1 00:00:06,000 --> 00:00:07,880 Speaker 1: Welcome to Fear in Greek Q and A, where we 2 00:00:08,000 --> 00:00:11,400 Speaker 1: ask and to answer questions about business, investing, economics, politics 3 00:00:11,400 --> 00:00:13,640 Speaker 1: and more. I'm Sean Almer. A few weeks back, we 4 00:00:13,720 --> 00:00:16,960 Speaker 1: had doctor Zach Turner on the show talking about weight 5 00:00:17,000 --> 00:00:20,120 Speaker 1: loss drugs. We've got such a great response we decided 6 00:00:20,239 --> 00:00:22,919 Speaker 1: to ask him back again. Zack Turner is a medical doctor, 7 00:00:23,000 --> 00:00:26,560 Speaker 1: media personality and biomedical scientist. Doctor Zach, Welcome to Fear 8 00:00:26,560 --> 00:00:28,120 Speaker 1: and Greed Q and A again. 9 00:00:28,600 --> 00:00:32,640 Speaker 2: Thank you so much. I'm excited. I hope the listeners 10 00:00:32,680 --> 00:00:34,320 Speaker 2: love the last part and we can add more and 11 00:00:34,320 --> 00:00:36,599 Speaker 2: more bits to the health routine. That's right. 12 00:00:36,640 --> 00:00:39,320 Speaker 1: So you know, if you want to hear doctor Zach's 13 00:00:39,400 --> 00:00:42,960 Speaker 1: views on GLP one drugs, we'll put it in the 14 00:00:42,960 --> 00:00:45,559 Speaker 1: show notes for this one. But let's move on to 15 00:00:45,880 --> 00:00:49,760 Speaker 1: exogenous testosterone. Hard word to say, which is something you 16 00:00:49,840 --> 00:00:51,960 Speaker 1: seem to read a lot about, though I'm not quite 17 00:00:51,960 --> 00:00:52,680 Speaker 1: sure what it is. 18 00:00:53,200 --> 00:00:59,120 Speaker 2: Okay, So there's endogenous and exogynists. Essentially, exogynist testosterone is 19 00:00:59,160 --> 00:01:02,279 Speaker 2: given to people who are not making enough of their 20 00:01:02,320 --> 00:01:04,920 Speaker 2: own and they can't make enough even if we stimulate it, 21 00:01:05,400 --> 00:01:07,520 Speaker 2: and so we give it to them from outside of 22 00:01:07,560 --> 00:01:12,000 Speaker 2: their body. X body exogenists, and so it's an interesting 23 00:01:12,040 --> 00:01:14,840 Speaker 2: thing that I chat to lots and lots of patients 24 00:01:14,880 --> 00:01:17,880 Speaker 2: about because it's I mean, if you google one of 25 00:01:17,920 --> 00:01:20,800 Speaker 2: these things, ever, then for you the next week, it's 26 00:01:21,040 --> 00:01:24,520 Speaker 2: your entire feed is about testosterone and every single thing. 27 00:01:24,520 --> 00:01:26,400 Speaker 2: And I'm sure it's about every other topic as well, 28 00:01:26,440 --> 00:01:28,280 Speaker 2: But you go into this kind of deep dive where 29 00:01:28,319 --> 00:01:31,920 Speaker 2: everyone thinks it's benefit. It's a benefit to everyone. And 30 00:01:31,959 --> 00:01:34,160 Speaker 2: I think if you have a look at some of 31 00:01:34,160 --> 00:01:36,760 Speaker 2: the data coming out, and this will be really being 32 00:01:37,720 --> 00:01:40,080 Speaker 2: spoken about a lot more with GPS. Probably is a 33 00:01:40,080 --> 00:01:44,039 Speaker 2: big clinical trial that's come out called the Traverse Study. Now, 34 00:01:44,120 --> 00:01:45,880 Speaker 2: unlike some of the studies I spoke about the last 35 00:01:45,880 --> 00:01:48,880 Speaker 2: time I was on that are often funded by the companies, well, 36 00:01:48,960 --> 00:01:51,800 Speaker 2: testosterone's been around for a long long time, and so 37 00:01:51,880 --> 00:01:55,360 Speaker 2: this one was funded by a few different groups, and 38 00:01:55,400 --> 00:01:56,840 Speaker 2: I think it was some of the bigger grants in 39 00:01:56,920 --> 00:01:59,080 Speaker 2: the in the US. But they had over five thousand 40 00:01:59,120 --> 00:02:04,520 Speaker 2: people using