Does gallbladder removal impede optimum nutrition down the road?
•Large gallstone (1.8 x 1.7 x 1.7 cm) found in 2011 when I became VERY ill and lost 12% of body weight. •Kept gallbladder, took supplements, changed diet and turned things around. •In the past 1-2 years I have been more lax at times, hence more symptoms. •Blood labs are normal, no acute gallbladder distress. But symptomatic. •I subscribe to your philosophy and eat high protein, healthful fats, lots of veggies, I workout and do heavy resistance training and sleep well, rarely drink alcohol, etc. QUESTION. If I have a cholecystectomy, will I still be able to eat a good diet and absorb nutrients to maintain good health and muscle mass?
Peter's opinion on an "Athlete's glucotype" (comparatively high HBA1c despite leanness and training volume)
Could you discuss a potential “athlete’s glucotype” underrepresented in CGM discussions? In lean, fat-adapted endurance athletes HbA1c can look surprisingly high (~5.3 in my case) despite normal insulin sensitivity (HOMA-IR), leanness and high training volume. My CGM shows prolonged spikes/plateaus at rest, rapid clearance with activity (via insulin-independent GLUT4), sometimes with rebound. Could this phenotype explain why many fit athletes run higher HbA1c, and how should we think about its cardiovascular implications? I have referenced Peter in this LinkedIn post: https://www.linkedin.com/posts/lorenz-wild-89411b287_athleteglucotype-activity-7372955095954698241-y8IT?utm_source=share&utm_medium=member_desktop&rcm=ACoAAEWbXDABQn1X09U_kq2QOawOEx7VKWcbDpk
Case studies for interventional endocrinology
I would love it if you had an episode where you walked through your thought process for working up and treating hormonal issues based on de-identified or made up patients. There is so much info out there, and it would be great to see how you think about things so that with my own PCP and interactions with medical providers, I could get a sense for if they have a similar approach or not and why.
Optimization for busy unicorns
Background for context: I am a 49 y/o busy working mom. I’m also a breast cancer survivor (2022) with the added benefit of having acquired Type 1 diabetes, hyperthyroidism and menopause at age 45/46 as a result of the chemotherapy/immunotherapy I underwent to treat the cancer. I like to run (~10 minutes pace, more in Zone 3 than 2) and usually get in 2 strength training sessions a week. I work out at lunch time and usually allot 30-40 minutes for these workouts (alternate between a 5k and strength with one rest day). I walk my dogs a mile or two a day during the week, more on weekends. In the past year, I have been more fatigued, gained ~15 lbs (definitely fat and not muscle) and it seems like menopause symptoms have come back for round 2. I can’t do any HRT or peptides. I’d like to explore Zone 2 training but I really can’t do 45 minutes in one chunk on weekdays. Regarding T1D, my A1C is right around 6.0 and TIR is 90-92%. I am on 500 mg Metformin 1x/day. I would really like to decrease body fat and increase energy. Can I do this implementing Zone 2 training with only 30 minutes a day during the week? Weekends I could do the 45+ minutes.
Alpha-1 Antitrypsin Deficiency
Diagnosed with Alpha-1 Antitrypsin deficiency in mid 40s, caught early … how should we consider applying Peter’s longevity and health span protocols when managing this or other genetic issues that may/will compromise lifespan or health span? While I’m especially interested in Alpha-1, perhaps this can be viewed as one example of a class of pathologies to make the episode/discussion may be more broadly applicable?
Can you please update The Straight Dope on Cholesterol?
Your 9 part series "The Straight Dope on Cholesterol" is great - but it's 13.5 years old, Part II says "the pace at which the field is developing is too great for most doctors to keep up with", and many links don't work any more. Can you please update? Thank you!!
Removing rods from prior scoliosis surgery
Your recent re-release of your interview with Stuart McGill has me (again) researching getting surgery to remove the rods on my spine from a scoliosis surgery 20+ years ago. The rods extend from T5 to L1. I have been suffering from sciatica starting at L2, which I've been told partly results from overuse of the joint due to immobility of the fused sections. What are your initial impressions? Have you seen this type of surgery done before?
Training Protocols
I am interested in an ask me anything focused on training and basic training advice for preparing for performance efforts. I would like to know anything you would suggest for preparing for hyrox, iron man, or marathons. Basic minimums for performance would be helpful. This could be answered in an interview with experts in these fields filtered through peter - although not longevity focused it would be nice to have a series detour from longevity to performance. This is mostly because performance efforts are motivational and taking on popular performance challenges helps me with my motivation. Even such things as hiking etc. or other focused domains would be interesting.
Statin and brain health for women in the menopause transition
Should women in the menopause transition with low desmosterol and who and are high absorbers of cholesterol be on a statin? Is ezetimibe a sufficient alternative? Standard cariologists don't seem to know how to deal with this situation which is important for brain and cardiovascular health.
Pregnancy
I’ve been a long-time listener and would love to hear an episode on pregnancy. There’s so much conflicting information about how to best take care of yourself while pregnant — from nutrition to exercise to what’s most important in each trimester. I’m sure I’m not alone in wanting clarity on how to optimize for a healthy pregnancy.
Incline Treadmill Zone 2 Workout Recovery and Injury Prevention
I have been following your advice on doing Zone 2 for about 2 years. I've had an incline treadmill set an 8 degree incline on which I walk about 5 kmh, maintaining a heart rate at about 143 bpm for about 4k steps, which takes about 40 minutes, 3 times a week. After about a year of this routine, I started regularly experiencing ankle pain in the posterior tibialis shin splint area. I generally pushed through this with some semi-regular recovery exercises using the BlackBoard. However, after almost 2 years, the shin splint paint reached a point of intensity such that I can no longer do the incline treadmill Zone 2 workout. Also, even after stopping, my right ankle seems to be healing but my left ankle has gotten worse, making me suspect I have a stress fracture, which I am going to see my doctor for. So my question is, how can I make Zone 2 sustainable and avoid injuries like this? I own a massage gun now for other purposes and am especially open to that since it fixes other muscle issues quickly.
Long-Term Effects of a Ketogenic Diet for Cancer
Can you comment on the scientific validity of the paper entitled "Long-Term Effects of a Ketogenic Diet for Cancer" (https://pubmed.ncbi.nlm.nih.gov/37242217/). The results seem very positive but I don't have the skills to evaluate how rigorous the methodology was.