Dr. Kyle Gillett: How to Optimize Your Hormones for Health & Vitality
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
Andrew Huberman:
安德鲁·休伯曼：
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
Today, my guest is Dr. Kyle Gillett.
今天，我的嘉宾是凯尔·吉列博士。
Dr. Gillett is dual board-certified in family medicine and obesity medicine and practices out of a clinic in Kansas and via telemedicine.
吉列医生获得了家庭医学和肥胖医学的双重委员会认证，并在堪萨斯州的一家诊所通过远程医疗进行执业。
He provides full-spectrum medicine including hormone health, preventive medicine, obstetrics, which is the branch of medicine and surgery concerned with childbirth and the care of women giving birth, and pediatrics.
他提供全方位的医学服务，包括激素健康、预防医学、产科（与分娩和妇女分娩护理有关的医学和外科分支）以及儿科。
Andrew Huberman:
安德鲁·休伯曼：
I first learned about Dr. Gillett from a podcast, of all things, and was immediately struck by the breadth and depth of his knowledge on all things hormones and hormone optimization.
我第一次从播客中了解到吉列博士，并立即被他在激素和激素优化方面知识的广度和深度所震惊。
As you'll see very soon today, Dr. Gillett can teach you how to optimize your hormones using behavioral tools, nutrition, exercise-based tools, supplementation, and hormone therapies if those are appropriate for you.
正如您今天很快就会看到的那样，吉列医生可以教您如何使用行为工具、营养、基于运动的工具、补充剂和激素疗法（如果适合您的话）来优化您的激素。
There are many professionals out there, including many medical doctors, of course, talking about hormone health.
当然，有很多专业人士，包括很多医生，都在谈论激素健康。
What really sets Dr. Gillett apart from the pack is his ability to understand how the different factors that I described before, nutrition, supplementation, exercise, and hormone therapies, how those interact with one another, and the safest and most rational ways to approach hormone optimization.
吉列博士真正与众不同的是，他能够理解我之前描述的不同因素，营养、补充剂、运动和激素疗法，这些因素如何相互作用，以及实现激素优化的最安全、最合理的方法。
Andrew Huberman:
安德鲁·休伯曼：
During today's episode, you will learn how to optimize your hormones, not just testosterone and estrogen, but also prolactin and other hormone pathways that impact your mood, mental health, and physical health.
在今天的节目中，您将学习如何优化您的激素，不仅是睾酮和雌激素，还有催乳素和其他影响您的情绪、心理健康和身体健康的激素途径。
Dr. Gillett is also an avid educator about hormones and other aspects of health.
吉列博士还是一位热衷于激素和健康其他方面的教育家。
He does this on zero-cost-to-consumer platforms such as Instagram and other social media.
他在 Instagram 和其他社交媒体等消费者零成本平台上做到了这一点。
On Instagram, he is kylegillettmd.
在 Instagram 上，他是 kylegillettmd。
That's K-Y-L-E-G-I-L-L-E-T-T, no E at the end, M-D.
即 K-Y-L-E-G-I-L-L-E-T-T，末尾没有 E，M-D。
So, kylegillettmd on Instagram, and he is gilletthealth on all other platforms, including LinkedIn, Twitter, YouTube, TikTok and Facebook.
因此，Instagram 上的 kylegillettmd，以及所有其他平台上的 giletthealth，包括 LinkedIn、Twitter、YouTube、TikTok 和 Facebook。
If you go to his Instagram or his other social media, you will learn a lot about hormone health, about the latest science impacting obesity and metabolic health.
如果你访问他的 Instagram 或其他社交媒体，你会学到很多关于激素健康、影响肥胖和代谢健康的最新科学知识。
He is a wealth of knowledge, and, again, he's providing all that information at zero cost to you, the consumer.
他拥有丰富的知识，并且他以零成本向您（消费者）提供所有这些信息。
Andrew Huberman:
安德鲁·休伯曼：
What you are soon to hear is a conversation between me and Dr. Gillett about all things hormones, and hormone health, and hormone optimization.
您很快就会听到我和吉列博士之间关于激素、激素健康和激素优化的所有话题的对话。
We dive deep into mechanisms, but we are clear to establish what each word or set of concepts mean.
我们深入研究机制，但我们清楚地确定每个单词或一组概念的含义。
So if you have no background in biology, or even if you do, I'm sure that you'll come away with a wealth of valuable knowledge.
因此，如果您没有生物学背景，或者即使您有生物学背景，我相信您也会获得大量有价值的知识。
We also talk about specific protocols related, again, to lifestyle factors, nutrition, supplementation, and, where appropriate, hormone-replacement therapy.
我们还讨论了与生活方式因素、营养、补充以及适当情况下的激素替代疗法相关的具体方案。
I know there's a lot of interest about these topics.
我知道人们对这些话题很感兴趣。
Dr. Gillett is very thorough about addressing both male and female issues and addressing hormone health for people at all stages of life.
吉列博士非常彻底地解决男性和女性问题以及生命各个阶段的人们的荷尔蒙健康问题。
I'm sure that you'll come away from this episode with the same impression that I did, which is that Dr. Gillett is an extraordinarily clear communicator, and that he has tremendous compassion for his patients, and that he has a deep love of understanding biology and medicine in ways that can benefit you.
我相信看完这一集你会得到和我一样的印象，那就是吉列医生是一位非常清晰的沟通者，他对病人充满同情心，并且他非常热爱以有益于你的方式理解生物学和医学。
Andrew Huberman:
安德鲁·休伯曼：
Before we begin with today's episode, I want to emphasize that this podcast is separate from my teaching and research roles at Stanford.
在我们开始今天的节目之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是将有关科学和科学相关工具的零成本消费者信息带给公众。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
Today's episode is also brought to us by InsideTracker.
今天的节目也是由 InsideTracker 为我们带来的。
InsideTracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you reach your health goals.
InsideTracker 是一个个性化营养平台，可分析您的血液和 DNA 数据，帮助您更好地了解您的身体并帮助您实现健康目标。
I've long been a believer in getting regular blood work done, for the simple reason that many of the factors that impact your immediate and long-term health can only be analyzed from a quality blood test.
长期以来，我一直坚信定期进行血液检查，原因很简单，影响您当前和长期健康的许多因素只能通过高质量的血液测试来分析。
Andrew Huberman:
安德鲁·休伯曼：
There are a lot of blood and DNA tests out there, but a major issue with many of them is that you get numbers back about levels of hormones, metabolic factors, lipids, et cetera but you don't know what to do with that information.
目前有很多血液和 DNA 测试，但其中许多测试的一个主要问题是，你得到有关激素、代谢因素、血脂等水平的数据，但你不知道如何处理这些信息。
InsideTracker has solved that problem by creating a personalized dashboard.
InsideTracker 通过创建个性化仪表板解决了这个问题。
You take your blood and/or your DNA test, you get the results back, and where certain values might be too high or too low for your preference, you can click on that and it will direct you immediately to lifestyle factors and nutrition and supplementation, et cetera that can help you bring those numbers back into the ranges that are ideal for you.
你进行血液和/或 DNA 测试，然后得到结果，如果某些值对于你的偏好来说可能太高或太低，你可以点击它，它会立即引导你了解生活方式因素、营养和补充品等，帮助你将这些数字恢复到最适合你的范围。
It not only gives you information about where your health stands, it gives you directives as to how to improve your health.
它不仅为您提供有关您的健康状况的信息，还为您提供如何改善健康的指导。
If you'd like to try InsideTracker, go to insidetracker.com/huberman to get 20% off any of InsideTracker's plans.
如果您想尝试 InsideTracker，请访问 insidetracker.com/huberman，享受任何 InsideTracker 计划 20% 的折扣。
That's insidetracker.com/huberman to get 20% off.
访问 insidetracker.com/huberman 可享受 20% 的折扣。
Andrew Huberman:
安德鲁·休伯曼：
Now, for my discussion about hormone health and optimization with Dr. Kyle Gillett.
现在，我与凯尔·吉列博士讨论荷尔蒙健康和优化。
Andrew Huberman:
安德鲁·休伯曼：
Dr. Gillett, welcome.
吉列博士，欢迎光临。
Kyle Gillett:
凯尔·吉列：
Thank you for having me.
谢谢你有我。
Andrew Huberman:
安德鲁·休伯曼：
Well, I'm super excited to talk to you because I found out about you on a podcast and it immediately became clear that you are an encyclopedia of knowledge about hormone health for men and for women across the lifespan.
嗯，我非常高兴能与您交谈，因为我在播客上发现了您，并且立即意识到您是关于男性和女性一生中激素健康的知识百科全书。
I have many, many questions, but before we dive into those questions, I'd love to just get a little bit of your background in terms of your medical training and what your particular orientation is toward treating your patients.
我有很多很多问题，但在我们深入探讨这些问题之前，我想先了解一下您的医疗培训背景以及您治疗患者的具体方向。
How do you think about this whole landscape that we call hormone health?
您如何看待我们称之为激素健康的整个景观？
What is a hormone?
什么是激素？
How do you envision people managing their hormones?
您认为人们如何管理荷尔蒙？
If you could just fill in a few of those blanks for us, I think a lot of people would appreciate it.
如果您能为我们填补其中一些空白，我想很多人都会很感激。
Kyle Gillett:
凯尔·吉列：
Absolutely.
绝对的。
I'm dual board-certified in family medicine and obesity medicine.
我获得了家庭医学和肥胖医学的双重委员会认证。
I've kind of tailored my training in order to provide what I call a balanced approach to total health, which includes body, mind and soul.
我对我的训练进行了量身定制，以便提供我所说的全面健康的平衡方法，包括身体、思想和灵魂。
I recently saw a podcast with Joe Rogan and Mr. Beast, and Joe asks Mr. Beast, "How do you become such an amazing YouTuber and have all these great click-bait videos, and how did you become good at it?" It turns out he just became obsessed when he was a teenager, and that's essentially how I've tailored my education as well.
我最近看了 Joe Rogan 和 Beast 先生的播客，Joe 问 Beast 先生：“你是如何成为如此出色的 YouTuber 并拥有所有这些精彩的点击诱饵视频的？你是如何变得擅长的？”事实证明，他在十几岁的时候就开始着迷，这基本上也是我调整我的教育的方式。
I've become obsessed with optimal human performance, their body, their mind, and even their spirit.
我对人类的最佳表现、他们的身体、他们的思想，甚至他们的精神着迷。
Kyle Gillett:
凯尔·吉列：
I attended med school at the University of Kansas, which is one of the few med schools that still emphasizes full-spectrum care.
我就读于堪萨斯大学医学院，这是少数仍然强调全方位护理的医学院之一。
They emphasize exercise is medicine.
他们强调运动是良药。
They emphasize food is medicine, of which I was active in both of those interest groups.
他们强调食物就是药物，我在这两个兴趣小组中都很活跃。
In residency, I was active in a lot of mindfulness curriculum and then also things like Walk with a Doc, where you emphasize preventative medicine.
在住院医师实习期间，我积极参加了很多正念课程，还有像“与医生同行”这样强调预防医学的课程。
That's something that we've kind of got away from, and that niche led me to hormone health.
这是我们已经摆脱的东西，而这个利基引导我走向荷尔蒙健康。
It didn't really start as hormone health, but it's a very important component of health in general that many people don't emphasize.
它并不是真正从激素健康开始，但它是一般健康的一个非常重要的组成部分，但很多人都没有强调。
Andrew Huberman:
安德鲁·休伯曼：
Great.
太棒了。
Well, this idea of preventative medicine, I think, is starting to really take hold in the general population, especially given the events of the last few years.
嗯，我认为，这种预防医学的想法已经开始真正在普通人群中扎根，特别是考虑到过去几年发生的事件。
People realize that they are showing up to health challenges at a bunch of different levels and with some people feeling very robust, other people feeling back on their heels.
人们意识到，他们正面临着一系列不同层面的健康挑战，有些人感觉非常健康，而另一些人则感觉疲惫不堪。
When someone comes to you as a patient, what are some of the first things that you want to know about them?
当某人作为病人来找您时，您首先想了解他们的哪些事情？
Obviously, you want to know their blood pressure, you want to know something about their mental health and family history, but in terms of hormone health, what are the sorts of probe questions that you ask, and what are you looking for?
显然，您想了解他们的血压，您想了解他们的心理健康和家族史，但就激素健康而言，您会提出哪些类型的探究问题，以及您在寻找什么？
I ask this because I'd like people to be able to ask some of these very same questions for themselves.
我问这个问题是因为我希望人们能够自己问一些同样的问题。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
When you do a physical exam and a history, you have a lot of different parts.
当您进行体检和病史检查时，您会发现很多不同的部分。
You have your history of present illness, if they have a complaint.
如果他们有投诉，您有您目前的病史。
Maybe the patient doesn't have a complaint.
也许病人没有抱怨。
In that case, things like their social history and their family history are extremely important because that gives you an insight into their genetics and insight into their hormone health.
在这种情况下，他们的社会史和家族史等事情就非常重要，因为这可以让您深入了解他们的遗传学和激素健康状况。
Patients will tell me, "Oh, I'm doing okay," but it helps to ask them, "Well, how are you now?" Let's say the patient is 50.
病人会告诉我，“哦，我做得很好”，但问他们“嗯，你现在怎么样？”会有所帮助。假设病人今年 50 岁。
"How are you now versus when you were 20, and what has changed?"
“你现在和20岁时相比怎么样，有什么变化吗？”
Kyle Gillett:
凯尔·吉列：
I've gotten the question a lot, "How do you get your doctor to order a better lab workup or to even include your basic hormones?" There's no magic answer to that, but what really helps is you tell them, "My energy is not as good as it used to be.
我经常被问到这样的问题：“你如何让你的医生安排更好的实验室检查，甚至包括你的基本激素？”这个问题没有神奇的答案，但真正有帮助的是你告诉他们：“我的精力不像以前那么好。
My focus is not as good as it used to be.
我的注意力不像以前那么好。
My athletic performance is not as good as it used to be." You don't have to have a pathology in order for a lab to be indicated.
我的运动表现不如以前了。”您不必有病理学即可指定实验室。
You just need to have that pertinent symptom.
您只需要有相关症状即可。
Andrew Huberman:
安德鲁·休伯曼：
I think this is going to be really helpful because for many people, the idea of getting a blood test to look at their hormones just seems like such an enormous hurdle to get over, and many doctors won't prescribe them.
我认为这真的很有帮助，因为对许多人来说，进行血液检查来检查荷尔蒙的想法似乎是一个需要克服的巨大障碍，而且许多医生不会开这种药。
Would you say, using the approach you just described, that it's equally effective for men and women, or do you find that, for one reason or another, that men and women have different challenges and advantages in trying to access their deeper hormone data?
您是否会说，使用您刚才描述的方法，它对男性和女性同样有效，或者您是否发现，出于某种原因，男性和女性在尝试获取更深入的激素数据时面临不同的挑战和优势？
Kyle Gillett:
凯尔·吉列：
Yeah, it's slightly different.
是的，略有不同。
With women, there's a lot more objective data.
对于女性来说，有更多客观数据。
If they're having menstrual irregularities or if they're going in ...
如果她们有月经不规律或者如果她们要...
If they're not having a period, if they're having too heavy of periods, then those are things that they talk about very frequently with their doctor.
如果她们没有来月经，或者月经量过多，那么她们会经常与医生谈论这些事情。
Men are more hesitant.
男性则比较犹豫。
Men really want to know what their testosterone is, but, at the same time, they really don't want to tell their doctor how their libido is or how their energy is because it's almost like they feel less masculine or they feel less like a guy when they say that, even if they're just talking to their doctor about it.
男人真的想知道他们的睾丸激素是什么，但同时，他们真的不想告诉医生他们的性欲如何或他们的能量如何，因为当他们这么说时，他们几乎感觉自己不太男性化，或者感觉不像一个男人，即使他们只是在和医生谈论这件事。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
I think that that raises a really important point, which is that the whole discussion around hormone health is a bit of a barbed-wire topic because, in many ways, when we hear the word hormone, we think testosterone and estrogen; we think notions of masculinity and femininity.
我认为这提出了一个非常重要的观点，那就是围绕激素健康的整个讨论有点像铁丝网话题，因为在很多方面，当我们听到激素这个词时，我们会想到睾酮和雌激素;我们思考男性气质和女性气质的概念。
Of course, testosterone and estrogen are present in all sexes, all chromosomal backgrounds, and just to varying degrees and ratios.
当然，睾酮和雌激素存在于所有性别、所有染色体背景中，只是程度和比例不同。
It also raises all these issues about sexual health that ...
它还提出了所有这些有关性健康的问题......
It's kind of interesting because I'm surrounded by medical doctors in my lab at Stanford, and the more physicians that I surround myself with, the more open is the discussion around sexual health and reproductive health.
这很有趣，因为我在斯坦福大学的实验室里周围都是医生，而且我身边的医生越多，关于性健康和生殖健康的讨论就越开放。
In the general population, I think, some of these topics are a little bit taboo or, again, just kind of barbed wire, so I think that people are seeking a lot of this information on YouTube and through communities that may or may not be very educated about the actual biology.
我认为，在一般人群中，其中一些话题有点禁忌，或者只是一种铁丝网，所以我认为人们正在 YouTube 上以及通过可能对实际生物学了解甚少的社区寻找大量此类信息。
Andrew Huberman:
安德鲁·休伯曼：
Along those lines, we could probably assume that hormones are changing across the lifespan; certainly from childhood and puberty and onward.
沿着这些思路，我们可以假设荷尔蒙在整个生命周期中都在变化。当然是从童年和青春期开始。
If you would, I'd love to just take a snapshot of what you think everybody should be thinking about or doing to optimize their hormone health, male or female; let's say in their 20s.
如果您愿意，我很乐意简单介绍一下您认为每个人都应该考虑或采取哪些措施来优化荷尔蒙健康，无论男性还是女性；假设他们20多岁。
Then, maybe we can migrate that to their 30s and 40s.
然后，也许我们可以将其迁移到他们的 30 多岁和 40 多岁。
Before that, could you just tell us what everyone should be doing for their hormone health from puberty onward?
在此之前，您能告诉我们从青春期开始每个人都应该为荷尔蒙健康做些什么吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
The law of diminishing returns applies.
收益递减法则适用。
Doing a little amount of what I call lifestyle interventions over a long period of time is going to be far more helpful or efficacious than doing a lot and then doing nothing.
长期进行少量我所说的生活方式干预，会比做很多事情然后什么都不做更有帮助或更有效。
I talk about the big six pillars.
我谈论六大支柱。
The two strongest ones are likely diet and exercise.
最有力的两个可能是饮食和运动。
For hormone health, specifically, resistance training is particularly helpful.
具体来说，对于荷尔蒙健康来说，阻力训练特别有帮助。
For diet, caloric restriction can be particularly helpful, especially with the epidemic of metabolic syndrome that is continuing to ongo in this country and in developed countries in general.
对于饮食来说，热量限制特别有帮助，特别是在代谢综合征在这个国家和整个发达国家持续流行的情况下。
Those are the two most powerful.
他们是最强大的两个。
Number one and number two are diet and exercise.
第一和第二是饮食和运动。
Kyle Gillett:
凯尔·吉列：
For the last four, I have a little bit of alliteration.
对于最后四个，我有一点头韵。
There's stress and stress optimization.
有压力和压力优化。
That has to do with cortisol.
这与皮质醇有关。
That has to do with your mental health.
这与你的心理健康状况有关。
That has to do with societal health, and collective health of your family as well.
这与社会健康以及家庭的集体健康有关。
When you're a member of a family or even a very close friend, trying to achieve optimal health together is very important.
当您是家庭成员甚至是非常亲密的朋友时，努力共同实现最佳健康非常重要。
It's the same thing with nicotine cessation.
戒烟也是如此。
It's the same thing with hormone optimization.
激素优化也是如此。
If you do it as a household unit, it's far more helpful.
如果您以家庭为单位进行此操作，则会更有帮助。
Kyle Gillett:
凯尔·吉列：
After stress, you have sleep optimization.
压力过后，您可以优化睡眠。
Sleep is extremely important, especially for mitochondrial health as well.
睡眠极其重要，尤其是对于线粒体健康而言。
Then you have sunlight, which encompasses anything that's outdoors.
然后就是阳光，它涵盖了户外的一切。
You move more.
你多动动。
You have cold exposure.
你暴露在寒冷中。
You have heat exposure.
您暴露在高温下。
That's sunlight.
那是阳光。
Then, the last one is spirit.
然后，最后一个是精神。
That's kind of the body, mind and soul.
这就是身体、思想和灵魂。
If you have all the other five and they're dialed in completely but you don't have your spiritual health, whatever you believe, then that's going to profoundly impact your body and your mind as well.
如果你拥有所有其他五个并且它们完全拨通，但你没有精神健康，无论你相信什么，那么这也会对你的身体和思想产生深远的影响。
Andrew Huberman:
安德鲁·休伯曼：
We're definitely going to touch into this notion of spiritual health because I think for some people, that might draw connotations of certain things that may or may not be accurate.
我们肯定会触及精神健康的概念，因为我认为对于某些人来说，这可能会引出某些可能准确或不准确的事物的含义。
I know a number of academic laboratories that are focused on this and a number of not just functional medicine clinics but research clinics and hospitals throughout the country that are achieving some really interesting data, not just in people that are quite sick but in healthy people who are trying to further optimize health.
我知道许多专注于此的学术实验室，以及全国各地的许多研究诊所和医院，不仅是功能医学诊所，而且是研究诊所和医院，他们正在获得一些非常有趣的数据，不仅是在病重的人身上，而且是在试图进一步优化健康的健康人身上。
So we will definitely touch back to that.
所以我们肯定会回过头来讨论这一点。
Andrew Huberman:
安德鲁·休伯曼：
If you would be so kind as to maybe give us a little bit more detail about some of these other areas.
如果您愿意向我们提供有关其他一些领域的更多详细信息。
When people hear diet, I immediately think, "Okay, now we get into the combat around vegan, plant-based, carnivore, et cetera," but I think that my general view of this is that most people should probably be eating as few highly processed foods, highly palatable foods, as possible, which doesn't mean eating foods that don't taste good, of course.
当人们听到饮食时，我立即想，“好吧，现在我们开始围绕纯素食、植物性食品、肉食动物等展开斗争”，但我认为我对此的总体看法是，大多数人可能应该尽可能少吃高度加工的食品、高度适口的食品，当然，这并不意味着吃味道不好的食物。
What other sorts of things do you recommend in the realm of diet?
在饮食领域你还推荐哪些其他的东西？
Then, I also want to know about caloric restriction because my understanding is that a caloric surplus can actually support certain hormones like testosterone.