all different types of exogenost testosterone supplements to 41 00:02:04,560 --> 00:02:08,880 Speaker 2: take their levels up to the upper to a pre 42 00:02:09,520 --> 00:02:12,120 Speaker 2: kind of written idea. I think it was around about 43 00:02:12,120 --> 00:02:14,520 Speaker 2: having a free test of around about five fifty to 44 00:02:14,560 --> 00:02:16,280 Speaker 2: six fifty and if you don't know what that means, 45 00:02:16,280 --> 00:02:19,760 Speaker 2: it's it's probably in the upper eightieth percentile. And they 46 00:02:19,760 --> 00:02:21,160 Speaker 2: did this for a whole lot of people because they 47 00:02:21,200 --> 00:02:24,239 Speaker 2: wanted to know a few other bits of data other 48 00:02:24,280 --> 00:02:26,720 Speaker 2: than just does this improve energy and things like that. 49 00:02:26,760 --> 00:02:28,760 Speaker 2: But what we wanted to rule out was does this 50 00:02:28,919 --> 00:02:33,480 Speaker 2: cause an increased risk for cutting ask disease, heart attack, 51 00:02:33,639 --> 00:02:37,839 Speaker 2: and stroke in men compared to placebo. And I think 52 00:02:37,880 --> 00:02:40,480 Speaker 2: this was one of the major risk factors that really 53 00:02:40,520 --> 00:02:44,360 Speaker 2: made testosterone and the amount of people and I guess 54 00:02:44,639 --> 00:02:46,000 Speaker 2: for any of the people that have been to the gym, 55 00:02:46,000 --> 00:02:48,960 Speaker 2: there's always somebody there potentially that's we say, is aroided 56 00:02:49,040 --> 00:02:52,160 Speaker 2: up gym junkie, and they're just kind of pumping testosterone 57 00:02:52,200 --> 00:02:55,080 Speaker 2: all the time. And those sorts of things have been 58 00:02:55,080 --> 00:02:57,960 Speaker 2: seen as really negative because at high high high levels, 59 00:02:58,400 --> 00:03:01,480 Speaker 2: at least in all about animal studies, the animals have 60 00:03:01,520 --> 00:03:04,680 Speaker 2: died earlier, and they've died of things that have been 61 00:03:05,280 --> 00:03:08,960 Speaker 2: big issues like strokes and heart attacks. And so what 62 00:03:09,000 --> 00:03:10,960 Speaker 2: they wanted to look at is if we take men 63 00:03:11,000 --> 00:03:14,560 Speaker 2: who have got a reducing level of testosterone because they're 64 00:03:14,560 --> 00:03:18,920 Speaker 2: getting to above above fifty or sixty you always say, Look, 65 00:03:19,840 --> 00:03:22,280 Speaker 2: nothing about evolution says you should be happy, horny, fit, 66 00:03:22,320 --> 00:03:25,320 Speaker 2: and forty let alone fifty, let alone sixty. So things 67 00:03:25,520 --> 00:03:29,720 Speaker 2: kind of go down. And so if we replace it, 68 00:03:29,760 --> 00:03:33,119 Speaker 2: is there an increased risk of issues? And at least 69 00:03:33,120 --> 00:03:35,520 Speaker 2: this study came out and basically said no, if we 70 00:03:35,640 --> 00:03:39,040 Speaker 2: replace it safely, it's not, which leads me to my 71 00:03:39,120 --> 00:03:42,680 Speaker 2: next part of this whole fun testosterone topic go on. 72 00:03:43,880 --> 00:03:47,480 Speaker 2: So what I find though, is that one of the 73 00:03:47,520 --> 00:03:50,760 Speaker 2: biggest things that I've taken away from this study is, yeah, look, 74 00:03:50,880 --> 00:03:52,560 Speaker 2: I've got all these patients coming to me and saying 75 00:03:52,600 --> 00:03:55,720 Speaker 2: I want some testosterone. Well, reality is the biggest killer 76 00:03:55,760 --> 00:03:59,720 Speaker 2: of testosterone is cortisol levels and poor sleep. If you 77 00:03:59,760 --> 00:04:02,760 Speaker 2: want to reduce your cortisol, if you want to reduce 78 00:04:02,800 --> 00:04:06,600 Speaker 2: your testosterone by twenty percent, just reduce your