Welcome to Huberman Lab Essentials,

where we revisit past episodes for the

most potent and actionable science-based

tools for mental health, physical

health, and performance.

I'm Andrew Huberman and I'm a professor

of neurobiology and opthalmology at

Stanford School of Medicine. And now for

my discussion about hormone health and

optimization with Dr. Kyle Gillette. Dr.

Gillette, welcome.

>> Thank you for having me.

>> Well, I'm super excited to talk to you.

You are an encyclopedia of knowledge

about hormone health for men and for

women across the lifespan. So I have

many many questions. When someone comes

to you as a patient in terms of hormone

health, what are the sorts of probe

questions that you ask and and what are

you looking for? And I asked this

because I'd like people to be able to

ask some of these very same questions

for themselves.

>> So when you do a physical exam and a

history, you have a lot of different

parts. You have your history of present

illness. if they have a complaint, maybe

the patient doesn't have a complaint.

And in that case, things like their

social history and their family history

are extremely important because that

gives you an insight into into their

genetics and an insight into their

hormone health. So patients will tell

me, I'm doing okay, but it helps to ask

them, well, how are you now? Let's say

the patient is 50. How are you now

versus when you were 20? And what has

changed? So, I've got the question a

lot, how do you get your doctor to order

a better lab workup or to even include

your basic hormones? And there's no

magic answer to that. But what really

helps is you tell them, you know, my

energy is not as good as it used to be.

My focus is not as good as it used to

be. My athletic performance is not as

good as it used to be. So, you don't

have to have a pathology in order for a

lab to be indicated. You just need to

have that pertinent symptom. Would you

say that using the approach you just

described that it's um equally effective

for men and women or do you find that um

for one reason or another that men and

women have different challenges in and

advantages in trying to access their

deeper hormone data? With women, there's

a lot more objective data. So, if

they're having menstrual irregularities

or if they're not having a period, if

they're having too heavy of periods,

then those are things that they talk

about very frequent frequently with

their doctor. Men are more hesitant. Men

really want to know what their

testosterone is, but they at the same

time they really don't want to tell

their doctor how their libido is or how

their energy is because it it's almost

like um they feel less masculine or they

feel less like a guy when they say that,

even if they're just talking to their

doctor about it. I'd love to just kind

of take a snapshot of what you think

everybody should be thinking about or

doing to optimize their hormone health,

male or female, from puberty onward. The

law of diminishing returns applies. So,

doing a little amount of what I call

lifestyle interventions over a long

period of time is going to be far more

helpful or efficacious than doing a lot

and then doing nothing. So, I talk about

the big six pillars. The two strongest

ones are likely diet and exercise for

hormone health. Specifically, resistance

training is particularly helpful for um

diet. Caloric restriction can be

particularly helpful especially with the

epidemic of metabolic syndrome that is

continuing to ongo in developed

countries in general. Those are the two

most powerful. For the last four, I have

a little bit of alliteration. So there's

stress and stress optimization that has

to do with cortisol that has to do with

your mental health that has to do with

societal health and collective health of

your family as well. Um when you're a

member of a family or even a very close

friend um trying to achieve optimal

health together is very important. It's

the same thing with nicotine sessation.

It's the same thing with hormone

optimization. If you do it as a

household unit, it's far more helpful.

So after stress, you have sleep

optimization. Sleep is extremely

important uh especially for

mitochondrial health as well. And then

you have sunlight which encompasses

anything that's outdoors. So you move

more, you have cold exposure, you have

heat exposure. Um that's sunlight. And

then last one is spirit. So um that's

kind of the body, mind, and soul. If you

have all the other five in uh they're

dialed in completely, but you don't have

your spiritual health, whatever you

believe, then that's going to profoundly

impact your body and your mind as well.

>> What would you say is a really terrific

way to think about and approach diet?

