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

In this episode, we discuss:
00:00 - Intro
01:02 - The thyroid system
15:02 - The adrenal system
26:57 - The female sex hormone system
40:21 - The male sex hormone system

Great video. Highly informative. Thank you for explaining why you are not a fan of clomiphene/clomid for men.

This is by far the best episode. Love the lecture format! Would be great to have more like this. Thank you, Peter!

Spot on re the thyroid. Been hypo for about 40 years. I've had to educate myself to exactly how you explained everything. And source my own meds, do my own labs, because it's been impossible to find a doctor who will test and treat appropriately. Thanks! Very validating.

More lectures like this would be very appreciated. Not that your other content isn't top notch but this is really wonderful. Clinical experience overlying basic mechanism is a phenomenal approach. Thanks for all you do!

Damn Peter, Just when I thought your excellent track record was unsurpassable, you've raised the bar even higher. This material is gold !

I really liked this episode. Would love to see one of these lecture-type videos every few weeks and perhaps to go even more in-depth.

Amazing breakdown. The information out there on the internet for the endocrine system holistically, from a bird's eye view, is sparse or hidden in textbooks. Truly appreciate the at no-cost overview of these otherwise complex systems. Definitely information everyone needs to know and be aware of for themselves and those they care for.

This lecture format is outstanding, please keep creating content in this form!

I feel so much more confident evaluating my blood test results. Thank you!

Thank you Dr. Peter Attia for Breaking down the endocrine system! You made a very complicated system a little bit easier to understand! Good job young man! 👏 Please keep up the great work 👍😊

If everyone could have a doctor like you we’d all be living to 100. Thanks for your work. Do you know if an estrogen level of 550 is ok in a 69 year old female supplementing with HRT? PCP says yes but a second opinion was aghast and wants it 60.

Great episode. This was very helpful for knowing what labs to ask for in my yearly physical.

Thank you also for the cortisol explanation. That is the most understandable i have heard. I know I have issues, symptomatic and have had a couple of 4-point saliva tests, but figuring out how to address it has been difficult. I'd love to hear a movmrecin deoth episode on treatment.

Thank you. And more of this type of explanatory videos Peter. You’re very good at explaining complicated things in a very understandable way.

I've seriously been interested in the endocrine system for the last couple years, this is what I would like to study

This is very informative for the laymen like me. Wishing for more videos like this 😊

Very well done with the graphics...one of the times it was worth it to sit down and watch rather than listen to the podcast on my walk. What is interesting about the pituitary ( in my experience ) is that a tumour may be responsible for disturbances in many systems other than the tissue that is "cancerous". I had a giant macro adenoma (FSHoma) that was not disturbing my life in any tangible way that I could tell...probably had great sperm production, but no real symptoms. At the same time, I was a reactive hypoglycaemic, for no known reason. With diet, I could control the negative effects of hypoglycaemia. Once the adenoma was discovered and the first surgery performed in an attempt to "debulk" it, I lost thyroid and some adrenal function. The second, more involved surgery, resulted in regaining thyroid function, only minimal decrease in adrenal function, but total loss of FSH and LH. Plus I am still a reactive hypoglycaemic. Perhaps it has something to do with the original tumour or not. But I wouldn't rule it out. It will be interesting to see what happens in the future.

I appreciate the clarity in these lectures, Thanks Peter!

Thank you so much for helping to liberate the understanding of the mysterious thyroid hormone lab tests from the mystic of the white lab coat endocrinology specialists! May primary doctors everywhere now be empowered to order and interpret these labs so that patients may have optimal health 🎉🙌

Very excellent presentation! I learned so much from this. Endocrinology is fascinating for me.

Up to the point direct focused no waste of time on personal stories.Amazing change in format,content.Good change 10 out of 10.

This is a Masterclass, so insightful and enlightening

I so much appreciate the comprehensive information that this video provides.

extremely helpful! i have to have a thyroid lobectomy due to a TI-RADS grade IV nodule (had the thyroseq genetic testing). im having it done at a top academic center but am concerned about my thyroid hormone levels after (normal now). any advice about what exactly to look out for? if it is malignant that will be dealt with, but i know this may sound strange but im a former professional athlete and im actually more worried about uncontrolled weight gain or my metabolism going wacky. thank you for any guidance on hormone level management.

Thank you for the work you are doing. Best overview of these topics I’ve come across

Hi, what role does aldosterone play in the entire adrenal system? Could primary Aldosteronism (in the absence of an obvious Adenoma) be probably brought on by insulin resistance or vice versa? Anything that can be done to bring this under control under than MRAs?

Good afternoon. I'm not sure if you will check this but I do have a question. I've been listening to all your podcasts for awhile and really have learned alot. I just had blood work done and I have a question. I had half my thyroid removed. I had my TSH and Free T4 tested and it came back a little high at 5.36. I guess I'm asking for your opinion on what I should do next. Should I get my T3 and FreeT3 tested?

