The Peter Attia Drive

#291 ‒ The role of testosterone in males and females, performance-enhancing drugs, sustainable fat loss, supplements, and more | Derek, More Plates More Dates Pt.2


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Derek is a fitness educator, the entrepreneur behind More Plates More Dates, and an expert in exogenous molecules commonly used and misused by bodybuilders and athletes. In this episode, Derek returns to the podcast to explore the impact of exogenous molecules on male and female health. He covers testosterone, DHT, DHEA, progesterone, clomiphene (Clomid), hCG, and various peptides, alongside updates from the FDA affecting peptide use. Additionally, he addresses the recent hype around increasing muscle mass through myostatin inhibition via follistatin gene therapy and supplementation. Additionally, Derek discusses the various strategies that bodybuilders use for losing fat while preserving muscle, including insights on weight loss drugs.

We discuss:

  • Testosterone and DHT: mechanisms of action, regulation of muscle growth, and influence on male and female characteristics [2:15];
  • TRT in women: the complexities and potential risks associated with testosterone use in women [9:00];
  • DHEA supplementation: exploring the benefits and risks for women, and the differing effects on men vs. women [22:00];
  • The role of progesterone in both men and women, pros and cons of supplementation, the importance of tailored doses, and more [28:00];
  • Measuring levels of free testosterone [37:15];
  • The trend towards earlier interest in TRT, and the risks of underground sources of testosterone [42:00];
  • The complexities and considerations surrounding the use of Clomid, E-Clomid, and hCG in TRT [46:00];
  • Low testosterone: diagnosis, potential causes, treatment options, and other considerations [53:45];
  • Growth hormone-releasing peptides: rationale and implications of the recent FDA categorization as high-risk substances [1:03:45];
  • Follistatin gene therapy and myostatin inhibition for increasing muscle mass: the recent hype online, human and animal data, and the need for more research [1:14:45];
  • Simple tips for lowering calorie intake and losing fat [1:32:30];
  • Methods of sustainable fat loss with muscle preservation: insights gleaned from bodybuilders [1:40:00];
  • Could prolonged fasting impact testosterone levels? [1:55:30];
  • High-protein ice cream [1:57:00];
  • Exploring fat loss supplements and drugs: L-carnitine, yohimbine, and more [2:02:15];
  • Potential remedies for individuals experiencing metabolic dysfunction due to hypercortisolemia [2:12:30];
  • The cornerstones of body composition improvement remain nutrition and exercise, even in the presence of exogenous testosterone [2:19:15];
  • The importance of approaching health advice found online with a critical eye and a healthy dose of skepticism [2:23:30]; and
  • More.

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The Peter Attia DriveBy Peter Attia, MD

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