Infections & Cancer, Finasteride Side Effects, Blueberry Benefits, Vitamin D & Fertility, and CoQ10

Dave Asprey (0:00)

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I'm Dave Asprey. That's Dave spelled D-A-I-V-E. And this is your 10-minute weekly upgrade on the biggest stories in biohacking, longevity, and the world of health. Let's go.

This first one is pretty wild.

A new global analysis estimates that infections were responsible for about 2.3 million new cancer cases in 2024

That's roughly one out of every eight cancers worldwide. And when people hear infection, they usually think of something acute. You get sick, your immune system fights it, and it goes away.

That's not what we're talking about here. We're talking about persistent biological stress from things like H pylori, HPV, hepatitis B, Epstein-Barr virus, and hepatitis C.

H pylori and HPV alone were each linked to around 3 quarters of a million cancer cases. Epstein-Barr is especially interesting because it's now estimated to be the fourth largest infectious contributor to cancer globally, partly because the evidence linking EBV to certain stomach cancers has gotten stronger. This is something I think medicine still under appreciates. Cancer isn't one disease and it doesn't come from one pathway. Chronic infection can keep inflammation turned on, damage DNA, interfere with tumor suppressor systems, change immune surveillance, and basically create an environment where dysfunctional cells have more opportunities to survive. That does not mean getting EBV means you're getting cancer. Most of you have probably been exposed to EBV, and it definitely doesn't mean cancer itself is contagious. What it does mean is that chronic infections are not always benign passengers. If you know you have something treatable like H pylori, something millions of people have that is easy to test, hepatitis C or chronic hepatitis B, ignoring it because you feel fine is not a great longevity strategy. Go check your infections history and buy an H pylori test on Amazon. Treat the infections we actually know how to treat and use the preventive tools that have strong evidence behind them. This is one of those cases where prevention is dramatically easier than trying to undo decades of chronic cellular stress.

Now let's go from infections to something millions of men are taking because they don't want to lose their hair.

New documentary recently came out on life after finasteride. Finasteride reduces the conversion of testosterone into DHT by inhibiting 5-alpha-reductase. And yes, we know it can cause sexual side effects in some men while they're taking it.

The much harder question is whether a subset of people develop persistent symptoms after they stop taking it. That's what gets called post-finasteride syndrome. This is where the internet tends to split into two completely useless camps. One side says the syndrome isn't real. The other side creates these giant mechanistic flowcharts where finasteride destroys your gut, thyroid, hormones, bile acids, dopamine, cortisol, and probably your relationship with your parents. The evidence doesn't justify either extreme. There are legitimate reasons to take the persistent symptoms seriously. 5-alpha reductase doesn't just affect DHT. It participates in neuro steroid pathways, including the pathway that produces allopregnanolone, which affects GABA signaling, stress, sleep, mood, and neuronal excitability. There are also small studies in symptomatic former users showing differences in neuro steroids, androgen signaling, gene expression, and even possible nerve abnormalities.