Ask Me Anything

If you have a question for Peter that you want answered on one of his AMA podcasts, this is the place to ask it.

Does chewing sugar free gum break one’s fast (does it initiate xenobiotic metabolism)?

December 6, 2018

With Testosterone Replacement Therapy, you had mentioned in a podcast that you had patients on a 2x/wk injection schedule. What are the reasons behind the 2x/wk, vs. a 1x/wk schedule?

December 6, 2018

What will happen to our prostate if we live 120 years?

December 6, 2018

Have you thought of starting a training course in evidence based longevity for physicians to create an Attia approved doc? Or what would you recommend Physicians do to improve their abilities to practice “state of the art” longevity medicine?

December 6, 2018

Fasting insulin level for women

December 6, 2018

would you change your fasting insulin recommendations for some women given the results of this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093770/? Looks like thin nondiabetic women with low insulin more likely to develop dementia. Would enjoy hearing your perspective.

What are your thoughts on glutathione. I’m looking at a product called cellagivity and immunical.

December 6, 2018

What are your thoughts on zero calorie energy drinks, specifically the Monster Ultra Zero, and what are side effects and risks, and what would be a better alternative for energy?

December 6, 2018

Have you ever used Linus Pauling’s therapy for reducing Lp(a)? If so, what results have you seen?

December 6, 2018

Hi Peter, I just listened to your podcast, a Deep Dive in to Lp(a). I first heard of it on your interview (#65) with Tim Ferris. I was pleasantly surprised to hear you mention Lp(a)! When I changed physicians and my new provider tested my level I was shocked at my level of 500! First…

What vitamins/supplements do you find worthwhile, and in what amounts?

December 6, 2018

Thoughts on gut biome in regards to health span, and any good recommendations on further research?

December 6, 2018

IMPAIRED “PDH” DUE TO INSULIN RESISTENCE IN ALZHEIMER’S AND PARKINSON’S

December 6, 2018

IN THE KETOSIS BLOG PART II YOU SAID YOU WOULD ADDRESS THIS ISSUE AT A LATTER DATE: DID I MISS IT? BE WELL, BE HAPPY, KEEP UP THE GOOD WORK, STAN

Can you cover testosterone creams vs over the counter supplements? Pros Cons. etc.

December 6, 2018

Testosterone was measured during my last blood work. Fasted, and sample was taken 8:00 AM. Number was 257 ng/dL. I’m late 40’s. Really don’t have any of the typical symptoms of LowT. Thanks so much for your time and sharing.

Blood Pressure Medication – Side Effects

December 6, 2018

Can you speak to all of the possible BP med combinations? Have heard that average person on BP meds takes an average of 2.5 different meds. Does it have to be this complicated? Can someone find a way to get off these meds? Are there long term side effects? Thanks.

Excessive thirst — can that just be ketosis? I feel healthy…

December 6, 2018

I have been dedicated to keeping my carbs down to around 20 grams per day, but sometimes hit the upper 20’s. Not too often. I got my blood sugar from 109 to the 80’s and even lower (when fasting) within a couple of weeks of really focusing on this lifestyle. I never break 100. My…

Can talk about excercise routine for maximalizing health?

December 6, 2018

Thoughts on How To Test and Improve Your Gut Microbiome and the Importance.

December 6, 2018

Everything from testing to probiotics, fiber, fecal transplants, etc. Seems relevant to longevity? * http://podcastnotes.org/2017/12/20/1054-dr-rhonda-patrick-on-the-joe-rogan-experience/ * Many healthy older people in their 90s, have microbiomes that look very much like that of a younger person in their 30s * This makes a case for microbiome transplants, like fecal transplants * The microbiome regulates the immune…

Thoughts on exercise and treatment for someone who has lower back issues – DDD (Degenerative Disc Disease).

December 6, 2018

An older study said aspirin is helpful for top quartile Lp(a) patients. The recent ASCEND study said aspirin does not lower mortality for patients without CHD event. What do you think about aspirin for high LP(a) patients?

December 6, 2018

Which do you find more efficacious in treating hypothyroid patients Natural Desiccated Thyroid or Synthetic T4?

December 6, 2018

I’ve heard you mention certain types of strength training exercises are especially beneficial for increasing glucose storage capacity in muscle tissue. What would be a good joint-friendly regimen for someone with not a lot of spare time?

December 6, 2018

As a fellow Toronto native, I was bummed out when I learned you don’t practice here, but I think I speak for many people outside the US when I say the online content (blog, email, podcast, etc.) is really, really appreciated. Thanks for sharing your knowledge-seeking journey with us.

Hi peter, I recently stumbled upon your podcasts about aging and wanted to know your opinion on if and where could machine learning be applied in this field to help us understand it better and potentially helping us stopping it

December 6, 2018

I am currently studying machine learning full time as artificial intelligence always passionned me, but pretty young in my life I set myself, as my only life goal, to prevent aging (hopefully using AI) and wanted a more concrete opinion than mine on where and how could machine learning be applied for this task. Thanks…

What lifestyle and diet choices can improve Lp(a), LDL-P and ApoB?

December 6, 2018

I know you’ve said that you’re not an expert on hormone replacement therapy but I would really appreciate an interview with an expert. I’m post menopausal and I can’t find a single physician who will truly weigh in on the risks and benefits. The only reason I have an estradiol patch is due to extreme vaginal dryness. Please dedicate a show to women! Thank you!

December 6, 2018

You mentioned briefly that you stopped Lipitor, Zetia and Metformin. Why? Did you switch to using other tools?

December 6, 2018

Can you discuss causes of, and risks associated with, low fasting insulin (< 2)? I saw a study linking low insulin with vascular dementia and Alzheimer’s (Mehlig et al, 2018). What, if anything, can I do to reduce my risk?

December 6, 2018

Can a test, that only uses 3 finger prick blood tests like at https://habit.com/buy-habit-core-dna-import/, provide useful information for diet is better for one’s system?