I been on armor thyroid 60mg and it works great for me. Thank you

Much appreciate your gift of medicine and communication and the care of others.

Thanks so much for the information about the transfer situation to menopause/ perimenopause. There are so many more symptoms that are really serious (except for hot flushes or night sweats) like difficulties to concentrate, brain fog, heart racing, anxiety or paralyzing joint aches. Many women with these symptoms are sent to psychiatrists or orthopedists (me included) but it was acutally the fluctuation of hormones, especially estrogen and testosterone (which is as of today rarely prescribed in Germany since it is not licensed for women yet!!!). It was a real fight to get progesterone and estrogen prescribed, I was seeing at least 6 doctors and spending 1000s of€ to get help. Now I am on HRT in perimenopause and slowly feeling better.

Was wondering about the parathyroid glands.
Really like the lecture format and the content. Excellent. Thank you.

Great that's my mayor issue as a woman in my fourty-five, I'm struggling with adrenal cortisol levels at night. Also I'm in HRT testosterone pallets. God bless you and thank you for your care.

I love his sharing his experience. It's not just theories. It's also about application of the theories.

Love your book, appreciate this format.

Every time I listen to Peter I think: Why not to open Attia University? Whatever he explains is way better than any other source I have ever attend to. Despite his role in longevity field his educational contribution is enormous.

Thanks! It's so interesting! Does licorice root have an instant effect? I mean if you're low on cortisol at the end of the day and you want to keep your level high, how much licorice should you take? When?

This is awesome, thank you for creating this.

Great episode, just wish to hear Dr. Attila's take on Grave's and hyperthyroidism.

Amazing, thank you. Format is easy to absorb for the data to be used.

Thank you for sharing your knowledge! You are the best.

Very informative video. Thank you!

Wow good presentation in content ,style,voice,it is as good as the Scottish professors who taught us in Royal College of Edinburgh.Good dr Petter Attila this should be the style of delivering a lecture to well informed listeners like medical consultants.Thank you for showing us the best.God bless you.

Thank you I wish I could find a doctor that would treat symptoms seems like the last 10 years we have went backwards

Very well spoken and articulated physician
Thank you

wowoowowow so amazing and sharing with literally aEVERYONE, thank you for these basics... wellness culture really lets to through a ton of really not at all acurate info out there... love love love learning more from here! thank you!

More episodes like this! 👍

Where were you during my A and P course? 😂 Thanks for the breakdown Doc! Much appreciated.

Love this, thank you!

Excellent review! Thank you

Appreciate the huge amount of info u give

Curious in the role of salt\sodium in the function of TSH, T3 and T4

I've had high TSH for years (am now a post menopausal woman) but whenever my doctor raises my dose of Tirosint beyond 75 mcg, I feel very wired, hot, digestion speeds up, etc. The thing is, she only raises it to 88! And the TSH stays in the 4-5 range. Do you think this is a t4-t3 conversion issue? I'm concerned about continuing to have a low functioning thyroid but don't want to feel so wired when I up the dose.

doctor, I am premenopausal 52 getting HRT plus anticonceptional, it would be so important to understand how the system function while getting anticonceptional treatment and estradiol gel,because some ladies need up to 200mg HRT some 5 mg , some 1 mg and it varies a lot ,but in most cases it is challenging to keep under control and forecast how if the ovaries are producing few eggs yet while getting hrt , but especially how each individual can adjust estradiol gel dosage. thanks for your answer

Great summary!

THANK YOU SO MUCH for making this episode free on your channel.

I'm a 47 yr. old female and after listening to this, i absolutely do not have or have never had a doctor who cares about me this much. So damn sad.

For a percentage of us, there is an intolerance to progesterone. Adding progesterone during the luteal phase dramatically increases PMS symptoms. Its not the rapid decline of progesterone, its the progesterone itself. I tried virtually every variation, duration and combo of prog and/or estrogen and only in menopause found relief

You’re Simply the Best! Thank you!🙏🏻

You are amazing!
God bless you 🤲

How I wish I knew of you a decade ago! Unfortunately I missed the boat with hrt. I am almost 61, just had sex hormones checked and still have not flat lined. Are there any options for me? No family history of cancer, but heart disease and osteoporosis does run rampant.

Dr mentions looking at Free T level (and other things) when deciding on Trt. This because Dr says free T is the truly active part of T as it is unbound. My question is, as the bond of T to albumin is relatively weak (not nearly as strong as bond to shbg), can the albumin bound T also be considered in the TRT decision, as many labs consider bioavailable T to be the sum of Free T plus Albumin bound T (because of the weaker bond to albumin). It seems that the body can unlock albumin bound T relatively easily from my reading. My thoughts would be that bioavailable T could be defined as the sum of Free T plus a % "of Albumin bound. Comments will be appreciated

bravo. you have the gift of clarity. thank you.