sleeping by 79 00:04:06,600 --> 00:04:09,320 Speaker 2: going out and having some extra drinks after work, impacting 80 00:04:09,320 --> 00:04:12,080 Speaker 2: your sleep for three nights a week. You will reduce 81 00:04:12,120 --> 00:04:15,640 Speaker 2: to testosterone but up to twenty percent. So what I 82 00:04:15,720 --> 00:04:18,080 Speaker 2: find is a lot of guys come to me and 83 00:04:18,080 --> 00:04:19,400 Speaker 2: have a chat to me. This is not just guys 84 00:04:19,440 --> 00:04:22,080 Speaker 2: as well, women as well come to you and go, look, 85 00:04:22,120 --> 00:04:24,720 Speaker 2: I really need some more testosterone for a bit more energy. 86 00:04:24,960 --> 00:04:27,320 Speaker 1: I'm going to shay my total ignorance here. I think 87 00:04:27,360 --> 00:04:31,800 Speaker 1: of testosterone as a male thing. Yeah, but females have 88 00:04:31,880 --> 00:04:32,920 Speaker 1: testosterone as well. 89 00:04:33,600 --> 00:04:37,880 Speaker 2: Yeah, totally. So women actually have ten times more testosterone 90 00:04:38,040 --> 00:04:42,320 Speaker 2: then they have estrogen. Oh wow, Okay, So it is 91 00:04:42,400 --> 00:04:44,440 Speaker 2: really important and a lot of people don't go down 92 00:04:44,440 --> 00:04:45,599 Speaker 2: the path. A lot of doctors don't go to the 93 00:04:45,600 --> 00:04:48,880 Speaker 2: path of giving women estrogen even though they've only got 94 00:04:48,920 --> 00:04:50,760 Speaker 2: a tenth. So women have only got a tenth of 95 00:04:50,760 --> 00:04:53,920 Speaker 2: the testosterone that men do, it's still ten times higher 96 00:04:53,920 --> 00:04:56,240 Speaker 2: than the amount of estrogen that they've got. So it's 97 00:04:56,279 --> 00:04:59,520 Speaker 2: a really important substance for men and women that often 98 00:04:59,520 --> 00:05:02,560 Speaker 2: goes down heel over time. But we make it worse 99 00:05:03,360 --> 00:05:05,920 Speaker 2: because what we do is we combine in our thirties 100 00:05:05,920 --> 00:05:08,360 Speaker 2: and forties a little bit of a reduction in our 101 00:05:08,480 --> 00:05:12,320 Speaker 2: hormone levels, but we combine it with stress, poor sleep, 102 00:05:12,800 --> 00:05:16,960 Speaker 2: poor routines, alcohol, kids, you name it. We do all 103 00:05:16,960 --> 00:05:19,480 Speaker 2: these sorts of things that reduce it. And so before 104 00:05:19,520 --> 00:05:21,680 Speaker 2: I put a lot of my patients or even think 105 00:05:21,720 --> 00:05:23,320 Speaker 2: about testosterone, replace them for them. 106 00:05:23,440 --> 00:05:23,640 Speaker 1: One. 107 00:05:23,720 --> 00:05:25,400 Speaker 2: We do pathology and we have a look at it, 108 00:05:26,160 --> 00:05:30,080 Speaker 2: but primarily if you just start looking at your health routine, 109 00:05:30,400 --> 00:05:32,839 Speaker 2: at your sleep and what time you wake up, whether 110 00:05:32,839 --> 00:05:35,680 Speaker 2: you're getting sunlight in the morning, your walk, your water, 111 00:05:35,920 --> 00:05:39,320 Speaker 2: your protein levels, it is amazing and I'll see patients 112 00:05:39,480 --> 00:05:42,440 Speaker 2: regularly do nothing else other than wake up at a 113 00:05:42,520 --> 00:05:45,159 Speaker 2: set time, go for a twenty minute walk, have some 114 00:05:45,200 --> 00:05:48,599 Speaker 2: more protein, have their coffee. After some proteins, they don't 115 00:05:48,640 --> 00:05:51,680 Speaker 2: spike their courtisol, and they will increase their testosterone by 116 00:05:51,680 --> 00:05:56,560 Speaker 2: twenty to thirty percent without taking exogronously, so they won't 117 00:05:56,600 --> 00:05:58,800 Speaker 2: need to take it a supplement for it. They can 118 00:05:58,839 --> 00:06:01,320 Speaker 2: basically just boost up their production. And this is important 119 00:06:01,320 --> 00:06:04,840 Speaker 2: because when you go on testosterone, it for a lot 120 00:06:04,880 --> 00:06:07,520 Speaker 2: of people is difficult to come off because your body 121 00:06:07,560 --> 00:06:10,360 Speaker 2: starts to stop producing it itself at certain levels. 