LS 18 - Getting Serious with Dr. Brett Osborn

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Welcome to the Longevity Show. Informing listeners on the important aspects of health, wealth and happiness to ensure you live life to its fullest. With fascinating interviews with top authors and gurus in the field, along with the latest news in the science and technology of longevity, we're going to reveal expert advice and amazing secrets of living a longevity happier life. And now, here's your host, Jason Hartman.

It's my pleasure to welcome Dr. Brett Osborne to the show. He is a board certified neurosurgeon and author of Get a Neurosurgeon's Guide to Optimal Health and Fitness. Brett, welcome. How are you?

I'm doing well. And yourself?

Well, good, good. It's good to have you on the show. And, you know, this is an interesting take. I mean, you know, who would think, you know, a Neurosurgeon's Guide to Optimal Health and fitness. Tell us about the connection there.

The bottom line is that halfway through residency in neurosurgery, I started realizing more so than ever that the vast majority of the diseases that we were as humans were afflicted with. And actually the majority of the diseases that were killing us were these age related, but more importantly, preventable diseases.

Such as diabetes, which leads to things like cancer and Alzheimer's disease and coronary artery disease, cerebral vascular disease, and all of these diseases are interrelated. So it's not so much that I was a neurosurgeon that sets me up to speak.

As I do about these various diseases. It's just that this has allowed me, by recognizing all the bad things that we're doing to ourselves during my training and during my 11 years in practice.

That I've come to be able to not only understand the diseases themselves, but offer some sort of preventative modalities.

Which I offer to my patients in the form of nutrition, exercise modifications, hormonal therapies, et cetera. And that's really sort of the evolution of the genesis of this whole thing.

Would you agree that it's sort of, for the layman, it's an odd connection, you know, neurological issues and fitness. You know, most people would say just eat right and work out and exercise, but I don't know if they'd think much about neurological things coming into this. Tell us more about that. I mean, you know, does physical training, what does it do? You know, your neurological system, for example.

Right. So exercise, particularly strength training, offers a variety of health related benefits Both to sort of our periphery and to our brain itself. For one thing, exercise allows us to obtain better glucose control. And as I had alluded to previously, one of the underpinnings, one of the major underpinnings of age related disease, Alzheimer's disease, cancer, atherosclerotic heart disease, cerebral vascular disease, is poor glucose control, or what's known as pre diabetes or insulin resistance, however you want to term it. So exercise, by virtue of that, and particularly putting muscle on your body, allows one to reduce the amount of circulating glucose and thereby reduce the amount of circulating insulin, which is the hormone that normally regulates our glucose in our blood. And insulin is an inflammatory hormone. So by virtue of that, number one, exercise does.

Reduce the incidence of these age related diseases, all of which are to some degree related to diabetes or pre diabetes or insulin, insulin resistance. So that's number one. Number two.

Exercise increases blood flow to the brain. That allows us to wash out some of the toxic metabolites that accumulate during the day, similar to sleep, except there are two polar opposites, exercise and sleep, but they both have a sort of a washout effect in the brain. Thirdly, exercise increases what's known as bdnf, which is.

A cytokine. So it's a chemical messenger in the brain that promotes or fosters the generation of what was thought to be impossible previously, new neurons. So new nerve cells in the adult brain in to.

Bettering the interneuronal or neuron to neuron connections. So exercise actually by virtue of that actually does enhance our learning capabilities. In addition to thwarting the development of these neurodegenerative diseases such as Alzheimer's disease. There's a whole list of things that exercise does to the brain and to the nervous system itself, but those are some of the, the mechanisms that we believe are responsible for some of its beneficial effects.

Yeah, very interesting. So you know, in terms of longevity specifically, Katie Couric released this new documentary entitled Fed up and it talks about how kids born in the Internet age may be the first generation to have a shorter life expectancy than their parents. I really thought we were going in the right direction with this life expectancy stuff, but that's a rather disturbing and amazing assertion I think, huh?

It absolutely is. Because obesity is on the rise. It's an epidemic. You will notice that obesity is obesity, type 2 diabetes, insulin resistance, again, similar underpinnings here, similar themes.

As the incidence of obesity rises, you're going to develop more of those associated diseases. Again, cancer is associated with obesity, Alzheimer's diseases.