December 6, 2018

My partner is very excited about us trying the above test, as we respond to diets differently. I do well with fasting (usually 36-48hrs), keto cycling (5 days on, 2 off), and IF (16/8), he is much more sluggish when he tries these diets.

If you somehow knew you would create a practice focused on longevity/performance/quality of life as a medical student, which residency would you choose?

December 6, 2018

There obviously needs to be a lot of self-directed learning from any training background but I’m curious if you think any of them would help develop a more applicable skill set.

Does the science really prove out that mammograms are correlated with increased cancer risk. Does an MRI “solve” this (less radiation, equal detection)?

December 6, 2018

Dave Asprey

December 6, 2018

Eager to hear you and Dave to discuss “Head Strong” to flesh out comparisons and contrasts in your philosophies.

Can you speak about Best CGMs, how you went about implementing it and measuring:interpreting the data?

December 6, 2018

How late is too late to start making a meaningful impact on health and longevity and what would be the most important changes to make?

December 6, 2018

context – 62 yo female with IR (managed with low carb diet), obesity (81 kg, 160 cm), and suffering severe PTSD from years as front line emergency service responder. Lives alone (husband died 4 yrs ago) and becoming more reclusive. I dont “do “people well. Currently having psych therapy – on no meds. Determined to…

All right, this one may be out of left field but I think it’s an important topic. As a physician myself, I grapple with this everyday, both at work and in life. What are your thoughts about inequity? Have you or anyone looked into this topic? Has it gotten better or worse in recent years? Is there any hope for making it better, and if so, what are the targets we should focus on to do it?

December 6, 2018

Thoughts on hormonal birth control and its effects?

December 6, 2018

Having just started an experiment to see how I feel without hormonal birth control (really to see if ditching it helps with fatigue), I’m wondering if it comes up in your practice and what you tell your patients about it. Is it actually a bad idea to mess with our hormones in this way? Has…

Hi Peter, I am interested in the nuance of pre, during and post training food/supplement consumption. Specifically, do you have any heuristics for high intensity days vs low intensity or for muscle fatigue recovery vs central nervous system recovery.

December 6, 2018

Breast cancer risk with HRT (Estrogen) in women that have Atypical Ductal Hyperplasia and a full Hysterectomy?

December 6, 2018

Does taking Estrogen increase the risk of Breast Cancer in women who have Atypical Ductal Hyperplasia (and Hysterectomy) and is the risk of not taking Estrogen greater? It also seems that more recent studies indicate that the increased risk of Breast Cancer in women with Atypical Ductal Hyperplasia is less than previously thought?

Risk / reward of increasing testosterone levels in men age > 40 to the level it was when < 40?

December 6, 2018

Risk / reward of taking Phosphatidylserine (PS) every night before sleep to lower cortisol and improve sleep vs ‘as needed’?

December 6, 2018

Some comments seem to suggest that Dr. Attia takes it as needed vs every night. But if the Oura ring measurements suggest an improvement in sleep quality from taking it nightly is there a significant downside? Similarly some comments suggest that Dr. Attia takes Sleep Remedy as needed vs nightly but not sure why?

intermittent resistance training – effectiveness?

December 6, 2018

Hi Peter, I’m hoping you could provide insight on the effectiveness of spacing out resistance training throughout the day vs. doing it in a dedicated block of time. For example, I do one set of push-ups or squats in my office, go back to my desk for a couple hours, do another set, etc. Thanks!

Benefits of extended water only fast

December 6, 2018

Hi Peter, First of all thank you very much for the work that you are doing and the knowledge that you are sharing with us. I listened to most of your pod costs. Can you please touch upon the benefits of extended fasting (That lasts more than 5 days)? Role of extended fasting in longevity/reverse…

Good sleep during water fast

December 6, 2018

Are we wakeful when the brain senses lack of nutrients? In full ketosis, kentone bodies would keep the brain with enough energy. On many diets, glucose will fall during the night and the brain sensing an energy emergency would be naturally wakeful… even without the gut derived hunger hormones. I have been experimenting with eating…

How does TRF affect your RHR nadir? When eating one meal a day in the evening my RHR does not stabilize till the later half of the night/morning.

December 6, 2018

This makes my recovery suffer. Have you dealt with this? What helps to stabilize the RHR nadir earlier in the night?

Disc injuries. I would love to hear you elaborate on your road to recovery from your disc injuries. Mindset, attitude, & any corrective exercises that helped. Thanks Peter

December 6, 2018

Peptides?

December 6, 2018

Do you think peptides currently have a place in clinical practice to increase healthspan? If so, which are the ones you feel have sufficient data behind them?

Is taking Creatine safe? I’ve seen different results in the fitness and health community.

December 6, 2018

How awesome are avocados?

December 6, 2018

I mean – seriously. They’re awesome right?

Does taking metformin the meal before an extended fast do anything?

December 6, 2018

But no metformin meals prior. Does it make the fast more “effective”? Any easier?

Do you do 1 on 1 conultation over the phone or via internet?

December 6, 2018

eg. recommending blood work and reviewing results as well as diet recommendations on an already healthy and diet conscious fit (no meds) 55 year old male in the Mississauga, Ontario area (GTA)

Would you consider interviewing Lance Armstrong for your podcast? Not so much for the “cheating” that we’ve all heard about–more for his knowledge of his body during high stress athletics. Also his take on the toughness of the Tour and how the intensity impacts the riders’ fitness level.

December 6, 2018

Can you do a focus episode on Hyperuricemia, best meds/route to reduce it, how it contributes to higher LDL, risk of Stroke, CKD and other Cardiovascular Diseases? Possible gout as a warning sign for elevated UA too?

December 6, 2018

Medical professionals tell me 15% is diet related but if I am a healthy weight, lift weights, workout, eat clean but with some keto cycles, 1 alcoholic drink/month, and started getting gout at 21 yrs old after 2 ankle surgeries, it has to be related to the surgery or genetics? Experimenting on myself it appears…

Do you think that stem cells therapy have the potential to replace the current approach to longevity or Do you think that someone having access stem cell therapy could do away with 90% of the longevity stuff that we do today?