然后，我还想了解热量限制，因为我的理解是热量盈余实际上可以支持某些激素，例如睾酮。
How does one combine caloric restriction and still optimize hormones?
如何将热量限制与优化荷尔蒙结合起来？
What would you say is a really terrific way to think about and approach diet?
您认为思考和对待饮食的真正绝佳方式是什么？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Diet should be an individualized approach.
饮食应该是个体化的方法。
If you have a car, each car is made different and requires a different sort of fuel.
如果您有一辆车，每辆车的制造方式都不同，并且需要不同类型的燃料。
Whether it's a race car, whether it's a diesel truck, they have different fuels for different performance outcomes: so, if you're trying to tow something or you're trying to go fast.
无论是赛车，还是柴油卡车，它们都使用不同的燃料来实现不同的性能结果：因此，如果您想牵引某物或想开得更快。
It's the same way with athletes.
运动员也是如此。
It's pretty well studied the more intra-workout carbs ultra-long-distance athletes take, in general they do better.
研究表明，超长距离运动员在训练中摄入的碳水化合物越多，一般来说他们的表现就越好。
I think they've studied this in cyclists quite often.
我认为他们经常对骑自行车的人进行研究。
It also depends on your genetics.
这也取决于你的基因。
You can have a genetic polymorphism and you metabolize carbs and sugar better, even when they're unopposed by fiber.
你可以拥有基因多态性，并且可以更好地代谢碳水化合物和糖，即使它们不受纤维的阻碍。
Andrew Huberman:
安德鲁·休伯曼：
How does one determine whether or not they have such a polymorphism?
如何判断它们是否具有这种多态性呢？
I've an omnivore, so I do eat some high-quality meats, not in huge quantities, but I also eat vegetables and starches.
我是杂食动物，所以我确实吃一些优质的肉类，但数量不多，但我也吃蔬菜和淀粉。
I feel fine.
我感觉很好。
I've never done an elimination diet.
我从来没有进行过消除饮食。
I think I did a very-low-carb diet once, and all it gave me was a lot of psoriasis and poor sleep, so I backed off.
我想我曾经做过一次非常低碳水化合物的饮食，但它给我带来的只是很多牛皮癣和睡眠质量不佳，所以我放弃了。
I probably didn't do it correctly, but I know a lot of people that do quite well on a very-low-carb or a zero-carb diet.
我可能做得不对，但我知道很多人在极低碳水化合物或零碳水化合物饮食中表现得很好。
Kyle Gillett:
凯尔·吉列：
Yeah, particularly those who are at risk of cancer, because you have less glucose that can be easily uptaken into cells, and then also people with autoimmune diseases.
是的，特别是那些有患癌症风险的人，因为细胞中容易吸收的葡萄糖较少，还有患有自身免疫性疾病的人。
Andrew Huberman:
安德鲁·休伯曼：
They tend to do well on-
他们往往在以下方面表现出色——
Kyle Gillett:
凯尔·吉列：
On lower-carb diets.
低碳水化合物饮食。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
As far as the "how do you know," basically you can use your biofeedback, how you're feeling, to guess what you tolerate well.
至于“你怎么知道”，基本上你可以利用你的生物反馈，你的感受，来猜测你能很好地忍受什么。
Or you can just get genetic testing, which can be fairly expensive, but most of all, it requires a physician or someone who knows how to interpret the test accurately.
或者您也可以进行基因检测，这可能相当昂贵，但最重要的是，它需要医生或知道如何准确解释测试的人。
Andrew Huberman:
安德鲁·休伯曼：
If someone had the means, would you say that getting regular blood testing is a good idea?
如果有人有办法，你会说定期验血是个好主意吗？
If so, what is regular blood testing?
如果是的话，什么是定期验血？
Is it every three months?
是每三个月一次吗？
Is it every six months?
是每六个月一次吗？
Of course, the backdrop of life is changing too; stress levels, et cetera.
当然，生活的背景也在发生变化。压力水平等。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Every three to six months for preventative purposes.
出于预防目的，每三到六个月一次。
At times, you need blood tests at faster frequencies than that.
有时，您需要比这更快的频率进行血液检查。
Then, you should also get a blood test when you're fasting and when you're not fasting.
然后，您还应该在禁食和非禁食时进行血液检查。
If you're looking for damage to the beach, you don't just look at low tide.
如果您要查找海滩的损坏程度，您不能仅查看退潮情况。
You look at high tide, and you see what's happening at high tide as well.
你观察涨潮，你也会看到涨潮时发生的事情。
Andrew Huberman:
安德鲁·休伯曼：
That's a great way to put it.
这是一个很好的表达方式。
In terms of general recommendations around exercise, I'm of the mind, based on the data that I've seen, that almost everybody, or everybody, should be getting 150-180 minutes minimum of zone 2 cardio per week, the kind of ...
就锻炼的一般建议而言，根据我所看到的数据，我认为几乎每个人或每个人都应该每周至少进行 150-180 分钟的 2 区有氧运动，这种……
could continue while having a conversation, but if one were to exert any more effort, they would have a hard time getting the words out.
说话的时候还可以继续说下去，但是再用力的话，就很难把话说出口了。
At least that for cardiovascular health, and general brain health, and musculoskeletal health, plus resistance exercise.
至少对于心血管健康、一般大脑健康、肌肉骨骼健康以及抗阻运动来说是这样。
Is that more or less the contour of what you recommend?
这或多或少是你推荐的轮廓吗？
Kyle Gillett:
凯尔·吉列：
Yeah, that's more or less the contour.
是的，这或多或少是轮廓。
The more you're doing your zone 2 cardiovascular exercise, the slightly less important a long-duration of caloric restriction is.
您进行 2 区心血管运动的次数越多，长期热量限制的重要性就越小。
Andrew Huberman:
安德鲁·休伯曼：
Interesting, and that brings us the caloric restriction.
有趣的是，这给我们带来了热量限制。
It's very clear that caloric restriction can allow one to lose weight.
很明显，热量限制可以让人减肥。
This is the classic CICO, C-I-C-O: calories in, calories out.
这是经典的 CICO，C-I-C-O：卡路里输入，卡路里输出。
We are not disputing calories, in calories out.
我们不是在争论卡路里，而是卡路里的消耗。
Somehow, that always has to be stated 50 times in any forum because of whatever follows.
不知何故，由于以下原因，在任何论坛上总是必须声明 50 次。
People, I think, will anchor to and assume that we don't mean that, but I know you and I both agree on calories in, calories out as a fundamental law of thermodynamics.
我认为，人们会认为我们不是这个意思，但我知道你和我都同意卡路里输入和卡路里输出是热力学的基本定律。
It's clear to me that, based on what I've read, that when one is in a slight caloric surplus, that hormones like testosterone can be optimized, but is that true for somebody who's showing up with excessive body fat?
根据我所读到的内容，我很清楚，当一个人的热量略有盈余时，睾酮等激素可以得到优化，但对于身体脂肪过多的人来说是这样吗？
How does this all work?
这一切是如何运作的？
Body fat is manufacturing enzymes that convert testosterone to estrogen.
身体脂肪正在制造将睾酮转化为雌激素的酶。
In other words, how does someone know if they should use caloric restriction or avoid caloric restriction?
换句话说，人们如何知道他们是否应该限制热量或避免热量限制？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Here's how to parse that out.
以下是如何解析它。
Before I delve into the details a bit more, I should say, as a board-certified obesity medicine physician, obviously the laws of thermodynamics apply.
在深入研究细节之前，我应该说，作为一名经过委员会认证的肥胖医学医师，显然热力学定律适用。
Then, in addition to that, there is nothing special about intermittent fasting, or caloric restriction, or exercise, when it pertains to losing body weight in general.
除此之外，间歇性禁食、热量限制或锻炼对于一般减肥来说并没有什么特别之处。
When you do lose weight, about 33% of that is lean body mass, and about 10% of fat cells, adipose cells, are actually lean body mass as well because it has proteins and water and things like that in it too.
当你减肥时，大约 33% 是去脂体重，大约 10% 的脂肪细胞实际上也是去脂体重，因为它也含有蛋白质和水以及类似的东西。
Kyle Gillett:
凯尔·吉列：
The reason for exercise and the reason for caloric restriction in general, including intermittent fasting, is health reasons.
锻炼的原因和一般热量限制的原因（包括间歇性禁食）都是出于健康原因。
That's how you increase your health span.
这就是延长健康寿命的方法。
It's not necessarily going to make the weight on the scale change, but that doesn't matter as much.
这不一定会使秤上的重量发生变化，但这并不重要。
It's been fairly well studied in both mice and humans.
它在小鼠和人类身上都得到了相当充分的研究。
It's much easier to study in mice.
在小鼠身上进行研究要容易得多。
That's a precursor to our six types of people: the ones that care about my studies and the ones that care about human studies.
这就是我们六种人的前身：关心我的研究的人和关心人类研究的人。
If you calorically restrict mice by 40%, then they can have improved testosterone parameters, but only if they're obese to start, and it appears to be that same way in humans as well.
如果你将小鼠的热量限制 40%，那么它们的睾酮参数就可以得到改善，但前提是它们一开始就肥胖，而且对于人类来说似乎也是如此。
Kyle Gillett:
凯尔·吉列：
The easy way to think about it is if you're obese or you have metabolic syndrome, caloric restriction will improve your testosterone.
简单的思考方法是，如果您肥胖或患有代谢综合征，热量限制会提高您的睾酮水平。
There has been a study, and they talk about all these studies in a systematic review from the Mayo Clinic Proceedings, in March of last year.
有一项研究，他们在去年三月的《梅奥诊所会议录》的系统综述中讨论了所有这些研究。
They note that there is a study in young healthy men.
他们指出，有一项针对年轻健康男性的研究。
They calorically restrict them, and their testosterone does decrease.
他们限制热量摄入，睾酮水平确实下降。
If you're young and healthy and you don't have metabolic syndrome, then caloric restriction will likely decrease your testosterone.
如果您年轻、健康并且没有代谢综合征，那么热量限制可能会降低您的睾酮水平。
Andrew Huberman:
安德鲁·休伯曼：
That clarifies a lot for me, and I believe it will clarify a lot for other people as well.
这对我来说澄清了很多，我相信它也会对其他人澄清很多。
I'm delighted that you pointed out this distinction about intermittent fasting not being the only way to achieve caloric restriction.
我很高兴您指出间歇性禁食并不是实现热量限制的唯一方法。
There are a number of young healthy or older healthy people I know who like using intermittent fasting, even if they're not trying to lose weight, for a couple of reasons.
我认识的许多健康的年轻人或健康的老年人喜欢间歇性禁食，即使他们并不想减肥，原因有几个。
Some believe that it might extend lifespan.
有些人认为它可以延长寿命。
I think that's still a bit of an open question.
我认为这仍然是一个悬而未决的问题。
It's a bit of a hard experiment to do because no one wants to be in the control group, as I say.
这是一项有点困难的实验，因为正如我所说，没有人愿意成为对照组。
Kyle Gillett:
凯尔·吉列：
It does in mice.
在老鼠身上也是如此。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Exactly.
确切地。
Kyle Gillett:
凯尔·吉列：
Captive audience.
俘虏观众。
Andrew Huberman:
安德鲁·休伯曼：
Exactly.
正是如此。
The other feature of it that's a little bit tricky is that many people like intermittent fasting because of the mental effects — the clarity of mind that they feel during fasting, the increased pleasure in eating when they finally do eat.
它的另一个有点棘手的特点是，许多人喜欢间歇性禁食，因为它会对精神产生影响——禁食期间他们会感到头脑清晰，当他们最终吃东西时会增加进食的乐趣。
Here, I'm referring to intermittent fasting of the sort where eating windows are anywhere from 8 to 12 hours a day, not extended fasts of 24 hours or more.
在这里，我指的是间歇性禁食，即每天的进食时间为 8 至 12 小时，而不是 24 小时或更长时间的延长禁食。
The question, therefore, is for the healthy, lean-enough person, nonobese person, is intermittent fasting a bad idea in terms of hormone health?
因此，问题是，对于健康、足够瘦的人、非肥胖者来说，间歇性禁食对于激素健康来说是一个坏主意吗？
Is oscillating between this period of feast and famine within a 24 hours a problem if one is getting sufficient calories to maintain weight?
如果一个人摄入了足够的热量来维持体重，那么在 24 小时内的盛宴和饥荒之间摇摆会是一个问题吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
If they're in a caloric maintenance, then it's not going to be deleterious.
如果他们正在进行热量维持，那么这不会是有害的。
It's not going to be bad for their hormone health.
这不会对他们的荷尔蒙健康有害。
There's a couple different hormones that we can talk about.
我们可以讨论几种不同的激素。
We can talk about testosterone; we can talk about DHEA, which usually go hand in hand.
我们可以谈论睾丸激素；我们可以谈论 DHEA，它们通常是齐头并进的。
Then, we can also talk about growth hormone, which is not a steroid hormone, but it's a peptide hormone.
然后，我们还可以谈谈生长激素，它不是类固醇激素，而是一种肽激素。
It's a chain of proteins, amino acids that are put together instead of a sterol.
它是由蛋白质、氨基酸组成的链，而不是甾醇。
Think of sterol hormones as coming from cholesterol.
将甾醇激素视为来自胆固醇。
Intermittent fasting, you do get a little spike in growth hormone after you eat, but you also get a huge spike in growth hormone, a more significant, less negligible spike, overnight.
间歇性禁食，进食后生长激素确实会出现一点峰值，但在一夜之间，生长激素也会出现巨大的峰值，这是一个更显着、更不可忽略的峰值。
That is improved if you are intermittent fasting, so it's probably going to help your growth hormone and, subsequently, IGF-1 levels, which will help more in the older age groups than younger age groups.
如果您进行间歇性禁食，这种情况会得到改善，因此它可能会帮助您提高生长激素，进而提高 IGF-1 水平，这对老年组的帮助比年轻组更大。
Andrew Huberman:
安德鲁·休伯曼：
I like to eat dinner.
我喜欢吃晚饭。
For me, that means sometime around six or seven o'clock.
对我来说，这意味着六点或七点左右的某个时间。
Sometimes eight o'clock.
有时八点。
I confess, last night, because I was working late, I ate pretty big.
我承认，昨晚因为工作到很晚，我吃得很大。
It was basically my only meal of the day, at 10 o'clock.
这基本上是我一天中唯一的一餐，十点钟。
That's a rare thing for me.
这对我来说是一件罕见的事情。
Can I still achieve a high degree of growth-hormone output if, let's say, I avoid food in the two to three hours before going to sleep, or does one have to be very deep into a fast in order to achieve the increase in growth hormone?
比方说，如果我在睡觉前两到三个小时内避免进食，或者我是否必须进行非常深入的禁食才能实现生长激素的增加，我是否仍然可以实现高水平的生长激素输出？
Kyle Gillett:
凯尔·吉列：
There's still pretty good growth-hormone output even if you eat two or three hours before you sleep.
即使你在睡觉前两三个小时吃东西，仍然会产生相当好的生长激素。
It's just the law of diminishing returns: the longer you go, you get slightly more and slightly more.
这就是收益递减法则：走的时间越长，你得到的就会越来越多。
Andrew Huberman:
安德鲁·休伯曼：
Great.
太棒了。
I know a number of people think of growth hormone in the context of the exogenous growth hormone and the fact that that can, in some cases, be associated with cancers.
我知道很多人在外源性生长激素的背景下想到生长激素，事实上，在某些情况下，生长激素可能与癌症有关。
I've been asked many times before, "Can the increase in growth hormone from things like saunas or intermittent fasting cause levels of growth hormone that are so high that they cause cancers?" My impulse is to say, "No. That seems like it's not likely to happen," but I should probably verify that statement with you.
以前曾多次有人问我：“桑拿或间歇性禁食等活动导致的生长激素增加是否会导致生长激素水平过高，从而导致癌症？”我的冲动是说：“不。这似乎不太可能发生”，但我可能应该与您核实一下这一说法。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Quite unlikely.
不太可能。
I think about growth hormone, and especially IGF-1 ...
我想到了生长激素，尤其是 IGF-1...
There's actually an IGF-1 and IGF-2, but I think about it in terms of endocrine IGF-1, mostly IGF-1 that's synthesized in the liver and released in the liver, versus IGF-1 that's released classically.
实际上有 IGF-1 和 IGF-2，但我从内分泌 IGF-1 的角度来考虑，主要是在肝脏中合成并在肝脏中释放的 IGF-1，而不是传统释放的 IGF-1。
An example of this would be your IGF-1 levels increase after resistance training or exercise.
例如，抗阻训练或运动后 IGF-1 水平会增加。
That's more of like paracrine or autocrine, and they have more local action.
这更像是旁分泌或自分泌，而且它们有更多的局部作用。
That IGF-1, it's pretty well studied that if you just give people IGF-1, at physiologic levels it's not going to improve their body composition.
IGF-1，经过充分研究表明，如果您只是给人们提供 IGF-1，在生理水平上不会改善他们的身体成分。
However, that IGF-1 that's autocrine and paracrine, just working in those local tissues and muscles, is likely part of the reason why you get an improved body-composition response after exercise.
然而，自分泌和旁分泌的 IGF-1 仅在局部组织和肌肉中发挥作用，这可能是运动后身体成分反应得到改善的部分原因。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
Just to clarify for me and for others, what can we say are the major functions of IGF-1 and IGF-2 that are distinct from just growth hormone?
为我和其他人澄清一下，IGF-1 和 IGF-2 与生长激素不同的主要功能是什么？
Are they just kind of the active form of growth hormone; the pick ax end of the assembly line?
它们只是生长激素的活性形式吗？装配线的镐头？
Kyle Gillett:
凯尔·吉列：
They have a much longer duration of action.
它们的作用持续时间要长得多。
I believe the half-life of IGF-1 is several days, almost a week, whereas growth hormone has an extremely fast half-life of only hours.
我相信 IGF-1 的半衰期是几天，几乎一周，而生长激素的半衰期非常快，只有几个小时。
Growth hormone acts significantly on the liver to produce IGF-1, so it's around in the serum and the blood long enough to where it's producing an effect pretty much all the time.
生长激素对肝脏产生显着作用，产生 IGF-1，因此它在血清和血液中存在足够长的时间，几乎一直在产生作用。
Andrew Huberman:
安德鲁·休伯曼：
Very interesting.
非常有趣。
Well, and then your other pillars.
好吧，然后是你的其他支柱。
Stress, we've talked a lot about stress on this podcast before, and tools for managing stress.
压力，我们之前在这个播客上讨论过很多关于压力以及管理压力的工具。
Sleep obviously is a big one.
睡眠显然是一件大事。
I think, if nothing else, I will either put people to sleep with my podcasts, certainly not this one, but my solo episodes, or hopefully convince people that sleep is the foundation of mental and physical health and performance.
我想，如果不出意外的话，我要么用我的播客让人们入睡，当然不是这个，而是我的个人节目，要么希望让人们相信睡眠是身心健康和表现的基础。
Are there any aspects of hormone optimization that can improve sleep?
激素优化的哪些方面可以改善睡眠？
I know sleep can improve hormone optimization, but are there any aspects of hormone optimization that can improve sleep?
我知道睡眠可以改善荷尔蒙优化，但荷尔蒙优化是否有任何方面可以改善睡眠？
For people that are suffering from this common syndrome of going to sleep and then waking up at three or four in the morning, we know that can be associated with depression, but are there any hormonal indications that might lead to that kind of situation?
对于那些患有这种常见综合症的人来说，他们会在凌晨三四点睡觉，然后醒来，我们知道这可能与抑郁症有关，但是是否有任何荷尔蒙迹象可能导致这种情况呢？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
There's three big ones.
有三个大的。
The first one is not super common, but it's a very direct correlation.
第一个并不是很常见，但它是非常直接的相关性。
If you have a growth-hormone deficiency, a true deficiency, whether you're an adult or a child, then your sleep is likely going to be affected.
如果您缺乏生长激素，真正的缺乏，无论您是成人还是儿童，那么您的睡眠都可能会受到影响。
Let's say you're a child with growth-hormone deficiency.
假设您是一个患有生长激素缺乏症的孩子。
Once that is replaced with therapy, your sleep is going to get significantly better.
一旦用治疗代替，你的睡眠就会明显好转。
The second one that's a very common scenario is if you're having what's called vasomotor symptoms of menopause, or vasomotor symptoms of andropause, which are also applicable, and that's where your progestogenic activity ...
第二种非常常见的情况是，如果您有所谓的更年期血管舒缩症状，或男性更年期血管舒缩症状，这也适用，这就是您的孕激素活性......
Your main progestogens are progesterone, and then pregnenolone, and then 5-alpha, 3-alpha progesterone, which is-
您的主要孕激素是黄体酮，然后是孕烯醇酮，然后是 5-α、3-α 黄体酮，即：
Andrew Huberman:
安德鲁·休伯曼：
Where are those manufactured in the body?
体内的那些物质是在哪里制造的？
Kyle Gillett:
凯尔·吉列：
They're manufactured in a few places.
它们是在几个地方制造的。
In men, they're manufactured, some, in the testes, in the Leydig cells.
在男性中，它们是在睾丸、间质细胞中制造的。
In women, they're manufactured in the ovaries until menopause, and then they're also manufactured in the adrenal glands.
对于女性来说，它们在卵巢中产生，直到更年期，然后它们也在肾上腺中产生。
If you're preadrenopausal, where your adrenal glands are still working fairly well, you usually still have a decent amount of progesterone around.
如果您处于肾上腺绝经前期，您的肾上腺仍然工作良好，那么您通常仍然有相当数量的黄体酮。
This can be measured too.
这个也是可以测量的。
After menopause, women make progesterone from their adrenal glands.
更年期后，女性会从肾上腺产生黄体酮。
If that progesterone crosses the blood-brain barrier, especially if it's 4-alpha and 3-alpha reduced, so it's modified a little bit, then it is both a GABA agonist, which helps sleep just like GABA does.
如果黄体酮穿过血脑屏障，特别是如果它的 4-α 和 3-α 减少，因此它被稍微修改，那么它就是 GABA 激动剂，就像 GABA 一样有助于睡眠。
Gamma-aminobutyric acid, the main inhibitory neurotransmitter, of which lots of things work on.
γ-氨基丁酸是主要的抑制性神经递质，许多物质都在其中发挥作用。
Alcohol works on GABA as well.
酒精对 GABA 也有作用。
Gabapentin also works on GABA.
加巴喷丁也对 GABA 起作用。
Migraine medicines, many of them work on GABA.