Diabetes, atherosclerotic heart disease. So hardening of the arteries in the heart, hardening of the arteries in the brain, all of these diseases are going to rise in parallel to the rise in obesity. Why? Why is obesity on the rise? It's because we are the fast food nation. As you know, we want a quick and easy way. We don't want to spend time preparing our food, buying the right types of food, and certain we don't want to exercise. Despite the advent of all of these fitness crazes, et cetera, more and more people are sitting on their butts. The combination of these two things is nothing short of lethal. And this is why it's actually interesting. If you look at males testosterone levels, which are heavily dependent upon one's body fat level and one's level of fitness, and particularly how much muscle they have on their body or how much exercise they're doing to put that muscle, to stimulate that muscle muscle growth. If you look at it over the past 50 years.

The average male testosterone normalized for age. It's plummeting.

Dr. Pompa, how much is it plummeting? Yeah, let's talk about that. Doctor.

Very significantly, this is not a little blip on the radar. It's appreciably lower. If you look at the average male testosterone, say 50 years ago versus now, it's appreciably lower. And that is a direct function of one's level of fitness, one's level of muscularity, et cetera.

Correlated to basically how much exercise we're doing and what types of estrogenic foods we're putting in our body and what types of bad foods in general we're putting in our body, which.

Make us more and more unhealthy. Testosterone is just one of the barometers which is closely linked to lean muscle mass, but it's a good barometer.

Okay, so let me ask you about that. So first of all, where do you stand on testosterone supplementation? I've had some other guests on my show that recommend that. What do you think about it?

Absolutely. It's something that I've been on for years and I have sort of an adjuvant. One of the adjuvant parts of my practice is sort of this wellness or anti aging, whatever you want, rejuvenative medicine.

Type of protocols in the institute, and they're heavily based upon hormonal replacement and one of which obviously is testosterone. So I write it out of my office quite frequently. So I am a very, very big advocate of it, both for myself and for My patients.

Are there any dangers to it though? I would be afraid it might cause hair loss on your head, it might cause cancer growth, it might cause too much body hair. Hair in the wrong places, shall we.

Say, and understandably so. There are uncommon side effects such as hair loss and hormone induced, what's called alopecia. And you do see that among some of the bodybuilders. But I will tell you that, that if dosed properly in physiologic doses, not super physiologic doses, these side effects are unusual. It's rare. When I have a patient come back to say that they've noticed that their hair is thinning as a result of the initiation of testosterone therapy in the context of cancers. It used to be thought that testosterone was the.

You're sort of pouring gasoline on the fire in the context of prostate cancer. Well, we all know that 16, 18 year old males have very, very high levels of testosterone and they don't have prostate cancer, do they? So that entire, I will call it a mistake. Evolved or the genesis of that was from a study in the 19, late 1930s which had. How many subjects do you think? One.

Oh, really?

One? One? One. This is a farce, okay? As a matter of fact, and I'm not going to mention any names, there are urologists, there's one very prominent urologist at Harvard who's written books on testosterone, who actually puts his prostate cancer patients on testosterone not as a treatment for the tumor itself, but for these individuals to maintain their libido, their energy levels, their brain health. Because testosterone is good for the brain and there's plenty of data on that as well. So he's really sort of spit in the face of anybody who says that.

Prostate causes, excuse me, testosterone causes prostate cancer. Because we all know that it doesn't. Absolutely does not. So it's not putting fuel onto the fire, so to speak. Now, if you have a hormonally sensitive tumor, of course, or cancer, you don't want toif it happens to be sensitive to testosterone. You of course don't want to pour gasoline in the fire. But these tumors that I'm talking about.

Are unusual. And I will tell you that de novo tumor formation by virtue of testosterone treatment. So one's ability to form tumors by virtue of the fact that he or sheexcuse me that he has been on testosterone, that just simply doesn't happen, okay? These tumors are not from testosterone, okay?

Prostate cancer is a hormonally responsive tumor, okay? So you have to watch out. And I wouldn't recommend it putting somebody with prostate cancer on testosterone, unless you're extremely, extremely familiar with the drug and the cancers. And that's why I, not being a urologist, don't do that. But this gentleman does, because this is what he studies on a daily basis. But testosterone does not unto itself cause cancer.

How about the concern that supplementation would cause the body to stop naturally producing it? You know, if you go off it, then will you have this, you know, bad hangover effect?

I mean, that's a very, very good question. And does cause that.