December 6, 2018

Is there anything lacking in a pure technology based approach to primary care? A lot of these services seem to be popping up (i.e. Forward).

December 6, 2018

https://goforward.com/ It reminds me of social media replacing friends and the deep depression this has caused in so many. Is there a potential harm in the tech-doctor – driven by algorithms and all of the -ics (analytics, metrics, stastitics)? Peter, you seem like someone with a balanced approach – a technophile with an ever greater…

Cold / Flu Prevention

December 6, 2018

Cold and Flu probably sound like small potatoes compared to cancer or heart disease but are there any best practices for staying avoiding minor illnesses? Especially with airplane travel and young children. Thank you!!

Sulforaphane. Do you recommend it?

December 6, 2018

NAD

December 6, 2018

Hi Peter; I’ve listened to (2) podcasts and still don’t know if NAD taken orally can enter the Mitochondria? In your opinion does MitoQ. Does this work? Great Website! All the Best; Robert

RAPAMYCIN DR. MIKHAIL BLGOSKLONNY

December 6, 2018

MAY I SUGGEST YOU DO A PODCAST WITH DR. MIKHAIL BLAGOSKLONNY, THE GURU ON RAPAMYCIN?

ORAL NAD

December 6, 2018

I PREVIOUSLY ASKED ABOUT ORAL NAD AND FOUND THE ANSWER IN YOUR PODCAST WITH BOB KAPLAN. ALL THE BEST; ROBERT

I have very high Lp(a). Here in the UK, PCSK-9 inhibitors are only available to those with LDL-C above a certain level and I don’t meet that (lame as it probably is). Any advice on whether I should pursue slow-release niacin to reduce Lp(a)? Or anything else that might be good alongside or instead of that?

December 6, 2018

Large unethical study by Ivan France running Ancel keys theorys and polyunsaturated fats proved lower cholesteral actually raised cardiac risks ?

December 5, 2018

I am a physician and surgeon. Also an AG triathlete. Have always reveled in the personal experimentation of performance improvement. I believe your following of many like minded physicians and scientists would offer you a forum for many more “personal experiments “ like your “nothingburger”. It would be interesting for you to propose some ideas of questions that would be interesting to answer. This would further your N of 1 to a more significant contribution to the scientific cause.

December 5, 2018

For instance. I performed a 3 day fast. With the purpose of providing some perspective to patients. I have the ability to test laboratory and other medical parameters. Could be interesting. Thanks

Hi Peter, I am an amateur triathlete and really struggle with the swim portion and being in open water. Could you talk about any programs, guides, or coaches you used when you undertook your endurance swims?

December 5, 2018

*I compete in full IM distance races for context with the 2.4 miles completed in roughly two hours.

Should I quit keto?

December 5, 2018

Dear Peter, I have just gotten my blood work results after being in keto for some months now. In units of mg/dl they are Uric acid: 8.2 up from 5.7 last year HDL cholesterol: 36 down from 52 last year LDL cholesterol: 161 up from 114 last year Triglyceride: 244 up from 67 last year…

Have you ever helped a patient manage or cure back acne, and if so how?

December 5, 2018

Could dirty electricity from a treadmill elevate blood sugar and cause diabetes?

December 5, 2018

I found a study in Pubmed claiming dirty electricity from a treadmill elevates blood sugar and might cause diabetes in some people? What do you think of this? https://www.ncbi.nlm.nih.gov/pubmed/18568931

In Canada, where can I get these more detailed lipid panel tests? VAP Panel testing seems to be hard to find in western Canada even privately.

December 5, 2018

Have you considered collaborating on research with flight surgeons or aviation physiologists from North Island or Miramar?

December 5, 2018

Flight surgeons and aviation physiologists have significant overlap with some of your stated interests, especially performance and critical thinking. Since you live in the same town as two major Naval Aviation bases (North Island and Miramar), there is a significant population of flight surgeons and aerospace physiologists close to you. You might also be interested…

Did Dr. Attia finish his residency and what significance does that really have?

December 5, 2018

I am a ct tech at a local hospital in Mesa AZ. I watch/listen to Dr. Attia on Joe Rogan, Jocko Willink, Dr. Rhonda Patrick etc. as much as possible. I told an E.R. doc about the podcasts and information. He said to be wary because Dr. Attia never finished a residency. With all that…

One of the most helpful aspects of the podcast is your ability engage experts from different fields, who also think critically, in order to collaborate, optimize each others knowledge, and create solutions to shared questions. For someone starting medical school (or any career, I suppose), what insight can you offer on how you’ve initiated mutually beneficial relationships, and expanded your network of high-performing physicians, researchers, and individuals in non-medical fields?

December 5, 2018

What are the most over-looked and under-mitigated drivers of inflammation? What pathways allow omega 3’s to be anti-inflammatory?

December 5, 2018

Based on your understanding of heat and cold therapy, how would you incorporate them into your exercise regimen? (Duration, Frequency, after aerobic vs. anaerobic etc.)

December 5, 2018

I have noticed after long runs or other strenuous exercise my clothes have a strong odor of ammonia from my sweat. Is there something lacking in my diet.

December 5, 2018

When can we expect your book ?

December 5, 2018

What steps can be taken to mitigate the negative effects of sleep deprivation.

December 5, 2018

I have a hypersomnia disorder, I can keep myself awake for extended periods but when I do sleep whether deprived or not I can sleep for 20+ hours without waking to external stimuli and for many sleeps in a row. Sometimes it makes sense for me to stay awake to take part in normal activities…

Forget lean body mass. Who are the “1/3 of people on Keto Diet” (Dayspring) who are getting big elevations in LDL(p)? Dayspring’s Lipidaholics #291 commentary describes the Ketone to Cholesterol path, but not why it relates only to SFA (not MUFA/PUFA) and why not all Keto Dieters.

December 5, 2018

Kudos for pressing the worry about lipid changes with the Keto/low carb community. I doubt most Keto dieters check lipids. Big public health issue.

