256 ‒ The endocrine system: exploring thyroid, adrenal, and sex hormones | Peter Attia, M.D.

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In this special episode of The Drive, Peter provides a comprehensive overview of the various endocrine systems: the thyroid system, the adrenal system, and the sex hormone system (for both men and women). He walks through the basic biology and the feedback cycles that regulate the production of these hormones and discusses the various options for the treatment of hormone deficiencies. In addition, Peter delves into hormone replacement therapy (HRT), providing nuanced insights into its appropriate usage and the clinical approach he adopts when working with patients.
We discuss:
00:00 - Intro
01:02 - The thyroid system
15:02 - The adrenal system
26:57 - The female sex hormone system
40:21 - The male sex hormone system
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
Learn more: peterattiamd.com
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Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies.

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2 июн 2024

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Комментарии : 167

@PeterAttiaMD Год назад

In this episode, we discuss: 00:00 - Intro 01:02 - The thyroid system 15:02 - The adrenal system 26:57 - The female sex hormone system 40:21 - The male sex hormone system

@mydieunguyen5359 Год назад

Thank YOU Dr. Peter, Really appreciate this episode. Between timestamps 23:30-23:37 you've mentioned a supplement (Phosphatidylserine(?)) for your patient and yourself to suppress an adrenal system. I can't find the exact spelling in your show notes. Can you please confirm if the supplement Phosphatidylserine is what you've mentioned ?

@jacksonjstewart Год назад

Where'd we get this excellent dress-shirt boss?

@petrichor100 Год назад

Great overview. Thanks. We need a video on TRT for females. When is it justified and what side effects it can cause

@MrMikkyn 11 месяцев назад

@@mydieunguyen5359I heard the same word. But I’m not sure the correct spelling. I’m assuming its phosphatidylserine

@LasheXX 10 месяцев назад

Thank you Dr. Peter Attia for everything what you do.

@hubermanlab Год назад

Great video. Highly informative. Thank you for explaining why you are not a fan of clomiphene/clomid for men.

@trenbear4469 11 месяцев назад

Hey Andrew, good too see you here. Have a nice day :)

@MarthaGrace382 Год назад

This is by far the best episode. Love the lecture format! Would be great to have more like this. Thank you, Peter!

@heidirexin5141 Год назад

Spot on re the thyroid. Been hypo for about 40 years. I've had to educate myself to exactly how you explained everything. And source my own meds, do my own labs, because it's been impossible to find a doctor who will test and treat appropriately. Thanks! Very validating.

@daniel1RM Год назад

test and treat exactly how you want rather

@heidirexin5141 Год назад

@@daniel1RM As Peter indicated, testing only TSH and treating with only a T4 med does not work well for all patients, so it isn't appropriate to offer nothing else, even if it is the standard.

@carolynvanzlow 7 месяцев назад

I have come to the same conclusion. I would love to talk to you. I need to find another outlet to source my own drugs. Thank you for this post.

@OlivierAsselin 5 месяцев назад

This is the single most concise and clear explanation I've seen of the thyroid and adrenal functions, testing, etc. I wish every doctor would watch this...

@szghasem Год назад

Damn Peter, Just when I thought your excellent track record was unsurpassable, you've raised the bar even higher. This material is gold !

@tylerbeck3806 11 месяцев назад

More lectures like this would be very appreciated. Not that your other content isn't top notch but this is really wonderful. Clinical experience overlying basic mechanism is a phenomenal approach. Thanks for all you do!

@tsi2568 Год назад

I really liked this episode. Would love to see one of these lecture-type videos every few weeks and perhaps to go even more in-depth.

@absbi0000 Год назад

Amazing breakdown. The information out there on the internet for the endocrine system holistically, from a bird's eye view, is sparse or hidden in textbooks. Truly appreciate the at no-cost overview of these otherwise complex systems. Definitely information everyone needs to know and be aware of for themselves and those they care for.

@SalitosInside Год назад

This lecture format is outstanding, please keep creating content in this form!

@auricauric8150 Год назад

bravo. you have the gift of clarity. thank you.

@LP-fz5xm Год назад

The gift of genius

@andrealordelo2926 3 месяца назад

Wow what a presentation. ❤ Easy to understand even given it’s such a complicated and medical topic.

@jayraymond9707 Год назад

Where were you during my A and P course? 😂 Thanks for the breakdown Doc! Much appreciated.

@marynguyen6417 Год назад

I so much appreciate the comprehensive information that this video provides.

