#63 – AMA #7: Exercise framework, deadlifting, lower back pain, blood pressure, nootropics, CGM, and more

“The single greatest risk to my longevity is my lower back.” —Peter Attia

Read Time 15 minutes

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from subscribers. Bob Kaplan, Peter’s head of research, asks the questions. If you’re not a subscriber and 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. You can also watch (or listen) to this full episode on our website at the AMA #7 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

AMA #7 Sneak Peak:

We discuss:

  • What can I do to prevent/reduce interruptions in sleep due to needing to get up to urinate at night? [2:15];
  • Peter’s note card system for organizing his to-do lists [6:15];
  • How do I get smarter at reading/understanding the studies (or the media’s interpretation of them) that get the headlines on health and/or disease? [10:30];
  • How can I obtain a continuous glucose monitor (CGM) as a non-diabetic individual? [11:55];
  • What is the most effective way to bring blood pressure down? [15:00];
  • Does Peter use any nootropics? [28:10];
  • Peter’s thoughts pertaining to concussions and head trauma [33:00];
  • Does Peter structure his exercise plan for lifespan or healthspan? [36:45];
  • How did Peter rebuild his lower back strength after his devastating injury during med school? [38:15];
  • Peter’s approach to deadlifting with a bad lower back [43:25];
  • Did Peter cave and buy a dog? [51:50]; and
  • More.


What can I do to prevent/reduce interruptions in sleep due to needing to get up to urinate at night? [2:15]

Step 1: Don’t drink water too close to bed (captain obvious)

Step 2: Avoid alcohol

  • Alcohol inhibits a hormone called ADH, antidiuretic hormone, also known as vasopressin
  • Alcohol disproportionately will drive you to want to pee

If you’ve taken those first two steps and you’re still having trouble, you may want to contact your doctor and 

  • Investigate prostate size (men); and/or
  • Measure a “post void residual” for urinary retention (men and women)

Peter’s note card system for organizing his to-do lists [6:15]

  • Peter carries note cards in a pouch made by Levenger
  • He uses 3” by 5” cards

The system

  1. First card (green or white)=daily to do list

{end of show notes preview}

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  1. Great episode thank you. If you pursue concussion please check the work of Micky Collins at UPMC, he has done ground breaking work and helped my daughter and many, many other athletes and non athletes

  2. Hey everyone….

    How does ADMA play into kidney function? Is this an important marker as far as endothelial health? Just trying to get a handle on this….


  3. Can anyone find a similar leather pouch to the one Dr. Peter Attia uses?

  4. Just a heads up that your timing in brackets, doesn’t line up with the podcast. I’m assuming you add the intro after. Thank you for your great information!

  5. Regarding Peter’s To-Do list card system: His approach can be directly applied to the Trello app by setting up “Boards” titled Today, This Week and Later. In fact I have exactly this system but over time I have added Boards for
    – “Waiting for” for delegated items or questions sent out by email or vmail with dates by which I expect an answer or report or the need to follow up.
    – “Periodic items” for items I must do on a repeating schedule.

    By moving away from paper (note cards) onto Trello I’m not having to rewrite items but can just move them around from Board to Board in the app.

    I have used numerous to-do list organizers over the years. I’ve found Trello to be the best ever for my approach, which turns out to be the same as Peter’s.

    I have no connection to Atlasian, the creator of Trello. I’m just a happy user.

    • Same here. They mentioned it’s a simple model, maybe the Omron 3? That seems to check the boxes, but some Amazon reviews say it reads off (20 mmHg high). I’d also like to know which they recommend because there are wrist/upper arm models, and features galore…

      • Ditto E H. I’d like to get a monitor as well, would definitely trust Peter’s recommendation above the spotty reviews by people not using them correctly. I believe he mentions upper arm when describing using it, so that would eliminate wrist models.

  6. Not sure if Peter has looked at Biotensegrity in relationship to his back. Dr Levine has an interesting video on this topic. https://en.wikipedia.org/wiki/Tensegrity.
    Tim Ferris also had a brief mention of squats in his Chef book and emphasizes hinging exercises.
    With these factors in mind, I think it would be helpful to demonstrate something that the older crowd could do at home, i.e. kettlebells, for the Centenarian olympic training. The Hex bar might be nice, but it large and expensive.
    What precautions for those with spinal stenosis and general L-S degenerative diseases?

  7. What would be a more useful test (in terms of general protective health markers) to see if lifestyle tweaks are working, done i.e. 2 months apart: OGTT, apoB/lipid profile, or simply doing glucometer tests on a regular basis (no CGM available)?

    I’m 29 and interested in getting some of the recommended tests done, but since docs in Canada aren’t terribly liberal with ordering them covered they can be prohibitively expensive for the end user.

  8. “The single greatest risk to my longevity is my lower back.”

    I would love a discussion on what you think about John Sarno.

  9. For lumbar problems, please at least look at the lifetime of research by Dr. Stu McGill. It will spare you a lot of unnecessary and painful heavy lifting! Good luck!

  10. Has Peter released his framework for exercise yet? It says here he will be releasing it in 2019

  11. I recently came across this video which contradicts the use of a hex/trap bar: https://startingstrength.com/video/why-the-trap-bar-is-completely-useless

    Or does it? I have had a “bad lower back” for 35 years or so since a college football injury and have never been able to do deadlifts (squats with low weight are OK). Probably because of improper form. I would like to learn and am wondering which bar I should use

    Anyway, I would like to hear Peter’s response to that video by Mark Rippetoe, thank you!

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