HRT for women; health initiative study explained, bio-identicals, diet and nutrition for menopause

December 5, 2018

Would donating blood regularly lower LDL-P?

December 5, 2018

I’m 32-years old and losing my hair. I am considering using Finasteride. Do you have any thoughts on this drug or any hair loss prevention? Thanks!

December 5, 2018

What is your preferred FMD protocol?

December 5, 2018

In your podcast with Tom Dayspring, you alluded to an FMD protocol that is lower in carbs than the Valter Longo FMD protocol. Can you detail your preferred FMD protocol? Macro / micro composition, duration, calories, meals, etc.

I like the look of your website. Did you do it yourself with wordpress? If so, what theme did you use? If not, how did you make it, which could include an individual or company you hired to help you create it, if applicable.

December 5, 2018

Peter – How do I find a physician in my State that shares your views on functional medicine/optimizing health and will give me a thorough blood work / bio-marker assessment? I want optimize my health, not be within recommended range dictated by the majority.

December 5, 2018

Would it possible to summarize the ranges Peter likes to see certain bio-markers within? (i.e. benchmark blood work & lipid panel)

December 5, 2018

What do you think about the prospect of using tDCS (electrical brain stimulation) to increase brain plasticity and accelerate learning? How about to treat mental health disorders? A few companies are attempting to go mainstream with this technology.

December 5, 2018

Keep up the awesome work! You’ve changed a lot of people’s lives that I know!

Your personal reference ranges for thyroid levels. Do you use rT3 and freeT3/free T4, TT3/free T3 ratios in your practice?

December 5, 2018

Any evidence based comments about thyroid levels would be greatly appreciated!

What weight training would you suggest for people who are unable to hold weights due to illness or disability?

December 5, 2018

For example I have syringomyelia and my father has had surgery for carpal tunnel and has severe arthritis and gout.

Do you consider wireless headphones (Airpods, Bose, etc.) safe to use from a brain health standpoint? Do you use them? Do you let your kids use them?

December 5, 2018

I see a variety of opinions with no clear consensus. Is there any research you find compelling that steers you toward sticking to wired headphones or toward going wireless? Would you differentiate between the risk of using them sparingly (just for workouts) vs using them all the time for calls and listening to music while…

Hey Peter. What was your strategy and tactics for memorizing all the information required during Medical School, as well as now when you’re learning new things.

December 5, 2018

I have to get my cholesterol down. What video or information would be best for me?

December 5, 2018

Elevated Liver Enzymes?

December 5, 2018

Hello Peter, on the liver functions test, are elevated AST/ALT levels truly a sign of poor liver function for active healthy adults? Should an AST score of 50 for example, be a cause for concern.

Do you think women should take HRT to reduce their risk of dementia?

December 5, 2018

Possible strategy for longevity/health span increase. When interviewed recently you mentioned that poeple tend to foucus on goal and tactics and neglect the strategy formulation part of the process. Although things like nutrition cycling was mentioned as one such strategy, it would be great to hear more of how you think about it.

December 5, 2018

Dr. Attia, Do you think now is a good time to start advocating for policy changes in healthcare in terms of establishing interventions at birth and controlling for epigenetic changes throughout life vs addressing diseases at the point of diagnosis. Also, I wanted to hear our input on looking at healthcare a bottom up approach instead of a top down approach, do you believe that the bottom up approach is better and should we as citizens be advocating for it?

December 5, 2018

Dr. Attia, I appreciate the work that you have done and continue to do. It is amazing that you are providing an open platform for individuals to get information to specialists such as yourself and others in order for us to expand our health age. I myself have started a non-profit in Boston, MA called…

Is being in ketosis for long periods glucose sparing or glucose impairing?

December 5, 2018

In your interview with Thomas Seyfried you talked about your experience with insulin sensitivity and blood glucose levels, and that you’re an anomaly, and that for many it takes a few days of carb eating for the body to get back to it’s efficient use of glucose (and I assume glycogen). This would explain why…

Hi Peter, could you give us a comment regarding the last study by Dr. Ludwig? Here: https://www.bmj.com/content/363/bmj.k4583. Thank you

December 5, 2018

what are the counter indications (reasons to avoid) FMD?

December 5, 2018

e.g., how do I make sure I don’t lose muscle mass? Is an electrical impedance scale enough? how about gastric ulcers or aggravation of ulcers due to fasting?

Gallbladder polyp – how can I use lifestyle interventions to avoid continued growth and cancer risk?

December 5, 2018

low carb? fasting? unstressing?

Gary Taubes and the Cause of Obesity

December 5, 2018

I was recently trolling bc I had nothing better to do other than work, help wife out with 2 kids under 3, clean the garage and multiple number of other demands and saw this post on IG and wanted to get your thoughts. View this post on Instagram This is an excellent, unbiased, evidence based…

From the Tom Dayspring episodes you mentioned that you had Tom follow a modified fasting mimicking diet 1 week a month. Could you share details of what that recommendation looked like?

December 5, 2018

When it comes to blood work lab results, what are the recommended levels for Albumin and Bilirubin and what do these numbers mean? Also, are there any websites or databases where someone can upload lab results and get detailed information on what the results mean as far as good/bad, typical causes for the numbers, and recommendations for improvement?

December 5, 2018

The only recommendation I received from my doctor was that I had low vitamin D and should supplement, which I’m now doing. Looking at my results though my Albumin was 5.2 and Bilirubin was 1.3. Doing some research I know both of these numbers are slightly high. I’m a 29 year old male and want…

Curry Stir-Fry Recipie

December 5, 2018

You’ve mentioned your love for your curry stir-fry multiple times, and I’ve seen it on your Instagram, can you please share your recipe?!?

Evidence for bacterial etiology of Crohn’s, UC, and even colorectal cancer?