@dr.samierasadoonalhassani2669 Год назад

I am glad I listened to this video after 3 days of delay if it is boring ,long as before.

@dmitryagafonov9096 Год назад

Every time I listen to Peter I think: Why not to open Attia University? Whatever he explains is way better than any other source I have ever attend to. Despite his role in longevity field his educational contribution is enormous.

@patrickparronchi Год назад

Thank you. And more of this type of explanatory videos Peter. You’re very good at explaining complicated things in a very understandable way.

@sharifahjais3524 Год назад

I love his sharing his experience. It's not just theories. It's also about application of the theories.

@jeremiash5180 Год назад

More episodes like this! 👍

@rekaahne7190 Год назад

You’re Simply the Best! Thank you!🙏🏻

@jayraymond9707 Год назад

Better than all the rest? RIP Tina

@mohanish 11 месяцев назад

@@jayraymond9707she died in Switzerland

@georgebush7694 Год назад

I've seriously been interested in the endocrine system for the last couple years, this is what I would like to study

@RhinaAlvarado Год назад

Great that's my mayor issue as a woman in my fourty-five, I'm struggling with adrenal cortisol levels at night. Also I'm in HRT testosterone pallets. God bless you and thank you for your care.

@stephenparker2346 Год назад

Take a cold shower at night. Will bump adrenaline and lower cortisol. Thank you Wim Hof Method!

@petrichor100 Год назад

How do u feel on T pellets?

@BigMoneyLion Год назад

Curious in the role of salt\sodium in the function of TSH, T3 and T4

@mechonok Год назад

Great episode, just wish to hear Dr. Attila's take on Grave's and hyperthyroidism.

@gem2148 Год назад

THANK YOU SO MUCH for making this episode free on your channel.

@Hasmiral 11 месяцев назад

Thanks so much for the information about the transfer situation to menopause/ perimenopause. There are so many more symptoms that are really serious (except for hot flushes or night sweats) like difficulties to concentrate, brain fog, heart racing, anxiety or paralyzing joint aches. Many women with these symptoms are sent to psychiatrists or orthopedists (me included) but it was acutally the fluctuation of hormones, especially estrogen and testosterone (which is as of today rarely prescribed in Germany since it is not licensed for women yet!!!). It was a real fight to get progesterone and estrogen prescribed, I was seeing at least 6 doctors and spending 1000s of€ to get help. Now I am on HRT in perimenopause and slowly feeling better.

@MrMikkyn 11 месяцев назад

That’s concerning that women with those symptoms are getting misdiagnosed and sent to psychiatrists despite not having psychiatric conditions. I guess people will just have to watch this video or realise the hard way. I hope they don’t realise the hard way though, and get the right treatment.

@hellogoodbye4894 Год назад

I appreciate the clarity in these lectures, Thanks Peter!

@LocutusHealth Год назад

I feel so much more confident evaluating my blood test results. Thank you!

@Notsorandomwalk Год назад

Thank you so much for helping to liberate the understanding of the mysterious thyroid hormone lab tests from the mystic of the white lab coat endocrinology specialists! May primary doctors everywhere now be empowered to order and interpret these labs so that patients may have optimal health 🎉🙌

@dr.samierasadoonalhassani2669 Год назад

Up to the point direct focused no waste of time on personal stories.Amazing change in format,content.Good change 10 out of 10.

@RocketMartin 11 месяцев назад

Thank you for the work you are doing. Best overview of these topics I’ve come across

@AJ22-80 11 месяцев назад

For a percentage of us, there is an intolerance to progesterone. Adding progesterone during the luteal phase dramatically increases PMS symptoms. Its not the rapid decline of progesterone, its the progesterone itself. I tried virtually every variation, duration and combo of prog and/or estrogen and only in menopause found relief

@jeffreyerb7139 3 месяца назад

When was the progesterone added during the luteal phase? On day 15 or around day 21? We’re day 21 progesterone levels measured low, or was it treated empirically? Is there a plausible mechanism for why some may be intolerant to progesterone? Just curious about what may have occurred in your case. Did HRT provide relief in menopause?

@AJ22-80 3 месяца назад

The article talks about emotional and behavioral symptoms but in truth this is a physiological/endocrine problem not a psych problem

@travencunningham8323 Год назад

Amazing, thank you. Format is easy to absorb for the data to be used.

@vv7584 18 дней назад

Great video, good information. Thank you for sharing your knowledge.

