256 ‒ The endocrine system: exploring thyroid, adrenal, and sex hormones | Peter Attia, M.D.
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- Опубликовано: 19 июн 2024
- Watch the full episode and view show notes here: bit.ly/432u3eB
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In this special episode of The Drive, Peter provides a comprehensive overview of the various endocrine systems: the thyroid system, the adrenal system, and the sex hormone system (for both men and women). He walks through the basic biology and the feedback cycles that regulate the production of these hormones and discusses the various options for the treatment of hormone deficiencies. In addition, Peter delves into hormone replacement therapy (HRT), providing nuanced insights into its appropriate usage and the clinical approach he adopts when working with patients.
We discuss:
00:00 - Intro
01:02 - The thyroid system
15:02 - The adrenal system
26:57 - The female sex hormone system
40:21 - The male sex hormone system
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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 60 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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In this episode, we discuss:
00:00 - Intro
01:02 - The thyroid system
15:02 - The adrenal system
26:57 - The female sex hormone system
40:21 - The male sex hormone system
Thank YOU Dr. Peter, Really appreciate this episode. Between timestamps 23:30-23:37 you've mentioned a supplement (Phosphatidylserine(?)) for your patient and yourself to suppress an adrenal system. I can't find the exact spelling in your show notes. Can you please confirm if the supplement Phosphatidylserine is what you've mentioned ?
Where'd we get this excellent dress-shirt boss?
Great overview. Thanks. We need a video on TRT for females. When is it justified and what side effects it can cause
@@mydieunguyen5359I heard the same word. But I’m not sure the correct spelling. I’m assuming its phosphatidylserine
Thank you Dr. Peter Attia for everything what you do.
Great video. Highly informative. Thank you for explaining why you are not a fan of clomiphene/clomid for men.
Hey Andrew, good too see you here.
Have a nice day :)
This is by far the best episode. Love the lecture format! Would be great to have more like this. Thank you, Peter!
Spot on re the thyroid. Been hypo for about 40 years. I've had to educate myself to exactly how you explained everything. And source my own meds, do my own labs, because it's been impossible to find a doctor who will test and treat appropriately. Thanks! Very validating.
test and treat exactly how you want rather
@@daniel1RM As Peter indicated, testing only TSH and treating with only a T4 med does not work well for all patients, so it isn't appropriate to offer nothing else, even if it is the standard.
I have come to the same conclusion. I would love to talk to you. I need to find another outlet to source my own drugs. Thank you for this post.
Damn Peter, Just when I thought your excellent track record was unsurpassable, you've raised the bar even higher. This material is gold !
I really liked this episode. Would love to see one of these lecture-type videos every few weeks and perhaps to go even more in-depth.
More lectures like this would be very appreciated. Not that your other content isn't top notch but this is really wonderful. Clinical experience overlying basic mechanism is a phenomenal approach. Thanks for all you do!
This is the single most concise and clear explanation I've seen of the thyroid and adrenal functions, testing, etc. I wish every doctor would watch this...
bravo. you have the gift of clarity. thank you.
The gift of genius
Amazing breakdown. The information out there on the internet for the endocrine system holistically, from a bird's eye view, is sparse or hidden in textbooks. Truly appreciate the at no-cost overview of these otherwise complex systems. Definitely information everyone needs to know and be aware of for themselves and those they care for.
This lecture format is outstanding, please keep creating content in this form!
Wow what a presentation. ❤ Easy to understand even given it’s such a complicated and medical topic.
I so much appreciate the comprehensive information that this video provides.
Thank you. And more of this type of explanatory videos Peter. You’re very good at explaining complicated things in a very understandable way.
I feel so much more confident evaluating my blood test results. Thank you!
Thank you Dr. Peter Attia for Breaking down the endocrine system! You made a very complicated system a little bit easier to understand! Good job young man! 👏 Please keep up the great work 👍😊
I love his sharing his experience. It's not just theories. It's also about application of the theories.
Thank you for the work you are doing. Best overview of these topics I’ve come across
I appreciate the clarity in these lectures, Thanks Peter!
Much appreciate your gift of medicine and communication and the care of others.
