Anabolic Doc video on how he manages side effects of TRT

[Cataceous]

Epidemiological studies are unfortunately a horrible way to assess anything diet related. ...

You seem to have missed the part where many of the same mechanisms exist in animals, and have been examined with a multitude of randomized trials. For example, the link between higher protein consumption and reduced longevity. I see a lot of denial on this subject because guys are all about building big muscles at any cost.

The ability of protein/amino acid restriction to extend rodent longevity is linked to a reduction in the levels of IGF-1, in agreement with the role of pro-growth signaling in blunting longevity in organisms ranging from yeast to mice (Figure 2) (Longo et al., 2021). In humans, [calorie restriction] results in beneficial changes in cardiometabolic risk factors but is not associated with reduced IGF-1 levels unless participants are also protein restricted (Fontana et al., 2008). In both mice and humans, a low-protein diet imposes a reduction in growth factors/signaling both upstream of IGF-1 (GHRH, GH) and downstream of it (mTOR, S6K). With [protein-restricted] diets, lower growth signaling goes hand in hand with lower insulin and improved insulin sensitivity, and although clinical studies more often focus on insulin, it is clear that there is a connection between these pathways.​

​

The role of protein intake in increasing mortality and reducing longevity appears to be also conserved in humans, although this relationship is complex. There is evidence that diet should be tailored to age. Whereas consumption of more than 20% of calories in the form of proteins is associated with a 75% increase in overall mortality risk and 400% increase in the risk of cancer mortality in subjects 65 years old or younger compared to consumption of less than 10% of calories from proteins, these associations are not observed in those 66 and older (Levine et al., 2014). These results are in agreement with those in mice in which, prior to 85 weeks of age, mortality is minimized by a low protein consumption, but as animals aged beyond 85 weeks, a major increase in the protein to carbohydrate ratio is necessary to minimize mortality (Senior et al., 2019).​

 

[FunkOdyssey]

These concerns are allayed by what is observed in vivo. Take a look at this study from last year, which examines dietary influence on longevity. Their version of a longevity diet:

• A legume and whole grain-rich pescatarian or vegetarian diet
• 30% of calories from vegetable fats such as nuts and olive oil
• A low but sufficient protein diet until age 65 and then moderate protein intake
• Low sugar and refined carbs
• No red or processed meat
• Limited white meat
• 12 hours of eating and 12 of fasting per day
• Around three cycles of a five-day fasting-mimicking diet per year

[R]

It is understandable how someone would combine epidemiology and extrapolation of life extending dietary interventions in lower life forms and prescribe this diet for a human. However, we've made alot of mistakes in medicine and in nutrition by thinking we're smarter than we are and applying compelling theories of the day to disastrous effect.

From a 50,000 ft view that takes into account our evolutionary history, the DASH diet is probably not a species-appropriate diet for humans. More on that here:

https://onlinelibrary.wiley.com/doi/10.1002/ajpa.24247

 

[FunkOdyssey]

You seemed to have missed the part where many of the same mechanisms exist in animals, and have been examined with a multitude of randomized trials. For example, the link between higher protein consumption and reduced longevity. I see a lot of denial on this subject because guys are all about building big muscles at any cost.

What makes this topic complicated is that so many of the best predictors of mortality in humans at advanced ages depend on muscular strength and power. Peter Attia, whose singular goal is to "win the centenarian decathalon", is as familiar with the literature around IGF-1 as anyone, and yet has stopped fasting and started eating a bodybuilder-style 5 servings of protein a day to maximize the muscle mass he carries into old age.

It is very often a period of reduced mobility as the consequence of a fall or another injury that precipitates the downward spiral that ultimately kills someone. This is a consideration you will miss if you're only looking at mechanisms of aging in lower life forms.

 

[Cataceous]

...
It is very often a period of reduced mobility as the consequence of a fall or another injury that precipitates the downward spiral that ultimately kills someone. This is a consideration you will miss if you're only looking at mechanisms of aging in lower life forms.

It was interesting to see that there's a similar switch-point in older mice, when protein must be increased to maximize longevity.

...
From a 50,000 ft view that takes into account our evolutionary history, the DASH diet is probably not a species-appropriate diet for humans. More on that here:
...

I think it depends on the objective function you want to maximize. For Mother Nature that function is reproductive success. In this case being larger/stronger/faster is the way to go. As long as you can protect and raise the offspring to the point of self-sufficiency then Mother Nature is pretty happy. She's less concerned with how long you live after that. This can easily be at cross-purposes with trying to maximize your life/health-span.

 

[Guided_by_Voices]

What makes this topic complicated is that so many of the best predictors of mortality in humans at advanced ages depend on muscular strength and power. Peter Attia, whose singular goal is to "win the centenarian decathalon", is as familiar with the literature around IGF-1 as anyone, and yet has stopped fasting and started eating a bodybuilder-style 5 servings of protein a day to maximize the muscle mass he carries into old age.