>> Yeah, diet should be an individualized

approach. So, if you have a a car, each

car is made different and requires a

different sort of fuel. Whether it's a

race car, whether it's a diesel truck,

they have different fuels for different

performance outcomes. So if you're

trying to tow something or you're trying

to go fast, it also depends on your

genetics. So you can have a genetic

polymorphism and you metabolize carbs

and sugar better even when they're

unopposed by fiber. Basically, you can

use your BOF feedback, how you're

feeling to guess what you tolerate well,

or you can just get genetic testing,

which can be fairly expensive, but most

of all, it requires a physician or

someone who knows how to interpret the

test accurately. And if someone had the

means or uh would you say that getting

regular blood testing is a good idea?

And if so, what is regular blood

testing? Is it every 3 months? Is it

every 6 months?

>> Every 3 to 6 months for preventative

purposes. You should also get a blood

test when you're fasting and when you're

not fasting.

>> And in terms of uh general

recommendations around exercise, I'm of

the mind based on the data that I've

seen that almost everybody should or

everybody should be getting 150 to 180

minutes minimum of zone 2 cardio per

week.

>> Yeah, that's more or less the contour.

The more you're doing your zone 2

cardiovascular exercise,

the slightly less important a long

duration of caloric restriction is.

>> And that brings us to caloric

restriction. How does someone know if

they should use caloric restriction or

avoid caloric restriction?

>> The reason for exercise and the reason

for caloric restriction in general,

including intermittent fasting, is

health reasons. That's how you increase

your health span. It's not necessarily

going to make the weight on the scale

change, but that doesn't matter as much.

So, the easy way to think about it is if

you're obese or you have metabolic

syndrome, caloric restriction will

improve your testosterone. There has

been a study and they talk about all

these studies in a systematic review

from the Mayo Clinic Proceedings. They

note that there is a study in young

healthy men and they chlorically

restrict them and their testosterone

does decrease. So if you're young and

healthy and you don't have metabolic

syndrome, then caloric restriction will

likely decrease your testosterone. For

the healthy um lean enough person,

right, non-obese uh person, is

intermittent fasting a bad idea in terms

of hormone health. Is oscillating

between this period of of kind of feast

and famine within a 24 hours a problem

if one is getting sufficient calories to

maintain weight? So if they're in a

caloric maintenance, then it's not going

to be uh it's not going to be

delotterious. It's not going to be bad

for their hormone health. There's a

couple different hormones that we can

talk about. We can talk about

testosterone. We can talk about DHEA,

which usually go hand in hand. And then

we can also talk about growth hormone,

which is not a steroid hormone, but it's

a peptide hormone. So it's um a chain of

proteins, amino acids that are put

together instead of a sterile. Think of

sterile hormones as coming from

cholesterol. So you do get a little

spike in growth hormone after you eat.

But you also get a huge spike in growth

hormone, a more significant, less

negligible spike overnight.

And that is improved if you are

intermittent fasting. So, it's probably

going to help your growth hormone and

subsequently IGF-1 levels, which will

help more in older age groups than

younger age groups. Can I still achieve

a high degree of growth hormone output

if I, let's say, I avoid food in the 2

to three hours before going to sleep? Or

does one have to be very deep into a

fast in order to achieve this the

increase in growth hormone? there's

still pretty good growth hormone output

even if you eat two or three hours

before you sleep. It's just the law of

diminishing returns. The longer you go,

you get slightly more and slightly more.

But I think about it in terms of

endocrine IGF-1, mostly IGF-1 that's uh

synthesized in the liver and released in

the in the liver versus IGF-1 that's

released um classically an example of

this would be your IGF-1 levels increase

after resistance training or exercise.

And that's more of like paracrine or

autocrine and they have more local

action. So that IGF-1 it's pretty well

studied that if you just give people

IGF-1 it's not going to at uh

physiologic levels it's not going to

improve their body composition.