@77777jetta Год назад

Thank you Dr. Peter Attia for Breaking down the endocrine system! You made a very complicated system a little bit easier to understand! Good job young man! 👏 Please keep up the great work 👍😊

@LP-fz5xm Год назад

This is awesome, thank you for creating this.

@francisbertolini2538 11 месяцев назад

Much appreciate your gift of medicine and communication and the care of others.

@dr.samierasadoonalhassani2669 Год назад

Wow good presentation in content ,style,voice,it is as good as the Scottish professors who taught us in Royal College of Edinburgh.Good dr Petter Attila this should be the style of delivering a lecture to well informed listeners like medical consultants.Thank you for showing us the best.God bless you.

@honeysucklewoes1627 Год назад

Was wondering about the parathyroid glands. Really like the lecture format and the content. Excellent. Thank you.

@natalieaxl804 Год назад

I been on armor thyroid 60mg and it works great for me. Thank you

@elliek5350 Год назад

Excellent review! Thank you

@thandilengwenya1297 10 месяцев назад

This is a Masterclass, so insightful and enlightening

@naimab6714 Год назад

Very well spoken and articulated physician Thank you

@maxred222 Год назад

Love your book, appreciate this format.

@christinacarrio 6 месяцев назад

Love the format and education from this video! Thank you for the work you do, truly wonderful. I think more videos educating in this way would be attractive to many

@NYGuy2000 Год назад

Great summary!

@KaonTaAnay Год назад

This is very informative for the laymen like me. Wishing for more videos like this 😊

@KimikoMaui Год назад

Appreciate the huge amount of info u give

@Candleflower42 Год назад

If everyone could have a doctor like you we’d all be living to 100. Thanks for your work. Do you know if an estrogen level of 550 is ok in a 69 year old female supplementing with HRT? PCP says yes but a second opinion was aghast and wants it 60.

@Elizabeth-oh3cp 10 месяцев назад

Great episode. This was very helpful for knowing what labs to ask for in my yearly physical.

@ssharp8900 11 месяцев назад

Thank you for sharing your knowledge! You are the best.

@garyhenderson7389 Год назад

Very well done with the graphics...one of the times it was worth it to sit down and watch rather than listen to the podcast on my walk. What is interesting about the pituitary ( in my experience ) is that a tumour may be responsible for disturbances in many systems other than the tissue that is "cancerous". I had a giant macro adenoma (FSHoma) that was not disturbing my life in any tangible way that I could tell...probably had great sperm production, but no real symptoms. At the same time, I was a reactive hypoglycaemic, for no known reason. With diet, I could control the negative effects of hypoglycaemia. Once the adenoma was discovered and the first surgery performed in an attempt to "debulk" it, I lost thyroid and some adrenal function. The second, more involved surgery, resulted in regaining thyroid function, only minimal decrease in adrenal function, but total loss of FSH and LH. Plus I am still a reactive hypoglycaemic. Perhaps it has something to do with the original tumour or not. But I wouldn't rule it out. It will be interesting to see what happens in the future.

@joeweiderdasilva4018 3 месяца назад

Great video! Thank you!

@pkstiever 8 месяцев назад

Very excellent presentation! I learned so much from this. Endocrinology is fascinating for me.

@heidirexin5141 Год назад

Thank you also for the cortisol explanation. That is the most understandable i have heard. I know I have issues, symptomatic and have had a couple of 4-point saliva tests, but figuring out how to address it has been difficult. I'd love to hear a movmrecin deoth episode on treatment.

@KJB0001 9 месяцев назад

In depth episode for what High Cortisol or Low cortisol for High cortisol try box breathing, meditation, vagus nerve stimulation, grounding, sunshine, take phosphatidylserine, drink calming teas, get a therapist, DANCE

@jennyk9833 11 месяцев назад

Very informative video. Thank you!

@sarahwinter3587 5 месяцев назад

Thanks for this informative content.

@TteokbokkiNari 11 месяцев назад

Love this, thank you!

@minastern7501 11 месяцев назад

You are amazing! God bless you 🤲

@laetiziacampana Год назад

Thanks! It's so interesting! Does licorice root have an instant effect? I mean if you're low on cortisol at the end of the day and you want to keep your level high, how much licorice should you take? When?

@kellywalker8393 11 месяцев назад

Fantastic, thank you!

@franciscoadolfo5805 Год назад

Excellent. Thank you.

@vanguard7674 Год назад

Amazing.