December 5, 2018

Have you studied the latest research on mycobacterium avium ss paratuberculosis (MAP) as infectious agent responsible for Crohn’s and possibly some colorectal cancers? Dr. Borody’s team in Sydney has been doing solid clinical work with Crohn’s patients using an anti-MAP cocktail of abx. Interestingly, many immunosuppressants which show efficacy in Crohn’s also happen to be…

So, you have been very good at capturing risks in diets and associated longevity. There is enormous talk about the lack of sustainability in diets that contain meat (I.E., the Tim Ferris podcast with James and Suzy Cameron). It is very difficult to find an objective review of the sustainability of a keto/paleo diet, so I am asking you and your team; is a meat based (or at least, meat supplemented diet with sufficient protein) sustainable from a global climate change standpoint?

December 5, 2018

Appreciate all you do!!

What are your thoughts on the use of HCG?

December 5, 2018

Peter: can you speak to metabolic changes for those who’ve had a cholecystectomy? Are there changes in AST/ALT (and are those diet related); can one be ketogenic; are there changes to bile production from any kind of fasting?

December 5, 2018

High hs-CRP, Can this be a hormetic effect?

December 5, 2018

I was in nutritional ketosis for 4 weeks, lost 20 lbs. I took a hs-CRP a week after, the result was 4.3. I’ve had a CT cardiac score done, it was zero. Prior to ketosis, I wore a CGM. I wanted to associate what I ate with my insulin response. I lost 6 lbs without…

Have your analytic team do podcasts on interesting studies or issues

December 5, 2018

It would be great to have some podcasts from Bob and the rest of your analytic team where they go into particularly interesting studies (papers) or issues and breakdown what they believe and question. Possibly also as a follow-up to your interviews when your interviewees release those papers they can only hint at. (This probably…

relationship between vaccines and increase in immunity based diseases?

December 5, 2018

Is there a relationship and harm in immunisation of children.

Vaccines and autoimmunity

December 5, 2018

Vaccines autoimmunity link, link with autism, bullshit or not?

Navigating New Ideas as a Medical Student?

December 4, 2018

Hi Dr Attia – I’m a 2nd year medical student in California who tends to be pretty outspoken about healthcare-related things (I have a public blog and social medias where I share ideas). I joined the diabetes research and education team at my medical school, which made me dive into this research on my own,…

You mentioned previously about taking BCAA’s during fasting. Can you please expand on correct supplementation for both fasting and muscle building during a regular non fasted state

December 4, 2018

How does your CGM help you in your daily life?

December 4, 2018

What are some podcasts similar to yours you listen to? aka, health based with a sprinkle of other interesting people. Sorry but as much as I love your podcast, once a week is not enough for the long hours spent in traffic.

December 4, 2018

Thoughts on balancing an increase in protein intake while working to lower insulin levels with research linking high protein consumption to cancer.

December 4, 2018

You’ve been asked many times about finding a doctor “like you” and have said you don’t know what that means. As a healthcare provider (who understands the current medical protocols of western medicine and the CYA and/or simplistic approach many clinicians follow) and follower of your content, for me (and maybe others) that means: a doctor who not only wants to dig deep, but knows the value in doing so, knows how to do so and cares enough to want to (getting past the CBC, CMP, – while still important) and also knows how to manipulate the information once it is received; one who can set his/her ego aside (but not their knowledge) and work with the patient to come up with nuanced testing/protocols/treatment. As you know this will be very difficult to procure a list since you have said yourself, you cannot teach curiosity (or work ethic, initiative, etc.).

December 4, 2018

In the “Straight dope on Cholesterol” video you mention that phytosterol is more atherogenic than cholesterol, citing a situation where it was once trendy to “pre-load” with phytosterols similir to the tactic of dosing with Potassium iodide pills when the radioactive cloud is blowing in from the nuke plant in order to prevent cholesterol settling in with its wily ways, resulting in a massive upswing in cardiac events for those populations. Yet In the same discussion, it is noted that ingested exogenous sterols have very little to do with the nefarious atherosclerotic interactions of which they are accused. Where may I find a discussion of the quantification of these opposing ideas? Thanks!

December 4, 2018

Please consider devoting a podcast to your thoughts on hyperuricemia, its relationship to other pathologies (ex-gout), fasting, etc.

December 4, 2018

Atherosclerosis and Vegan diet

December 4, 2018

Peter I am new to your website. Glad I found it. As a physician I have done the expanded lipoprotein panel for 7 years now. I use True health. Have you seen the all of the data on vegan diets and severe hyperlipidemia? In my practice once I reduce or eliminate animal protein I notice…

In med school, what routines/strategies did you have to help balance the demands of studying with fitness, sleep, and diet? Any ideas to mitigate the physical and emotional negatives of excessive amounts of sitting that go along with school?

December 4, 2018

What are 3 things you value most about your medical education? What are 3 things you would change/add in traditional MD curriculum’s?

December 4, 2018

Osteoporosis/fracture prevention/healing – does fasting or ketosis help, if at all?

December 4, 2018

What’s your take on those who have had a thyroidectomy due to thyroid cancer? Any thoughts on how to manage synthetic thyroid hormones?

December 4, 2018

i want to ask ;is red meet raise insulin like surge? and what is your thought about lowering insulin as a must for fat loose?

December 4, 2018

Any gut issues cramming all your calories into such a short time window? Is it hard on your gut at times (reflux)? Since eating so much so late, do you notice your sleep score takes a hit?

December 4, 2018

Admittedly behind on the podcasts but I have never heard and read good information about the intersection of age-related hormonal changes and metabolism. Specifically as a woman, how do you overlay menopausal changes on top of insulin resistance and effective dietary strategies for improving metabolism and weight loss or maintenance?

December 4, 2018

Actually a comment – sorry!

December 4, 2018

In regards to this video – https://www.youtube.com/watch?v=YY-_ux4ZXp4 – at around 41:30 you talk about handling emotional reactions as something more challenging than pushing yourself to work harder, etc. This is one of the reasons I have taken up tennis again: a sport I walked away from at 18 and never looked back largely because I…

A deep dive into supplements, metformin, interpreting results from genetic testing, genotypes and PNG’s to customize dietary choices.