偏头痛药物中，很多都对 GABA 起作用。
Benzodiazepines and also nonbenzos.
苯二氮卓类药物和非苯并类药物。
An example of a benzo would be Xanax.
苯并类药物的一个例子是 Xanax。
An example of a nonbenzo would be Ambien.
非苯并类药物的一个例子是安必恩（Ambien）。
Those all work on GABA, so GABA is also helped by the progestogenic activity as well.
这些都对 GABA 起作用，因此 GABA 也受到孕激素活性的帮助。
That's why a lot of women in menopause feel like their sleep is much worse, because they have lower activity of those progestogens.
这就是为什么许多更年期女性感觉自己的睡眠质量更差，因为她们的孕激素活性较低。
Andrew Huberman:
安德鲁·休伯曼：
For men in so-called andropause, low testosterone, is that also one of the causes of poor sleep?
对于处于所谓男性更年期的男性来说，睾丸激素水平较低，这也是睡眠不佳的原因之一吗？
Kyle Gillett:
凯尔·吉列：
Low testosterone can lead to poor sleep, but my third scenario is actually if a man begins TRT, then they develop poor sleep because of sleep apnea.
低睾酮水平会导致睡眠质量不佳，但我的第三种情况实际上是，如果一个男人开始 TRT，那么他们会因为睡眠呼吸暂停而导致睡眠质量不佳。
It drastically raises the risk that somebody is going to have sleep apnea.
它大大增加了某人患有睡眠呼吸暂停的风险。
Then a lot of people, especially when they first start it, in their first month or two, it puts them into this hypersympathetic state because they have overactive androgen receptors, especially after a long time of being hypogonadal.
然后很多人，特别是当他们第一次开始使用它时，在他们的第一个月或两个月内，它会让他们进入这种交感神经亢进的状态，因为他们的雄激素受体过度活跃，特别是在长期性腺功能减退之后。
Then they have a physiologic dose of TRT, and that causes the sleep issue itself.
然后他们接受生理剂量的 TRT，这会导致睡眠问题本身。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
I have a lot of questions about TRT, testosterone replacement therapy.
我对 TRT（睾酮替代疗法）有很多疑问。
I should just mention that when you say it increases sympathetic activity, you don't mean that taking testosterone increases sympathy for others.
我应该提一下，当你说它会增加交感神经活动时，你并不是说服用睾酮会增加对他人的同情心。
It may in fact do the opposite, although it's very clear from my discussions with my colleagues on the endocrinology side, and also with the great Dr. Robert Sapolsky, that increasing testosterone merely exacerbates existing features of people.
事实上，它可能会起到相反的作用，尽管从我与内分泌学方面的同事以及伟大的罗伯特·萨波尔斯基博士的讨论中可以清楚地看出，增加睾酮只会加剧人们现有的特征。
The jerks become bigger jerks.
混蛋变得更大的混蛋。
Kind people become even more kind, in general.
一般来说，善良的人会变得更加善良。
Andrew Huberman:
安德鲁·休伯曼：
I want to get into TRT in depth, but it's very interesting to me to hear that testosterone replacement therapy increases the risk of sleep apnea, and I want to make sure that I ask, is that also the case in people that are using TRT who are not hypogonadal?
我想深入了解 TRT，但听到睾酮替代疗法会增加睡眠呼吸暂停的风险对我来说非常有趣，我想确保我问的是，使用 TRT 且非性腺功能减退的人也会出现这种情况吗？
The classic situation is somebody isn't making enough testosterone, they're below 300 nanograms per deciliter on the chart, they go in and take TRT, but many people nowadays, let's be honest, are taking doses of testosterone even though they are in the standard range because the range is so large, because of other symptomology.
典型的情况是某人没有产生足够的睾酮，图表上的睾酮水平低于每分升 300 纳克，他们就去接受 TRT，但老实说，现在很多人都在服用一定剂量的睾酮，即使他们在标准范围内，因为范围太大，还有其他症状。
Is that right?
是这样吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
I do love the analogy that Dr. Sapolsky had about monks taking testosterone and making them more and more generous.
我确实喜欢萨波尔斯基博士关于僧侣服用睾酮并使他们变得越来越慷慨的类比。
That does appear to be what testosterone usually does, is it exacerbates, if you will, what you're previously like.
这似乎确实是睾丸激素通常的作用，如果你愿意的话，它是否会加剧你以前的情况。
It's not going to change you as a person, but if you're eugonadal before you start testosterone-
它不会改变你作为一个人，但如果你在开始睾丸激素之前性腺功能正常-
Andrew Huberman:
安德鲁·休伯曼：
Meaning?
意思是？
Kyle Gillett:
凯尔·吉列：
Meaning that you have normal testosterone, and then you start TRT, or self-administered TRT, steroids, however you want to look at it, then your risk of sleep apnea still goes up in a dose-dependent fashion.
这意味着你的睾酮水平正常，然后你开始 TRT，或自行施用 TRT、类固醇，无论你想如何看待它，那么你患睡眠呼吸暂停的风险仍然会以剂量依赖的方式上升。
The higher the dose, the more risky.
剂量越高，风险越大。
With the sympathetic and the parasympathetic nervous system, the sympathetic is the fight-or-flight nervous system.
与交感神经和副交感神经系统一样，交感神经是战斗或逃跑神经系统。
The parasympathetic is the rest and digest.
副交感神经负责休息和消化。
If you have too much fight-or-flight, and stress can cause that too, then you're not going to rest as well at night.
如果你有太多的“战斗或逃跑”，而压力也会导致这种情况，那么你晚上就不会休息得很好。
Andrew Huberman:
安德鲁·休伯曼：
I want to touch on testosterone in women, because there is testosterone in women.
我想谈谈女性的睾酮，因为女性体内有睾酮。
I'd like to know where that testosterone comes from, which tissues.
我想知道睾酮从哪里来，来自哪些组织。
I'd like to know whether or not testosterone replacement therapy makes sense in women.
我想知道睾酮替代疗法对女性是否有意义。
I'm hearing more and more about women using testosterone.
我越来越多地听到有关女性使用睾酮的消息。
I'd like to know whether or not knowing a woman's ...
我想知道是否了解女人的...
for her to know her testosterone is of equal, less than, or more value than knowing, for instance, progesterone and estrogen levels, because I think there are a lot of misconceptions about the roles of testosterone in women.
对她来说，了解自己的睾酮水平与了解黄体酮和雌激素水平等同等、低于或更高的价值，因为我认为人们对睾酮在女性中的作用存在很多误解。
Kyle Gillett:
凯尔·吉列：
For health optimization, testosterone is just as important to know.
为了优化健康，了解睾酮同样重要。
For pathology prevention, for example, breast cancer, osteoporosis, estrogen and progesterone are more important to know.
对于病理预防，例如，了解乳腺癌、骨质疏松症、雌激素和黄体酮更重要。
When you're thinking about women, women think that they have such a tiny amount of testosterone because you test it, and most people test a free testosterone, so testosterone that's unbound, which is by far the smallest proportion of testosterone.
当你想到女性时，女性会认为她们的睾酮含量非常少，因为你测试了睾酮，而大多数人测试的是游离睾酮，因此未结合的睾酮，这是迄今为止睾酮比例最小的。
Any androgen is bound by lots of different steroid-binding proteins, but the ones that are most pertinent are called SHBG, or sex hormone-binding globulin, and that binds the androgenic steroid, for example DHT or dihydrotestosterone.
任何雄激素都与许多不同的类固醇结合蛋白结合，但最相关的被称为 SHBG（性激素结合球蛋白），它与雄激素类固醇（例如 DHT 或二氢睾酮）结合。
It's associated with prostate enlargement.
它与前列腺肥大有关。
It's associated with male pattern baldness.
它与男性型秃发有关。
It binds that the most strongly, and then it binds testosterone next most strongly.
它与睾酮的结合最强，然后与睾酮的结合最强。
Then it binds things like androstenedione or DHEA, dehydroepiandrosterone, and then it binds the estrogens, the weakest, like estradiol.
然后它与雄烯二酮或DHEA、脱氢表雄酮等物质结合，然后与雌激素（最弱的雌激素）结合，如雌二醇。
Kyle Gillett:
凯尔·吉列：
If you look at the total amount of testosterone women actually have, almost all women, not all women but almost all of them have significantly more testosterone than estradiol, but it's because it's in different measurements.
如果你看看女性实际拥有的睾酮总量，几乎所有女性，不是所有女性，但几乎所有女性的睾酮水平都明显高于雌二醇，但这是因为它的测量值不同。
Estradiol, a lot of the time, is picograms per mil, as opposed to nanograms per deciliter.
很多时候，雌二醇的单位是皮克每密耳，而不是纳克每分升。
Women have more testosterone than estrogen and significantly more DHEA than either.
女性的睾酮水平高于雌激素水平，而 DHEA 也明显高于两者。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Do women make dihydrotestosterone?
女性会产生二氢睾酮吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Where does this testosterone come from?
这种睾酮从何而来？
They don't have testes.
他们没有睾丸。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Most testosterone in women that are premenopausal can come from theca cells, T-H-E-C-A.
绝经前女性的大多数睾酮可能来自卵泡膜细胞 T-H-E-C-A。
Theca cells are cells in the ovaries that can produce testosterone.
卵泡膜细胞是卵巢中可以产生睾酮的细胞。
A lot of people have actually heard about hyperthecosis.
很多人实际上听说过卵泡细胞增多症。
Not the term itself, but a lot of Olympians that are ...
不是这个词本身，而是很多奥运选手......
their chromosomes are XY, they're females, and they're not taking any PEDs-
他们的染色体是 XY，他们是女性，而且他们没有服用任何 PED——
Andrew Huberman:
安德鲁·休伯曼：
Wait.
等等。
They're XY but they're females?
他们是XY但他们是女性？
Kyle Gillett:
凯尔·吉列：
Sorry, they're XX.
对不起，他们是XX。
Andrew Huberman:
安德鲁·休伯曼：
Oh, okay.
哦，好吧。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Thank you.
谢谢。
They're XX, they're not XY, and they have never transitioned or been on any sort of hormone replacement or testosterone, but they naturally produce a huge amount of testosterone, as much as many men.
他们是 XX，他们不是 XY，他们从未变性或接受过任何形式的激素替代或睾酮，但他们自然会产生大量的睾酮，与许多男性一样。
Some of these women, I believe they were from Botswana, were banned from competing in the Olympics in certain distances.
其中一些女性，我相信她们来自博茨瓦纳，被禁止参加奥运会某些距离的比赛。
I believe they were banned from the 400-meter and 800-meter because their natural testosterone was deemed to be too high.
我相信他们被禁止参加 400 米和 800 米比赛是因为他们的天然睾丸激素被认为太高了。
Andrew Huberman:
安德鲁·休伯曼：
So, they mistakenly thought that they were using steroids.
因此，他们错误地认为自己正在使用类固醇。
Kyle Gillett:
凯尔·吉列：
They actually knew they were not using steroids.
他们实际上知道自己没有使用类固醇。
They knew it was their theca cells were just genetically gifted, I suppose, and they still made them change distances.
我想，他们知道他们的卵泡膜细胞具有遗传天赋，但他们仍然让他们改变距离。
Andrew Huberman:
安德鲁·休伯曼：
Wow.
哇。
Kyle Gillett:
凯尔·吉列：
One or two of these athletes changed to ...
这些运动员中的一两个变成了……
I believe it was the 3K, or the 5K, and they still did quite well, but it was not their best-
我相信是3K，或者5K，他们仍然做得很好，但这不是他们最好的-
Kyle Gillett:
凯尔·吉列：
...
...
over the 5K.
超过5K。
And they still did quite well, but it was not their best event.
他们仍然表现得很好，但这不是他们最好的赛事。
PART 1 OF 5 ENDS Andrew Huberman:
第 1 部分（共 5 部分）结束 Andrew Huberman：
Interesting.
有趣。
Yeah, that's turning out to be a very interesting and controversial area of this notion of hormone therapies and natural variation in hormones on different chromosomal backgrounds.
是的，事实证明，这是激素疗法和不同染色体背景下激素自然变异这一概念的一个非常有趣且有争议的领域。
Fascinating.
迷人。
We should probably do a whole episode about that because it's very much of the times.
我们可能应该为此制作一整集，因为很多时候都是这样。
Andrew Huberman:
安德鲁·休伯曼：
So men and women both make DHT.
所以男性和女性都会产生 DHT。
I'd like to ask about DHT in men.
我想问一下男性的DHT。
So often we hear about testosterone and men and free testosterone and being the unbound form, of course, but dihydrotestosterone, where does it come from in men?
我们经常听说睾酮和男性以及游离睾酮和游离睾酮，当然，它是未结合的形式，但是二氢睾酮，它来自男性的哪里？
What is the cascade of events that takes testosterone to dihydrotestosterone, and what are some of the, quote-unquote, positive and negative effects of ...
将睾酮转化为二氢睾酮的一系列事件是什么，以及......的一些积极和消极影响是什么？
here I'm only referring to endogenous dihydrotestosterone, and in fact, I'll make it very clear whether or not I'm talking about taking something or one's own natural production.
这里我只是指内源性二氢睾酮，事实上，我会说得很清楚，我是在谈论服用某种东西还是自己自然产生的。
Andrew Huberman:
安德鲁·休伯曼：
And here we're just, I think, up until now we've just been talking about natural production.
我认为，到目前为止，我们只是在谈论自然生产。
So tell us about DHT in men; it's such a powerful hormone during development, obviously, but what is it doing?
请告诉我们有关男性的 DHT 的信息；显然，它在发育过程中是一种非常强大的激素，但它有什么作用呢？
Kyle Gillett:
凯尔·吉列：
DHT is a very androgenic hormone.
DHT 是一种雄激素。
So whether you're talking about DHEA, which is a weak androgen, or testosterone, which is a relatively strong androgen, or DHT, which is a very strong androgen, they bind into the androgen receptor in both men and in women.
因此，无论是 DHEA（一种弱雄激素），还是睾酮（一种相对较强的雄激素），还是 DHT（一种很强的雄激素），它们都会与男性和女性的雄激素受体结合。
Kyle Gillett:
凯尔·吉列：
So the effect of all three of those is mediated by the androgen receptor.
因此，所有这三种作用都是由雄激素受体介导的。
There's a couple different beta-estradiol receptors and alpha-estradiol receptors, but there's only one androgen receptor.
有几种不同的 β-雌二醇受体和 α-雌二醇受体，但只有一种雄激素受体。
Kyle Gillett:
凯尔·吉列：
Intriguingly, it is on the x chromosome.
有趣的是，它位于 x 染色体上。
So men get their androgen receptor gene from their mother.
因此，男性从母亲那里获得雄激素受体基因。
Women get one androgen receptor gene from their father, one from their mother, often the one that is more sensitive to androgens in people with PCOS.
女性从父亲那里获得一种雄激素受体基因，从母亲那里获得一种雄激素受体基因，对于多囊卵巢综合症患者来说，这种基因通常对雄激素更敏感。
That's the one that's active.
那就是活跃的那个。
The other one is methylated and inactive.
另一种是甲基化的且无活性。
Andrew Huberman:
安德鲁·休伯曼：
Can I just pause you one second, sorry to interrupt, but I have to ask this question before I forget.
我可以暂停一下吗，很抱歉打扰，但我必须在忘记之前问这个问题。
And I know a number of people are probably wondering, I've heard that whether or not one develops male pattern baldness, whether or not a male develops male pattern baldness, just to be very precise, you could get some information about that by looking at your mother's father.
我知道很多人可能想知道，我听说一个人是否会出现男性型秃发，男性是否会出现男性型秃发，准确地说，您可以通过查看您的母亲的父亲来获得一些信息。
And that would, in keeping with what you just described, that the X chromosome, which of course is handed off through the mother, is carrying the genes that encode for the number and distribution of these androgen receptors that DHT will bind to.
根据您刚才的描述，X 染色体当然是通过母亲传递的，它携带着编码 DHT 将结合的雄激素受体的数量和分布的基因。
Andrew Huberman:
安德鲁·休伯曼：
Because of course, I think as you'll probably tell us, that DHT is a responsible for male pattern baldness and beard growth.
当然，我认为您可能会告诉我们，DHT 是导致男性型秃发和胡须生长的原因。
Is that right?
是这样吗？
Should I look at my grandfather on my mother's side to determine what I'm likely to look like in terms of my DHT-ness?
我是否应该看看我母亲那边的祖父，以确定我的 DHT 状态可能会是什么样子？
Is that a word?
这是一个词吗？
Kyle Gillett:
凯尔·吉列：
Yeah, it's the best guess that you can make purely from phenotypes.
是的，这是您可以纯粹根据表型做出的最佳猜测。
Now you can measure your genotype and get a better idea of that.
现在您可以测量您的基因型并更好地了解这一点。
Assuming that it's true male pattern baldness, it's related to the gene transcription of the androgen receptor.
假设这是真正的男性型秃发，它与雄激素受体的基因转录有关。
So I like to think of it as how much of this androgen receptor gene is activated by any androgen.
所以我喜欢将其视为雄激素受体基因有多少被任何雄激素激活。
Kyle Gillett:
凯尔·吉列：
So if you have an extremely sensitive gene, which usually means you have very few CAG repeats, which is basically just a certain ...
因此，如果您有一个极其敏感的基因，这通常意味着您的 CAG 重复很少，这基本上只是某个......
CAG encodes for a certain amino acid.
CAG 编码某种氨基酸。
And if you have very few of the repeats, then your androgen receptor gene works better.
如果你的重复序列很少，那么你的雄激素受体基因就会发挥更好的作用。
Think of it as a corollary to Huntington's disease, where if you have very few of ...
将其视为亨廷顿舞蹈病的必然结果，如果您很少......
called trinucleotide repeats, then it's not as severe of as a disease.
称为三核苷酸重复，那么它就没有疾病那么严重。
Kyle Gillett:
凯尔·吉列：
But after you get more and more CAG repeats, which by the way are ...
但是当你得到越来越多的 CAG 重复之后，顺便说一下......
in the population you're getting more and more CAG repeats.
在人群中，您会看到越来越多的 CAG 重复。
So it's a natural selection of process that has been ongoing for a variety of number reasons.
因此，这是一个自然选择的过程，由于多种原因而一直在进行。
But anyway, if you have more repeats, then that gene activates in the cytoplasm and moves to the nucleus and causes gene transcription more often and hair loss more often.
但无论如何，如果重复次数更多，那么该基因就会在细胞质中激活并移动到细胞核，导致基因转录更频繁，脱发也更频繁。
Andrew Huberman:
安德鲁·休伯曼：
Does That mean that we're seeing more hair loss now due to elevated levels of DHT than we were 50 years ago?
这是否意味着我们现在因 DHT 水平升高而导致的脱发比 50 年前更多？
Kyle Gillett:
凯尔·吉列：
Probably not.
可能不会。
The hair loss 50 years ago, well, not 50 years ago, but 500 years ago, was probably more significant because, on average, 500 years ago, people were more sensitive to androgens.
50 年前，嗯，不是 50 年前，而是 500 年前，脱发可能更为严重，因为平均而言，500 年前，人们对雄激素更加敏感。
So there's a syndrome called androgen insensitivity syndrome, AIS.
所以有一种综合症叫做雄激素不敏感综合症，AIS。
And that syndrome was related to when men who have the copy from their mother who is a carrier, their AR gene or androgen receptor gene is completely insensitive.
这种综合症与当男性携带来自母亲（携带者）的拷贝时，他们的 AR 基因或雄激素受体基因完全不敏感有关。
Kyle Gillett:
凯尔·吉列：
So think of it ...
所以想想...
it doesn't have a ...
它没有...
it's not related to the CAG repeats, but think of that receptor as just not working at all.
它与 CAG 重复无关，但认为该受体根本不起作用。
So there's a continuum.
所以有一个连续体。
So everybody's receptor works a little bit better or a little bit worse, and the better your receptor works, the more likely you are to have male pattern baldness.
因此，每个人的受体的工作效果都会好一点或差一点，而你的受体工作得越好，你就越有可能患有男性型秃发。
Andrew Huberman:
安德鲁·休伯曼：
To zoom out from this, but still keeping an eye on DHT, what do you like to see all women and all men do to optimize DHT?
抛开这个话题，但仍然关注 DHT，您希望看到所有女性和男性做什么来优化 DHT？
And here I'm talking about regardless of age, so we're still in this "from puberty onward" phase.
这里我所说的是不分年龄的，所以我们仍然处于“从青春期开始”的阶段。
We haven't yet microdissected out decade by decade, which we will do.
我们还没有逐个十年地进行微观解剖，但我们将会这样做。
But what do you like to see people do to keep DHT in check?
但您希望人们采取哪些措施来控制 DHT？
But before you tell us that, could you tell us what positive things DHT does when it's in the proper range?
但在您告诉我们之前，您能告诉我们当 DHT 在适当的范围内时会产生哪些积极的作用吗？
Kyle Gillett:
凯尔·吉列：
Yeah, so DHT helps a lot for the same reason why testosterone helps.
是的，所以 DHT 有很大帮助，就像睾丸激素有帮助一样。
It activates the antigen receptor gene, it helps effort feel good, so it can be motivating.
它激活抗原受体基因，有助于感觉良好，因此可以具有激励作用。
So, that's how it's active in the CNS.
这就是它在中枢神经系统中的活跃方式。
It also is active in cardiovascular tissue.
它在心血管组织中也很活跃。
So if you look at someone that has heart failure, or if someone has cardiac hypertrophy, the level of DHT can matter because it's also binding to the androgen receptor in the myocardium or in the heart itself.
因此，如果您观察患有心力衰竭或心脏肥大的人，双氢睾酮的水平可能很重要，因为它还与心肌或心脏本身的雄激素受体结合。
Kyle Gillett:
凯尔·吉列：
So you think of the classic bodybuilder heart, that's an easy example to make.
所以你会想到经典的健美运动员的心脏，这是一个很容易做的例子。
They have a very thickened muscle.
他们的肌肉非常厚实。
Their muscle is very strong because they're pumping blood, often with high blood pressure.
他们的肌肉非常强壮，因为他们在泵血，通常患有高血压。
And that DHT and the testosterone and any DHT derivatives like Masteron or Oxandrolone, Primabolin also bind to the heart, and they cause even more hypertrophy or enlargement of that muscle tissue.
DHT 和睾酮以及任何 DHT 衍生物（如 Masteron 或 Oxandrolone、Primbolin）也会与心脏结合，它们会导致肌肉组织进一步肥大或扩大。
Kyle Gillett:
凯尔·吉列：
So then let's say the person stops in, they're recovering and they're trying to have cardiac remodeling, which is where you take a very thick heart — and cardiac remodeling's important in a lot of different cardiac pathologies — but if you give them finasteride or dutasteride, which inhibit the enzyme that converts testosterone to DHT.