122 00:06:10,640 --> 00:06:14,800 Speaker 1: So sleep generally, so this is with relation to testosterone, 123 00:06:14,880 --> 00:06:18,800 Speaker 1: but sleep generally in a habitual sleep. So what I 124 00:06:18,839 --> 00:06:21,600 Speaker 1: mean is actually having a routine, which you know, as 125 00:06:21,600 --> 00:06:23,360 Speaker 1: a kid, I hated that idea. As a parent, I 126 00:06:23,360 --> 00:06:27,120 Speaker 1: think it's wonderful. But that is very beneficial, isn't it 127 00:06:27,160 --> 00:06:29,279 Speaker 1: being in a habit and getting lots of sleep. 128 00:06:30,000 --> 00:06:33,400 Speaker 2: One hundred percent? There is there's a reason why evolution 129 00:06:33,520 --> 00:06:35,960 Speaker 2: has not got rid of this eight hour period in 130 00:06:36,000 --> 00:06:39,320 Speaker 2: our lives where we can't eat, we can't reproduce, and 131 00:06:39,320 --> 00:06:43,800 Speaker 2: we can't protect ourselves, so it is protected by evolution. Interestingly, 132 00:06:44,240 --> 00:06:46,760 Speaker 2: the rate at which we burn energy sitting around doing nothing, 133 00:06:46,760 --> 00:06:49,680 Speaker 2: which is called our basal metabolic rate, it actually goes 134 00:06:49,800 --> 00:06:52,680 Speaker 2: up when we sleep, which means our body turns on 135 00:06:52,800 --> 00:06:55,440 Speaker 2: and starts to process all these things. You look at 136 00:06:55,680 --> 00:06:58,479 Speaker 2: all the clinical trials around people laying down memories for 137 00:06:58,520 --> 00:07:02,760 Speaker 2: better learning, for better for more study, for doing better 138 00:07:02,800 --> 00:07:07,760 Speaker 2: at exams, for producing better results essentially, and it was 139 00:07:07,920 --> 00:07:12,040 Speaker 2: really impacted by sleep for the week before. If you can, 140 00:07:12,240 --> 00:07:15,360 Speaker 2: if you're going into more busy time, it is way 141 00:07:15,400 --> 00:07:17,800 Speaker 2: more important. I tell my patients this all the time. 142 00:07:17,920 --> 00:07:21,760 Speaker 2: Pre going into Christmas. Don't do Christmas parties at night, 143 00:07:21,960 --> 00:07:25,679 Speaker 2: make them all brunch parties. Do not sacrifice your sleep 144 00:07:25,680 --> 00:07:28,000 Speaker 2: at the most important time of the year, when everyone's 145 00:07:28,040 --> 00:07:31,160 Speaker 2: burnt out, everyone's stressed, everyone's tired. You have to make 146 00:07:31,200 --> 00:07:34,560 Speaker 2: big decisions around that time. It's not like the year 147 00:07:34,640 --> 00:07:37,120 Speaker 2: just ends for a lot of my patients and who 148 00:07:37,120 --> 00:07:40,400 Speaker 2: are running companies or just working in companies. So take 149 00:07:40,440 --> 00:07:42,280 Speaker 2: the time when things get busy and I love. What 150 00:07:42,320 --> 00:07:43,960 Speaker 2: the Dala Lama said is when it was told he's 151 00:07:43,960 --> 00:07:45,600 Speaker 2: going to have a very very busy day, twice as 152 00:07:45,640 --> 00:07:48,120 Speaker 2: busy as normal, he said, well, I'm going to meditate 153 00:07:48,240 --> 00:07:52,000 Speaker 2: twice today, and I think it's important to go cool 154 00:07:52,080 --> 00:07:54,640 Speaker 2: when things get busy. If you think your testosterone is 155 00:07:54,680 --> 00:07:57,400 Speaker 2: going down, you have to care for yourself more. And 156 00:07:57,400 --> 00:07:59,640 Speaker 2: it's about putting yourself to sleep, waking up at the 157 00:07:59,640 --> 00:08:02,320 Speaker 2: set time time, and taking that time in the morning 158 00:08:02,400 --> 00:08:03,160 Speaker 2: to care for yourself. 