December 4, 2018

A cycling podcast stated that during aerobic exercise, our insulin response is almost completely shut down while our GLUT4 transporters nevertheless allow us to absorb glucose for use. If so, does that mean that carbs consumed during such exercise don’t count towards the carb limit we must follow to remain in ketosis?

December 4, 2018

My source is the first 10 min of this podcast: https://www.velonews.com/2017/03/podcast/fast-talk-ep-15-should-you-eat-gummy-bears-like-sagan_433470

A 40 year old person with no general bad habits and health problems went from normal level LDL to 198 5 months after starting keto – what would the protocol for him be?”

December 4, 2018

Hdl went up Triglycerides and Blood Glucose and CRP went down

Hi Peter, I wanted to get your thoughts on whether the consumption of black coffee in the am breaks one’s fast. Effectively, this is another way of asking whether the consumption of black coffee in the am raises insulin levels? I ask this, because there seems to be some contradictory advice on the internet regarding this topic and curious your take. Thank you

September 21, 2018

How do you become a patient at Attia Medical or with one of your medical groups?

September 21, 2018

What’s your take on thyroid nodules and cancers in young, healthy adults?

September 21, 2018

I’m thinking about taking Metformin for longevity. What considerations should I think about before doing so? Thanks!

September 21, 2018

Children

September 21, 2018

Like you Peter i’m the father of young children (3). This has many interesting health implication for us parent and the children. Could you do a podcast or AMA section on children? Like how do you manage a keto diet with young children? Can children be fed a keto diet? I give my kids fat…

Children (part II)

September 21, 2018

When we think children, we think sleep deprivation. Thoughts and opinion? tips?

Children (part III)

September 21, 2018

Children and ADHD or similar issues and drugs (Ritalin etc…) and short and long term effects.

Microbiome Deep Dive, AI for longevity

September 21, 2018

Would you consider doing a podcast on microbiome health, monitoring, and the potential use of AI to help solve health related problems and increase longevity? Seems there is a lot of fascinating research in both spaces that overlap to some degree.

I appreciate your podcast series. Many of them dwell on Lp(a), ApoB etc. but I haven’t heard much about Coronary Artery Calcium (CAC) Scanning, that is a quick affordable screening test with less debate about what to do after you get the results compared with NMR data. What do you think of CAC as a diagnostic tool versus NMR ?

September 21, 2018

After listening to your podcasts, and reading the literature you referenced, I brought the topic up with my PCP during my annual medical. I asked if I could have an NMR test vs the traditional bloodwork I had done in previous years. He quoted that NMR results are considered controversial based on some studies and…

What can we learn from centenarians (e.g. Blue Zone descriptions)Some of the interpretations seem to be overgeneralizations.

September 21, 2018

How would you design an informative centenarian study? What are best questions to ask? What metrics? What metabolites? How to identify efficient mitochondria? Epigenetics?

Why, during your KFK (aka “nothing burger”) weeks, would your trigs and uric acid levels have increased so much given that you were consuming no fructose?

September 21, 2018

You have mentioned a couple of times that you have your own set of reference ranges for many biomarkers. For example, you recently spoke about wanting uric acid below 5 and ALT below 25. What are some other markers where you differ substantially on your reference ranges?

September 21, 2018

Do you know anything about PEMF therapy and whether or not it is beneficial?

September 21, 2018

Berberine vs. Metformin – Some studies show Berberine as being as effective as Metformin. Thoughts on this?

September 21, 2018

Are there any known benefits to “cycling” in and out of ketosis?

September 21, 2018

People on the internet (like Mercola) suggest going in and out of ketosis benefits the mitochondria, although Mercola has a habit of using no little data to back up his claims. https://fitness.mercola.com/sites/fitness/archive/2018/01/19/fasting-ketogenic.aspx

How to screen for chronic hyperinsulinemia? In your podcast with Robert Lustig, you stated that you felt that we should treat a patient with “normal” A1C but chronic hyperinsulinemia with the same urgency as a T2 diabetic. Absent a direct measurement, how would the patient become aware of that chronic hyperinsulinemia?

September 21, 2018

In your podcast with Robert Lustig, you stated that you felt that we should treat a patient with “normal” A1C but chronic hyperinsulinemia with the same urgency as a T2 diabetic. Absent a direct measurement, how would the patient become aware of that chronic hyperinsulinemia?

Can you compile a list of medical professionals across the country who you would recommend

September 21, 2018

Do you partake on any non-western practices for longevity?

September 21, 2018

I understand you’re have strong position on quantification and use of scientific principles in everything that you do. But do you practice any type of other so-called “alternative medicine” to your practice that you think can promote longevity?

After listening to the podcast with Dr. Robert Lustig, I wonder what Peter thinks of the FODMAP diet.

September 21, 2018

That is e.g. does Peter think that the other sugars in the FODMAP diet are similarly metabolized and therefore ‘bad’ for us? How much fructose can be still considered healthy – assuming you eat it as a whole food, and it is not a high glycemic food/fruit. FODMAP on wiki: FODMAPs are short chain carbohydrates…

What advice would you give to the 25 year old Peter. You often allude to wishing that you previously prioritized sleep, but what additional advice would you give on health and mental wellbeing

September 21, 2018

This is more of a request. Can you provide the introduction music of podcast as a seperate download. I can’t think of a better alarm clock tune.

September 21, 2018

What are the diseases that kill monks? Have you done any research into the possible connection of longevity and religion? Since religion provides community, a sense of purpose, and connection, one would think this would ultimately help lead to better mental health, and a longer, healthier life

September 21, 2018

Your discussions about mental health are very eye opening, so thank you! It seems as though the mind body connection is stronger than seems possible, and the quest to find meaning and happiness in life is a key factor in longevity.

Do you take a multivitamin, is so which one?

September 21, 2018

I currently don’t take any, but have been doing a lot of research and Ultra Preventive® X, from Douglas Labs seem to be a good candidate. What are your thoughts?

What blood tests and reference ranges would you recommend for a male focusing on healthy lifespan/longevity?

