AMA #28: All things testosterone and testosterone replacement therapy

**Peter Attia** (0:11)
Hey, everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything episode number 28 I'm joined once again by Bob Kaplan. In this episode, we talk about all things related to testosterone and its replacement. So we talk about the physiology of testosterone, how it works.
We talk about the epidemiology of testosterone, how it changes in level over the course of a person's life. We talk about what happens when testosterone levels are low and what happens when it is replaced. So we talk about the benefits of testosterone, and we also talk about the risks of testosterone, mainly focusing on two risks, cardiovascular and prostate cancer. Now, a couple of things to mention before we jump into this one. This is a pretty important episode, whether or not you have low testosterone or not, because almost everyone at some point in the course of their life will get to a point where their levels get to a level that is defined as low, and we'll talk about what those cutoffs are.
Therefore, I think that whether it's something that pertains to you or something that pertains to someone that you care about, whether it's a spouse or a family member, a relative or friend, I think it's worth getting smart on this because there is a lot of misinformation out there on this topic, just as there is a lot of misinformation out there on the topic of hormone replacement therapy for women. So yes, this is a pretty male-centric discussion because we focus on testosterone replacement therapy, and while testosterone does play a very important role in women, for this episode, we are focusing almost exclusively on the role of testosterone in men.
Now, this is not an episode where we get into case studies. I'm not going to be going over clinical studies, though I do pepper in a lot of clinical vignette, so to speak, all the way through it. So I talk a lot about the different ways in which testosterone was replaced, the pros and cons of different ways it's replaced, injections versus patches versus gels versus oral, and different manners in which it's dosed. So the frequency with which you dose it and all of these things.
Again, this podcast is probably much more geared towards males. And we're of course aware that our audience is only half male. So that said, just as I suggested to males when we did the HRT discussion, it's something that you ought to be aware of because you undoubtedly know a female who is going to go through menopause. And similarly, if you're a female, you undoubtedly know a male who is going to experience their own version of menopause, which is to say their testosterone levels are going to go down. And the question will be, should anything be done about it? So if you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page. I highly recommend that like many of the recent AMAs, this one will be better served by watching it on video because there's just so much data that Bob and I present, and we do it in the form of graphs and figures. If you're not a subscriber, you can still watch a sneak peek of this on our YouTube page. But again, you'll get more out of this by watching it on video than listening it if you are a subscriber. So, without further delay, I hope you enjoy AMA number 28

**Bob Kaplan** (3:50)
Hey, Peter.

**Peter Attia** (3:50)
Hey, Bob.

**Bob Kaplan** (3:52)
You ready for another AMA?

**Peter Attia** (3:53)
Sure am, man.

**Bob Kaplan** (3:55)
Okay, I think we're gonna get to maybe one big topic here. We've got a bunch of questions around one topic, but I think we can distill it down into, can you do a deep dive on testosterone or testosterone replacement therapy?
And can you do it in under six hours?

**Peter Attia** (4:15)
I think it'll be tight, but I think we can do it. Yeah, super interesting topic. And one that probably just generates almost as much confusion as the hormone replacement therapy question does on the female side. So we've already had a great podcast that debunks a lot of the myths around hormone replacement therapy for perimenopausal and postmenopausal women.