Peter Attia's AMA #3: supplements, women’s health, patient care, and more

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apod
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Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby apod » Mon Oct 29, 2018 6:52 pm

This was a fun podcast to listen to:
https://peterattiamd.com/ama03/

I loved his commentary on walking around with CGM as being analogous to driving a racecar with an RPM tach vs driving without one. What always got to me while wearing one, was the slight discomfort of the device vs the data. After a certain level of cleaning up your diet / sleep / exercise regimen, the data becomes less actionable since you're kind of doing everything as well as you can.

What struck me as particularly interesting was the Nicotinamide Riboside discussion at the end, where Peter ultimately seems to view the supplementation of NR / NMN as a waste of money, whereas microdose lithium was mentioned to offer some cost-effective benefit. I'd love to rack his brain on a number of supplements / biometrics.

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby SoCalGuy » Mon Oct 29, 2018 9:33 pm

Yeah, I have really enjoyed his podcasts. I found this one particularly helpful because he gave an overview of his reference ranges in terms of what he likes to see with his patients. It would be cool if at some point he did a podcast with Dr. Gundry. Attia really understands the lipid side of things and being able to talk to someone who has a ton of experience on heart disease would make for a pretty good podcast.

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby JimBG » Tue Oct 30, 2018 10:41 am

Agree that this was an enjoyable and informative podcast. One noteworthy point is that one question was "Why are you taking Zetia and Lipitor? Are you mitigating risk based upon your APOE4?" He noted he's not taking them now (he's taking something else which he didn't elaborate) but did to mitigate as much as possible CV risk. I did not know he has a least one APOE4 allele as the questioner seemed to know. Apparently another member of the club.

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby LanceS » Sun Nov 11, 2018 9:31 am

apod wrote:What struck me as particularly interesting was the Nicotinamide Riboside discussion at the end, where Peter ultimately seems to view the supplementation of NR / NMN as a waste of money, whereas microdose lithium was mentioned to offer some cost-effective benefit. I'd love to rack his brain on a number of supplements / biometrics.


His latest with podcast has Sinclair taking NMN(750mg), Resveratrol(1g), and Metformin(1.5g), though he worked to it over time, not sure if taking NMN sublingually. Just FYI. I think there is a pony in this stuff, Sinclair knee deep in finding it. Though who knows it seems to me this "highly conserved" pathway would have been manipulated in extreme ways by evolution by now.... but maybe it is us with our extreme food intake that is manipulating the "highly conserved pathway".???

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby apod » Sun Nov 11, 2018 11:52 am

LanceS wrote:
apod wrote:What struck me as particularly interesting was the Nicotinamide Riboside discussion at the end, where Peter ultimately seems to view the supplementation of NR / NMN as a waste of money, whereas microdose lithium was mentioned to offer some cost-effective benefit. I'd love to rack his brain on a number of supplements / biometrics.


His latest with podcast has Sinclair taking NMN(750mg), Resveratrol(1g), and Metformin(1.5g), though he worked to it over time, not sure if taking NMN sublingually. Just FYI. I think there is a pony in this stuff, Sinclair knee deep in finding it. Though who knows it seems to me this "highly conserved" pathway would have been manipulated in extreme ways by evolution by now.... but maybe it is us with our extreme food intake that is manipulating the "highly conserved pathway".???

I've been keeping an eye on NMN for a while -- I'm not quite sure what to make of it. I see some guys claiming that NMN is a precursor for NR, and other guys claiming NR is a precursor for NMN. Currently, I'm using the Niagen "NAD Powder" which is essentially low-dose NR mixed with soluble fiber. With my B-complex that's missing B3 (HomocysteX+) it seems to be a fairly safe bet. I came across a few threads that mentioned labwork deviations post-NMN supplementation, but they might have been coincidental.