However that IGF-1 that's autocrine and

paracrine just working in those local

tissues and muscles is likely part of

the reason why you get a improved body

composition response after exercise. Are

there any aspects of hormone

optimization that can improve sleep? I

know sleep can improve hormone

optimization, but for people that are

suffering from this common syndrome of

going to sleep and then waking up at

3:00 or 4 in the morning, we know that

can be associated with depression. But

are there any hor hormonal indications

that might lead to that kind of

situation? There's three big ones. The

first one is not super common, but it's

a very direct correlation. If you have a

growth hormone deficiency, a true

deficiency, whether you're an adult or a

child, then your sleep is likely going

to be affected. And uh let's say you're

a child with growth hormone deficiency.

Once that is replaced with therapy, your

sleep is going to get significantly

better. The second one that's a very

common scenario is if you're having

what's called vasomoter symptoms of

menopause or vasomoter symptoms of

andropause, which are also applicable.

That's why a lot of women in menopause

feel like their sleep is much worse is

because they have lower activity of

those progesterrogens.

>> And for men in so-called andropause, um,

low testosterone, is that also one of

the causes of poor sleep?

>> Low testosterone can lead to poor sleep.

But my third scenario, uh, is actually

if a man begins TRT, then they develop

poor sleep because of sleep apnea. It

drastically raises the risk that

somebody is going to have sleep apnea.

And then a lot of people especially when

they first start it in the first month

or two. It puts them into this hyper

sympathetic state because they have uh

overactive androgen receptors especially

after a long time of being hypogonatal.

Then they have uh a physiologic dose of

TRT and that causes the sleep issue

itself.

>> Is that also the case in people that are

using TRT who are not hypogonatal? Many

people nowadays, let's be honest, are

are taking doses of of testosterone even

though they are in the sort of standard

range because the range is so large

because of other symptomology. Is that

right?

>> Uh if you're yugenatal before you start

testosterone,

>> meaning meaning

>> meaning you have normal testosterone and

then you start TRT or um

self-administered TRT, steroids, what

however you want to look at it, then

your risk of sleep apnea still goes up

in a dose dependent fashion. So the

higher the dose, the more risky.

>> I want to touch on testosterone in

women. I'd like to know whether or not

knowing a woman's testo for her to know

her testosterone is of equal, less than,

or more value than knowing uh for

instance progesterone and estrogen

levels because I think there are a lot

of misconceptions about the roles of

testosterone in women.

>> For health optimization, testosterone is

just as important to know. for pathology

prevention. For example, breast cancer,

osteoporosis, estrogen, and progesterone

are more important to know. So, when

you're thinking about women, women think

that they have such a tiny amount of

testosterone because you could you test

it. Most people test a free

testosterone. So, a testosterone that's

unbound, which is by far the the

smallest proportion of testosterone. Any

androgen is bound by lots of different

steroid binding proteins, but the ones

that are most pertinent are called SHBG

or sex hormone binding globulin. And

that binds the androgenic steroid, for

example, DHT or dihydrotestosterone.

It's associated with prostate

enlargement associated with male pattern

baldness. It binds that the most

strongly and then it binds testosterone

next most strongly and then it binds

things like andadione or DHEA dehydroepi

androsterone and then it binds the

estrogens the weakest like estradiol. So

if you look at the total amount of

testosterone, women actually have um

almost all women, not all women, but

almost all of them have significantly

more testosterone

than estradiol, but it's because it's in

different um measurements. So estradile

a lot of time is, you know, pog grams

per mill as opposed to nanogs per

deciliter. So women have more

testosterone than estrogen and

significantly more DHEA than either. I'd

like to ask about DHT in men. Uh so

often we hear about testosterone in men

and free testosterone and uh being the

unbound form of course, but

dihydrotestosterone.

