all men across all age groups when compared to decades ago. The fragrance industry is self regulated and loading up things like laundry detergent with endocrine disruptors. Imagine wearing an off gassing endocrine disruptor all day and co mingling with other humans indoors who do the same.