Regarding the female sex hormones…I’m 53 and long done with menopause. I wish my doctor would have done HRT with me when I was going through peri menopause

Can you tell me is this is going to be different after a full hysterectomy? I will be getting one in Oct. I'm 60 and I have had lots of thyroid issues since 16.

Great information 🔥

Any info on why testosterone would totally tank in women? I’m in perimenopause currently at 41 but my T was at 0 when I was 35 causing huge cognitive issues among other things . HRT for low T helped

I'd love for you to explain any benefits (if there are?) of bioidentical HRT over synthetic, or can a woman use either? And why do we want FSH to stay lower and not rise high like we typically see in menopausal women? And also, if a woman is experiencing night sweats and hot flashes should she be on HRT at that point? Or should she only go onto HRT if FSH is rising?

I tried a few dissociated versions and I tried Cytomel. Synthroid works best for me.

How common are side effects in men from over-aromatization to estrogen?

Absolutely helpful

Fantastic, thank you!

With respect to the adrenal system, Peter gave the impression to suggest licorice to combat obesity, IR, ect; however, licorice increases cortisol as well as IR and obesity, how am I going to take licorice for those problems when I already have increased cortisol? It's contradictory, cause licorice is said to lower IR and fight obesity but all these dysfunctional states increases cortisol which increases blood pressure too.

Love your content

Excellent. Thank you.

More like this!

Just excellent

You are a great teacher

How does increased insulin resistance affect female reproductive issues?

As for a pharmaceutical fix to PMS a better fix would be that all women who menstruate should be able to take a couple days off to hang out with each other and focus on well-being away from all responsibility exception nurturing herself and each other. I think women deserve that each month and maybe the man can step up and take over while she's gone even if it's just an overnight in a nice hotel and a day at the spa.

Please do an episode on her for both men and women!

My husband has hypothyroidism. If he gets the cheaper drug which is mostly T4 he gets twitchy, then argumentative, then violent. He therefore is prescribed T3 rich thyroxine. If he forgets to take it in the morning I can tell by his manner by about 10.30am. By 8.30pm he is scary.

Would you recommend the Dutch test to optimize female hormones for training?

Amazing.

I am glad I listened to this video after 3 days of delay if it is boring ,long as before.

A lot of information here to digest. I know patient insurance can be nitpicky with various blood test coverages, but I'm real curious why one doctor would test the t3, t4, and rT3, where another doctor only checks one.
Most people do not know how to relay the important information that would help a doctor hone in on the actual problem. And, anecdotally, most doctors address symptoms rather than root cause. (if such can even be determined)
Seems to me there should be a higher standard for these blood panel tests.
There's too much I don't know, but it seems to me the Thyroid impacts SO many other hormones, that there should be a much more comprehensive testing process by default.

quest diagnostics tests free cortisol in the blood along with cortisone (i believe free and total) as well. why are these not good tests to use?

Thank you ❤

I'd like to know if there is alcolol consumption most people seem to want to ignore it's making them feel miserable.

Thank you!!!!

Adrenal cocktail- 1/4 tsp sea salt. 1/4 tsp cream of Tartar. 2 oz OJ and/or coconut water

Damn dude you should just say “ I don’t treat anyone but drop a check at the front counter because I’m afraid to treat hormone related issues but I like your money. Thanks and come again. Oops you can’t get it up….lol so I guess telling you to come was a bad choice of words”…. Give your patients some freaking T so they can function properly and give them 2.5 of letrozole once or twice a week to keep the nads working. I had a doc like you in my younger years and lost the quality of life because he was afraid to treat. My message to doctors like that get off your high horse and treat your patients or hang it up. You’re screwing up they’re lives. By the way if you use an AI to cut the E2 you can keep the bones strong just by giving (heaven forbid) a bit more testosterone😮😮😮😮😮😮

Where do TPO auto antibodies fit in?

@Peter Attia MD is it true after 25 that males don't need DHT? and all it causes is hair loss? For example people on Finasteride and Dutasteride

What about thiamine? How does that interact with thyroid and adrenal? I feel better taking benfotamine. Inflammation gone

Sure glad you aren't my doc. I was having serious mood issues due to higher estradiol levels. If you have a patient who isn't feeling better on what you think he should give him more testosterone and an aromatase inhibitor....they'll likely feel much much better.

phosphatidylserine - cortisol- cushings- 11‐β hydroxysteroid dehydrogenase type 1 in cutaneous fibroblasts cultures of psoriatic lesional skin before and after narrow band‐UVB phototherapy

Trying to understand how Hashimoto's & estrogen dominance can lead to IDC Breast Cancer.

Seems like the body wants to titrate T3 in differs ways

@dr Attia, how do I become a patient of yours?