Um but what's it what is it doing? DHT

is a very androgenic hormone. So whether

you're talking about DHEA, which is a

mild a weak androgen, or testosterone,

which is a relatively strong androgen,

or DHT, which is a very strong androgen,

they bind to the androgen receptor in

both men and in women. So the uh effect

of all three of those is mediated by the

androgen receptor. Intriguingly, it is

on the X chromosome. So men get their

androgen receptor gene from their

mother. So DHT helps a lot for it's the

same reason why testosterone helps. It

helps effort feel good. So it can be

motivating. There's lots of dietary

changes and supplementation that you're

probably doing right now that's

affecting your DHT.

>> You mean me personally?

>> Well, every everybody all all of the

listeners um because let's say you have

a diet high in plant polyphenols. Many

of those inhibit the enzyme that

converts testosterone to DHT. Could you

give us an example of of one of those um

either in supplementation form or in

food form?

>> Yeah, turmeric, black pepper extract.

>> Do you recommend that people avoid

curcumin and turmeric for that reason?

>> If someone's DHT is already low or if

they have somewhat insensitive androgen

receptor via genetics or via lifestyle,

then I recommend they avoid bioavailable

curcumoids like bioavailable turmeric,

black pepper extract. I know many people

want to avoid the hair loss that can

sometimes be associated with DHT levels

going too high. If somebody is concerned

about or is experiencing hair loss, male

or female, what are their options of uh

ways to offset that hair loss that are

not going to negatively impact other

tissues sensitive to DHT? And and what

I'm what I'm basically saying here is I

could imagine taking a a DHT inhibitor,

um a pill of some sort or an injection

of some sort and offsetting hair loss,

maybe even stimulating more hair growth.

Um it's clear that I'm not doing that,

but but I know people that do, but then

experience some of the other negative

effects of of blunting DHT, reduced

affect, reduced libido, reduced drive,

um disruptions in um prostate function

or or even um sexual function generally.

So, what could can people do if they

want to maintain or grow back hair, but

they don't want all those other effects?

What should they avoid and what should

they perhaps consider talking to their

doctor about? You want some sort of

strategy to decrease the activity of

that androgen receptor. There's a lot of

different things that you can do that

are topical. The most promising is

called dutasteride misotherapy.

Essentially, what it is is it's very

localized injections in areas that are

prone to male pattern baldness. um

whether they're a female or a male and

it acts locally only and you repeat

these injections from time to time. It

decreases the conversion of testosterone

to DHT just in the scalp. How does a

woman know if she has PCOS, polycystic

ovarian syndrome? I know you uh have

treated a lot of PCOS. Uh what age women

um should be thinking about PCOS? What's

PCOS? Teach us about PCOS, please.

>> Yeah. So PCOS is polycystic ovarian

syndrome and this is one of those

conditions which is underdiagnosed. So

it's prevalence is much higher than we

think it is. There's been a lot of

studies and some some studies say

prevalence of 10% some say 20%.

It's not completely clinically

penetrant. So most people don't know

they have PCOS until they have

infertility or subfertility. And is this

is PCOS happening at this frequency in

20-year-old women and 30-year-old women

and 40 and onward?

>> Most women find out they have PCOS in

their 30s, especially because it's on a

spectrum or a continuum like a lot of

things where you can have a weaker

version or a very severe version.

>> What are the symptoms?

>> There's a criteria called the roder dam

criteria. And in the Roderdam criteria,

there's a couple different ways that you

can diagnose it. You're looking for

androgen excess insulin resistance and

you can also look for polycystic

ovaries. You don't actually have to have

polycystic ovaries or get an ultrasound

of your ovaries to be diagnosed. If you

have androgen access for example

androgenic acne or hormonal acne. If you

have hair growth like a hair growth on

the chin it's called herutism. or if you

have uh you know like deepening of the

voice um any symptom of too much and uh

male pattern baldness if you're a female

that's a a symptom of PCOS as well then

you can also have insulin resistance so

this is obesity it's pre-diabetes a high

fasting insulin a over two a fasting

insulin of over six so if you have

significant insulin resistance and also

So androgen dominance that's a sign of

it. Androgen dominance often leads to

what's called ilom minora. So if you're

having more than 35day intervals in

between a period or if you have less

than nine per year then that can be a

sign that you have oligo which means too

little minora which means minces. So

that's a very common sign of PCOS.

