#256 ‒ The endocrine system: exploring thyroid, adrenal, and sex hormones | Peter Attia, M.D. | The Peter Attia Drive

Intro

In episode #256 of “The Peter Attia Drive” podcast, Dr. Peter Attia explores the endocrine system and its hormones, focusing on the thyroid, adrenal, and sex hormones. The podcast aims to translate the science of longevity into accessible content for everyone.

Main Takeaways

Thyroid Hormones

• The thyroid gland is regulated by TSH, which is stimulated by the anterior pituitary gland, which is regulated upstream by the hypothalamus via TRH.
• T4 and T3 are the two main hormones produced by the thyroid gland, with T3 being the active version responsible for most of the thyroid-promoting functions.
• Hypothyroidism symptoms include feeling cold, slow metabolism, difficulty sleeping, brittle nails, and constipation, which can make diagnosis difficult.
• Hypothyroidism is more common than hyperthyroidism, and the standard treatment is synthetic T4, which the body converts to T3.
• Compounded controlled-release T3 is a more tolerable alternative to traditional T3 supplementation.

Adrenal System

• Blood tests cannot provide much information about adrenal gland function.
• Saliva or urine tests can measure free cortisol levels.
• Addressing issues like insulin resistance, obesity, inflammation, low thyroid function, and leptin resistance can help regulate cortisol levels.
• Licorice root and phosphatidyl serine can be potent supplements to regulate cortisol levels.
• Lifestyle management is key for addressing underlying issues with cortisol levels.

Female Reproductive System

• The menstrual cycle is divided into two phases: the follicular phase and the luteal phase.
• PMS is likely caused by the drop in progesterone levels at the end of the cycle, and low-dose progesterone can effectively treat PMS symptoms.
• Testosterone changes very little during the cycle, but women have 5-10 times more testosterone than estrogen in their bodies.
• Hormone replacement therapy should be initiated before flatline estradiol and progesterone, and sky-high FSH and LH occur in menopause.

Summary

The Thyroid: Regulating Hormones

The thyroid gland is regulated by a complex feedback system involving the hypothalamus, anterior pituitary gland, and thyroid-stimulating hormone (TSH). T4 and T3 are the main hormones produced by the thyroid, with T3 being the active form responsible for various bodily functions. Hypothyroidism, characterized by low thyroid hormone levels, is more common than hyperthyroidism. Synthetic T4 is the standard treatment, but some patients may not convert it to T3 effectively, requiring alternative T3 supplementation methods such as compounded controlled-release T3.

The Adrenal System: Cortisol Regulation

Assessing adrenal gland function through blood tests may not provide comprehensive information. Saliva or urine tests can measure free cortisol levels, which are important for understanding adrenal health. Addressing underlying issues like insulin resistance, obesity, inflammation, low thyroid function, and leptin resistance can help regulate cortisol levels. Licorice root and phosphatidyl serine are supplements that can support cortisol regulation. Lifestyle management plays a crucial role in maintaining optimal adrenal function.

The Female Reproductive System: Menstrual Cycle and Hormones

The menstrual cycle consists of the follicular phase and the luteal phase, each characterized by specific hormone levels. PMS symptoms can be attributed to the drop in progesterone levels at the end of the cycle, and low-dose progesterone can effectively alleviate these symptoms. Testosterone levels in women remain relatively stable throughout the cycle, with women having higher testosterone levels than estrogen. Hormone replacement therapy should be initiated before menopause to maintain balanced hormone levels.

Conclusion

In this episode of “The Peter Attia Drive” podcast, Dr. Peter Attia provides valuable insights into the endocrine system, focusing on the thyroid, adrenal, and sex hormones. Understanding how these hormones function and interact can help individuals optimize their health and well-being. It is important to consult healthcare professionals for personalized advice and treatment. To access additional resources and benefits, listeners can explore the membership options available on the podcast’s website.