那么，假设这个人停下来，他们正在康复，他们正在尝试进行心脏重塑，这就是心脏非常厚的地方——心脏重塑在许多不同的心脏病中很重要——但是如果你给他们服用非那雄胺或度他雄胺，它们会抑制将睾酮转化为双氢睾酮的酶。
So making less activity at the androgen receptor gene, they have cardiac remodeling and their heart health improves.
因此，减少雄激素受体基因的活性，他们的心脏就会重塑，心脏健康也会得到改善。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
So for the nonbodybuilder, the typical woman or man or younger or older, what sorts of things support DHT and thereby heart health?
那么，对于非健美运动员、典型的女性或男性、年轻或年长的人来说，什么样的东西可以支持 DHT 从而支持心脏健康呢？
Presumably DHT is involved in some of the other things that testosterone is famous for in both men and women.
据推测，DHT 还与睾酮在男性和女性中的其他一些作用有关。
Things like libido, as you mentioned, making effort feel good.
正如你提到的，像性欲这样的事情，让努力感觉良好。
So motivation, drive and vitality, I guess, could be the general phrase.
因此，我想，动机、动力和活力可能是一个笼统的短语。
What sorts of things support DHT?
什么样的东西支持DHT？
What sorts of things create problems for DHT?
哪些因素会给 DHT 带来问题？
Kyle Gillett:
凯尔·吉列：
There's lots of dietary changes and supplementation that you're probably doing right now that's affecting your DHT.
您现在正在做的许多饮食改变和补充剂可能会影响您的 DHT。
Andrew Huberman:
安德鲁·休伯曼：
You mean me personally?
你是说我个人吗？
Kyle Gillett:
凯尔·吉列：
Well everybody, all of the listeners, because let's say you have a diet high in plant polyphenols, many of those inhibit the enzyme that converts testosterone to DHT.
好吧，各位，所有的听众，因为假设您的饮食中植物多酚含量很高，其中许多会抑制将睾酮转化为 DHT 的酶。
Andrew Huberman:
安德鲁·休伯曼：
Could you give us an example of one of those?
您能给我们举一个其中的例子吗？
Either in supplementation form or in food form.
无论是补充剂形式还是食物形式。
Kyle Gillett:
凯尔·吉列：
Curcumins, certain curcuminoids, depending on the structure, will inhibit the enzyme called 5-alpha reductase that converts testosterone to DHT.
姜黄素，某些姜黄素类化合物，根据结构的不同，会抑制将睾酮转化为 DHT 的 5-α 还原酶。
Andrew Huberman:
安德鲁·休伯曼：
Turmeric?
姜黄？
Kyle Gillett:
凯尔·吉列：
Yeah, Turmeric.
是的，姜黄。
Black pepper extract.
黑胡椒提取物。
So if you ...
所以如果你...
it's used often to increase bioavailability.
它经常用于提高生物利用度。
It's also called BioPerine.
它也被称为胡椒素。
It's also a 5-alpha reductase inhibitor.
它也是一种 5-α 还原酶抑制剂。
Kyle Gillett:
凯尔·吉列：
And on top of that, people have different genetics too.
最重要的是，人们也有不同的基因。
So some people, their 5-alpha reductase enzymes, there's three of them.
所以有些人的 5-α 还原酶有三种。
They're on chromosome two, three, and four, I believe.
我相信它们位于第二、第三和第四号染色体上。
But some of them are active in the prostate, some of them are active in the brain, and some of them ...
但其中一些在前列腺中活跃，一些在大脑中活跃，还有一些......
so it depends on which tissue, they're tissue specific enzymes that depend on how much DHT you convert.
所以这取决于哪个组织，它们是组织特异性酶，取决于您转化的 DHT 量。
Andrew Huberman:
安德鲁·休伯曼：
Do you recommend that people avoid curcumin and turmeric for that reason?
您是否因此建议人们避免使用姜黄素和姜黄？
And is there any specific recommendations for men versus women?
对于男性和女性有什么具体的建议吗？
Kyle Gillett:
凯尔·吉列：
If a man or a woman ...
如果一个男人或一个女人...
by the way in women, a lot of times if you just ask your doctor for a DHT check, it's the same units as in men.
顺便说一句，对于女性来说，很多时候如果你只是要求医生进行双氢睾酮检查，它的单位与男性相同。
So it's essentially undetectable.
所以基本上是检测不到的。
So you have to, especially if they're on oral contraceptives, which is a different topic, their DHT is very likely undetectable, especially if it's free DHT.
所以你必须这样做，特别是如果他们服用口服避孕药，这是一个不同的话题，他们的双氢睾酮很可能检测不到，特别是如果它是免费的双氢睾酮。
You can measure both a DHT and a free DHT.
您可以测量 DHT 和免费 DHT。
Kyle Gillett:
凯尔·吉列：
But if someone's DHT is already low or if they have somewhat insensitive androgen receptor via genetics or via lifestyle, then I recommend they avoid bioavailable curcuminoids like bioavailable turmeric, black pepper extract.
但如果某人的 DHT 已经很低，或者由于遗传或生活方式而使雄激素受体有些不敏感，那么我建议他们避免使用生物可利用的姜黄素，例如生物可利用的姜黄、黑胡椒提取物。
And they might be a good candidate for creatine.
它们可能是肌酸的良好候选者。
Creatine, like creatine monohydrate can significantly increase the conversion of testosterone to DHT.
肌酸，如一水肌酸，可以显着增加睾酮向 DHT 的转化。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
There's also a lot of really interesting data coming out now about the role of creatine as a brain fuel and maybe even as a cognitive enhancer over time.
现在还有很多非常有趣的数据，关于肌酸作为大脑燃料的作用，甚至可能随着时间的推移作为认知增强剂的作用。
The data are still ongoing, but some of the studies in humans are pretty impressive, at least to me.
这些数据仍在进行中，但一些针对人类的研究令人印象深刻，至少对我来说是这样。
Andrew Huberman:
安德鲁·休伯曼：
I'm glad you mentioned this thing about curcumin and black pepper.
我很高兴你提到关于姜黄素和黑胡椒的事情。
I wish we had had this conversation six years ago because I had the experience of jumping on the bandwagon of the excitement around turmeric, and I took a turmeric supplement.
我希望我们六年前就进行过这样的对话，因为我有过跟随姜黄兴奋潮流的经历，并且服用了姜黄补充剂。
It was a couple capsules of what I thought to be and I think was high-quality turmeric, and I've never felt as poor as I did in the subsequent few days.
这是几粒我认为是高质量姜黄的胶囊，我从来没有像接下来的几天那样感到那么贫穷。
Flat line of let's just say everything that one would want to have in life energy, vitality, just ...
平直的线条让我们说出一个人在生命能量、活力中想要拥有的一切，只是......
it was a cliff, and a friend somehow knew that curcumin could inhibit 5-alpha reductase.
这是一个悬崖，一位朋友不知何故知道姜黄素可以抑制 5-α 还原酶。
It converts testosterone to DHT, as you pointed out.
正如您所指出的，它将睾酮转化为双氢睾酮。
I stopped taking ...
我停止服用...
It was the only new addition to my diet and supplementation, and things bounced back within about three, four days.
这是我的饮食和补充剂中唯一新添加的，大约三四天内就恢复了。
Andrew Huberman:
安德鲁·休伯曼：
But it was remarkable.
但这是了不起的。
I mean, I felt like garbage and it was actually kind of frightening to experience the sharpness of that cliff, but I know that some people like turmeric for its anti-inflammatory properties, et cetera.
我的意思是，我感觉自己像垃圾一样，体验悬崖的陡峭实际上有点可怕，但我知道有些人喜欢姜黄，因为它具有抗炎特性，等等。
Sounds like people either need to experiment and if they do, obviously to approach that with caution.
听起来人们要么需要尝试，如果他们这样做，显然要谨慎对待。
Anytime you add or remove something, you need to talk to your doctor.
每当您添加或删除某些东西时，您都需要咨询您的医生。
Andrew Huberman:
安德鲁·休伯曼：
You're a doctor, and I'm guessing that if one were to experiment, would you say that most of these effects of things like curcumin are reversible, as they were in me?
你是一名医生，我猜如果有人要进行实验，你会说姜黄素等物质的大部分影响都是可逆的，就像在我身上一样？
Or is there any potential of permanent damage if people have been taking them for a long time?
或者，如果人们长期服用它们，是否有可能造成永久性损害？
Kyle Gillett:
凯尔·吉列：
The effects are nearly always reversible when you're talking about 5-alpha reductase inhibition.
当您谈论 5-α 还原酶抑制时，效果几乎总是可逆的。
So what turmeric does, but stronger.
姜黄有什么作用，但更强。
The most common story that we hear is regarding a supplement known as saw palmetto, which a lot of older men take for their prostate health, or finasteride, which you can take for your prostate or your heart or your hair, or dutasteride.
我们听到的最常见的故事是关于一种名为锯棕榈的补充剂，许多老年男性为了前列腺健康而服用这种补充剂，或者是非那雄胺，您可以服用它来治疗前列腺、心脏或头发，或者是度他雄胺。
Kyle Gillett:
凯尔·吉列：
So if you're having side effects on these, then it's probably because of a couple different reasons.
因此，如果您对这些药物产生副作用，那么可能是由于几个不同的原因。
One can be your ratio of androgens to estrogens is off and that needs addressed.
其中之一可能是您的雄激素与雌激素的比例失调，需要解决这一问题。
Kyle Gillett:
凯尔·吉列：
Another one can be it's inhibiting the conversion of your progesterone to that other type of progesterone.
另一种可能是它抑制孕酮向其他类型孕酮的转化。
The 5-alpha, 3-alpha that we talked about earlier, that's helping with your sleep and your brain and your calmness, and that's definitely an effect.
我们之前谈到的 5-α、3-α 有助于您的睡眠、大脑和平静，这绝对是一种效果。
Kyle Gillett:
凯尔·吉列：
Another one is, depending on the type of supplement or med, they inhibit different isoenzymes of that 5-alpha reductase.
另一种是，根据补充剂或药物的类型，它们会抑制 5-α 还原酶的不同同工酶。
Kyle Gillett:
凯尔·吉列：
So if they're just inhibiting one and two, then that's going to be a different effect than if they're inhibiting two and three.
因此，如果它们只是抑制一和二，那么这将与抑制二和三产生不同的效果。
So finasteride does two and three, saw palmetto does one and two, and then dutasteride does all three.
因此，非那雄胺起两种和三种作用，锯棕榈起一种和两种作用，然后度他雄胺起全部三种作用。
Kyle Gillett:
凯尔·吉列：
The third one is active in the brain, and dutasteride inhibits that third one a little bit weaker in vivo, but strongly in vitro.
第三种在大脑中很活跃，度他雄胺在体内对第三种的抑制作用稍弱，但在体外则很强。
So it's really hard to parse out.
所以真的很难解析。
You can use biofeedback and experimentation.
您可以使用生物反馈和实验。
I do think with supplements, it's safe to experiment.
我确实认为使用补充剂进行实验是安全的。
The time that it takes to set in is usually about three months.
适应时间通常为三个月左右。
Kyle Gillett:
凯尔·吉列：
So the risk of, and this is anecdotally, there's been lots of research published about if post-finasteride syndrome is real or fake.
因此，有很多关于非那雄胺后综合症是真是假的研究已经发表，这是有趣的。
And it is real, but it's one of those things that's a combination of organic and inorganic disease, almost kind of like fibromyalgia, where it's definitely real and there's lots of things that you can do to help with it, but it's very unlikely to occur if you stop taking your supplement or medication after you have side effects.
它是真实的，但它是有机和无机疾病的结合体之一，几乎有点像纤维肌痛，它绝对是真实的，你可以做很多事情来帮助解决它，但如果你在出现副作用后停止服用补充剂或药物，这种情况就不太可能发生。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Well, I certainly feel better when I'm taking five grams of creatine monohydrate per day.
嗯，当我每天服用五克一水肌酸时，我确实感觉好多了。
I know most people take it for muscle growth and tissue repair and things of that sort, mainly, I think, brings water into the muscle tissue, et cetera.
我知道大多数人都将其用于肌肉生长和组织修复之类的事情，我认为主要是将水带入肌肉组织等。
But I take it for the brain effects and also because I like to think that it gives me a little bit of a DHT bump that I can actually see in my blood charts when I've done them.
但我之所以接受它，是因为它对大脑有影响，也因为我喜欢认为它会给我带来一点双氢睾酮（DHT）的提升，当我做完这些工作时，我实际上可以在我的血液图表中看到它。
Andrew Huberman:
安德鲁·休伯曼：
I know many people want to avoid the hair loss that can sometimes be associated with DHT levels going too high.
我知道很多人都想避免脱发，这种脱发有时可能与 DHT 水平过高有关。
And so I've been asked many times, does creatine monohydrate cause hair loss?
所以我多次被问到，一水肌酸会导致脱发吗？
It would make sense that if creatine increases DHT, and DHT binding to the androgen receptor on the scalp can induce hair loss, that would be the case.
如果肌酸增加 DHT，并且 DHT 与头皮上的雄激素受体结合会导致脱发，那么情况就是这样，这是有道理的。
Is that true or are people just overly concerned about something that's a trivial or nonexistent?
这是真的还是人们只是过度关心一些微不足道或不存在的事情？
Kyle Gillett:
凯尔·吉列：
Each male in ...
每个男性在...
So yes, it can potentially add it.
所以是的，它有可能添加它。
I don't like to say it causes it, but it can be a little bit more fuel to the fire.
我不想说是它造成的，但它可能会火上浇油。
So just like everybody has a different sensitivity of their androgen receptor, they have a different amount of gene transcription that is going to cause death of the follicle.
因此，就像每个人对雄激素受体的敏感性不同一样，他们的基因转录量也不同，这会导致卵泡死亡。
That's an arbitrary threshold.
这是一个任意的阈值。
So you don't really know until you start losing hair.
所以直到你开始脱发时你才真正知道。
Andrew Huberman:
安德鲁·休伯曼：
And if somebody takes a little bit of creatine to increase their DHT, maybe for the cognitive-enhancing effects or for whatever reason, and they notice a little bit more hair falling out in the sink and they stop taking it.
如果有人服用一点肌酸来增加 DHT，也许是为了增强认知效果或出于任何原因，他们会注意到水槽里有更多的头发脱落，他们就会停止服用。
You said death of the follicle, which sounds very dramatic.
你说的是卵泡的死亡，这听起来很戏剧化。
Are those little stem cell niches that reside in the follicle, which hairs grow from, are those then abolished?
毛囊中生长毛发的那些小干细胞巢穴是否会被废除？
There's no going back, or can one rescue the hair?
已经没有回头路了，头发还能挽救吗？
Kyle Gillett:
凯尔·吉列：
It takes months.
这需要几个月的时间。
If they're still there, the hair will come back.
如果它们仍然存在，头发就会长回来。
So the loss of the hair itself is a normal part of the hair cycle.
因此，脱发本身是毛发周期的正常部分。
So you have your anagen phase, your catagen phase, your telogen phase, and then your hair loss and then a new follicle-
所以你有你的毛发生长初期、你的毛发生长中期、你的毛发生长终期，然后是脱发，然后是新的毛囊——
Andrew Huberman:
安德鲁·休伯曼：
Of the stem cell niche in the hair follicle?
毛囊中的干细胞生态位？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Think of it like sharks have teeth.
就像鲨鱼有牙齿一样。
So a shark loses the tooth and they have a new one that comes through, or losing your baby tooth and you have a new one, but your hair just always keeps coming through, so it's natural for it to die and lose.
因此，鲨鱼失去了牙齿，它们会长出一颗新牙齿，或者失去乳牙，你会长出一颗新牙齿，但你的头发总是会长出来，所以它的死亡和脱落是很自然的。
That's why when you start 5-alpha reductase inhibitors, often you have a big shed.
这就是为什么当您开始使用 5-α 还原酶抑制剂时，通常会出现一个大棚子。
So what happens during that big shed is all of these cells that are unhealthy, they immediately jettison that hair, and then they start making a much healthier new follicle.
所以在那个大棚子里发生的事情是所有这些不健康的细胞，它们立即抛弃那些头发，然后它们开始制造一个更健康的新毛囊。
Kyle Gillett:
凯尔·吉列：
So all of the hairs that are at the end of their telogen phase, then they have what's called telogen effluvium, which also happens after pregnancy, also happens in thyroid pathologies.
因此，所有处于休止期末期的毛发都会产生所谓的休止期脱发，这也会发生在怀孕后，也会发生在甲状腺病变中。
So you shed it, a new one comes in place, and you think that you're having a horrible hair loss caused by your finasteride or whatever you're doing, and minoxidil does this too, but you're really just having a new healthier follicle.
所以你把它掉了，一个新的出现了，你认为你的脱发是由你的非那雄胺或你正在做的任何事情引起的，米诺地尔也会这样做，但你实际上只是有了一个新的更健康的毛囊。
If you go a really long time, if you go a year, then those hairs might come back and they might not.
如果你走了很长一段时间，如果你走了一年，那么这些毛发可能会回来，也可能不会。
Andrew Huberman:
安德鲁·休伯曼：
So for simplicity's sake, if somebody is concerned about or is experiencing hair loss, male or female, what are their options of ways to offset that hair loss that are not going to negatively impact other tissue sensitive to DHT?
因此，为了简单起见，如果有人担心或正在经历脱发，无论男性还是女性，他们可以选择哪些方法来抵消脱发，而又不会对其他对 DHT 敏感的组织产生负面影响？
Andrew Huberman:
安德鲁·休伯曼：
And what I'm basically saying here is I could imagine taking a DHT inhibitor, a pill of some sort or an injection of some sort, and offsetting hair loss, maybe even stimulating more hair growth.
我在这里基本上想说的是，我可以想象服用 DHT 抑制剂、某种药丸或某种注射剂，可以抵消脱发，甚至可能刺激更多的头发生长。
It's clear that I'm not doing that, but I know people that do.
很明显我没有这样做，但我知道有人这样做。
But then experience some of the other negative effects of blunting DHT, reduced affect, reduced libido, reduced drive, disruptions in prostate function or even sexual function generally.
但随后会经历一些其他因双氢睾酮减弱而产生的负面影响，比如情感减弱、性欲降低、动力减弱、前列腺功能甚至性功能受损。
Andrew Huberman:
安德鲁·休伯曼：
So can people do if they want to maintain or grow back hair, but they don't want all those other effects?
那么，如果人们想要保留头发或重新长出头发，但又不想要所有其他效果，可以这样做吗？
What should they avoid and what should they perhaps consider talking to their doctor about?
他们应该避免什么以及他们应该考虑与医生讨论什么？
Kyle Gillett:
凯尔·吉列：
Yeah, there's a whole host of options.
是的，有很多选择。
I try to separate alopecia or hair loss into two different categories.
我尝试将脱发或脱发分为两个不同的类别。
Male pattern baldness or androgenic alopecia, also known as androgenetic alopecia, versus other types of alopecia, usually telogen effluviums.
男性型秃发或雄激素性脱发，也称为雄激素性脱发，与其他类型的脱发（通常是休止期脱发）相比。
And if it's androgenetic alopecia or male pattern baldness, even if they're female, perhaps they have PCOS, something like that, then you want some sort of strategy to decrease the activity of that androgen receptor.
如果是雄激素性脱发或男性型秃发，即使他们是女性，也许他们患有多囊卵巢综合症，类似的东西，那么你需要某种策略来降低雄激素受体的活性。
Andrew Huberman:
安德鲁·休伯曼：
So women can get male pattern baldness?
那么女性也会得男性型秃发吗？
Kyle Gillett:
凯尔·吉列：
Absolutely.
绝对的。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
I'm going to have to wrap my head around that one, but okay.
我将不得不全神贯注于这个问题，但是没关系。
Kyle Gillett:
凯尔·吉列：
So there's a lot of different things that you can do that are topical.
因此，您可以做很多不同的热门事情。
The most promising is called dutasteride mesotherapy.
最有前途的是度他雄胺中胚层疗法。
Essentially what it is is it's very localized injections in areas that are prone to male pattern baldness, whether they're a female or a male, and it acts locally only, and you repeat these injections from time to time; it decreases the conversion of testosterone to DHT just in the scalp.
从本质上讲，它是在容易出现男性型秃发的区域进行非常局部的注射，无论是女性还是男性，并且它仅在局部起作用，并且您不时重复这些注射;它会减少头皮中睾酮向 DHT 的转化。
Andrew Huberman:
安德鲁·休伯曼：
So that can avoid prostate effects.
这样可以避免前列腺的影响。
And what are some of the negative effects of blocking DHT in females in the periphery?
阻断 DHT 对周边女性有哪些负面影响？
Meaning not on the scalp or in the brain?
意思是不是在头皮上或在大脑中？
Where is DHT doing its stuff?
DHT 在哪里发挥作用？
Kyle Gillett:
凯尔·吉列：
Yeah, so it's both DHT and then also that 5-alpha, 3-alpha progesterone, which is called THP or dihydroprogesterone or tetrahydroprogesterone.
是的，所以它既是 DHT，又是 5-α、3-α 黄体酮，称为 THP、二氢黄体酮或四氢黄体酮。
So they're active in the central nervous system, but it's also just active, again, binding to the androgen receptor in a female as well, causing them to have that effort-feel-good motivation.
因此，它们在中枢神经系统中很活跃，但它也很活跃，再次与女性的雄激素受体结合，使它们产生那种努力感觉良好的动机。
Kyle Gillett:
凯尔·吉列：
A lot of women that are sensitive to DHT, because women can be sensitive to DHT as well, feel very different when they start an oral contraceptive.
许多对 DHT 敏感的女性（因为女性也可能对 DHT 敏感）在开始口服避孕药时感觉非常不同。
Not because it alters their DHT to a huge amount.
并不是因为它极大地改变了他们的 DHT。
It does to some degree because the negative feedback inhibition in the pituitary and less produced in the ovaries, but it increases SHBG really high.
它在某种程度上确实是因为垂体中的负反馈抑制和卵巢中产生的负反馈抑制较少，但它确实使性激素结合球蛋白（SHBG）增加得很高。
So because their SHBGs are significantly higher, their free DHT is way lower.
因此，由于他们的性激素结合球蛋白（SHBG）显着较高，所以他们的游离双氢睾酮（DHT）要低得多。
Andrew Huberman:
安德鲁·休伯曼：
Lets see.