159 00:08:03,840 --> 00:08:06,040 Speaker 1: I've got to ask Michael Thompson, my colleague on Fear 160 00:08:06,080 --> 00:08:08,480 Speaker 1: and Greed. Isn't Radio man through and through? He's been 161 00:08:08,560 --> 00:08:10,560 Speaker 1: used to the three four am mornings. And I have 162 00:08:10,600 --> 00:08:12,640 Speaker 1: a number of people that I know they seem to 163 00:08:12,680 --> 00:08:16,000 Speaker 1: manage on five hours sleep. Is that true or they're 164 00:08:16,040 --> 00:08:17,760 Speaker 1: just making it up now? I mean it is true, 165 00:08:17,800 --> 00:08:20,560 Speaker 1: because they do function quite well in five six hours sleep. 166 00:08:20,760 --> 00:08:23,320 Speaker 1: Would Mike be even better if he was on seven 167 00:08:23,400 --> 00:08:23,760 Speaker 1: or eight. 168 00:08:23,640 --> 00:08:26,880 Speaker 2: Hours one hundred percent? Yeah, definitely. And I think you're 169 00:08:26,920 --> 00:08:29,720 Speaker 2: only see we're seeing people when they wake up at 170 00:08:29,840 --> 00:08:32,760 Speaker 2: three or four o'clock in the morning, and you just 171 00:08:32,760 --> 00:08:34,600 Speaker 2: said that they function I don't know if that's the 172 00:08:34,679 --> 00:08:36,600 Speaker 2: life that I would want to have just being that 173 00:08:36,920 --> 00:08:39,440 Speaker 2: I function at a time. Certainly when you wake up 174 00:08:39,480 --> 00:08:40,960 Speaker 2: first thing in the morning, at that time, often you've 175 00:08:41,000 --> 00:08:42,800 Speaker 2: got adrenaline, you're on air, you've got all these other 176 00:08:42,840 --> 00:08:44,720 Speaker 2: fun things happening. I wonder what the rest of his 177 00:08:44,800 --> 00:08:47,240 Speaker 2: day looks like? How productive the rest of this day 178 00:08:47,320 --> 00:08:49,360 Speaker 2: with me, he's haying, being a great time, having a 179 00:08:49,400 --> 00:08:52,600 Speaker 2: fabulous time. Obviously it's all going up here, it's all going. 180 00:08:52,640 --> 00:08:55,079 Speaker 2: But also he's young. This is the other part, like true, 181 00:08:55,360 --> 00:08:57,200 Speaker 2: what we don't realize about a lot of these things 182 00:08:57,200 --> 00:09:00,200 Speaker 2: we're studying. All of these things work pretty well. The 183 00:09:00,200 --> 00:09:04,400 Speaker 2: mean age of partying was around about mid seventies. Now, 184 00:09:04,720 --> 00:09:06,319 Speaker 2: like I don't even think someone's old and in the 185 00:09:06,360 --> 00:09:08,560 Speaker 2: hospital to their ninety five. Like, this is going to 186 00:09:08,600 --> 00:09:11,480 Speaker 2: go quickly, and it's going to be these small changes 187 00:09:11,480 --> 00:09:13,320 Speaker 2: that you make now. And getting that extra half an 188 00:09:13,320 --> 00:09:16,680 Speaker 2: hour to an hour makes frankly, across a four week 189 00:09:16,840 --> 00:09:19,600 Speaker 2: clinical trial, getting an extra hour of sleeper night will 190 00:09:19,600 --> 00:09:22,760 Speaker 2: basically boost your testosterone by about ten percent. 191 00:09:22,960 --> 00:09:25,199 Speaker 1: Fantastic, doctor Zach, thanks for talking to fear and greed. 192 00:09:25,360 --> 00:09:26,040 Speaker 2: Thank you so much. 193 00:09:26,160 --> 00:09:29,880 Speaker 1: That's doctor Zach Turner, medical commentator, doctor and biomedical scientist. 194 00:09:29,880 --> 00:09:31,760 Speaker 1: I'm Schanel Mat And this is fear and greed, Q 195 00:09:31,920 --> 00:09:33,679 Speaker 1: and da