The issue is this. If somebody comes to me and they have low testosterone or manifestations of low testosterone, I should say, because it's a clinical diagnosis and then it's a laboratory diagnosis. Secondarily, they get put on testosterone, but they get put on testosterone for life, you see. So there's no on, off. That's a bodybuilder. We're not bodybuilders. We are.

Aiming to optimize one's health lifelong. We're not looking to bulk up for the show that's in six months and on and off. And cycling.

That phenomenon that you're describing, I'm never concerned about that. And if somebody did want to come off testosterone for some reason they were losing hair, it would be rare, but they were losing hair. Could I get them off the testosterone? Sure I could. Same way that bodybuilders come off of their drugs and I'll call them drugs.

Probably a weaning process.

I assume what they do is they wean and then they use something that's called HCG or Clomid. Okay. And I use HCG in my clinic for other reasons, not related to weight loss. But if somebody is having issues with their libido, but they're still of childbearing age, and I don't want to put them on testosterone supplementation because testosterone could lower your sperm count. If they're of childbearing age, I'll just use hcg. And that actually will bolster your sperm count and it bring up your testosterone level just not as aggressively as.

A purified exogenous testosterone will. Does that make sense?

Is HGC the better supplement?

Dr. HCG works. It does work well. People always hear about it. HCG is human chorionic gonadotropin.

Hcg? Yes. You may have heard about it in the context of the HCG diet, which is, I think, not a good diet for a variety of reasons. That's a topic of a whole other conversation. But hcg, testosterone is.

An analog to what's called lh, which is luteinizing hormone. Luteinizing hormone brings up a male sperm count, and it also stimulates the testicles to produce testosterone. So is it something that's better? It's not necessarily better. Is it equivalent? No, it's a little bit less of a robust response as opposed to just giving yourself the.

Injectable straight testosterone. But it does work on the body's physiology. So you're stimulating your own body to produce testosterone as opposed to overriding your body's testosterone production, which ultimately result in your body shutting down or slowing down the production of its own testosterone. Does that make sense?

Yeah.

So it's used by bodybuilders, like I said, after they come off the testosterone to bring their sperm counts back up and also to prevent some of the testicular atrophy that is seen in a low percentage of patients on testosterone.

Doctor, what about women? We sort of went into this tangent on men, but, you know, we've got female listeners, of course. What do they need to be concerned with here?

In the context of what?

Hormone replacement, I guess. You know, I mean, we talked about testosterone as that's a pretty common supplementation. It seems nowadays from other guests I've had on the show that a lot of people are talking about that. They're talking about human growth hormone. You know, what do women need to be thinking about along these lines?

Well, if they're having perimenopausal or postmenopausal hot flashes, vaginal dryness, issues with their libido, similar things that would. Similar things that men go through, through, they too are candidates for hormone replacement. And I will typically write them a combination of estrogen.

What'S known as B.I. s, which is a compounded estradio, estriol, transdermal cream. Progesterone, which is a pill taken at night. Typically you can get it in other types of forms, but I usually write it in a pill. And they too, are candidates for testosterone therapy. And these hormones or hormone replacement in properly selected patients works extremely well. Well, it can literally give you your youth and your life back.

As far as problems, there are problems with hormone replacement, and these are things that you need to discuss with your doctor. Some patients are very, very sensitive to estrogen. Some patients are very, very sensitive to progesterone. So these things need constant tweaking. The communication between the patient and doctor can't be understated because sometimes there are monthly or weekly fluctuations in one's requirement for estrogen, testosterone and progesterone. It's a little bit more difficult to obtain a balance in females as it is in males. In males, all you really have to worry about is the testosterone and then usually use something that will block the formation of estrogen which comes from testosterone. So we are trying to keep males testosterone up and their estradiol levels down, which is a little bit different than what we're trying to do in women. So women are a little bit more labor intensive from a physician standpoint, but nevertheless they do respond well to hormone replacement therapy in those that are properly selected.

Okay, good. Good stuff. Well, hey, give out your website and tell people where they can learn more.

Sure. My website is www.doctor Brett Osborne and that's B R E T T O S B-O-R-N.com and you can get the book there. And there are a variety of other health related topics and a blog that is updated at least once weekly on a topic which may or may not be appropriate for some versus the other because some of them are a bit esoteric. But nevertheless, there's something for everyone on there.

Well, thank you so much for joining us today. Dr. Brett Osborne, thanks so much for having me.

You have a great day.

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