让我们看看。
How does a woman know if she has PCOS?
女性如何知道自己是否患有多囊卵巢综合症？
Polycystic ovarian syndrome?
多囊卵巢综合症？
What are the issues with polycystic ovarian syndrome?
多囊卵巢综合症有哪些问题？
What can be done about PCOS?
对于多囊卵巢综合症可以做什么？
I confess I was naive to PCOS ...
我承认我对 PCOS 很天真......
that wasn't supposed to rhyme, but since it does, I do confess I was completely naive to it, and I started getting a lot of questions about it in various forums, and I think that's actually the reason why I initially approached you.
这本来不应该押韵，但既然它押韵了，我承认我对此完全天真，我开始在各种论坛上收到很多关于它的问题，我认为这实际上就是我最初联系你的原因。
I know you have treated a lot of PCOS.
我知道您治疗过很多多囊卵巢综合症。
What age women should be thinking about PCOS?
什么年龄的女性应该考虑多囊卵巢综合症？
What's PCOS?
什么是多囊卵巢综合症？
Teach us about PCOS, please.
请教我们有关多囊卵巢综合症的知识。
Kyle Gillett:
凯尔·吉列：
Yeah, so PCOS is polycystic ovarian syndrome and this is one of those conditions which is underdiagnosed.
是的，多囊卵巢综合症是多囊卵巢综合症，这是未被充分诊断的疾病之一。
So its prevalence is much higher than we think it is.
所以它的流行程度比我们想象的要高得多。
There's been a lot of studies, and some studies say prevalence of 10%, some say 20%, it's not completely clinically penetrant.
有很多研究，有的研究说患病率为10%，有的说20%，临床上并不完全渗透。
So most people don't know they have PCOS until they have infertility or subfertility.
因此，大多数人直到出现不孕或生育能力低下时才知道自己患有多囊卵巢综合症。
Andrew Huberman:
安德鲁·休伯曼：
And is PCOS happening at this frequency in 20-year-old women, in 30-year-old women, in 40 and onward?
PCOS 在 20 岁、30 岁、40 岁及以后的女性中是否以这种频率发生？
Kyle Gillett:
凯尔·吉列：
Most women find out they have PCOS in their 30s, especially, it's on a spectrum or a continuum, like a lot of things where you can have a weaker version or a very severe version.
大多数女性在 30 多岁的时候发现自己患有多囊卵巢综合症，尤其是，它是一个谱系或一个连续体，就像很多事情一样，你可以有较弱的版本或非常严重的版本。
Andrew Huberman:
安德鲁·休伯曼：
What are the symptoms?
有什么症状？
Kyle Gillett:
凯尔·吉列：
There's a criteria called the Rotterdam criteria.
有一个标准称为鹿特丹标准。
And in the Rotterdam criteria, there's a couple different ways that you can diagnose it.
在鹿特丹标准中，有几种不同的诊断方法。
You're looking for androgen excess, insulin resistance, and you can also look for polycystic ovaries.
您正在寻找雄激素过多、胰岛素抵抗，还可以寻找多囊卵巢。
You don't actually have to have polycystic ovaries or get an ultrasound of your ovaries to be diagnosed.
实际上，您不必患有多囊卵巢或进行卵巢超声检查即可诊断。
If you have androgen excess, for example, androgenic acne or hormonal acne.
如果您有雄激素过多，例如雄激素性痤疮或激素性痤疮。
If you have hair growth, like a hair growth on the chin, it's called hirsutism.
如果您有毛发生长，例如下巴上有毛发生长，则称为多毛症。
Or if you have deepening of the voice.
或者如果你的声音变得低沉。
Kyle Gillett:
凯尔·吉列：
At any symptom of too much ...
任何过多的症状...
male pattern baldness, if you're a female.
如果您是女性，则为男性型秃发。
That's a symptom of PCOS as well.
这也是多囊卵巢综合症的症状。
Then you can also have insulin resistance.
那么你也可能有胰岛素抵抗。
So this is obesity, it's prediabetes, a high fasting insulin, a HOMA-IR over two, a fasting insulin of over six.
所以这就是肥胖、糖尿病前期、空腹胰岛素过高、HOMA-IR 超过 2、空腹胰岛素超过 6。
So if you have significant insulin resistance and also androgen dominance, that's a sign of it.
因此，如果您有明显的胰岛素抵抗并且雄激素占主导地位，那就是一个迹象。
Kyle Gillett:
凯尔·吉列：
Androgen dominance often leads to what's called oligomenorrhea.
雄激素占主导地位通常会导致所谓的月经稀发。
So if you're having more than 35-day intervals in between a period, or if you have less than nine per year, then that can be a sign that you have oligo, which means too little, menorrhea, which means menses.
因此，如果您的月经间隔超过 35 天，或者每年少于 9 天，那么这可能表明您患有月经过少（月经量过少）和月经过多（月经量过少）。
So that's a very common sign of PCOS.
这是多囊卵巢综合症的一个非常常见的症状。
Kyle Gillett:
凯尔·吉列：
If you have infertility.
如果您患有不孕症。
So if you're under the age of 35 and you've been trying for more than a year, or if you're over the age of 35 and you've been trying for more than six months, then that can also be ...
所以，如果你在 35 岁以下，并且你已经尝试了一年多，或者如果你超过 35 岁，并且你已经尝试了六个月以上，那么这也可以......
it's a very common presenting complaint when somebody presents with PCOS.
当某人患有多囊卵巢综合症时，这是一种非常常见的主诉。
Andrew Huberman:
安德鲁·休伯曼：
And assuming that a woman is doing all these other things, is paying attention to the six pillars that you talked about earlier: diet, exercise, caloric restriction, in some cases.
假设一个女人正在做所有这些其他事情，那就要注意您之前谈到的六大支柱：饮食、锻炼、在某些情况下限制热量。
Not everyone needs to be caloric restricted.
并不是每个人都需要限制热量。
Stress, sleep and sunlight.
压力、睡眠和阳光。
Spirit.
精神。
Assuming that they're doing all those things.
假设他们正在做所有这些事情。
What other things in the realm of diet or supplementation can help them avoid PCOS if they have subclinical PCOS or they have not developed it but don't want to develop it.
如果他们患有亚临床多囊卵巢综合症，或者他们尚未患上多囊卵巢综合症，但不想患上多囊卵巢综合症，饮食或补充剂领域还有哪些其他方法可以帮助他们避免患上多囊卵巢综合症。
Because it doesn't sound like a good thing.
因为这听起来不是什么好事。
Kyle Gillett:
凯尔·吉列：
So depending on where they are, if they're very strong on the insulin-resistance spectrum, then optimizing their body composition, decreasing their body fat and treating that metabolic syndrome can help.
因此，根据他们所处的位置，如果他们的胰岛素抵抗谱非常强，那么优化他们的身体成分、减少他们的体脂并治疗代谢综合症会有所帮助。
So a lot of people ask, "Well, does everybody that's on, like does everybody need to be on metformin that has PCOS?" Not necessarily, but metformin is one of the tools that can help with insulin sensitization.
所以很多人会问，“那么，每个接受二甲双胍治疗的人是否都需要服用二甲双胍，患有多囊卵巢综合症？”不一定，但二甲双胍是有助于胰岛素增敏的工具之一。
Kyle Gillett:
凯尔·吉列：
Other tools that can help are inositol.
其他有帮助的工具是肌醇。
So myoinositol is an insulin sensitizer.
所以肌醇是一种胰岛素增敏剂。
Its cousin, d-chiroinositol is a weak antiandrogen.
它的表亲 D-手性肌醇是一种弱抗雄激素。
A lot of types of inositol have both of those in it.
许多类型的肌醇都含有这两种成分。
So depending on if you're a female or a male and you're on inositol, the type of inositol does matter.
因此，根据您是女性还是男性以及您服用肌醇，肌醇的类型确实很重要。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, this is a very important point.
是的，这是非常重要的一点。
Just today I said I'm trying this new supplement, inositol, for its role in perhaps enhancing sleep even further.
就在今天，我说我正在尝试这种新的补充剂，肌醇，因为它可能在进一步增强睡眠方面发挥作用。
My sleep's generally pretty good.
我的睡眠总体来说还不错。
Lately it's been a little bit off for a number of reasons.
最近，由于多种原因，情况有点不太好。
So I took it for the first time last night, and I said I thought it helped and just subjectively.
所以我昨晚第一次服用它，我说我认为它有帮助，而且只是主观的。
And you said, "What kind of inositol is it, because an inositol is a very potent androgen inhibitor." It turns out I was taking myoinositol, which is not an androgen inhibitor.
你说，“它是什么样的肌醇，因为肌醇是一种非常有效的雄激素抑制剂。”事实证明我服用的是肌醇，它不是雄激素抑制剂。
The other type that you mentioned, which is an androgen inhibitor is?
您提到的另一种雄激素抑制剂是？
Kyle Gillett:
凯尔·吉列：
D-chiroinositol.
D-手性肌醇。
It's usually in a ratio of one to 25 or one to 40, in a much lower amount compared to myoinositol.
它的比例通常为 1:25 或 1:40，与肌醇相比，含量要低得多。
Andrew Huberman:
安德鲁·休伯曼：
In a supplement or in the body?
在补充剂中还是在体内？
Kyle Gillett:
凯尔·吉列：
In a supplement to help induce ovulation.
有助于诱导排卵的补充剂。
Andrew Huberman:
安德鲁·休伯曼：
But for women who have PCOS who might want to try and reduce androgen, then they would perhaps want to take a form of inositol that reduces the androgen receptor activity.
但对于患有多囊卵巢综合症的女性来说，她们可能想要尝试减少雄激素，那么她们可能会想要服用一种可以降低雄激素受体活性的肌醇。
Kyle Gillett:
凯尔·吉列：
Correct, yeah, they want both.
没错，是的，他们两个都想要。
So if you're a woman and you've ever talked to your doctor about getting on the oral contraceptive or spironolactone, which is also an antiandrogen, but it happens to be a potassium-sparing diuretic blood pressure medicine as well.
因此，如果您是一名女性，并且曾经与您的医生讨论过服用口服避孕药或螺内酯，这也是一种抗雄激素，但它恰好也是一种保钾利尿降压药。
D-chiroinositol might be a better option.
D-手性肌醇可能是更好的选择。
DIM, or diindolylmethane, is another weak antiestrogen, antiandrogen that a lot of women should consider as well.
DIM（即二吲哚基甲烷）是另一种弱抗雌激素、抗雄激素，许多女性也应该考虑使用。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned oral contraception.
你提到了口服避孕药。
I've done a few posts on these, let's just call them ...
我已经写了一些关于这些的帖子，让我们称它们为......
they really are perceptual effects, whereby it's been demonstrated in humans several times now and what appear to me to be very solid studies where women that take oral contraceptives, there is both a shift in their perception of men — because these studies only looked at heterosexual, that sort of arrangements here — where women who are on oral contraception, because it blunts some of the peaks and valleys of hormone output, no longer experience the same peaks and valleys in their assessment of other men's attractiveness.
它们确实是感知效应，现在已经在人类身上多次得到证实，在我看来，这是非常可靠的研究，服用口服避孕药的女性对男性的看法发生了转变——因为这些研究只关注异性恋，这里的这种安排——服用口服避孕药的女性，因为它会减弱荷尔蒙分泌的一些高峰和低谷，在评估其他男性的吸引力时不再经历相同的高峰和低谷。
Andrew Huberman:
安德鲁·休伯曼：
So it sort of flattens their perception, so to speak.
所以可以这么说，这有点扁平化了他们的看法。
They still find certain men attractive and certain men unattractive, but the degree of difference is mellowed out.
她们仍然认为某些男人有吸引力，而某些男人没有吸引力，但差异程度已经减弱。
And likewise, men per ...
同样，男人每...
these data say that men perceiving women's attractiveness, they still see women on oral contraceptives as attractive, but they're ...
这些数据表明，男性在感知女性的吸引力时，仍然认为服用口服避孕药的女性有吸引力，但他们……
a woman taking oral contraception eliminates this kind of peak in her attractiveness that men would otherwise perceive.
服用口服避孕药的女性消除了男性可能感知到的这种吸引力高峰。
Andrew Huberman:
安德鲁·休伯曼：
In other words, oral contraceptives are changing the way that we perceive each other, at least in terms of these male/female experiments.
换句话说，口服避孕药正在改变我们感知彼此的方式，至少在这些男性/女性实验方面是这样。
What is going on with that?
这是怎么回事？
Is that because oral contraceptives blunt the increase in testosterone that occurs just before ovulation?
这是因为口服避孕药会抑制排卵前睾酮的增加吗？
Or is it because of a complex cascade?
或者是因为复杂的级联？
What is going on?
到底是怎么回事？
I find this fascinating.
我觉得这很有趣。
Kyle Gillett:
凯尔·吉列：
Yeah, so there's differences in how your ...
是的，所以你的方式存在差异...
and I wouldn't use the word change necessarily, but alter the severity or alter the peak, as you said.
我不一定会使用“改变”这个词，而是改变严重程度或改变峰值，正如你所说。
So it's just like TRT is not going to change you as a person, an oral contraceptive will not change you as a person.
所以，就像 TRT 不会改变你这个人一样，口服避孕药也不会改变你这个人。
It will just change your day-to-day peaks and troughs in libido and attractiveness.
它只会改变你日常性欲和吸引力的高峰和低谷。
Kyle Gillett:
凯尔·吉列：
So one of the main effects of oral contraceptives, almost all of them have a synthetic estrogen and a synthetic progestogen in them.
因此，口服避孕药的主要作用之一是，几乎所有口服避孕药都含有合成雌激素和合成孕激素。
One common type of synthetic estrogen is ethinyl estradiol, another new synthetic estrogen that's out there as well.
一种常见的合成雌激素是乙炔雌二醇，这是另一种新的合成雌激素。
But that, anecdotally, that seems to have even more side effects.
但据传闻，这似乎有更多的副作用。
So this ethinyl estradiol is 100 times more potent than endogenous or bioidentical estradiol in the liver.
因此，这种乙炔雌二醇比肝脏中的内源性或生物同质性雌二醇强 100 倍。
Kyle Gillett:
凯尔·吉列：
So it binds to the estrogen receptor in the liver, and it's going to increase sex hormone-binding globulin, which secondarily, as you mentioned, decreases your free testosterone and especially your free DHT.
因此，它与肝脏中的雌激素受体结合，并且会增加性激素结合球蛋白，其次，正如您提到的，会减少您的游离睾酮，尤其是游离双氢睾酮。
So that whole little testosterone hump that you get when you're a female that's ovulating, that's really flatlined, and it's already, it's a pretty insignificant difference.
所以，当你是一个正在排卵的女性时，你得到的整个睾丸激素的小隆起，实际上是平坦的，而且已经是一个非常微不足道的差异了。
It's not negligible, but it's a little bit of a hump and you have significantly less of that when you're on an oral contraceptive.
它不是可以忽略不计的，但它有点驼峰，当你服用口服避孕药时，它会明显减少。
Andrew Huberman:
安德鲁·休伯曼：
And does that blunt the associated increase in libido that normally would occur from that increase in androgen?
这是否会削弱通常因雄激素增加而引起的性欲增加？
Kyle Gillett:
凯尔·吉列：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
And what about other forms of contraception, right, because there are, there's copper IUD, there's various implants, there's rings, there's a huge number of different forms of these.
那么其他形式的避孕方法呢，对吧，因为有，有铜宫内节育器，有各种植入物，有环，有大量不同形式的避孕方法。
So what we're talking about, as I understand it, is only the effect of oral contraception that impacts hormone output.
所以，据我了解，我们所说的只是口服避孕药影响激素分泌的作用。
Is that correct?
这是正确的吗？
Kyle Gillett:
凯尔·吉列：
Yeah, there's a lot of other effects as well.
是的，还有很多其他影响。
For example, your choice of synthetic progestin will alter how high your platelets and SHBG go.
例如，您选择的合成孕激素将改变您的血小板和性激素结合球蛋白 (SHBG) 的升高程度。
It appears to be the higher your platelets and the higher your SHBG, the higher your risk of a blood clot.
您的血小板和性激素结合球蛋白 (SHBG) 越高，出现血栓的风险就越高。
So a lot of women know that if they're on an oral contraceptive and they're already predisposed to a blood clot or a venous thromboembolism in their vein, they have a blood clot in either their leg or their lung, then it can increase that chance.
因此，很多女性都知道，如果她们正在服用口服避孕药，并且她们的静脉已经容易出现血栓或静脉血栓栓塞，那么她们的腿部或肺部出现血栓，那么就会增加这种可能性。
Kyle Gillett:
凯尔·吉列：
So you can choose a synthetic progestin that is not going to have as high of a response, but there's various pros and cons.
因此，您可以选择反应不那么高的合成孕激素，但它有各种优点和缺点。
Some synthetic progestins are weak antiandrogens as well.
一些合成孕激素也是弱抗雄激素。
For example, there's one known as Slynd, which is made from spironolactone.
例如，有一种名为 Slynd 的药物，由螺内酯制成。
So some women are on spironolactone and that as well, which is made from spironolactone, which probably isn't particularly necessary unless they do for a diuretic or a hypertensive effect.
因此，有些女性会服用螺内酯，以及由螺内酯制成的药物，这可能不是特别必要，除非她们需要利尿或高血压作用。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
I'm just going to intentionally interrupt, and I apologize, but specifically because I wanted to ask about, there is this notion that oral contraception taken over long periods of time can disrupt fertility in ways that are independent of just the age-related decrease in fertility.
我只是故意打断一下，我道歉，但特别是因为我想问，有一种观点认为，长期服用口服避孕药会以与年龄相关的生育力下降无关的方式扰乱生育能力。
Is that true?
这是真的吗？
Kyle Gillett:
凯尔·吉列：
It depends on what you mean by a long time.
这取决于你所说的长时间是什么意思。
Six to 12 months, it's possible.
六到十二个月是有可能的。
Past that, it seems very unlikely.
除此之外，似乎不太可能。
However, the persistently elevated SHBG can be present for quite some time.
然而，性激素结合球蛋白（SHBG）持续升高可能会存在相当长的一段时间。
Andrew Huberman:
安德鲁·休伯曼：
Wait, so if a woman takes oral contraception for six to 12 months and then stops, will she essentially be where she would've been anyway in terms of her fertility at that age?
等等，如果一名女性服用口服避孕药 6 到 12 个月然后停止，那么她在那个年龄的生育能力基本上会达到她本来应该达到的水平吗？
Or are you saying that it can cause permanent damage?
或者你是说它会造成永久性损害？
Kyle Gillett:
凯尔·吉列：
Her fertility would be equitable as if she had never taken it.
她的生育能力将是公平的，就好像她从未接受过一样。
If she's, certainly 12 months, but probably six months off.
如果是的话，肯定要休息 12 个月，但也可能要休息 6 个月。
Andrew Huberman:
安德鲁·休伯曼：
And what if she ...
如果她...
I know of women that have taken an oral contraception for many years.
我认识一些多年来一直服用口服避孕药的女性。
In addition to the age-related decline in fertility that occurs, that's inevitable — of course the slope is going to be different depending on the individual — but are they quickening the transition to infertility?
除了与年龄相关的生育率下降之外，这是不可避免的——当然，斜率会因个人而异——但它们是否会加速向不孕症的转变？
Kyle Gillett:
凯尔·吉列：
Probably not.
可能不会。
You could make a case that because they've been on an oral contraceptive, they may have been slightly more predisposed to insulin resistance and or lower lean body mass.
你可以说，因为他们一直在服用口服避孕药，所以他们可能更容易出现胰岛素抵抗和/或去脂体重较低。
But that's probably going to be a negligible difference compared to their resistance training and also their caloric restriction or caloric maintenance.
但与他们的阻力训练以及热量限制或热量维持相比，这可能是微不足道的差异。
Andrew Huberman:
安德鲁·休伯曼：
Of course there are also effects of having children.
当然，生孩子也有影响。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Right.
正确的。
I mean, all in all these parameters, right?
我的意思是，所有这些参数，对吗？
Cause it's a severe ...
因为这是一个严重的...
it's a major lifestyle shift, right?
这是生活方式的重大转变，对吧？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
That obviously people contend with and have since the beginning of human time anyway.
显然，从人类时代开始，人们就一直在与之抗衡。
I want to ask some questions about male hormone therapy and male hormones generally.
我想问一些有关男性激素治疗和男性激素的一般问题。
But before I do that, I have a couple of burning questions that I get very often that I'm just going to insert now.
但在此之前，我有几个经常遇到的紧迫问题，现在我将插入这些问题。
Andrew Huberman:
安德鲁·休伯曼：
Marijuana.
大麻。
I've heard that it can decrease testosterone in men and women.
我听说它可以降低男性和女性的睾丸激素。
I've heard that it can increase testosterone.
我听说它可以增加睾丸激素。
Andrew Huberman:
安德鲁·休伯曼：
Alcohol.
酒精。
I think there's general consensus that high alcohol intake, high barbiturate intake, does in fact reduce testosterone.
我认为人们普遍认为，高酒精摄入量、高巴比妥摄入量实际上会降低睾酮水平。
What about modest increase of alcohol?
适度增加酒精含量怎么样？
I'm not a drinker, so I'm not asking these questions for me.
我不喝酒，所以我不会替我问这些问题。
I don't smoke pot, and, quite over that, I just never really liked marijuana or alcohol, they're not my thing.
我不吸大麻，而且更重要的是，我从来都不喜欢大麻或酒精，它们不是我的菜。
But many people want to know the answers to these, and the data that I've seen are very confused and conflicting.
但很多人想知道这些问题的答案，而我看到的数据非常混乱和矛盾。
Andrew Huberman:
安德鲁·休伯曼：
So what about marijuana?
那么大麻呢？
Does it reduce testosterone to significant degree or not?
它是否会显着降低睾酮水平？
Kyle Gillett:
凯尔·吉列：
Cannabinoids itself, whether it's THC or CBD, are not going to reduce testosterone by themself.
大麻素本身，无论是 THC 还是 CBD，本身都不会降低睾酮水平。
If it's smoked marijuana, then it's very likely to increase your aromatase, which increases your estrogen, and that's going to ...
如果是吸食大麻，那么它很可能会增加您的芳香酶，从而增加您的雌激素，这会......
it's aromatizing from testosterone.
它是由睾丸激素芳香化的。
So that is going to decrease testosterone.
所以这会减少睾丸激素。
When you have an increased estrogen like estradiol, that's going to work on your pituitary to make less hormones that cause the release of testosterone.
当雌激素（如雌二醇）增加时，会作用于垂体，产生更少的导致睾酮释放的激素。
So you're going to have less LH and less FSH.