If you have infertility, so if you're

under the age of 35 and you've been

trying for more than a year or if you're

over the age of 35 and you've been

trying for more than six months, then

that can also be it's a very common

presenting complaint when somebody

presents with PCOS. If they're very

strong on the insulin resistance

spectrum, then uh optimizing their body

composition, decreasing their body fat,

and treating that metabolic syndrome can

help. So, uh, a lot of people ask, well,

does everybody that's on, uh, like does

everybody need to be on Metformin that

has PCOS? Not necessarily. But Metformin

is one of the tools that can help with

insulin sensitization.

Other tools that can help are anostitol.

So, myoinostitol is an insulin

sensitizer. It's uh, cousin

Dyroinostitol

is a a weak anti-androgen. A lot of

types of anostitol have both of those in

it. So depending on if you're a female

or a male and you're on anostitol, the

type of anostitol does matter.

Marijuana,

I've heard that it can decrease

testosterone in men and women. I've

heard that it can increase testosterone.

Alcohol, I think there's general

consensus that high alcohol intake, high

barbituate intake does in fact reduce

testosterone. I'm not a drinker, so I'm

not asking these questions for me. I

don't smoke pot. I'm quite open. I've

just never really liked marijuana or

alcohol. They're not my thing. But many

people want to know the answers to

these. So, what about marijuana? Does it

reduce testosterone to significant

degree or not? Canabonoids itself,

whether it's THC or CBD, are not going

to reduce testosterone by themsel. If

it's smoked marijuana, then it's very

likely to increase your aromatase, which

increases your estrogen

and uh you know that's going to it's

romatizing from testosterone. So that is

going to decrease testosterone. When you

have an increased estrogen like

estradiol, that's going to work on your

pituitary to make less hormones that

cause the release of of testosterone. So

you're going to have less LH and less

FSH. So, it's almost kind of like uh you

know, opiates are well known to um

opiate agonists.

They're going to decrease LH and FSH and

subsequently testosterone. Smoked

marijuana will as well. As far as

alcohol, high alcohol will decrease

testosterone as will any very potent

GABA agonist. Whether it's a barbituate

or a benzoizopene or a non-benzo or

alcohol, they're definitely going to.

>> So, let's talk about testosterone in in

males. I'm aware that a lot of people

are considering increasing their

testosterone by taking testosterone that

a few years ago that was considered, you

know, steroid use and it was really

extreme kind of stance. Nowadays it

seems like there's more discussion about

it. Does testosterone supplementation

and here I'm talking about prescription

from a doctor. Does it make one more

prone to prostate cancer? That seems to

always be the first question that comes

out. So testosterone is not going to

cause a prostate cancer. However, normal

aging causes prostate cancer and

testosterone will grow your prostate

cancer. So if you're a 80year-old male

and you have an autopsy, then there's at

least a 50% chance that you have a

prostate cancer. If you're 90 or 100

years old, there's at least a 90%

chance. So for humans with a prostate,

it's only a matter of time until you get

a prostate cancer.

So that begs the question, do you want

to take something that's going to grow

it for sure once you have it? So it's an

individual assessment with aging. You

know, fast aging is abnormal, very slow

aging is normal. There's a fine line to

walk between those two. What about uh

prolactin? Just as testosterone and

estrogen need to be in the proper

ratios, dopamine and prolactin need to

be in the appropriate ratios. So what

what how should we think about um and

perhaps act on our prolactin systems?

>> The way I describe it is the dopamine

wave pool. So if you're increasing your

dopamine too much, you're going to

overflow and then you're going to have

that wave crash too much. So you want to

have nice even waves that are not going

too far above the pool of dopamine and

prolactin will follow. So prolactin and

estrogen are quite close cousins.