Up to the point direct focused no waste of time on personal stories.Amazing change in format,content.Good change 10 out of 10.
Amazing, thank you. Format is easy to absorb for the data to be used.
Was wondering about the parathyroid glands.
Really like the lecture format and the content. Excellent. Thank you.
Love the format and education from this video! Thank you for the work you do, truly wonderful. I think more videos educating in this way would be attractive to many
Very well done with the graphics...one of the times it was worth it to sit down and watch rather than listen to the podcast on my walk. What is interesting about the pituitary ( in my experience ) is that a tumour may be responsible for disturbances in many systems other than the tissue that is "cancerous". I had a giant macro adenoma (FSHoma) that was not disturbing my life in any tangible way that I could tell...probably had great sperm production, but no real symptoms. At the same time, I was a reactive hypoglycaemic, for no known reason. With diet, I could control the negative effects of hypoglycaemia. Once the adenoma was discovered and the first surgery performed in an attempt to "debulk" it, I lost thyroid and some adrenal function. The second, more involved surgery, resulted in regaining thyroid function, only minimal decrease in adrenal function, but total loss of FSH and LH. Plus I am still a reactive hypoglycaemic. Perhaps it has something to do with the original tumour or not. But I wouldn't rule it out. It will be interesting to see what happens in the future.
This is awesome, thank you for creating this.
Where were you during my A and P course? 😂 Thanks for the breakdown Doc! Much appreciated.
Great episode. This was very helpful for knowing what labs to ask for in my yearly physical.
Excellent review! Thank you
Very well spoken and articulated physician
Thank you
Great video, good information. Thank you for sharing your knowledge.
Very excellent presentation! I learned so much from this. Endocrinology is fascinating for me.
Thanks so much for the information about the transfer situation to menopause/ perimenopause. There are so many more symptoms that are really serious (except for hot flushes or night sweats) like difficulties to concentrate, brain fog, heart racing, anxiety or paralyzing joint aches. Many women with these symptoms are sent to psychiatrists or orthopedists (me included) but it was acutally the fluctuation of hormones, especially estrogen and testosterone (which is as of today rarely prescribed in Germany since it is not licensed for women yet!!!). It was a real fight to get progesterone and estrogen prescribed, I was seeing at least 6 doctors and spending 1000s of€ to get help. Now I am on HRT in perimenopause and slowly feeling better.
That’s concerning that women with those symptoms are getting misdiagnosed and sent to psychiatrists despite not having psychiatric conditions. I guess people will just have to watch this video or realise the hard way. I hope they don’t realise the hard way though, and get the right treatment.
Thank you for sharing your knowledge! You are the best.
This is a Masterclass, so insightful and enlightening
Appreciate the huge amount of info u give
Love your book, appreciate this format.
Great video! Thank you!
Great summary!
Very informative video. Thank you!
You’re Simply the Best! Thank you!🙏🏻
Better than all the rest?
RIP Tina
@@jayraymond9707she died in Switzerland
Wow good presentation in content ,style,voice,it is as good as the Scottish professors who taught us in Royal College of Edinburgh.Good dr Petter Attila this should be the style of delivering a lecture to well informed listeners like medical consultants.Thank you for showing us the best.God bless you.
Thanks for this informative content.
This is very informative for the laymen like me. Wishing for more videos like this 😊
I've seriously been interested in the endocrine system for the last couple years, this is what I would like to study
I am glad I listened to this video after 3 days of delay if it is boring ,long as before.
Curious in the role of salt\sodium in the function of TSH, T3 and T4
You are amazing!
God bless you 🤲
Love this, thank you!
I been on armor thyroid 60mg and it works great for me. Thank you
More episodes like this! 👍
wowoowowow so amazing and sharing with literally aEVERYONE, thank you for these basics... wellness culture really lets to through a ton of really not at all acurate info out there... love love love learning more from here! thank you!
Thank you also for the cortisol explanation. That is the most understandable i have heard. I know I have issues, symptomatic and have had a couple of 4-point saliva tests, but figuring out how to address it has been difficult. I'd love to hear a movmrecin deoth episode on treatment.
