This is a fair comment as the metabolic pathway to form estrogen in women and men is through testosterone. Women have more testosterone than estrogen on a mg amount - it is just relatively 10 fold or so lower than men.
When we supplement men with testosterone, because estradiol increases due to more testosterone converting to estradiol, this does need monitoring and in some patients who convert too much, we need to place them on an aromatase inhibitor to not go too high on the estradiol.
Pretty much all hormones have a happy spot, including daily variation for many. For example, Testosterone is highest in the morning, and it is on the basis of these levels that we’d indicate someone is low. Measure it later in the day, and it may be “low” but this isn’t the time to measure it.
So yes -low or high is bad - I typically like is in the mid 20’s to 30.
For me the discussion on the class of SGLT2-i (at the end since only enough data when look at as a class) and the class of phosphodiesterase-5 inhibitor (PDE5-I) medications (not just viagra) and the pattern of the group of estrogen medicines and in general how he cross references other data from casual mice studies like ITP and other human data was most interesting.
He should be doing blog posts, not videos.
Matt,
I’ve heard you on Peter Attia’s podcast numerous times. Always appreciate you well grounded analysis that in my view, emphasizes rational, conservative approach to data interpretation. And you are a good conversation besides. I take 5mg cialis mostly for the increase in blood flow in the area of a muscle in the penis that inhibits the return of blood once it’s tumescent. Apparently this is a function that can degrade quickly as one ages - I’m 75. Canagaliflozin sounds very interesting to me as I have to restrict carbs. I yearn for a slice of pizza someday before I die. I’m sorry Rapamycin wasn’t included in this study-there just aren’t of us converts…yet.
I believe you mentioned acarbose but didn’t reference it in your talk. I bet it’s in the study and that it just didn’t reach significance even though it stands out in conjunction with Rapa in the ITP as one of the most powerful longevity drugs. What say you?
Not sure that Acarbose is common enough in the UK (tend to be mostly is Asian societies where populations don’t eat a lot of wheat and hence have less “side effects”). @adssx migh know if Acarbose was there but did not reach significance, it is a good question.
We discussed the paper here: First report from Epiterna on the search for drugs that can extend human lifespan
Acarbose wasn’t analyzed (you can check the supplemental material of the paper to see the whole dataset); it’s indeed extremely rare in the UK. In FY 2020, it was prescribed 26,742 times by the NHS in England (source). If I understand correct, this is not the number of patients but the number of boxes, so you can divide by 12 and you get… 2k people in England being on acarbose! To compare, metformin was prescribed 22,902,368 times and England has 56 million inhabitants.
More meaningless correlations… let me take a quick stab at it…
#14 Atorvastatin - lower LDL - good
#13 Naproxen - used for sports related injuries - EXERCISE reduces mortality
#12 Otomize - used for SWIMMER’s ear… need I go on ?
#11 Viagara - Sex is very healthy, regular sex probably reduces mortality via various mechanisms
#10 Sumatriptan - WTF ?
#9 Estradiol - HRT
#8 Estriol - HRT
#7 Vagifem - MORE SEX
#6 Avaxim (hep A vax) - hepatitis is bad
#5 Lymecyline - lowers periodontal disease
#4 Estraderm - HRT
#3 Ovestin - HRT
#3 Revavax -REPAVAX - DTaP with IPV… wow who knew, vaccines actually reduce mortality - SHOCKING ! /s
#1 Marvelon (oral contraceptive) pregnancy is risky and aging
Unfortunately (or fortunately) I’m not on any of those meds.
because you don’t have those problems…
you must had DTaP and IPV vaccinations though
Other statins were associated with lower lifespan in the paper: First report from Epiterna on the search for drugs that can extend human lifespan
The paper has some mistakes but it’s interesting and worth a read.
I was thinking the same thing about the DAV therapy. It also made theorize that maybe we have a lot more chronic infections than we realize.
Then it made me question my tenuous grasp of the microbiome. Are the antibiotics just effecting the gut or do they serve additional functions?
I’m throwing all my supplements in the trash and starting ear drops tomorrow.
Is it bc supplements caused your ear infection?
you have to earn that indication though thru… swimming in lots of dirty public pools !
No doubt he was, and so was I 
The capsules were getting stuck in my ear.
I’m taking some 30+ supplements. It’s too many and I feel tired of them. Need a serious plan to reduce.
Same here. I need to rank order them all, then every day take only the ones I think are critical and rotate the others.
I think I got my supplements down to 15.