September 30, 2019

Exercise & Physical Health

#73 – AMA #9: NAD & metformin, fat-burning zone, creatine, estrogenization of men, emergency kit for cold & flu, and more

"The sky is blue, and the trees are green; therefore, I should eat cyanide." — Peter Attia on the type of brilliant logic people use to suggest you burn more calories while sleeping vs. exercising

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 #9 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

AMA #9 Sneak Peak:

We discuss:

  • The story of how Peter almost worked for Theranos [2:00];
  • The trend of lower testosterone and higher estrogen in men: Why is it happening and what to do about it? [10:00];
  • Takeaways from Peter’s recent hunting trip in Hawaii [14:45];
  • What books are you currently reading/listening to? [21:30];
  • What advice would you give to the 25 year-old Peter? [24:00];
  • What is your emergency protocol if you start getting sick? [27:45];
  • How have your thoughts changed on NAD precursors, and also on metformin, in the past year or so? [30:30];
  • What are your thoughts on “fat burning” zones for cardio workouts? — A lesson in relative vs. absolute fat combustion [34:15];
  • What mental models do you use and how do you go about solving problems and approaching difficult questions? [49:00];
  • Creatine supplementation—Yay or nay? Why? [49:30]; and
  • More.


The story of how Peter almost worked for Theranos [2:00]

⇒ For a primer on Theranos and why this is even interesting…

An offer from Theranos

  • In 2006, Peter was working at McKinsey & Company in Palo Alto
  • Theranos contacted him and he was offered their Chief Medical Officer position
  • He met with Elizabeth Holmes
  • They looked at the black box machine together and discussed business and technology

Decided not to take the job for several reasons

  • First, someone Peter trusts did not say anything good about one of the investors in Theranos
  • Secondly, loved his job at McKinsey
  • Third, wasn’t convinced that what you could test in a box that size was interesting
    • I knew enough about diagnostics and…chemistry that I knew that there was…not going to be anything you could do on a drop of blood, in a box that size, that was clinically interesting.” 

8 years later

  • In 2014, 8 years after declining the job, Forbes valued Theranos at $9 billion
  • Calculated the money he would be worth if he had taken the job, “life changing money”

In 2015 

  • Peter was at a fundraising event where Elizabeth was the top speaker (ahead of Mark Zuckerberg) 
  • Elizabeth saw Peter and remembered him from 9 years prior
  • They exchanged contact info and kept in touch for a while
  • 2 days after this event, John Carreyrou put on an article in the WSJ exposing some of the fraud going on at Theranos

Cognitive dissonance

  • Here is Elizabeth as the headliner at this “who’s who” event
  • Simultaneously, she knows her world is about to get super messy was the WSJ article releases
  • From a psychology standpoint, Peter says he doesn’t believe that Elizabeth ever thought she was doing anything wrong
  • Which is not for a moment to say, she shouldn’t be held accountable for what happened
  • She should be absolved of the responsibility of what she’s done
  • But it’s a very important distinction… you can be so delusional that you really believe that the lies you’re telling are for the better good

Did Peter ever suspect fraud from Elizabeth and/or Theranos?

  • I never suspected [fraud]. . .I just thought it was the world’s most uninteresting business in the history of civilization. Like point of care testing in a drug store for Chem-7, and CBC? I would have more interest in a business that specialized in removing hangnails and nose hairs.


The trend of lower testosterone and higher estrogen in men: Why is it happening and what to do about it? [10:00]

Lower T, Higher E

  • If you took blood samples from a group of men in the 1950s, and did the same for a similar group of men today… 
  • You would notice that, in today’s men, testosterone is lower, and their estrogen is higher

The question is, WHY?

{end of show notes preview}

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