In depth episode for what High Cortisol or Low cortisol for High cortisol try box breathing, meditation, vagus nerve stimulation, grounding, sunshine, take phosphatidylserine, drink calming teas, get a therapist, DANCE
Fantastic, thank you!
Great episode, just wish to hear Dr. Attila's take on Grave's and hyperthyroidism.
Excellent. Thank you.
Amazing.
Thank you so much for helping to liberate the understanding of the mysterious thyroid hormone lab tests from the mystic of the white lab coat endocrinology specialists! May primary doctors everywhere now be empowered to order and interpret these labs so that patients may have optimal health 🎉🙌
Great that's my mayor issue as a woman in my fourty-five, I'm struggling with adrenal cortisol levels at night. Also I'm in HRT testosterone pallets. God bless you and thank you for your care.
Take a cold shower at night. Will bump adrenaline and lower cortisol. Thank you Wim Hof Method!
How do u feel on T pellets?
Thanks! It's so interesting! Does licorice root have an instant effect? I mean if you're low on cortisol at the end of the day and you want to keep your level high, how much licorice should you take? When?
You are a great teacher
Absolutely helpful
Just excellent
Great information 🔥
Thank you!!!!
Love your content
Thank you ❤
THANK YOU SO MUCH for making this episode free on your channel.
If everyone could have a doctor like you we’d all be living to 100. Thanks for your work. Do you know if an estrogen level of 550 is ok in a 69 year old female supplementing with HRT? PCP says yes but a second opinion was aghast and wants it 60.
For a percentage of us, there is an intolerance to progesterone. Adding progesterone during the luteal phase dramatically increases PMS symptoms. Its not the rapid decline of progesterone, its the progesterone itself. I tried virtually every variation, duration and combo of prog and/or estrogen and only in menopause found relief
When was the progesterone added during the luteal phase? On day 15 or around day 21? We’re day 21 progesterone levels measured low, or was it treated empirically? Is there a plausible mechanism for why some may be intolerant to progesterone? Just curious about what may have occurred in your case. Did HRT provide relief in menopause?
The article talks about emotional and behavioral symptoms but in truth this is a physiological/endocrine problem not a psych problem
extremely helpful! i have to have a thyroid lobectomy due to a TI-RADS grade IV nodule (had the thyroseq genetic testing). im having it done at a top academic center but am concerned about my thyroid hormone levels after (normal now). any advice about what exactly to look out for? if it is malignant that will be dealt with, but i know this may sound strange but im a former professional athlete and im actually more worried about uncontrolled weight gain or my metabolism going wacky. thank you for any guidance on hormone level management.
Thanks so much for this video! I have had the exact symptoms you described for hypothyroidism, I took some thing called Synthroid for some years in my early 40s but still felt like crap! I’m just wondering what the next thing is to do now (I am currently 53) that I’ve been off Synthroid for three or four years.? My TSH is 7.62 on last reading! some thing else to add is that when I first got my thyroid manually assessed back in my very early 40s, my endocrinologist who has sadly passed away said to me that I didn’t have a thyroid! Hashimoto’s has also been thrown around as a diagnosis too
Hi, what role does aldosterone play in the entire adrenal system? Could primary Aldosteronism (in the absence of an obvious Adenoma) be probably brought on by insulin resistance or vice versa? Anything that can be done to bring this under control under than MRAs?
As someone with panhypopituitarism due to a previous pituitary macroadenoma, this video was beneficial to my livelihood. Given my situation, there's a lot for me to unbox here, and I still have to delve further to understand and interpret my blood levels. For example, my TSH is normal, but T4 is low, no labs for T3 or rT3. Curious if this is a feedback error, have higher rT3 levels, or something else. Nonetheless, I appreciate you providing this resource to the public.
Every time I listen to Peter I think: Why not to open Attia University? Whatever he explains is way better than any other source I have ever attend to. Despite his role in longevity field his educational contribution is enormous.
More like this!