Estrogen upregulates a gene called the

PRL gene or prolactin gene that directly

increases prolactin synthesis. So

prolactin is going to uh also inhibit

the release of testosterone from the

pituitary. So if you're using a dopamine

agonist then you're going to help

decrease the prolactin producing cells.

So if someone's concerned about dopamine

or maybe they have a slightly higher

prolactin then they eliminate things

that could be increasing that prolactin

so such as uh casein or gluten which are

muopioid receptor agonists or any mu

opioid receptor agonist in the gut

casein so milk protein

>> correct

>> can increase prolactin

>> correct interesting I'd like to shift

gears slightly and and talk about uh

social interactions and relational

effects on hormones

What would you suggest people uh do or

think about as they enter relationship

or if for people that are in long-term

relationships where they feel like

something has shifted and indeed it

those shifts may reflect the output of

different hormone systems and

neurotransmitter systems. It almost

certainly has to be the case, right?

>> Yeah. So just like uh women who spend a

lot of time together whether they're

co-workers or whatever a lot of times

their men menstrual cycles will align

there is a lot of pherommonal and

hormonal cross talk including prolactin

between men and women. So spending 100%

of the time together this is why people

think it's so hard to work together and

live together. They're around each other

24/7. you don't have the reprieve where

you let that dopamine settle down and

then you're excited when you see them

again. Um, a lot of guys know that they

go on a trip for a long time, they come

back and they see their partner and it's

like a new, not quite like a new

relationship, but almost like a new

relationship and they have that

excitement again. And purposely building

that into every relationship can help

significantly, especially if you choose

to have a child or get pregnant or be

breastfeeding because you just plan

ahead for both of your prolactins to be

high and both of your dopamines to be

low and both of your testosterones to be

low. So, um there's a there's a lot of

planning that you can do. Essentially,

every relationship goes through uh a

crisis

>> and that crisis is personal between uh

the two of you and you can plan ahead

and figure out a way. Maybe it's not

supplementation, maybe it's not even uh

the amount of time you spend away from

each other, but plan ahead to have good

times if you know you're about to go

into a crisis.

>> Peptides. Lot of discussion these days

about peptides. What can we say

generally about peptides? Are they safe?

Are they not safe? What about sourcing?

And are there any peptides that you

think could be of particular use for

people? And we should probably also

touch on peptides that people shouldn't

go anywhere near with a 10-ft pole.

>> Yeah, definitely. So, peptides are very

heterogenous. There's very dangerous

ones and very safe ones. My favorite

peptide is the original peptide, which

is insulin.

>> And yet, insulin can kill you if you

take it at the incorrect dose.

>> Yeah.

>> Yeah. So just like insulin should be

prescribed by a doctor, there is

overcounter insulin uh rely on or NPH,

but ideally your insulin is prescribed

by your doctor for uh your diabetes uh

as it's life- saving. Peptides should be

prescribed by doctors as well. And

there's several that are FDA approved.

Growth hormone itself is also a peptide.

It's a peptide hormone, not a steroid

hormone. So if somebody wants to

increase their growth hormone output,

what are the risks and benefits of

taking a growth hormone releasing

hormone peptide prescribed by a doctor?

Of course, uh what should one be

concerned about? There's definitely a

lot of risk. Tumor growth and cancer. So

you look at a type 1 diabetic, they have

very high incidencies of various types

of cancer. They have very high growth

hormone but low IGF-1 paradoxically.

So they would likely give you a similar

cancer risk to a type 1 diabetic that

has very high uh growth hormone.

However, there are the benefits of it.

You think of lipolysis, uh decreased

body fat, increased lean body mass. A

lot of those can you can use other

things to get those benefits. So then

you know you don't need growth hormone

for those benefits. that just leaves

cosmetic benefit to which you can

usually use topicals to get uh you know

your hair and your skin and your nails.