September 21, 2018

Autoimmune diseases – reversible? Are diet/lifestyle interventions enough, or are drug interventions necessary? Long-term safety of new biologic meds? Effects of autoimmune diseases on longevity?

September 21, 2018

As someone who has suffered for a long time with psoriasis, I often wonder whether it’s better to take on the risk of immune-suppressing medications to treat, or not. I also have family history of heart disease, not sure how much my autoimmunity effects heart attack/stroke risks. Your podcast and website are fantastic. Please do…

I’ve been a Type-1 diabetic for 20 years (reasonably well-controlled with a HbA1c of 6, but would like to get it lower). Following a LCHF diet has vastly improved my blood glucose control and reduced my insulin requirement by half. My wife is a Mayo-educated primary care physician who basically dismisses this approach as ‘quackery’. She has numerous diabetic patients with off-the-charts HbA1c numbers. Any suggestion for convincing her of the legitimacy of this approach (LCHF) versus the standard treatment?

September 21, 2018

Creatine supplementation Y/N? Why?

September 21, 2018

I searched site and didn’t see any substantive comments about creatine.

Should someone who is at risk for Alzheimers disease (I have 2 APOE4 alleles) try psychedelics?

September 21, 2018

You’ve mentioned the benefits of psychedelics in previous podcasts but I am not sure if they would do more harm than good to me in the long term.

Why does my mountain bike performance decline so precipitously when its hot and especially humid.

September 21, 2018

I’m 53 (m) and a sub-elite rider in the Don river valley. Think Toronto summer humidity!

Have you heard of the Blue Zone? Do you think there are aspects you could draw from in the pursuit for a longer health-span? https://en.wikipedia.org/wiki/Blue_Zone

September 21, 2018

Using fake name on purpose, don’t think that changes the merit of the question. Thanks for a great blog+podcast with an insane amount of information.

What are your thoughts on an optimal weightlifting routines for longevity?

September 21, 2018

Should the focus be more so on pure strength opposed to hyper trophy, or vice versa? How many days a week per muscle group? Etc.

Lower Back Longevity

September 21, 2018

You wrote a blog post about your lower back problems and surgery while in medical school but talk in your podcast about your deadlifting routine involving some heavy weights. Could you talk about how you rebuilt your back and how you maintain a healthy spine?

You have referenced the “estrogenation” of man as one of the most important get largey uncovered trends. What is this, what causes it, and what can be done to fix it?

September 21, 2018

Can a low-carb diet cause panic attacks?

September 21, 2018

I have always been nervous about public speaking. However, I started having panic attacks whenever speaking in front of a group of people back in June. This is also around the same time I started cutting out carbs for (successful) fat loss. I get up in front of 100+ people about twice a month, but…

What do you think about the uptick in mainstream news articles about the “dangers” of low carb/keto diets and what impact these type of gross generalizations may have on the public?

September 21, 2018

Specifically referring to articles such as this: https://www.thisisinsider.com/is-the-keto-diet-healthy-studies-suggest-carbs-are-linked-to-long-life-2018-9

I am curious about Peter’s opinion regarding mixing carbs/fats in the same meal. Robert Lustig (and a couple others) have left me with the impression that there may be something especially is insidious about combining fats/carbs since foods in nature are either one or the other.

September 21, 2018

Wondering if you can discuss your thoughts on the usefulness of the running a PULS, (protein unstable lesion signature) test, and how it compares at elucidating/ evaluation someones overall cardiovascular risk profile, (I am a doctor). signature) Cardiac test

September 21, 2018

Hi peter, I heard you say you fixed a woman’s thyroid in a recent podcast. What do you mean you fixed her thyroid. I have hypothyroidism is there something I can do besides just taking synthroid?

September 21, 2018

Thank you. You are an inspiration.

What are your thoughts on sugar alternatives (sucralose, sugar alcohols, etc.)?

September 21, 2018

Not sure if there is anyone out there doing this research… but could you do a podcast with a neuroscientist focused on the prevention/reversal of brain aging? Specifically are there foods, exercise modalities, other protocols to maximize brain performance and long term health?

September 7, 2018

I guess this question rests on the assumption the brain can be specifically targeted by interventions that aren’t just systemic…

You wrote on Twitter that you are considering different avenues to monetize the podcast in order to make it sustainable: what do you think is the best way to do it?

September 7, 2018

I’ll try this again. :) I’m curious about you opinion of detox protocols- I.e. Dr Yu’s type of detox- a high Niacin to cardio to sauna to charcoal to cold shower type of protocol to detox your system from toxins, hormones being released from fat during high weight loss

September 6, 2018

Have you traveled to Europe, what did you particularly like about it?

September 6, 2018

How to reverse sleep deterioration in middle age and beyond.

September 6, 2018

Many middle aged people suffer poor sleep time/patterns. Peter has alluded to the evidence on the importance of good sleep to general health. A review article on evidence based ways to improve sleep length/quality would be very useful to many readers and followers.

What are these 8-12 genes that increase longevity that you always talk about?

September 6, 2018

What do you think is the role of sugar in obesity?

September 6, 2018

To detect lactose intolerance or inflammation you once recommended cutting dairy products. If cheese and cream are very low lactose products, why should one cut them? Is there another molecule in dairy products that can produce inflammation?

September 6, 2018

What dose of metformin do you take?

September 6, 2018

In your fasting podcast you mention you take metformin, I was wondering the dose. Strength/formulation/times per day, i.e. metformin 500mgER twice daily. It comes in 750 and 1000, some ER and some plain. Not asking to mimic your regimen but I am a health care professional and was curious to your approach. Thanks.

As a former fat but fit athlete, if you were nutritionist for elite (Olympic level) athletes, what would be one dietary recommendation you’d give them, regardless of sport?

