Peter Attia· MD
and so so Ted let me make sure I understood that I mean at the high level that made sense but some of those examples and numbers are are kind of mindboggling to me so you're you're saying if I heard you correctly that that uh prostate tissue and hair follicles might reach saturation as low as 250 nanograms per deciliter of testosterone which as you point out is very low uh that's that's a level that is probably at about the 10th percentile of the population for men over 18 suggesting that 90% of men walking around even not taking testosterone replacement therapy are already at levels of saturation for hair follicles and for prostate you alluded to the fact that presumably for antibo needs in the muscle the saturation level would be much higher so the so first of all let me pause before I go on am I getting those numbers about right yeah and the way to think about it is in the prostate and in heral there's there's five Al reductase that as soon as the as soon as testosterone enters a prostate epithelial cell it is immediately converted to DHT which is about 10 times more potent than testosterone so if you really wanted to kind of you know fiddle with the math actually if you didn't have DHT around the saturation level that you would need for the within to for prostate maximal saturation You could argue would be 2500 y nanograms per Mill right but the idea is that there's amplification of the effect of T by converting to DHT by about maybe 10x so does that imply that on average if a man is taking exogenous testosterone um so he start let's say he started out at 3 00 nanog per deciliter which truthfully would still be considered hypogonadal um and he gets replaced to 800 nanograms per deciliter would you not expect him to experience a a BPH trajectory growth or hair loss or any of the things that might be associated with the increase that he's going to experience in both testosterone and DHT yeah I mean most of this most of the data on on T supplementation within the prostate you're going to see more of a precipitation of BPH symptoms again we talked about the differential and so there may be a little bit of a bump in terms of lower urinary tract symptomatology but it's pretty subtle and in fact one of the biggest um genes that uses or is Androgen responsive is PSA and most people when you and you augment their their testosterone that's how they kind of measured or estimated the saturation to be between 200 and 250 Moira did a nice study he's a former uh Drive uh guest they estimated to be around there and and you can actually see that because most people that you supplement from let's say three to 800 you're not going to see a big bump in their PSA and so that would be the premise whereas if someone's at three they may have pretty limited you know muscle mass and and yet you bump them to 800 and you see a real nice impact