Thank you. I had thyroid cancer in 2001 and I still struggle and my Endo. He finds my situation very complicated. After 22 years I still take T4 and T3 short acting cytomel. I have so many hypo symptoms but my labs show I’m hyperthyroid. Ugh 😩
Thank you I wish I could find a doctor that would treat symptoms seems like the last 10 years we have went backwards
Good afternoon. I'm not sure if you will check this but I do have a question. I've been listening to all your podcasts for awhile and really have learned alot. I just had blood work done and I have a question. I had half my thyroid removed. I had my TSH and Free T4 tested and it came back a little high at 5.36. I guess I'm asking for your opinion on what I should do next. Should I get my T3 and FreeT3 tested?
Dr mentions looking at Free T level (and other things) when deciding on Trt. This because Dr says free T is the truly active part of T as it is unbound. My question is, as the bond of T to albumin is relatively weak (not nearly as strong as bond to shbg), can the albumin bound T also be considered in the TRT decision, as many labs consider bioavailable T to be the sum of Free T plus Albumin bound T (because of the weaker bond to albumin). It seems that the body can unlock albumin bound T relatively easily from my reading. My thoughts would be that bioavailable T could be defined as the sum of Free T plus a % "of Albumin bound. Comments will be appreciated
@dr Attia, how do I become a patient of yours?
With respect to the adrenal system, Peter gave the impression to suggest licorice to combat obesity, IR, ect; however, licorice increases cortisol as well as IR and obesity, how am I going to take licorice for those problems when I already have increased cortisol? It's contradictory, cause licorice is said to lower IR and fight obesity but all these dysfunctional states increases cortisol which increases blood pressure too.
Just started Clomid yesterday.
Please do an episode on her for both men and women!
Please explain acronyms when using terms.
doctor, I am premenopausal 52 getting HRT plus anticonceptional, it would be so important to understand how the system function while getting anticonceptional treatment and estradiol gel,because some ladies need up to 200mg HRT some 5 mg , some 1 mg and it varies a lot ,but in most cases it is challenging to keep under control and forecast how if the ovaries are producing few eggs yet while getting hrt , but especially how each individual can adjust estradiol gel dosage. thanks for your answer
How common are side effects in men from over-aromatization to estrogen?
Would you recommend the Dutch test to optimize female hormones for training?
super. We just subscribed/
Any info on why testosterone would totally tank in women? I’m in perimenopause currently at 41 but my T was at 0 when I was 35 causing huge cognitive issues among other things . HRT for low T helped
Sure glad you aren't my doc. I was having serious mood issues due to higher estradiol levels. If you have a patient who isn't feeling better on what you think he should give him more testosterone and an aromatase inhibitor....they'll likely feel much much better.
Hell yes.
I tried a few dissociated versions and I tried Cytomel. Synthroid works best for me.
Can you tell me is this is going to be different after a full hysterectomy? I will be getting one in Oct. I'm 60 and I have had lots of thyroid issues since 16.
Tnx tnx tnx 👌
quest diagnostics tests free cortisol in the blood along with cortisone (i believe free and total) as well. why are these not good tests to use?
Would love to know how the hormones change if someone is on oral contraceptives
The symptoms associated with the more common Low/Hypo thyroidism/Low T3.. fatigue, cold, constipation, seem to overlap adrenal fatigue?
I understand the hypothalamus sends trh to pituitary which sends tsh to thyroid which makes some free t3 (20%), and mostly t4 (80%).. the latter is converted to either free t3 (via d1 and d2) or reverse/anti t3 (via d3 due to inflammation/IR), but what are the good blood markers to look for? free t3/ reverse t3 = 0.25?
I know you can live with one or none (if you supplement with HRT), but when a kidney is removed, is the corresponding adrenal gland removed as well?
Finally, blood tests for the adrenal system are not helpful since it reports total coritsol (bound and unbound).. the better way is the urine dutch test that measure free cortisol. I like the part about how black licorice root increases cortisol, while phosphatidylserine decreases it!
My husband has hypothyroidism. If he gets the cheaper drug which is mostly T4 he gets twitchy, then argumentative, then violent. He therefore is prescribed T3 rich thyroxine. If he forgets to take it in the morning I can tell by his manner by about 10.30am. By 8.30pm he is scary.
Where do TPO auto antibodies fit in?