因此，您的 LH 和 FSH 将会减少。
Kyle Gillett:
凯尔·吉列：
So it's almost kind of like ...
所以这几乎有点像......
opiates are well known to ...
鸦片制剂众所周知...
opiate agonists, they're going to decrease LH and FSH, and subsequently, testosterone.
阿片受体激动剂会降低 LH 和 FSH，进而降低睾酮。
Smoked marijuana will as well.
吸食大麻也会。
Kyle Gillett:
凯尔·吉列：
As far as alcohol, high alcohol will decrease testosterone, as will any very potent GABA agonist, whether it's a barbiturate or a benzodiazepine or a nonbenzo or alcohol, they're definitely going to.
就酒精而言，高度酒精会降低睾酮水平，任何非常有效的 GABA 激动剂也会降低睾酮水平，无论是巴比妥类药物、苯二氮卓类药物、非苯并类药物或酒精，它们肯定会降低睾酮水平。
Moderate alcohol.
适量饮酒。
I guess it depends on what your definition of that is.
我想这取决于你对此的定义是什么。
The American-
美国人——
Andrew Huberman:
安德鲁·休伯曼：
I guess I'm getting like ...
我想我越来越像...
some people I know that don't seem to be alcoholics, at least by my assessment, will have a glass or two of wine four nights a week.
我认识的一些人似乎不是酗酒者，至少根据我的评估，每周四个晚上都会喝一两杯酒。
Which, to me, seems like a tremendous amount only because I don't like alcohol.
对我来说，这似乎是一个巨大的数字，只是因为我不喜欢喝酒。
I don't have a problem with other people liking alcohol.
我对其他喜欢喝酒的人没有意见。
But I think many people ...
但我想很多人...
for many people, that would be considered low or moderate intake.
对于许多人来说，这被认为是低或中等摄入量。
Kyle Gillett:
凯尔·吉列：
Yeah, I would consider that low intake.
是的，我会考虑摄入量低。
The American Heart Association for men recommends between one and two drinks a day on average.
美国心脏协会建议男性平均每天喝一到两杯酒。
Andrew Huberman:
安德鲁·休伯曼：
They recommend it?
他们推荐吗？
Kyle Gillett:
凯尔·吉列：
Yeah, so around one per week.
是的，所以大约每周一次。
Andrew Huberman:
安德鲁·休伯曼：
Wait, so I'm making my heart less healthy by not drinking alcohol?
等等，所以不喝酒会让我的心脏变得不健康？
Kyle Gillett:
凯尔·吉列：
Yeah, they recommend a very low amount of alcohol intake for men.
是的，他们建议男性饮酒量非常低。
For women, they recommend zero to one.
对于女性，他们建议从零到一。
So that's kind of hard to interpret zero to one.
所以这有点难以解释从零到一。
But the protective effect of alcohol, especially if it's a red wine with polyphenols in it, outweighs the deleterious effect.
但酒精的保护作用，尤其是含有多酚的红酒，超过了有害作用。
Andrew Huberman:
安德鲁·休伯曼：
Interesting because I've seen some studies that point to the idea that even low intake of alcohol over a prolonged period of time might actually decrease brain volume or at least volume of particular brain areas.
有趣的是，我看到一些研究表明，即使长时间摄入少量酒精，实际上也可能会减少大脑体积，或者至少减少特定大脑区域的体积。
Andrew Huberman:
安德鲁·休伯曼：
...
...
Actually decrease brain volume or at least volume of particular brain areas.
实际上减少大脑体积或至少减少特定大脑区域的体积。
But of course, we don't know the consequence of decreasing the volume of a given brain area either.
当然，我们也不知道减少特定大脑区域的体积会产生什么后果。
One can imagine it's decreasing the size of one's amygdala and making them less stressed, although there's no evidence to support that.
人们可以想象它会缩小杏仁核的大小并减轻压力，尽管没有证据支持这一点。
I've been told that I need a drink many, many times, but I always reply that I don't need to drink anything in order to speak my mind.
很多很多次有人告诉我我需要喝酒，但我总是回答说我不需要喝任何东西来表达我的想法。
So again, individual differences.
再说一遍，个体差异。
Very interesting.
非常有趣。
So it sounds like smoked marijuana may in fact reduce testosterone or at least increase the conversion of testosterone to estrogen.
因此，听起来吸食大麻实际上可能会降低睾酮水平，或者至少会增加睾酮向雌激素的转化。
Correct?
正确的？
PART 2 OF 5 ENDS Kyle Gillett:
第 2 部分（共 5 部分）结束凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Kyle Gillett:
凯尔·吉列：
And with alcohol and GABA agonist, it's important to remember that it shouldn't be daily.
对于酒精和 GABA 激动剂，重要的是要记住，不应该每天都喝。
So one drink of alcohol a day is actually very mildly immunosuppressive.
因此，每天喝一杯酒实际上会产生非常轻微的免疫抑制作用。
So it's better to have two drinks of alcohol one day of the week and then two more drinks of alcohol another day of the week and then no alcohol the rest of the time.
因此，最好在一周中的某一天喝两杯酒，然后在一周的另一天再喝两杯酒，然后在其余时间不喝酒。
The same could be said even for supplements that have GABA in them.
即使对于含有 GABA 的补充剂也是如此。
A lot of sleep supplements have gamma-aminobutyric acid, which is .
许多睡眠补充剂都含有 γ-氨基丁酸，即 γ-氨基丁酸。
Andrew Huberman:
安德鲁·休伯曼：
I occasionally take ...
我偶尔会拿...
Oh, sorry to interrupt.
噢，抱歉打扰了。
I occasionally take 100 to 200 milligrams of GABA in order to enhance sleep, but I do it maybe every third or four night, no more than three or four nights a week.
我偶尔会服用 100 到 200 毫克 GABA 以促进睡眠，但我可能每三到四个晚上服用一次，每周不超过三到四个晚上。
Kyle Gillett:
凯尔·吉列：
Yeah, that's perfect.
是的，那太完美了。
So there's a lot of sleep supplements that should not be taken daily, and GABA is one of them.
所以有很多睡眠补充剂不应该每天服用，GABA就是其中之一。
Another one of them is trazodone.
其中另一种是曲唑酮。
And melatonin is arguable, and it depends on the situation, but in general, if you're taking a sleep supplement, it should not be taken every night.
褪黑激素是有争议的，这取决于具体情况，但一般来说，如果您正在服用睡眠补充剂，则不应该每晚都服用。
Andrew Huberman:
安德鲁·休伯曼：
The sleep supplements that I understand are okay to take every night or nearly every night are things like magnesium threonate, apigenin.
据我所知，每天晚上或几乎每天晚上都可以服用的睡眠补充剂是苏糖酸镁、芹菜素等。
If that's not true, correct me.
如果这不是真的，请纠正我。
I certainly take them every night unless I forget them back home when I'm traveling.
我当然每天晚上都会带着它们，除非我在旅行时忘记带回家。
Kyle Gillett:
凯尔·吉列：
Magnesium is one of the exceptions.
镁是例外之一。
L-theanine is also another exception.
L-茶氨酸也是另一个例外。
Andrew Huberman:
安德鲁·休伯曼：
Great.
太棒了。
Well then, at least I haven't put anything into the world that's wrong in that category yet, and hopefully I won't, but if I do, I'll correct myself.
那么，至少我还没有在这个类别中放入任何错误的东西，希望我不会，但如果我这样做了，我会纠正自己。
Andrew Huberman:
安德鲁·休伯曼：
So let's talk about testosterone in males.
那么让我们来谈谈男性的睾丸激素。
You see these headlines all the times now that testosterone levels are dropping, sperm counts are dropping, phenotypes of men are changing over time.
现在你经常会看到这些头条新闻，睾丸激素水平正在下降，精子数量正在下降，男性的表型正在随着时间的推移而发生变化。
And I can't quite follow the literature on that because, obviously, those are hard controlled experiments to do because techniques change over time and sensitivity of techniques change over time.
我不太能理解这方面的文献，因为显然，这些都是很难控制的实验，因为技术会随着时间的推移而变化，技术的敏感性也会随着时间的推移而变化。
But regardless, I'm aware that a lot of people are considering increasing their testosterone by taking testosterone.
但无论如何，我知道很多人正在考虑通过服用睾酮来增加睾酮。
A few years ago, that was considered steroid use and it was a really extreme stance.
几年前，这被认为是类固醇的使用，这是一种非常极端的立场。
Nowadays, it seems like there's more discussion about it.
如今，似乎对此的讨论更多了。
First off I'd like to know, does testosterone supplementation, and here I'm talking about prescription from a doctor, does it make one more prone to prostate cancer?
首先我想知道，补充睾酮，这里我说的是医生的处方，是否会让人更容易患前列腺癌？
That seems to always be the first question that comes out.
这似乎总是第一个出现的问题。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
And there is a huge amount of misinformation about this too.
关于这一点也存在大量错误信息。
So testosterone is not going to cause a prostate cancer.
因此睾酮不会导致前列腺癌。
However, normal aging causes prostate cancer, and testosterone will grow your prostate cancer.
然而，正常的衰老会导致前列腺癌，而睾酮会促进前列腺癌。
So if you are an 80-year-old male and you have an autopsy, then there's at least a 50% chance that you have a prostate cancer; if you're 90 or 100 years old, there's at least a 90% chance.
因此，如果您是一名 80 岁男性，并且进行了尸检，那么您至少有 50% 的可能性患有前列腺癌；如果你90岁或100岁，至少有90%的机会。
So for humans with a prostate, it's only a matter of time until you get a prostate cancer.
因此，对于患有前列腺的人来说，患上前列腺癌只是时间问题。
So that begs the question, do you want to take something that's going to grow it for sure once you have it?
那么这就引出了一个问题，你想拿一些一旦你拥有它就肯定会生长的东西吗？
So it's an individual assessment, and it's important to follow things like PSAs as well.
因此，这是一项个人评估，遵循公益广告等内容也很重要。
Andrew Huberman:
安德鲁·休伯曼：
So a PSA of four or less — ideally you wouldn't be at four because that's the upper threshold — is the simplest readout of whether or not there's excessive prostate growth.
因此，PSA 为 4 或更低（理想情况下不会是 4，因为这是上限）是判断前列腺是否过度生长的最简单指标。
There's benign prostate hyperplasia,, where the prostate is growing but it's noncancerous.
有良性前列腺增生，即前列腺正在生长，但不是癌性的。
Correct?
正确的？
And then of course, there are the symptomologies like people have challenges with urination, they have sexual difficulties, et cetera.
当然，还有一些症状，比如人们排尿困难、性困难等等。
I'm always struck by the correlation that people draw between testosterone and prostate health, or, I should say, the claim that testosterone makes prostate health worse, because if you think about it, young males have high testosterone often, if not always, certainly often, and you don't see a lot of prostate overgrowth and cancer in young males.
我总是对人们在睾酮和前列腺健康之间的关联感到震惊，或者，我应该说，睾酮使前列腺健康恶化的说法，因为如果你仔细想想，年轻男性经常（如果不是总是，肯定经常）具有高睾酮，而且你不会在年轻男性中看到很多前列腺过度生长和癌症。
So something is going on here.
所以这里发生了一些事情。
How should we conceptualize this?
我们应该如何概念化这一点？
Kyle Gillett:
凯尔·吉列：
So if you have a PSA of 3.9 and you are a 25-year-old male, versus a 75-year-old male and you have a PSA of 5.9, the 3.9 PSA is significantly more concerning.
因此，如果您是 25 岁男性，PSA 为 3.9，那么与 PSA 为 5.9 的 75 岁男性相比，3.9 的 PSA 明显更令人担忧。
So think of your prostate as taking cumulative damage from not only testosterone but also estrogen and also growth hormone.
因此，您的前列腺不仅受到睾酮的累积损害，还受到雌激素和生长激素的累积损害。
So that's why obese individuals have higher incidences of prostate cancer as well.
这就是为什么肥胖者前列腺癌的发病率也更高。
It's because they don't have those cell checkpoints where your immune system takes a second and says, "All right, stop replicating as fast, prostate cells.
这是因为它们没有那些细胞检查点，你的免疫系统会花一秒钟的时间说：“好吧，停止快速复制，前列腺细胞。
Let's see if there's any atypical ones." And then it finds those and it prevents them from reproducing.
让我们看看有没有什么非典型的。”然后它找到这些并阻止它们繁殖。
That's why immunotherapy in cancer is so promising; it's because they can target these certain things.
这就是为什么癌症免疫疗法如此有前景。这是因为他们可以针对这些特定的事情。
Kyle Gillett:
凯尔·吉列：
So the older male is going to have that cumulative damage happen already.
因此，年长的雄性将会遭受累积性损害。
And arguably, prostate cancer is a normal ...
可以说，前列腺癌是一种正常的......
With aging, fast aging is abnormal, very slow aging is normal.
随着衰老，衰老快是不正常的，衰老很慢是正常的。
There's a fine line to walk between those two.
两者之间有一条细线。
But there's a lot of things that can be done to decrease the turnover, decrease the inflammation and decrease the congestion of the prostate over time.
但随着时间的推移，可以采取很多措施来减少前列腺的更新、炎症和充血。
There's also a lot more than just PSAs that can be done.
除了公益广告之外，还有很多事情可以做。
There's prostate MRIs and things like that that can look at the structure and the function of the prostate.
有前列腺核磁共振成像和类似的东西可以观察前列腺的结构和功能。
Andrew Huberman:
安德鲁·休伯曼：
So what should every male do to maintain the health of their prostate?
那么每个男性应该怎样做才能保持前列腺健康呢？
And I realize that younger males probably aren't thinking about it at all, although it seems like nowadays, I get these what I call cryptic questions.
我意识到年轻的男性可能根本没有考虑过这个问题，尽管现在看来，我遇到了这些我称之为神秘的问题。
I think women are more comfortable talking about their hormone and sexual health because of menstrual cycles.
我认为由于月经周期，女性更愿意谈论她们的荷尔蒙和性健康。
They're used to fluctuations that give them the experience of what it's like to have different levels of progesterone, estrogen, testosterone, et cetera.
他们习惯了波动，这让他们体验到不同水平的孕激素、雌激素、睾酮等的感觉。
But I get these cryptic questions often in my direct messages, where what I think people are asking is, "Is there something wrong with my prostate?
但我经常在私信中收到这些神秘的问题，我认为人们在问的是：“我的前列腺有问题吗？
What should I do for my prostate?" These are often indirect questions for other aspects of their life where they're suffering.
我的前列腺该怎么办？”这些通常是针对他们生活中遭受痛苦的其他方面的间接问题。
And I don't say that in jest.
我这么说并不是开玩笑。
I think more direct discussion would be great.
我认为更直接的讨论会很棒。
So what should all males do to maintain prostate health throughout their lifespan?
那么，所有男性应该怎样做才能在一生中保持前列腺健康呢？
Kyle Gillett:
凯尔·吉列：
Maintaining prostate health can be looked at similarly how you can maintain a good, natural, optimal testosterone.
保持前列腺健康可以类似地看待如何保持良好、自然、最佳的睾酮水平。
So you look for things that can hurt it.
所以你寻找可能伤害它的东西。
You don't necessarily look for one thing that can improve it or boost it.
你不一定要寻找一件可以改善或提升它的东西。
So for young males, those are prostatitis.
所以对于年轻男性来说，这些就是前列腺炎。
It goes hand in hand with epididymitis.
它与附睾炎密切相关。
So different infections of the prostate.
所以前列腺的感染情况不同。
The younger the male is, the more likely it is related to something that could be sexually transmitted.
男性越年轻，就越有可能与性传播疾病有关。
Kyle Gillett:
凯尔·吉列：
But another very common cause is what we call gram-negative and anaerobic bacteria.
但另一个非常常见的原因是我们所说的革兰氏阴性菌和厌氧菌。
The prostate is right by the end of the colon.
前列腺位于结肠末端。
So if you have chronic constipation, or if you have colitis, or if you have even just an E.
因此，如果您患有慢性便秘，或者患有结肠炎，或者只是患有大肠杆菌病。
coli overgrowth in the colon, it's very likely to cause an infection of the prostate as well.
结肠中的大肠杆菌过度生长，也很可能导致前列腺感染。
Andrew Huberman:
安德鲁·休伯曼：
What should males do to prevent that?
男性应该怎样做才能避免这种情况发生呢？
Kyle Gillett:
凯尔·吉列：
Have a diet that has good, healthy prebiotic fiber — probiotics as well.
饮食中含有良好、健康的益生元纤维——还有益生菌。
Make sure that they're having regular bowel movements that they don't have chronic constipation.
确保他们有规律的排便，没有慢性便秘。
Have good sources of dietary fiber, which is also a soluble fiber, and enough insoluble fiber.
有良好的膳食纤维来源，膳食纤维也是可溶性纤维，以及足够的不溶性纤维。
Most people get enough insoluble or nondietary fiber.
大多数人都会摄入足够的不溶性或非膳食纤维。
That can help prevent the chance of diverticulitis, which is another type of infection.
这可以帮助预防憩室炎（另一种感染类型）的机会。
It can also decrease the chance of colitis and decrease the chance of prostate infections as well.
它还可以减少结肠炎的机会和前列腺感染的机会。
Andrew Huberman:
安德鲁·休伯曼：
Are there any foods and/or supplements that men should take or avoid?
男性是否应该服用或避免服用任何食物和/或补充剂？
You hear about saw palmetto.
您听说过锯棕榈。
Supplements that support or cause issues for the prostate.
支持或引起前列腺问题的补充剂。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
If there's a strong genetic predisposition to enlarged prostates or even just really early prostate cancers that grow fast, then they can consider taking saw palmetto or even curcumin as an antiandrogen, as long as they're able to tolerate it.
如果有强烈的前列腺肥大遗传倾向，甚至只是生长迅速的早期前列腺癌，那么他们可以考虑服用锯棕榈甚至姜黄素作为抗雄激素，只要他们能够耐受。
It's an individualized basis and it depends on their history.
这是一个个性化的基础，取决于他们的历史。
As far as making sure that their prostate is not congested, there's an interesting correlation between having girls and having prostate cancer.
就确保她们的前列腺不充血而言，生女孩和患前列腺癌之间存在着有趣的相关性。
Andrew Huberman:
安德鲁·休伯曼：
Having a girl offspring.
生下一个女孩子。
Kyle Gillett:
凯尔·吉列：
So if your offspring are females, then you're slightly more likely to have prostate cancer.
因此，如果您的后代是女性，那么您患前列腺癌的可能性会稍高一些。
There's hypotheses that link estrogen to prostate cancer rather than testosterone.
有假设认为雌激素与前列腺癌有关，而不是睾酮。
So if you have hyperestrogenism, your prostate has more atypical cells.
因此，如果您雌激素过多，您的前列腺就会有更多的非典型细胞。
In general, the higher your C-reactive protein, which is the general marker of inflammation in your body ...
一般来说，C 反应蛋白越高，C 反应蛋白是体内炎症的一般标志......
We call it CRP, and the test order is hs-CRP, or high-sensitivity CRP.
我们称之为CRP，检测顺序是hs-CRP，即高敏CRP。
If your CRP raises up very high, if you have an autoimmune disease, like if you have a Crohn's flare, or if you have lupus or an infection or a sexually transmitted infection or even colitis or even the flu, your CRP is going to raise significantly.
如果您的 CRP 升高非常高，如果您患有自身免疫性疾病，例如克罗恩病，或者您患有狼疮、感染、性传播感染、甚至结肠炎甚至流感，您的 CRP 将会显着升高。
Andrew Huberman:
安德鲁·休伯曼：
You would detect in a blood test, of course?
当然，你会在验血中检测到吗？
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
Yeah.
是的。
So you want to get a baseline CRP when you haven't had any of those things recently.
因此，当您最近没有发生任何这些事情时，您希望获得基线 CRP。
And if your CRP is higher, you also have more female offspring.
如果你的 CRP 更高，你也会有更多的女性后代。
If your CRP is higher, then your reactive oxygen species which are causing mutations and atypical cell turnover in the prostate are also likely higher.
如果您的 CRP 较高，那么引起前列腺突变和非典型细胞更新的活性氧也可能较高。
So you want to keep a very low CRP.
所以你想保持一个非常低的 CRP。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
And what about blood flow and pelvic floor in general?
那么血流和盆底的总体情况又如何呢？
We should probably do a whole episode on pelvic floor.
我们也许应该在骨盆底上做一整集。
There's so much interesting data coming out of the fields of clinical and research urology.
临床和研究泌尿学领域有很多有趣的数据。
I realize it's the Netherlands of biology in medicine.
我意识到这是医学生物学领域的荷兰。
People probably aren't thinking so much about this, but pelvic floor is obviously a confluence of a ton of vasculature, of nerves; and, of course, the prostate resides there; and, of course, the genitals reside there as well.
人们可能并没有想太多，但盆底显然是大量脉管系统和神经的汇合处；当然，前列腺就在那里。当然，生殖器也在那里。
So I would imagine that one of the six pillars, exercise, being able to maintain adequate blood flow to those regions is key.
因此，我认为六大支柱之一——锻炼——能够维持这些区域足够的血液流动是关键。
What about just postural things, people sitting too much, not hydrating well enough?
如果只是姿势问题，人们坐得太多，水分不够充足呢？
You mentioned avoiding constipation.
你提到避免便秘。
What are some other things, including medications, that can serve to support the prostate over time and maybe even support pelvic floor in general, both in males and females over time?
还有哪些其他东西，包括药物，可以随着时间的推移支持前列腺，甚至可能支持一般的盆底，无论是男性还是女性？
Kyle Gillett:
凯尔·吉列：
Absolutely.
绝对的。
And this is something that's rightfully getting more and more attention.
这是理所当然地受到越来越多关注的事情。
The way I explain the pelvic floor is your abdominal cavity, which includes your peritoneum or where most of your organs are; your retroperitoneum, your pelvic space — think of it as a box, and your abs are the front of the box.
我对盆底的解释是指腹腔，其中包括腹膜或大部分器官所在的位置；你的腹膜后，你的骨盆空间——把它想象成一个盒子，你的腹肌就是盒子的前面。
Your back muscles are the back.
你的背部肌肉就是背部。
Your diaphragm is the top of the box.
你的隔膜是盒子的顶部。
And your pelvic floor, that's where your port is to the outside world.
而你的骨盆底，就是你通往外界的港口。
Especially important, it has muscles as well and you can do exercises.
尤其重要的是，它还有肌肉，可以锻炼身体。
Pelvic floor physical therapists are becoming more and more utilized, especially after childbirth but in other situations as well, including by men getting care from urologists.