It is very often a period of reduced mobility as the consequence of a fall or another injury that precipitates the downward spiral that ultimately kills someone. This is a consideration you will miss if you're only looking at mechanisms of aging in lower life forms.

What was his reasoning for stopping the fasts? I assume you mean his 5-7 days fasts. I n may case I strongly suspect the strength I would lose would be greater than what I could regain in the 3-month period he was recommending before the next fast, or at best put me on a physical road to nowhere.

 

[Guided_by_Voices]

It was interesting to see that there's a similar switch-point in older mice, when protein must be increased to maximize longevity.


I think it depends on the objective function you want to maximize. For Mother Nature that function is reproductive success. In this case being larger/stronger/faster is the way to go. As long as you can protect and raise the offspring to the point of self-sufficiency then Mother Nature is pretty happy. She's less concerned with how long you live after that. This can easily be at cross-purposes with trying to maximize your life/health-span.

I've theorized that the apparent need for more protein at an advanced age would largely disappear for an otherwise healthy person if the person maintains youthful levels of anabolic hormones, as many of us do here. I suspect that the problem is not lack of protein but rather that the lack of anabolic catalysts mean that growth via protein has to be stimulated more often.

Also, my understanding is that a lot of the problem is lack of glycine and leucine specifically. The general pattern is also certain to be highly variable depending on the overall health status of the person.

 

[FunkOdyssey]

What was his reasoning for stopping the fasts? I assume you mean his 5-7 days fasts. I n may case I strongly suspect the strength I would lose would be greater than what I could regain in the 3-month period he was recommending before the next fast, or at best put me on a physical road to nowhere.

Yes we are talking about multi-day fasts here. He realized the fasts were causing him a net loss of muscle over time, like the scenario you describe.

 

[DaveK22]

Interesting one from Dr O. He basically walks through his side effect management regimen.

He’s a little hard to follow as the doc can sometimes be but from what I was able to make out he takes
100mg Cyp every 5-6 days
Metformin 750mg at night
Telmisartan 30mg am 10mg pm
Nebivolol 10mg am and pm
Rosuvastatin 10mg
Repatha (didn’t catch dosage)
Vascepa 1000mg
I was skipping around so I may have missed it but pretty sure he takes 5mg Tadalafil daily as well.
His nadir tt is 656.

Worth a watch. He also talks about other medications as well. It’s interesting. Love the doc, even though he can be a little hard to follow. I think he needs a host to interview him for his videos.

I've been subscribed to Dr O'Connor's youtube channel for the past year. when I first stumbled on him I thought he was kind of corny. BUT...then I listened more & more... quickly realized this guy is totally legit. I also grew to enjoy his "man to man" demeanor & presentation. Knowledge wise...imho in same league as Crisler, Shippen, Saya, etc.

As a self admitted past steroid user & BB, he does NOT condone AAS use at all and actually speaks out against it. So he knows the "Bro' Science" in addition to his MD education.

Great resource in my opinion

 

[DaveK22]

What is everyone's thoughts about the statin every other day protocol? He references a CT Dr that was mentor and expert in lipids. Jump to the 31 min mark to watch. Just curious why 10 mg EOD vs 5mg ED? Crestor if it matters

PS I just posted the question on the youtube comments section...see if he answers himself.

 

[Deleted member 16042]

I think he is sincere, so kudos for that, but is this guy a doctor, or a middle school sports coach? The vibe is sophomoric, and presentations are disorganized.

Perhaps my own perceptual problem, but the presentations to me are cringeworthy.

Compare to presenters like Mohit Kera, Ramamusy, Morgantaler, et al. in this hormone field who actually present themselves as credible doctors.

 

[JmarkH]

I think he is sincere, so kudos for that, but is this guy a doctor, or a middle school sports coach? The vibe is sophomoric, and presentations are disorganized.

Perhaps my own perceptual problem, but the presentations to me are cringeworthy.

Compare to presenters like Mohit Kera, Ramamusy, Morgantaler, et al. in this hormone field who actually present themselves as credible doctors.

According to the Doc, he is on the spectrum and ADHD so I think we are seeing the real him.

 

[Deleted member 16042]

According to the Doc, he is on the spectrum and ADHD so I think we are seeing the real him.

OK, thanks, fair enough... my own filters might be an unfortunate consequence. Duly eating my own humble pie.

 

[Big_Alan]

What is everyone's thoughts about the statin every other day protocol? He references a CT Dr that was mentor and expert in lipids. Jump to the 31 min mark to watch. Just curious why 10 mg EOD vs 5mg ED? Crestor if it matters

PS I just posted the question on the youtube comments section...see if he answers himself.

Peter Attia kinda addresses the statin dosage issue in this video he published today. Apparently, statin effectiveness reaches dimishing returns at very low doses, so you're only buying side effects as you go above 5 or 10 mg.