There's a lot of other things that you

can do other than growth hormone.

>> So a lot of people just don't need these

GHRPS.

>> Yeah. Let's talk about BPC 157 and

melanitan because I think those are the

ones that most people are um eyeing so

to speak.

>> Yeah. So BPC57 is body protective

compound 157.

uh identical or bio identical to gastric

protective compound 157 that's produced

in the stomach. So as you age you get

atrophic gastritis very often. That's

why you have less intrinsic factor which

is kind of another peptide that binds to

vitamin B12. That's why you can get age

related B12 deficiencies.

So that's one reason why you have more

colitis, more diverticulitis as you age.

you don't have that gastroprotective

compound. It's uh it increases veg f

vascular endothelial growth factor which

basically makes your blood vessels grow

more. So that's what uh causes your body

to form a blood vessel. So another

medication known as avasten, it's on the

WHO's list of essential medications for

cancer. So many different types of

cancer, including colon cancer, you

treat it with avasten, which is a veg

inhibitor. So if you have cancer or a

high cancer risk, you probably don't

want to be taking a medication that's

the exact opposite mechanism of action

as your essential anti-cancer med.

>> In other words, if you have cancer or

you're at risk of cancer, avoid BPC57.

>> Correct? BPC57 is not FDA approved, but

it is essentially standard of care at

this point. Uh, I would say it's, you

know, if you're not counting insulin or

growth hormone as peptides, it's one of

the most commonly used peptides and

anecdotally and in some clinical

literature, it's fairly well tolerated

for short periods of time. I'm not in

the camp that everybody needs to do it

two to three times a week or even daily

for six weeks, no matter what. The major

benefit is when you're going to take it

early on because it's going to allow

your body to increase blood flow to the

injured area. And the less blood flow it

has, for example, cartilage ligaments

have horrible blood flow, especially as

people age, it's going to make a

significant difference. So, I would

wager that that Russian gymnast that

Achilles healed in one month completely

from a a full rupture was likely taking

BPC57 or something very similar.

>> Yeah, I'm willing to wager on that as

well. a remarkable recovery. Uh and so

because it is pres prescription, there

are non-prescription forms. My

understanding of the non-prescription

forms and the danger of going after

non-prescription forms is that often

times they will contain what they claim

they contain BPC 157 in this case, but

they are not adequately cleaning out the

LPS, the lipopolysaccharide, which can

cause inflammation. In fact, in the

laboratory, we use LPS to deliberately

induce fever and inflammation to study

systemic inflammation. So, this is a

warning to people. If you're interested

in peptides, you absolutely need to work

with a physician in my opinion.

>> Get it from a really good compounding

pharmacy who will clean out that cleans

out the LPS

>> because if you're buying it through a

source that um you know a lot of people

I don't want to name sources, but there

are these common sources on the internet

that everyone knows about. They're

buying these sources. They'll ship it to

anyone essentially. But then the LPS is

really causing inflammation and many

people experience a kind of mild fever

or tingling from that when they inject

it and they're like, "Oh, I can feel it

working." That's probably LPS action,

which

>> is not good for the brain. I don't know

about the on other peripheral tissues.

Um, I haven't heard of people dropping

dead from this stuff yet, but I

certainly wouldn't want to be ingesting

any LPS unnecessarily. You mentioned

melanitan. There are several kinds of

melanitan. I first learned about

melanitan from um reading about peptides

and discovering that people were taking

injecting melanitan to get tan because

it's in in the melanin um synthesis

pathway. Are there any clinical usage of

melanitan?

>> There's actually three FDA approved

indications believe it or not many

people know about this but there's three

wellaccepted indications.

One of them is the hypoactive sexual

disorder and more in women. That's for

brimlanotide. So those are those are

women that have essentially no libido

whatsoever. Yeah.

>> But other hormones are seem are in

check.