盆底物理治疗师的使用率越来越高，尤其是在分娩后，但在其他情况下也是如此，包括接受泌尿科医师护理的男性。
So you want to both strengthen that pelvic floor and make sure that the tubes that are docked to the outside world are working well enough, but they're not too loose, they're not working too well.
因此，您既要加强骨盆底，又要确保与外界相连的管子工作得足够好，但它们不能太松，工作得不太好。
Kyle Gillett:
凯尔·吉列：
So there's a lot of medications that can be positives or negatives for your pelvic floor.
因此，有很多药物可能对您的盆底有积极或消极的作用。
We talked about your gut and colon health in general.
我们讨论了您的肠道和结肠的总体健康状况。
As far as your prostate health and as far as your bladder and urinary system health, you think about a couple of different classes.
至于您的前列腺健康以及您的膀胱和泌尿系统健康，您会考虑几个不同的类别。
So you have your phosphodiesterases.
所以你有磷酸二酯酶。
You have your tadalafil.
你有他达拉非。
Basically, this is going to help decrease congestion in the prostate.
基本上，这将有助于减少前列腺充血。
A lot of people take it for ED, but it can actually help you decrease your-
很多人将其视为 ED，但它实际上可以帮助您减少 -
Andrew Huberman:
安德鲁·休伯曼：
Can you define that?
你能定义一下吗？
Kyle Gillett:
凯尔·吉列：
A lot of men take tadalafil, its generic is Cialis.
很多男性服用他达拉非，它的通用名是西力士。
It has a much longer half-life than Viagra or Levitra.
它的半衰期比伟哥或艾力达长得多。
Its half-life is almost a day.
它的半衰期几乎是一天。
So you can take a very low dose of it.
所以你可以服用非常低的剂量。
Instead of taking 20 milligrams, you take two or two-and-a-half milligrams.
您不再服用 20 毫克，而是服用两毫克或两毫克半。
Andrew Huberman:
安德鲁·休伯曼：
You're saying that a lot of men take it for erectile dysfunction.
你是说很多男人用它来治疗勃起功能障碍。
Kyle Gillett:
凯尔·吉列：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But that at lower doses, it may have served purposes for prostate health independent of erection.
但在较低剂量下，它可能有助于前列腺健康，而与勃起无关。
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
The most common scenario is if a male is waking up twice at night to pee, on average, it'll cut that down to once.
最常见的情况是，如果男性平均晚上醒来两次小便，那么它会将其减少到一次。
So if they're waking up four times at night, then it can cut that down to twice at night just because you have easier blood flow.
因此，如果他们晚上醒来四次，那么就可以将其减少到晚上两次，因为血液流动更顺畅。
We used to use other medications like Flomax, which is tamsulosin.
我们曾经使用其他药物，例如 Flomax，即坦索罗辛。
That's an alpha antagonist, so it basically binds to a receptor in smooth muscle and it helps relax that.
这是一种α拮抗剂，因此它基本上与平滑肌中的受体结合，有助于放松。
There's several other alpha antagonists.
还有其他几种α拮抗剂。
And then you also have your medications that are hormonal, like finasteride that a lot of people take for prostate health to decrease the enlargement of the prostate.
然后，您还需要服用激素药物，例如许多人为了前列腺健康而服用的非那雄胺，以减少前列腺肥大。
The periurethral area or periurethral lobe, there are several lobes of the prostate, that tends to be especially enlarged in cases of BPH and-
尿道周围区域或尿道周围叶，有几个前列腺叶，在前列腺增生症和 -
Andrew Huberman:
安德鲁·休伯曼：
BPH?
前列腺肥大？
Kyle Gillett:
凯尔·吉列：
Prostate hyperplasia or an enlarged prostate.
前列腺增生或前列腺肥大。
And if you are able to shrink that area, then at that point, it's just a plumbing problem, and the urine is able to get by easier.
如果你能够缩小该区域，那么到那时，这只是一个管道问题，尿液就可以更容易地通过。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
My understanding is that now there's a growing, I don't want to say a movement, but the idea of taking very low dose like 2.5 milligram or five milligram tadalafil even daily is becoming pretty common for many men who do not have erectile dysfunction, simply to either maintain or enhance prostate health.
我的理解是，现在有一种增长，我不想说是一种运动，但对于许多没有勃起功能障碍的男性来说，每天服用极低剂量（例如 2.5 毫克或 5 毫克他达拉非）的想法已经变得相当普遍，只是为了维持或增强前列腺健康。
Is that correct?
这是正确的吗？
Kyle Gillett:
凯尔·吉列：
Yeah, that's correct.
是的，这是正确的。
Andrew Huberman:
安德鲁·休伯曼：
And do you see any negative effects of doing that?
您认为这样做有什么负面影响吗？
Kyle Gillett:
凯尔·吉列：
There can be negative effects.
可能会产生负面影响。
It can lower blood pressure.
它可以降低血压。
So theoretically, it can increase your chance of vasovagal syncope.
因此从理论上讲，它会增加您发生血管迷走性晕厥的机会。
A lot of people take it as an alternative to "pump" because it works similarly to citrulline or different pump products in preworkout, and it can certainly help with that.
很多人将其视为“泵”的替代品，因为它在锻炼前的作用与瓜氨酸或其他泵产品类似，而且它肯定可以对此有所帮助。
But if you're about to go do a deadlift, where you might pass out anyway, it can certainly increase the chance that that happens because you don't have that compensatory exercise-hypertension response.
但如果你准备做硬拉，无论如何你都可能会昏倒，这肯定会增加发生这种情况的机会，因为你没有补偿性运动高血压反应。
Andrew Huberman:
安德鲁·休伯曼：
Could someone just take it away from exercise?
有人可以把它从锻炼中去掉吗？
Kyle Gillett:
凯尔·吉列：
They could.
他们可以。
If you took tadalafil, it has a long half-life.
如果您服用他达拉非，它的半衰期很长。
Whereas, Viagra and Levitra is just a few hours; tadalafil is almost a day.
而伟哥和艾力达只需几个小时；他达拉非几乎是一天。
Kyle Gillett:
凯尔·吉列：
Some interesting studies on Viagra have been done as well.
还进行了一些关于伟哥的有趣研究。
It can potentially alter your rays and cones in your eye.
它可能会改变您眼睛中的光线和视锥细胞。
So the usual recommendation for pilots that need to have red/green discrimination from very long distances with very small indicator lights is to not take Viagra.
因此，对于需要通过非常小的指示灯从很远的距离进行红/绿辨别的飞行员来说，通常的建议是不要服用伟哥。
So I usually say if you're a pilot and that's your profession, perhaps hold off from that for a while.
所以我通常会说，如果你是一名飞行员并且这就是你的职业，也许暂时不要从事这个职业。
Kyle Gillett:
凯尔·吉列：
There's also studies with Viagra that significantly, which is also known as sildenafil as the generic now, it can increase eyebrow hair growth.
还有关于伟哥的研究表明，伟哥（现在也被称为西地那非）可以显着增加眉毛的生长。
So potentially, what it does is it helps vasodilate and relax the veins, especially in older men, and when those veins are relaxed, you have better blood flow.
因此，它的潜在作用是帮助血管舒张和放松静脉，尤其是老年男性，当这些静脉放松时，血液流动会更好。
That's one of the proposals or theories behind why older men get the androgenetic alopecia more.
这就是为什么老年男性更容易患雄激素性脱发的提议或理论之一。
You're having less blood flow in the scalp.
你的头皮血流量减少了。
So theoretically, it can also help prevent that, so it's not going to-
所以从理论上讲，它也可以帮助防止这种情况发生，所以它不会-
Andrew Huberman:
安德鲁·休伯曼：
In theory, increasing blood ...
理论上来说，增加血...
Oh, because it increases blood flow systemically throughout the body, not just in specific tissues.
哦，因为它增加了全身的血流量，而不仅仅是特定组织的血流量。
Well, I find it incredibly interesting that there are these online forums building up now around low-dose tadalafil, daily use of low-dose tadalafil, again, not for sexual or erectile dysfunction but for sake of prostate health.
嗯，我发现非常有趣的是，现在围绕低剂量他达拉非建立了这些在线论坛，每天使用低剂量他达拉非，不是为了性或勃起功能障碍，而是为了前列腺健康。
Is there any reason why women might want to take low-dose tadalafil?
女性可能想要服用低剂量他达拉非有什么原因吗？
Kyle Gillett:
凯尔·吉列：
Tadalafil is also a weak androgen receptor sensitizer, kind of like L-carnitine, where the density of the available androgen receptors to bind increases slightly.
他达拉非也是一种弱雄激素受体敏化剂，有点像左旋肉碱，可结合的雄激素受体的密度略有增加。
So there could potentially be a benefit from that, but most of the time, it's used in men.
所以这可能有潜在的好处，但大多数时候，它用于男性。
Andrew Huberman:
安德鲁·休伯曼：
Very interesting.
非常有趣。
We haven't really talked about testosterone and optimizing testosterone in males.
我们还没有真正讨论过睾酮和优化男性睾酮。
Assuming someone is paying attention to the six pillars, there's a gap, as I see it, between doing all those things and TRT, hormone replacement therapy.
假设有人关注这六大支柱，那么在我看来，做所有这些事情与 TRT（激素替代疗法）之间存在差距。
And again, the R, the replacement in TRT, is a little bit in quotes nowadays because a lot of people who have testosterone in that 300-to-900-nanogram-per-deciliter range opt to take low-dose testosterone anyway.
再说一遍，R（TRT 的替代品）如今被引用了一点，因为许多睾酮水平在 300 至 900 纳克/分升范围内的人无论如何都会选择服用低剂量睾酮。
My understanding is that there have been some new movements in this area toward, for instance, not doing big, large doses injected infrequently, but rather low doses quite frequently, obviously prescribed by a doctor, monitored by a doctor, et cetera.
我的理解是，这一领域出现了一些新的举措，例如，不经常注射大剂量，而是经常注射低剂量，显然是由医生开处方，由医生监测，等等。
Is that generally what you like to see in your patients if they're going to take this route?
如果患者打算采取这种方式，您通常希望在患者身上看到这种情况吗？
Kyle Gillett:
凯尔·吉列：
If they're a hypogonadal patient whose benefits outweigh risks of TRT, then you want to have a nice, even steady state.
如果他们是性腺机能减退患者，且 TRT 的益处大于风险，那么您希望拥有良好、稳定的状态。
It's not going to be exactly the same as producing pulsatile testosterone release endogenously from your own body.
它不会与从您自己的身体内源性产生脉动睾酮释放完全相同。
When you have a steady state, you don't have a peak or a trough.
当你处于稳定状态时，就没有高峰或低谷。
And when you have a peak, that's when the androgen receptor gene is overactive.
当达到峰值时，雄激素受体基因就会过度活跃。
That's when you get more erythropoietin, or EPO, release, and that leads to a lot of the side effects of thick blood, so higher hemoglobins and hematocrits.
这时您会释放更多的促红细胞生成素（EPO），这会导致血液粘稠的许多副作用，从而导致血红蛋白和血细胞比容升高。
And then when you have a crash, you don't feel good, so it's definitely not optimal.
当你发生车祸时，你会感觉不舒服，所以这绝对不是最佳的。
Kyle Gillett:
凯尔·吉列：
There's a lot of ways to get around this.
有很多方法可以解决这个问题。
So when you're doing testosterone replacement if you're someone that needs it, you can have different types of esters, or you could do topical testosterone.
因此，当您进行睾酮替代治疗时，如果您有需要，可以服用不同类型的酯，或者也可以进行局部睾酮治疗。
So the ester is basically something that's attached to increase the biological half-life.
所以酯基本上是为了延长生物半衰期而附着的东西。
The most common ones are cypionate, enanthate.
最常见的是环丙酸、庚酸。
There's also a very short-acting propionate, which has almost no clinical relevance.
还有一种作用非常短的丙酸盐，几乎没有临床意义。
And there's also very long-acting ones, decanoate and undecanoate and different mixtures of all those.
还有非常长效的癸酸酯和十一酸酯以及所有这些的不同混合物。
So if you're someone who has a very, very low SHBG, you're going to have trouble of regulating your serum testosterone in the long run.
因此，如果您的性激素结合球蛋白水平非常非常低，从长远来看，您将难以调节血清睾酮。
If you do it topically and the testosterone is absorbed, hopefully bound to SHBG, and then a lot of times you reapply twice daily or once daily, but you have lots of variations.
如果你局部涂抹，睾酮被吸收，希望与性激素结合球蛋白结合，然后很多时候你每天重新涂抹两次或每天一次，但你有很多变化。
So for most people, especially for people who can absorb it well, that's not going to be a great option.
所以对于大多数人来说，尤其是对于那些能够很好吸收它的人来说，这不会是一个很好的选择。
Andrew Huberman:
安德鲁·休伯曼：
So injections would be preferred.
所以注射是首选。
Kyle Gillett:
凯尔·吉列：
Most people end up injecting because they have either side effects from too high, too low or just too much of a varied dose when they do topical.
大多数人最终选择注射，是因为局部注射时剂量过高、过低或过多会产生副作用。
There's also a capsule with a special lymphatic absorption, so it's not being absorbed through the liver, it's not hepatically metabolized, but it's absorbed through the lymph, and it's essentially a testosterone undecanoate and then put into a capsule.
还有一种胶囊有特殊的淋巴吸收，所以不是通过肝脏吸收，不是肝脏代谢，而是通过淋巴吸收，本质上是十一酸睾酮，然后装进胶囊里。
And that's taken twice daily.
每天服用两次。
It has fairly steady half-life, but you have to take it at specific times of the day.
它的半衰期相当稳定，但您必须在一天中的特定时间服用。
And it's new enough to where there isn't a huge amount of data on it, but it is FDA-approved.
它很新，没有大量数据，但它已获得 FDA 批准。
So it is brand-name now.
所以现在已经是名牌了。
It's called Jatenzo.
它叫贾坦佐。
Kyle Gillett:
凯尔·吉列：
But the injectables in general, the lower your SHBG, the longer of an ester you want because when you inject it, whether it's intramuscular or subcutaneous, just talk to your doctor about the risks and the benefits of those.
但一般来说，注射剂的性激素结合球蛋白 (SHBG) 越低，您需要的酯的时间就越长，因为当您注射时，无论是肌肉注射还是皮下注射，只需与您的医生讨论这些注射的风险和益处即可。
Subcutaneous has slightly longer active half-life because the esterases take longer to reach that cypionate or enanthate ester to cleave it.
皮下注射的活性半衰期稍长，因为酯酶需要更长的时间才能到达环戊丙酸酯或庚酸酯以将其裂解。
So most men ...
所以大多数男人...
A lot of people ask me about what a usual dose is.
很多人问我常用剂量是多少。
For most people, it would be a total of about 100 to 120 per week for an actual replacement dose.
对于大多数人来说，实际的替代剂量总共约为每周 100 至 120 剂。
Andrew Huberman:
安德鲁·休伯曼：
Milligrams.
毫克。
Kyle Gillett:
凯尔·吉列：
Milligrams, 120 to 100 milligrams per week, administered two to three times per week.
毫克，每周120至100毫克，每周给药2至3次。
Andrew Huberman:
安德鲁·休伯曼：
So you're saying dividing that into two or three, right?
所以你的意思是把它分成两部分或三部分，对吗？
Because I'm sure there's a bunch of people out there thinking, "Oh yeah, 100 three times a week," which is actually a quite high dose.
因为我确信有很多人在想，“哦，是的，每周 3 次 100 次”，这实际上是一个相当高的剂量。
Yeah.
是的。
There really does seem to be a shift toward spreading these dosages out, dividing them into two or three smaller doses.
似乎确实出现了将这些剂量分散的转变，将它们分成两到三个较小的剂量。
Andrew Huberman:
安德鲁·休伯曼：
And then along those lines, five, 10 years ago, it was common to hear about inhibiting estrogen through aromatase inhibitors.
沿着这些思路，五、十年前，人们经常听说通过芳香酶抑制剂抑制雌激素。
Nowadays you hear, and I think it's true at least by my read of the literature, that inhibiting estrogen can disrupt brain function, can cause connective tissue issues and even can cause reductions in libido.
现在你听说，而且我认为至少通过我读到的文献来看这是真的，抑制雌激素会扰乱大脑功能，会导致结缔组织问题，甚至会导致性欲降低。
So a lot of people think that estrogen, if you crash estrogen, that basically libido goes up, but actually the opposite is often true.
所以很多人认为雌激素，如果雌激素崩溃，基本上性欲就会上升，但实际上事实往往恰恰相反。
You don't want estrogen too high or too low.
您不希望雌激素过高或过低。
Is that correct?
这是正确的吗？
And for that reason, do you shy away from people taking aromatase inhibitors?
因此，您会回避服用芳香酶抑制剂的人吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Very few people truly need an aromatase inhibitor.
很少有人真正需要芳香酶抑制剂。
There's almost always lifestyle interventions.
几乎总是有生活方式干预。
It can just depend on which gene, how active your aromatase gene is.
这仅取决于哪个基因，您的芳香酶基因的活跃程度。
Some people's aromatase gene is very active.
有些人的芳香酶基因非常活跃。
A lot of times, these individuals have pubertal gynecomastia, which is breast tissue growth in males, even despite no other risk factor.
很多时候，这些人患有青春期男性乳房发育症，即男性的乳腺组织生长，即使没有其他危险因素。
Andrew Huberman:
安德鲁·休伯曼：
Even if they're lean?
即使他们很瘦？
Kyle Gillett:
凯尔·吉列：
Some people get it if they're lean.
有些人如果身材苗条就会得到它。
It's possible.
这是有可能的。
Andrew Huberman:
安德鲁·休伯曼：
I remember growing up, there were a few kids that got mild cases of gynecomastia that were transient.
我记得在我的成长过程中，有一些孩子患有轻微的短暂性男性乳房发育症。
They developed gynecomastia and then it went away.
他们患上了男性乳房发育症，然后就消失了。
Kyle Gillett:
凯尔·吉列：
Often it's unilateral on one side too.
通常它也是单方面的。
So growth hormone a lot of times is the fuel to that fire.
所以生长激素很多时候都是火上浇油。
Andrew Huberman:
安德鲁·休伯曼：
Oh, interesting.
哦，有趣。
Yeah.
是的。
There were a couple kids.
有几个孩子。
They took some teasing because back then, there wasn't online discussions about hormones and things like that, but then it would seem transient.
他们受到了一些嘲笑，因为当时网上还没有关于激素之类的讨论，但那时它似乎是短暂的。
The people I'm thinking of were actually lean individuals, so they weren't overweight, which of course can cause gynecomastia, because adipose fat tissue can convert testosterone into estrogen.
我想到的人实际上都是瘦人，所以他们没有超重，这当然会导致男性乳房发育症，因为脂肪组织可以将睾酮转化为雌激素。
So it sounds like except in special cases that avoiding aromatase inhibitors is probably going to be a good idea.
因此，听起来除了特殊情况外，避免使用芳香酶抑制剂可能是一个好主意。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
There's several other ways that you can control your estrogen and keep it at a healthy level, which you do have to check.
还有其他几种方法可以控制雌激素并将其保持在健康水平，您必须检查这些方法。
There's a lot of patients who assure me that their estrogen is going to be sky high, and it's actually very low and vice versa.
有很多患者向我保证，他们的雌激素会很高，但实际上很低，反之亦然。
But calcium d-glucarate is a supplement that can help with estrogen control.
但 D-葡萄糖酸钙是一种有助于控制雌激素的补充剂。
Andrew Huberman:
安德鲁·休伯曼：
What's a typical dosage of calcium d-glucarate?
D-葡萄糖酸钙的典型剂量是多少？
Kyle Gillett:
凯尔·吉列：
Five hundred to 1,000 milligrams.
五百到一千毫克。
Andrew Huberman:
安德鲁·休伯曼：
But is there the risk that if someone's estrogen is in normal range and they take this supplement that their estrogen will go too low?
但是，如果某人的雌激素在正常范围内并且服用这种补充剂，是否存在雌激素过低的风险？
Is it that potent?
有这么厉害吗？
Kyle Gillett:
凯尔·吉列：
It's not that potent.
它没有那么强大。
It's not near as potent as an aromatase inhibitor, so it helps with excretion and also the sensitivity of the estrogen receptor itself.
它的效力不如芳香酶抑制剂，因此它有助于排泄以及雌激素受体本身的敏感性。
It helps out-compete it.
它有助于超越它。
Some people also take DIM or different cruciferous vegetable.
有些人还服用 DIM 或不同的十字花科蔬菜。
They get them from cruciferous vegetables like kale or broccoli, and that is both an antiestrogen and an antiandrogen.
他们从羽衣甘蓝或西兰花等十字花科蔬菜中获取它们，这既是抗雌激素又是抗雄激素。
So if you're on TRT, and you're on that, then you're probably just on too much TRT.
因此，如果您正在接受 TRT，而且您正在这样做，那么您可能只是接受了过多的 TRT。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
I remember a few years ago I had a friend, and truly this is — it's not like I have a friend thing, because I'm very cautious about which supplements I take.
我记得几年前我有一个朋友，确实，这不像我有朋友那样，因为我对服用哪种补充剂非常谨慎。
I think people might get the impression that I'm very cavalier about this, but I'm not.
我想人们可能会觉得我对此很傲慢，但我不是。
I always alter one thing at a time.
我总是一次改变一件事。
I talk to physicians.
我和医生交谈。
What I suggest other people do, I actually do and have done for a long period of time.
我建议别人做的事情，我实际上也在做，而且已经做了很长一段时间了。
I recall wanting to take DIM because I thought, well ...
我记得想要服用 DIM 因为我想，嗯......
back then, you hear, "Okay, reduce estrogen." My estrogen levels weren't out of range ,so they were fine.
那时，你会听到，“好吧，减少雌激素。”我的雌激素水平没有超出范围，所以一切都很好。
But I thought, well, what would the experience be of bringing those down?
但我想，好吧，把它们打倒会是什么体验？
But someone I know is quite informed in this area.
但我认识的一个人在这方面非常了解。
So yeah, exactly what you said, which is that DIM can reduce estrogen but also testosterone.
是的，正如你所说，DIM 可以减少雌激素，也可以减少睾酮。
So I just never opted to try and take it.
所以我从来没有选择尝试接受它。
Andrew Huberman:
安德鲁·休伯曼：
I do want ...
我确实想要...
we're erring in this direction, but we went straight from the six pillars to TRT, or to what some people now call sports TRT, which is basically code language for saying taking exogenous testosterone, even though one doesn't need it, to get into a semi-supraphysiological range or a high-end, like 900-to-1,000-nanogram-per-deciliter range.