@user-mu2im4cz9i Год назад

You are a great teacher

@nutritionbyelsa 11 месяцев назад

wowoowowow so amazing and sharing with literally aEVERYONE, thank you for these basics... wellness culture really lets to through a ton of really not at all acurate info out there... love love love learning more from here! thank you!

@armoredbody8015 Год назад

Just excellent

@ambikalokesh4932 11 месяцев назад

Absolutely helpful

@erwinrogers9470 Год назад

Great information 🔥

@erwinrogers9470 Год назад

Love your content

@talgranit8998 Год назад

Thank you ❤

@lesliefram7820 11 месяцев назад

Thank you!!!!

@heatherh.197 11 месяцев назад

I'm a 47 yr. old female and after listening to this, i absolutely do not have or have never had a doctor who cares about me this much. So damn sad.

@mmags 7 месяцев назад

Thank you. I had thyroid cancer in 2001 and I still struggle and my Endo. He finds my situation very complicated. After 22 years I still take T4 and T3 short acting cytomel. I have so many hypo symptoms but my labs show I’m hyperthyroid. Ugh 😩

@Zimloader 2 месяца назад

Thanks so much for this video! I have had the exact symptoms you described for hypothyroidism, I took some thing called Synthroid for some years in my early 40s but still felt like crap! I’m just wondering what the next thing is to do now (I am currently 53) that I’ve been off Synthroid for three or four years.? My TSH is 7.62 on last reading! some thing else to add is that when I first got my thyroid manually assessed back in my very early 40s, my endocrinologist who has sadly passed away said to me that I didn’t have a thyroid! Hashimoto’s has also been thrown around as a diagnosis too

@Renku07 Год назад

With respect to the adrenal system, Peter gave the impression to suggest licorice to combat obesity, IR, ect; however, licorice increases cortisol as well as IR and obesity, how am I going to take licorice for those problems when I already have increased cortisol? It's contradictory, cause licorice is said to lower IR and fight obesity but all these dysfunctional states increases cortisol which increases blood pressure too.

@sonjaforrester9255 Год назад

Please do an episode on her for both men and women!

@str8shooter-talk116 Год назад

@dr Attia, how do I become a patient of yours?

@Mlrunlisted1 11 месяцев назад

Adrenal cocktail- 1/4 tsp sea salt. 1/4 tsp cream of Tartar. 2 oz OJ and/or coconut water

@ladydegen 6 месяцев назад

As someone with panhypopituitarism due to a previous pituitary macroadenoma, this video was beneficial to my livelihood. Given my situation, there's a lot for me to unbox here, and I still have to delve further to understand and interpret my blood levels. For example, my TSH is normal, but T4 is low, no labs for T3 or rT3. Curious if this is a feedback error, have higher rT3 levels, or something else. Nonetheless, I appreciate you providing this resource to the public.

@laurievitale1820 11 месяцев назад

extremely helpful! i have to have a thyroid lobectomy due to a TI-RADS grade IV nodule (had the thyroseq genetic testing). im having it done at a top academic center but am concerned about my thyroid hormone levels after (normal now). any advice about what exactly to look out for? if it is malignant that will be dealt with, but i know this may sound strange but im a former professional athlete and im actually more worried about uncontrolled weight gain or my metabolism going wacky. thank you for any guidance on hormone level management.

@varundivadkar1563 Год назад

Hi, what role does aldosterone play in the entire adrenal system? Could primary Aldosteronism (in the absence of an obvious Adenoma) be probably brought on by insulin resistance or vice versa? Anything that can be done to bring this under control under than MRAs?

@MVG7 7 месяцев назад

Just started Clomid yesterday.

@noeldunn126 Год назад

Dr mentions looking at Free T level (and other things) when deciding on Trt. This because Dr says free T is the truly active part of T as it is unbound. My question is, as the bond of T to albumin is relatively weak (not nearly as strong as bond to shbg), can the albumin bound T also be considered in the TRT decision, as many labs consider bioavailable T to be the sum of Free T plus Albumin bound T (because of the weaker bond to albumin). It seems that the body can unlock albumin bound T relatively easily from my reading. My thoughts would be that bioavailable T could be defined as the sum of Free T plus a % "of Albumin bound. Comments will be appreciated

@jamesdoyle5237 Год назад

More like this!

@heatherholland9114 10 месяцев назад

Good afternoon. I'm not sure if you will check this but I do have a question. I've been listening to all your podcasts for awhile and really have learned alot. I just had blood work done and I have a question. I had half my thyroid removed. I had my TSH and Free T4 tested and it came back a little high at 5.36. I guess I'm asking for your opinion on what I should do next. Should I get my T3 and FreeT3 tested?