>> Yeah. Classically it's um before

menopause. So those hormonal issues are

not contributing. And uh when you give

them this peptide, it's also known as

PT141. It helps significantly. A lot of

times you use it in nasal spray. It goes

straight into the central nervous system

and acts centrally. You can also inject

it and you can also take it via Troki.

>> Men and women take it. Correct. It's

approved for women, but it can also help

men and it's relatively safe. The only

relative contraindication that I tell

people, and a lot of people say, "Oh,

there's no side effects that I know of."

But if you have a family history of

melanoma or potentially have a melanoma

and don't know about it, that's why I'm

a big advocate of dermoscopy as well and

regular skin checks. Then theoretically,

it's going to increase that alpha

melanocyt stimulating hormone and it can

grow that. So, that's definitely not a

good thing. Um so be very careful about

long-term administration of it. It's

also approved for lipodistrophe which is

the same exact thing as tessammoralin

which I believe is also known as uh uh

vista or a grifta. And then it's also

approved for the rare genetic condition

where your uh receptors or your

melanocytes don't proliferate as well.

So you usually have hypopigmentation.

It's not true albinism. Um, but it's

associated with morbid morbid obesity

and very poor outcomes from that in

childhood. So, it's used in kids

actually.

>> Interesting. I want to talk about the

sixth pillar, spirit. How do you

conceptualize the spiritual aspect and

how do you talk to patients about this

given that people walking into your

clinic are presumably have a bunch of

different religious and not aigious

backgrounds? I'm sure some are atheists,

some are probably strong believers. How

do you deal with that and how should

people think about this?

>> Yeah, it is surprisingly wellreceived.

You wouldn't think at first glance that

a patient really wants to talk about

their spiritual health with their

doctor, but the way I think about it and

the way that it really is is it's like a

vin diagram and you have a body and a

mind and a soul and you can't have one

healthy without the other healthy. Even

if your mental health is uh phenomenal

and even if your physical health is

phenomenal, the mental aspect of

spirituality, if that piece is not

there, then that's going to affect your

body physiologically as well. And

regardless if someone's an atheist or

regardless of regardless of what someone

believes as far as religion or the

origin of the species, they can know

that their spirituality is going to have

a profound effect on their mental and

physical health as well. People like to

compartmentalize it. So they like to

talk to their doctor only about the

physical health because it's comfortable

to do that. They only talk to their

pastor or a mom or a you know Ricky

healer for their spiritual health and

they just talk to their therapist or

psychiatrist about their mental health.

But you need to bring all three of those

things together. Uh it's well known that

interdisciplinary clinics lead to

improved patient outcomes and that's

just disciplines within medicine. So

that's just uh doctors that are

specializing in this or this. So this

takes a step back and upper uh in the

upper part of that tree before you reach

those dichotoies or the split-offs. You

have your f you have your body and your

mind and your soul. So your spiritual

health and your mental health and your

physical health.

So if you're uh in line in all three of

those things that builds the cornerstone

for the rest of your health and the rest

of your life. So I hope that everybody

does find what they truly believe in as

far as their own spirituality. But uh

yeah, that that's a a personal journey.

Uh from a physician standpoint and even

if I'm friends with him as well from a

friend standpoint, I don't like to push

anybody in any specific direction. So I

don't think that everybody should

believe what I believe and uh I don't

feel like there should be any pressure

for them to believe something different.

So I think that there can be excellent

physician patient rapport regardless of

what of what we believe and what our

backgrounds are. I have one final

question. Is caffeine having a an effect

one way or the other on testosterone,

estrogen or other hormones that uh is

positive, negative or neutral?

>> Only if it affects your sleep. So, it

works on adenazine and it can actually

slightly improve allergies as well, but

uh negligible effect otherwise.

>> Kyle, Dr. Gillette, I should say, thanks

so much for your time. I really

appreciate it. I know the listeners will

too.

>> Thank you. My pleasure.