September 6, 2018

Systemic inflammation and osteoarthritis

September 6, 2018

In an interview you gave (I think it was with Jocko), you mentioned that inflammation may be one of the highest contributing factors of life threatening diseases (CVD, Cancer, Dementia). Does having osteoarthritis (which I’ve seen classified as noninflammatory arthritis) raise or contribute to systemic inflammation in say the same or similar way that rheumatoid…

Guillain-Barre, is a very interesting syndrome. This is a vague question, but would there be applicable information of diet/fasting, or mTOR. Currently it appears that only periodical immunoglobulin injections are the only therapy at the moment. Thank you

September 6, 2018

I’m currently in Ketosis to reduce my weight – and it’s eorking well- 11 weeks in and I’ve dropped 12kg. I live in the UK. Are there any labs you recommend for blood testing here. Is it worth having a genetic analysis? Is there value in having a DEXA scan?

September 6, 2018

what is the future of health care and what direction would you advise young like minded people to head in?

September 6, 2018

With the rise of AI and medical tech there is going to come a time in the near future where drs are superseded by diagnosis algorithms etc, what do you predict the health care landscape to look like in 10,20,30 years time. For an aspiring dr is it worth the investment in medical school for…

metformin

September 6, 2018

I understand you take Metformin. Is your goal to increase insulin sensitivity or anti-cancer? Does the correlation to AD/Dementia concern you? What is your daily dose

Do you order omega 3/lipids index blood tests to your patients ? I mean an analysis of the RBC membrane

September 6, 2018

Best protocol for raising testosterone levels

September 6, 2018

I’m 53 with a BMI of 44 and type 2 diabetes. In the month of August, I lost 26 lbs by eating a ketogenic diet and upping my daily dose of Victoza (from 1.8mg to 3.0mg). My hunger has been about a 2-3 most days. FBG is around 100-110. It’s been great. I can’t wait…

Losing weight without excess skin – Is fasting the proven method for losing weight AND avoiding excess skin?

September 6, 2018

Just read Dr. Fung’s post about Dolly’s results. She lost over 100 lbs and has no excess skin like most people who lose over 100 lbs. Her diet regimen was 3 days of fasting per week followed with a low carb, ketogenic diet. As Dr. Fung mentions, there is no research on this yet but…

Why are you taking Acrabose before “cheat meals”? Is this something everyone should be doing?

September 6, 2018

Can you help explain why fasting will increase serum cholesterol?

September 6, 2018

I am carnivorous, a-la Shawn Baker, which helps my Crohn’s and overall health but my LDL-C has. I am requesting an LDL-P test but it is not yet done. I’ve also been listening to David Feldman.

Huge fan of the podcast! What are your thoughts on omega 3 fatty acids for reducing inflammation? What are your thoughts on the theory that our diets, which were once to be far more balanced in omega 6’s:omega 3, are now grossly imbalanced to more pro-inflammatory omega 6’s?

September 6, 2018

How do you face the longevity optimization process with the possibility of a collapse of our civilization in the next 50 years ?

September 6, 2018

It is a constant paradox in my mind. I am both the grasshoper and the ant in Jean de La Fontaines’ Fable (https://www.mamalisa.com/blog/the-grasshopper-and-the-ant-jean-de-la-fontaine-fable-in-french-and-english/) There are multiple indicators (population growth, global warming, reduction of biodiversity, peak oil) pointing toward a possible collaspe of our civilization. So what’s the point in trying to tweak our über complex…

If most of our cholesterol is endogenous, how does diet affect it? What other mechanisms besides absorption..

September 6, 2018

Is it ok to cheat on keto once in a while? Would one cheat day a month hurt? What is a good time between cheats

September 6, 2018

Is there a case for psychedelics as potential remedial agents for those inflicting abuse on others?

September 6, 2018

On your podcast with Tim Ferris, you both described what I interpreted as zapping your mind into a momentary state of enlightenment that helped dissipate causes of anxiety, depression, and addiction. Following your podcast with Corey McCarthy, it was angering to hear about repeated acute and sometimes instant experiences that can have long-lasting damaging effects…

Biomarkers to assess when eating a modified Atkins diet

September 6, 2018

I am a doctor. I am frustrated with how little time I have to give patients. I would love to start another practice with concierge type care so I can provide closer advice and longer time with patients. Do you do this? any recomendations?

September 6, 2018

I’d really like to hear more about Metformin supplementation for longevity. Thanks!

September 6, 2018

There seems to be a trend of new articles saying low carb diets are unhealthy. Looks like it finally surfaced in time magazine. Could you please shed some light on this? Thanks!

September 6, 2018

http://time.com/5381570/low-carb-diets-longevity/

Trying again. I am writing with a scary situation.

September 6, 2018

I am 52 years old, used to be extremely athletic, healthy, and active. I eat what I think you would say is in a very wise way. Now I am barely 100 pounds, 6’1, have lost all my energy, can barely move, have bad nerve damage, my feet are blown up, and nobody can figure…

What are your thought on the effectiveness of foods with added plant sterols, as an alternative to statins?

September 6, 2018

for example – https://www.sanitarium.com.au/products/weet-bix/weet-bix-cholesterol-lowering/cholesterol-lowering?gclid=CjwKCAjwq57cBRBYEiwAdpx0vXX2E0K21CYK0zchGYMQOfPzrCqKYJd-HSnoNMXihLdn3yoiFkf1JRoCPgMQAvD_BwE

Any theories on what was happening with your thyroid during your fast?

September 6, 2018

Is Horvath’s epigenetic clock for aging (and Zymo’s commercial test of it) valuable for an individual?

September 6, 2018

Do you find it valuable and/or use it with your patients? Your thoughts on this would be greatly valued. Thank you, keep up the awesome podcast!

Protocol to establish understanding of personal blood glucose levels/insulin response?

September 6, 2018

What foods/times would be ideal to gather a good understanding of insulin response/blood glucose without finger-sticking non-stop?

Is there anything one can do to help regrow (regenerate) cartilage?

September 6, 2018

About 5 yr ago I’ve started experiencing pain in my knee and after getting 4 MRIs in one year and visiting three different surgeons, they all unanimously said that I should have surgery. Although between the three doctors I was given an option of 4 distinctly different types of procedures. I ignored them, modified my…

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