@bennguyen1313 7 месяцев назад

The symptoms associated with the more common Low/Hypo thyroidism/Low T3.. fatigue, cold, constipation, seem to overlap adrenal fatigue? I understand the hypothalamus sends trh to pituitary which sends tsh to thyroid which makes some free t3 (20%), and mostly t4 (80%).. the latter is converted to either free t3 (via d1 and d2) or reverse/anti t3 (via d3 due to inflammation/IR), but what are the good blood markers to look for? free t3/ reverse t3 = 0.25? I know you can live with one or none (if you supplement with HRT), but when a kidney is removed, is the corresponding adrenal gland removed as well? Finally, blood tests for the adrenal system are not helpful since it reports total coritsol (bound and unbound).. the better way is the urine dutch test that measure free cortisol. I like the part about how black licorice root increases cortisol, while phosphatidylserine decreases it!

@liliyanelson2991 11 месяцев назад

Any info on why testosterone would totally tank in women? I’m in perimenopause currently at 41 but my T was at 0 when I was 35 causing huge cognitive issues among other things . HRT for low T helped

@hayleysmith5077 10 месяцев назад

doctor, I am premenopausal 52 getting HRT plus anticonceptional, it would be so important to understand how the system function while getting anticonceptional treatment and estradiol gel,because some ladies need up to 200mg HRT some 5 mg , some 1 mg and it varies a lot ,but in most cases it is challenging to keep under control and forecast how if the ovaries are producing few eggs yet while getting hrt , but especially how each individual can adjust estradiol gel dosage. thanks for your answer

@BestLifeMD Год назад

How common are side effects in men from over-aromatization to estrogen?

@MrKengabe Год назад

Thank you I wish I could find a doctor that would treat symptoms seems like the last 10 years we have went backwards

@MK-ih6wp Год назад

Trying to understand how Hashimoto's & estrogen dominance can lead to IDC Breast Cancer.

@Zoe.TheBody360 Год назад

Estrogen positive breast cancer is often due to poor estrogen detoxification which Peter has not talked about in this video. Estrogen detox is measured as part of the Dutch test eg in the urine

@KJB0001 9 месяцев назад

why isnt this in high schools, specifically that big blue line representing Progesterone in the menstruation phases!!

@kvill11 11 месяцев назад

Would you recommend the Dutch test to optimize female hormones for training?

@marklowe5939 Год назад

Sure glad you aren't my doc. I was having serious mood issues due to higher estradiol levels. If you have a patient who isn't feeling better on what you think he should give him more testosterone and an aromatase inhibitor....they'll likely feel much much better.

@anthonylawrence5842 Год назад

Please explain acronyms when using terms.

@carolludwick7494 9 месяцев назад

I've had high TSH for years (am now a post menopausal woman) but whenever my doctor raises my dose of Tirosint beyond 75 mcg, I feel very wired, hot, digestion speeds up, etc. The thing is, she only raises it to 88! And the TSH stays in the 4-5 range. Do you think this is a t4-t3 conversion issue? I'm concerned about continuing to have a low functioning thyroid but don't want to feel so wired when I up the dose.

@heathersbling 9 месяцев назад

Can you tell me is this is going to be different after a full hysterectomy? I will be getting one in Oct. I'm 60 and I have had lots of thyroid issues since 16.

@deniseriverahallinan619 Год назад

Regarding the female sex hormones…I’m 53 and long done with menopause. I wish my doctor would have done HRT with me when I was going through peri menopause

@karenbraddock41 Год назад

It’s not too late?

@dilladawg13 Год назад

You still could as long as it’s within 10 years from menopause or under 60. Of course among a lot of other factors.

@Corrans Год назад

You can still go on HRT

@KJB0001 9 месяцев назад

Do HRT- for bones and brain!!!!

@2023Red 11 месяцев назад

super. We just subscribed/

@StankaKordic Год назад

How I wish I knew of you a decade ago! Unfortunately I missed the boat with hrt. I am almost 61, just had sex hormones checked and still have not flat lined. Are there any options for me? No family history of cancer, but heart disease and osteoporosis does run rampant.

@Hasmiral 11 месяцев назад

Dr Louise Newson says it is always possible to start HRT. Google her. You can still work against osteoporosis, diabetes, heart issues and alzheimer by taking HRT after having entered menopause.