I'd love to know what brand of resveratrol Sinclair takes. Resveratrol reminds me of the studies on curcumin, where there's seemingly a pretty big difference between say, a curcumin extract via ethanol extraction or whatnot, and something like Theracurmin. I like the studies on Longevinex, but I'm not totally sold on long-term supplementation with EGCG / phytic acid.

I came across this the other day:
http://www.jarcp.com/1201-two-methods-o ... study.html

https://www.reserol.com/

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby LanceS » Sun Nov 11, 2018 5:26 pm

The podcast is 2 hours but is pretty good. He maintained that NR to NMN to NAD and seemed to indicate there was a reason why you don't want to take too much NR (i was in car listening so I may have misheard this). Typical inside baseball he probably told Attia what he takes but not on the podcast. He actually indicates his pill regimen is inexpensive. I would have to imagine he is taking 750mg in pill form not sublingually, but who knows. Didn't he rip the face off the pharma industry with a pill that was completely ineffectual? Sometimes on the podcast I feel like he was just getting ready to effect his old playbook. Used to be screwing over some industry, consumers, partners was a bad thing in this country. Now we seem to lionize and celebrate the behavior. I realize he may have mixed feeling and perhaps has a different perspective, but if he is the guy who sold that prior company that completely failed, then he has a history of selling snake oil. He talks about Lenny wanting a legacy. Would make me feel better if his legacy to date wasn't escaping the train wreck with a bundle of $. Not realizing how expensive his daily pill regimen is makes me inherently distrustful. He is clearly in rainmaking mode with this new idea. However....

Like Attia says, if you get it you should get it. Maybe that was Yogi Berra who said that I dunno. I believe the dynamics regarding SIRT are highly individualized ( I have to believe some are going to be able to get SIRT activated far more easily than others), but that if you can boost your NMN / NR / NAD you are going to see and feel a difference (as long as you don't have something else going on keeping SIRT in check). So I'm probably gonna give some sublingual a shot.

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby LanceS » Tue Nov 13, 2018 3:51 pm

Dominick D'Agostino tweeted this link out recently:

Nutritional Ketosis Increases NAD+/NADH Ratio in Healthy Human Brain: An in Vivo Study by 31P-MRS

https://www.frontiersin.org/articles/10 ... 00062/full

Sounded like a better study would have you even more encouraged if you believe NAD+/NADH is a big deal and the ketogenic diet a possible contributor. I've been doing fasting with less care with regard to ketosis, and while the waistline is working, I do feel less sharp mentally. Looking forward to confounding all these factors with a fasting / ketogenic diet / with NMN sublingual. To heck with all this design of experiments, control variables, etc, I am just going to turn all the lights on in the house and see how that feels.

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby Kenny4/4 » Wed Nov 14, 2018 7:53 am

Peter Attia's Podcasts are some of the best non-dummied-down medical information on the web. I really like hearing him talk shop with his various guests. His notes on the podcasts are great as I am typically a little short on time to watch every podcast fully.

My opinion is don't get too bogged down in the NAD rabbit hole. Eat a good diet, exercise, fast(but not too much) and optimize markers. A lot of these specific vitamin and micro nutrient things you can mess up by over oversupplementing as much as you can from not quite getting enough. That said, some people that are MTHFR Homozygous the wrong way and have a high Homocysteine should probably do something methylated supplement wise. That's my guess.

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Re: Peter Attia's AMA #3: supplements, women’s health, patient care, and more

Postby LanceS » Wed Nov 28, 2018 6:39 pm

Thanks Kenny. I've taken some. My diet and lifestyle has been all over the map. Carb fueled, fasting, in and out of ketosis...and wine, eh. Clean living til xmas for mwah. I do think these pills are pretty worth it at this point. We'll see. They seem to provide an extra mental boost more than anything else. Is it my homozygous mthfr? My age? is it the years of pretty clean low carb living? Is it the sporadic nature of my diet? Would I get a bump if i was ketogenic for a longer time? Would I get a bump like this if I had taken them before cleaning up my lifestyle? In a month will I still think these pills are worth it? We'll see.


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