我们在这个方向上犯了错误，但我们直接从六大支柱转向TRT，或者有些人现在所说的运动TRT，这基本上是一种代码语言，表示服用外源性睾酮，即使不需要它，进入半超生理范围或高端，比如900到1,000纳克每分升的范围。
And people always point out, I should mention, that, "Oh, well, in certain countries, the high-end range is 1,200 nanograms per deciliter.
人们总是指出，我应该提一下，“哦，好吧，在某些国家，高端范围是每分升 1,200 纳克。
In the U.S., it's 900.
在美国，这个数字是900。
And so if you're 1,200, are you really supraphysiological?"
那么如果你有 1,200 岁，你真的是超生理的吗？”
Andrew Huberman:
安德鲁·休伯曼：
All that aside, I neglected to ask about that gap in between where individuals could think about supplementation, meaning nonprescription approaches to increasing testosterone.
除此之外，我忽略了询问个人可以考虑补充的差距，这意味着非处方方法可以增加睾丸激素。
And here we should probably also talk about things like, is it true that ice baths increase testosterone, or not?
在这里我们或许还应该讨论诸如冰浴是否真的会增加睾丸激素之类的问题？
Lifestyle factors that go beyond the six pillars, for increasing testosterone.
除了六大支柱之外，生活方式因素也能增加睾酮水平。
If you could comment on those, that would be terrific — supplements that are useful.
如果你能对这些发表评论，那就太好了——有用的补充剂。
And it'd be wonderful if you could mention where some of these same practices and supplements might be useful for women as well as men to increase testosterone for all the reasons we talked about earlier.
如果您能提及其中一些相同的做法和补充剂可能对女性和男性都有益，因为我们之前讨论过的所有原因，那就太好了。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So this is where a true individualized approach comes in.
因此，这就是真正的个性化方法的用武之地。
When you're talking about what dose of TRT you should be on, one thing to keep in mind is the law of diminishing returns.
当您谈论应该接受多少剂量的 TRT 时，需要记住的一件事是收益递减定律。
Quality of life is a subjective thing and it's different for each person.
生活质量是一个主观的事情，每个人的情况都不同。
So some people are more willing to give up a little bit of athleticism or body composition.
所以有些人更愿意放弃一点运动能力或身体成分。
Some people are more willing to give up or not willing to give up libido or sexual health.
有些人更愿意放弃或不愿意放弃性欲或性健康。
And as we mentioned earlier, everybody's androgen receptor is less or more sensitive.
正如我们之前提到的，每个人的雄激素受体都或多或少敏感。
So you can make a case that if somebody's androgen receptor is half as sensitive as somebody else, the person with the less sensitive receptor does need a level of 1,000 or 1,200.
因此，您可以证明，如果某人的雄激素受体敏感度只有其他人的一半，那么具有较不敏感受体的人确实需要 1,000 或 1,200 的水平。
There's no great way to know that.
没有什么好方法可以知道这一点。
And you can alter the sensitivity of your androgen receptor with things like L-carnitine and tadalafil, as mentioned.
正如前面提到的，您可以使用左旋肉碱和他达拉非等药物来改变雄激素受体的敏感性。
Andrew Huberman:
安德鲁·休伯曼：
We'll definitely come back to L-carnitine because I'm really intrigued by the data on L-carnitine, both for women and men, in terms of egg quality, sperm quality, fertility and a bunch of other interesting effects.
我们肯定会回到左旋肉碱，因为我对左旋肉碱的数据非常感兴趣，无论是对于女性还是男性，在卵子质量、精子质量、生育能力和许多其他有趣的影响方面。
So we'll come back to L-carnitine.
那么我们回到左旋肉碱。
Kyle Gillett:
凯尔·吉列：
But a lot of how you feel, the biofeedback or subjective "I feel like" this comes from the ratio of your androgens to your estrogens.
但你的很多感觉、生物反馈或主观的“我感觉”都来自于你的雄激素与雌激素的比例。
And a lot of that is lifestyle.
其中很多是生活方式。
So if someone is also on HCG, that could upregulate aromatase as well and-
因此，如果有人也服用 HCG，那么芳香酶也会上调，并且-
Andrew Huberman:
安德鲁·休伯曼：
You might want to just ...
您可能只想...
human chorionic gonadotropin, it used to found in ...
人绒毛膜促性腺激素，它曾经发现于......
is still found in pregnant women.
仍然存在于孕妇中。
Kyle Gillett:
凯尔·吉列：
It's still found in pregnant women.
它仍然存在于孕妇中。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Believe it or not, there was a black market for pregnant women's urine before this stuff was developed synthetically.
不管你信不信，在合成这种东西之前，孕妇尿液就存在黑市。
So in other words, what we're saying is men typically would buy pregnant women's urine through black markets in order to get the HCG, in order to get the testosterone-enhancing effects of HCG.
所以换句话来说，我们所说的男性通常会通过黑市购买孕妇的尿液来获取HCG，从而获得HCG增强睾酮的作用。
So in other words, men were using pregnant women's urine for HCG.
换句话说，男性利用孕妇的尿液来检测 HCG。
I do not want to know how they got it into their body.
我不想知道他们是如何将其摄入体内的。
Let's just skip to what you were going to say next instead.
让我们直接跳到您接下来要说的内容。
Kyle Gillett:
凯尔·吉列：
Yeah, so that's HCG.
是的，这就是HCG。
There's a lot of other things that upregulate estrogen.
还有很多其他东西可以上调雌激素。
Alcohol significantly increases aromatase.
酒精显着增加芳香酶。
So if you're very sensitive to estrogen, then you probably shouldn't even consume the two glasses three times a week.
因此，如果您对雌激素非常敏感，那么您可能甚至不应该每周喝 3 次两杯。
High-fat meals also upregulate aromatase.
高脂肪食物也会上调芳香酶。
So if you're on a ketogenic diet but you have hyperestrogenism, then you should take care with that as well.
因此，如果您正在进行生酮饮食，但雌激素过多，那么您也应该注意这一点。
Andrew Huberman:
安德鲁·休伯曼：
All kinds of fats or just saturated fats?
各种脂肪还是饱和脂肪？
Kyle Gillett:
凯尔·吉列：
I'm not sure if it's just saturated fats, but fat definitely, both fat in your body and consumption of a high amount of calories, increases aromatase.
我不确定是否只是饱和脂肪，但脂肪肯定会增加芳香酶，无论是体内的脂肪还是大量卡路里的消耗。
Andrew Huberman:
安德鲁·休伯曼：
So that it's the ratio of testosterone to estrogen.
这就是睾酮与雌激素的比例。
I don't want to break your flow, but since we're talking about fat, I have to ask: Since estrogen and testosterone are both synthesized from the cholesterol molecule, I've heard that ingesting some amount of saturated fat can be useful because of the way that cholesterol can serve as a precursor to these molecules.
我不想打断你的思路，但既然我们在谈论脂肪，我不得不问：由于雌激素和睾酮都是由胆固醇分子合成的，我听说摄入一定量的饱和脂肪会很有用，因为胆固醇可以作为这些分子的前体。
Now I once said on a podcast that I like butter so much that I occasionally eat pats of butter.
现在我曾经在播客上说过，我非常喜欢黄油，所以我偶尔会吃一小块黄油。
Somehow that got misinterpreted to mean that I eat entire, many pats of butter.
不知何故，这被误解为我吃了整块黄油。
I'm talking one or two pats of butter here and there, and I have no guilt or shame about it.
我到处谈论一两块黄油，对此我没有任何内疚或羞耻。
My blood lipids are in great shape also, so I feel good.
我的血脂也很好，所以我感觉很好。
But is it possible that people who are ingesting too little of saturated fats could directly or indirectly reduce or somehow disrupt the proper ratio of testosterone to estrogen in men and women?
但是，摄入太少饱和脂肪的人是否有可能直接或间接减少或以某种方式破坏男性和女性睾酮与雌激素的适当比例？
Kyle Gillett:
凯尔·吉列：
It's theoretically possible, but it probably doesn't happen in developed countries.
这在理论上是可能的，但在发达国家可能不会发生。
Just like it's theoretically possible to have not enough omega-6 fatty acids, but that probably does not happen in developed countries.
就像理论上可能没有足够的 omega-6 脂肪酸一样，但在发达国家可能不会发生这种情况。
Andrew Huberman:
安德鲁·休伯曼：
So I don't need the butter pats, but I'm going to do it anyway.
所以我不需要黄油块，但无论如何我都会这么做。
I'm just curious.
我只是好奇。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Kyle Gillett:
凯尔·吉列：
Grass-fed butter has good omega-3 content as well.
草饲黄油也含有良好的 omega-3 含量。
So grass-fed foods in general, it's not the end all be all, and everybody doesn't need grass-fed foods, but they are one of the only sources of healthy trans fat.
因此，一般来说，草饲食品并不是全部，每个人都不需要草饲食品，但它们是健康反式脂肪的唯一来源之一。
So a naturally occurring trans fat comes from ruminants.
因此，天然存在的反式脂肪来自反刍动物。
So ruminants, think of cows.
所以反刍动物，想想牛。
And the rumination in the different stomachs can change your omega-3 and omega-6 to trans linolenic and trans linoleic fatty acids.
不同胃中的反刍可以将您的 omega-3 和 omega-6 转变为反式亚麻酸和反式亚油酸脂肪酸。
Andrew Huberman:
安德鲁·休伯曼：
Which are healthy for us.
这对我们来说是健康的。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So it's actually omega-3s and omega-6s that just happened to have a trans instead of a cis isomer.
所以实际上是 omega-3 和 omega-6 碰巧有反式异构体而不是顺式异构体。
Andrew Huberman:
安德鲁·休伯曼：
And these healthy trans fats would be found in ruminant cheese and milk and butter from ruminants, or the meats.
这些健康的反式脂肪存在于反刍动物奶酪、反刍动物牛奶和黄油或肉类中。
Kyle Gillett:
凯尔·吉列：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And for people who are following a purely plant-based diet or mostly plant-based diet, are they at risk of not getting enough of certain types of fats or other nutrients to maintain that healthy ratio of testosterone to estrogen, or not?
对于遵循纯植物性饮食或主要以植物性饮食为主的人们来说，他们是否面临无法摄入足够的某些类型脂肪或其他营养素来维持睾酮与雌激素健康比例的风险？
Kyle Gillett:
凯尔·吉列：
If they're a vegetarian, they're probably not at risk.
如果他们是素食主义者，他们可能不会面临风险。
If they're a vegan, they very well could be at risk.
如果他们是素食主义者，他们很可能面临危险。
Most vegans are aware of this very acutely, and they'll supplement with algae, or they'll supplement with other sources of healthy fats.
大多数素食主义者都非常敏锐地意识到这一点，他们会补充藻类，或者补充其他健康脂肪来源。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
So the takeaway that I'm drawing from this is that less so than getting saturated fat, it's key to get these healthy trans fats from ruminants, or the food products of those ruminants as well, as to get proper amounts of omega-3s.
因此，我从中得出的结论是，从反刍动物或这些反刍动物的食品中获取这些健康的反式脂肪，比获取饱和脂肪更重要，这样才能获取适量的 omega-3。
Kyle Gillett:
凯尔·吉列：
And to be clear, you don't need any trans fats.
需要明确的是，您不需要任何反式脂肪。
It just happens that those omega-3s and omega-6s are in a trans isomer.
恰好那些 omega-3 和 omega-6 是反式异构体。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
Okay.
好的。
So that's nutrition.
所以这就是营养。
What other supplements can support healthy testosterone-to-estrogen ratios?
还有哪些其他补充剂可以支持健康的睾酮与雌激素比例？
Kyle Gillett:
凯尔·吉列：
Anything that alters aromatase can support healthy testosterone to estrogen.
任何改变芳香酶的物质都可以支持健康的睾酮转化为雌激素。
Your testosterone-to-estrogen ratio, think about it as how much estrogen activity do you have at the beta estradiol receptor and your alpha estradiol receptor?
您的睾酮与雌激素的比率，可以将其视为您的 β 雌二醇受体和 α 雌二醇受体上的雌激素活性有多少？
Andrew Huberman:
安德鲁·休伯曼：
How would I know that?
我怎么知道呢？
Kyle Gillett:
凯尔·吉列：
So it's hard to tell, but depending on what you're eating, if you have a lot of plant-based diets or polyphenols, many of these are beta estradiol receptors.
所以很难说，但根据你吃的东西，如果你有很多植物性饮食或多酚，其中许多是β雌二醇受体。
People know about turkesterone and also beta ecdysterone, which are two ecdysteroids that are beta estradiol receptor agonists, so they activate the beta estradiol receptor.
人们知道土耳其酮和β蜕皮甾酮，它们是两种蜕皮类固醇，是β雌二醇受体激动剂，因此它们可以激活β雌二醇受体。
So if you have a very low amount of estrogen naturally, you're probably a better candidate for it.
因此，如果您体内的雌激素含量非常低，那么您可能是更好的选择。
Andrew Huberman:
安德鲁·休伯曼：
For taking turkesterone or ecdysteroids.
用于服用土耳其酮或蜕皮类固醇。
Kyle Gillett:
凯尔·吉列：
Yeah, ecdysteroids.
是的，蜕皮类固醇。
Andrew Huberman:
安德鲁·休伯曼：
I've never tried them, but I know ...
我从未尝试过，但我知道......
my understanding is that they work tremendously well for some people and not at all for others, and so one just simply has to try.
我的理解是，它们对某些人来说非常有效，但对另一些人则完全无效，因此人们只需要尝试一下即可。
But in promoting the activity of this estrogen receptor, is there a risk that turkesterone or ecdysterone could cause some of the "problems" associated with increasing estrogen activity like reduced libido, water retention?
但在促进这种雌激素受体的活性时，土耳其酮或蜕皮甾酮是否有可能导致一些与雌激素活性增加相关的“问题”，如性欲降低、水分潴留？
Kyle Gillett:
凯尔·吉列：
Water retention?
保水？
Yes.
是的。
Reduce libido?
降低性欲？
Probably not.
可能不会。
Closing growth plates in the bone?
关闭骨骼中的生长板？
No, because that's the alpha estradiol receptor.
不，因为那是α雌二醇受体。
Andrew Huberman:
安德鲁·休伯曼：
I've talked before on a couple of podcasts about tongkat ali, which is this Indonesian herb.
我之前在几个播客上谈论过东革阿里，这是一种印度尼西亚草药。
I guess it's also made and found in Malaysia, but it seems to be the Indonesian variety of tongkat ali that's most effective potentially for reducing sex hormone and binding globulin and thereby freeing up testosterone.
我猜它也是在马来西亚制造和发现的，但似乎是印度尼西亚品种的东革阿里，它对于减少性激素和结合球蛋白，从而释放睾酮最有效。
Whether or not the effects are through that pathway, through another pathway, a lot of people report improvements in things like libido and maybe androgen-like phenotypes, feeling more vital, et cetera.
无论效果是通过这条途径还是通过另一条途径，很多人都报告说性欲和可能的雄激素样表型有所改善，感觉更有活力等等。
And of course, some of that could be placebo, correct?
当然，其中一些可能是安慰剂，对吗？
But what are your thoughts on tongkat ali?
但您对东革阿里有何看法？
And please challenge my statements about tongkat ali if they're incorrect.
如果我关于东革阿里的陈述不正确，请质疑它们。
I'm not looking for validation here.
我不是在这里寻找验证。
I just really want to know what your thoughts are on it.
我只是想知道你对此有何想法。
Do you ever recommend it to patients?
您曾经向患者推荐过它吗？
When?
什么时候？
Men, women, one or the other?
男人、女人，选其一还是选其一？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So tongkat ali or longjack has multiple mechanisms of action, and there have been several placebo-controlled studies on it.
因此，东革阿里或长杰克具有多种作用机制，并且已经有几项安慰剂对照研究。
Some of them show decrease in SHBG.
其中一些显示 SHBG 下降。
At least one of them did not show any change in SHBG.
至少其中之一的性激素结合球蛋白（SHBG）没有表现出任何变化。
However, it does act on aromatase very weakly, probably not so strongly that you would have to be concerned of hypoestrogenism.
然而，它对芳香酶的作用确实非常弱，可能没有那么强，以至于您必须担心雌激素水平低下。
Andrew Huberman:
安德鲁·休伯曼：
So it reduces aromatase and thereby can reduce estrogen?
那么它会减少芳香酶从而减少雌激素吗？
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Kyle Gillett:
凯尔·吉列：
It's not a SERM, so it's not a selective estrogen receptor modifier, but it's probably a NERM as well or a nonselective estrogen receptor modifier, and that should help ...
它不是 SERM，所以它不是选择性雌激素受体调节剂，但它可能也是 NERM 或非选择性雌激素受体调节剂，这应该会有所帮助......
Kyle Gillett:
凯尔·吉列：
...
...
estrogen receptor modifier.
雌激素受体调节剂。
And that should help with decreasing negative feedback, inhibition of estrodiol in various locations, and also increasing testosterone.
这应该有助于减少负反馈、抑制各个部位的雌二醇，并增加睾酮水平。
PART 3 OF 5 ENDS Andrew Huberman:
第 3 部分（共 5 部分）结束 Andrew Huberman：
Interesting.
有趣。
Yeah.
是的。
The dosage that I've been using for years now is, I think it's 400 milligrams taken once a day, typically early in the day, because it can kind of have a mild stimulant effect, very mild.
我多年来一直使用的剂量是，我认为每天服用一次 400 毫克，通常是在一天的早些时候，因为它可以产生轻微的兴奋作用，非常温和。
And I know that some of the products out there recommend dosages that are much higher.
我知道有些产品推荐的剂量要高得多。
Anytime I've taken more than 400, I don't feel very good.
每当我服用超过400的时候，我就感觉不太好。
I don't know how to describe it other than it's just a little overstimulatory in terms of makes me kind of ...
我不知道如何描述它，只是有点过度刺激，让我有点……
It's like drinking too much coffee.
就像喝太多咖啡一样。
So that's interesting.
这很有趣。
And so would women ever want to take tongkat ali for any reason?
那么女性会因为任何原因想要服用东革阿里吗？
Kyle Gillett:
凯尔·吉列：
Yeah, absolutely.
是的，绝对是。
So there's a lot of women that have hyperestrogenism, and unlike adrenal fatigue or andropause, there's actually ICD-10 codes for hyperestrogenism.
因此，有很多女性患有雌激素过多症，与肾上腺疲劳或男性更年期不同，实际上有针对雌激素过多症的 ICD-10 代码。
Andrew Huberman:
安德鲁·休伯曼：
ICD-10 codes.
ICD-10 代码。
That's doctor-speak.
这是医生的话。
Kyle Gillett:
凯尔·吉列：
So there's codes to where your doctor can actually diagnose you with something.
因此，您的医生可以通过代码对您进行实际诊断。
So if you go to your doctor and you say, "I have adrenal fatigue," they can't diagnose you with that.
因此，如果您去看医生并说“我患有肾上腺疲劳”，他们无法诊断您的情况。
Or if you say, "I have andropause," they also can't diagnose you with that.
或者，如果您说“我患有男性更年期”，他们也无法诊断您。
But if you say you have hyperestrogenism, the most common complaint that comes with it is endometriosis, which is overgrowth of the lining of the uterus.
但如果您说自己患有雌激素过多症，那么随之而来的最常见的症状是子宫内膜异位症，即子宫内膜过度生长。
Kyle Gillett:
凯尔·吉列：
And those people could potentially ...
那些人有可能......
I think that's one area where we might see tongkat supplementation more and more because not only does it decrease aromatase ...
我认为这是我们可能会越来越多地看到东革补充剂的一个领域，因为它不仅会减少芳香酶......
Like we mentioned, testosterone in females is higher than estrogen and females.
正如我们提到的，女性的睾酮水平高于雌激素和女性。
So a lot of females get estrogen from aromatization as well.
因此，许多女性也通过芳香化获得雌激素。
Peripheral estrogen is sometimes what we call it because it's not directly produced in the ovaries, but they could be good candidates for tongkat if that's the case.
我们有时称之为外周雌激素，因为它不是直接在卵巢中产生的，但如果是这样的话，它们可能是东革的良好候选者。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
And my understanding is that people should be looking for sources of Indonesian tongkat ali, in particular.
我的理解是，人们尤其应该寻找印度尼西亚东革阿里的来源。
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
Another interesting application is essentially a ...
另一个有趣的应用程序本质上是......
I'll call it a PCT, but essentially.
我将其称为 PCT，但本质上是。
Andrew Huberman:
安德鲁·休伯曼：
What that means is-
这意味着什么——
Kyle Gillett:
凯尔·吉列：
PCT, defined as post cycle therapy.
PCT，定义为循环后治疗。
Andrew Huberman:
安德鲁·休伯曼：
Physicians love acronyms, scientists love acronyms, military love acronyms.
医生喜欢缩写词，科学家喜欢缩写词，军人喜欢缩写词。
Yeah, PCT, post cycle therapy, So this would be people coming off hormone therapy or steroids.
是的，PCT，周期后治疗，所以这将是那些停止激素治疗或类固醇治疗的人。
Kyle Gillett:
凯尔·吉列：
This would actually be for women that are coming off of their birth control pill, because perhaps it can help lower that SHBG back to normal, which is sometimes persistently elevated, and then it can help prevent the subsequent hyperestrogenism that happens.
这实际上适用于正在停止服用避孕药的女性，因为它可能有助于将性激素结合球蛋白 (SHBG) 降低到正常水平，而性激素结合球蛋白有时会持续升高，然后它可以帮助预防随后发生的雌激素过多症。
Andrew Huberman:
安德鲁·休伯曼：
Does tongkat ali need to be cycled?
东革阿里需要循环吗？
When I first started taking it, I would cycle it.
当我第一次开始服用它时，我会循环使用它。
I would do three, four months, and I would take some time off.
我会做三、四个月，然后我会休息一些时间。
Now I've just been taking it continuously for years.
现在我已经连续服用多年了。
And I should say I do blood work to check my liver enzymes and everything else, and I don't see any reason for me to cease taking it.
我应该说我做了血液检查来检查我的肝酶和其他一切，我看不出有任何理由让我停止服用它。
Kyle Gillett:
凯尔·吉列：
Yeah, probably not.
是的，可能不会。
There's been human studies on both tongkat and Fadosia.
对东革和法多西亚都有人体研究。
And full disclosure, I did help design Derek's new testosterone optimization supplement, which has both Fadosia agrestris and also tongkat ali in it.
坦白说，我确实帮助设计了 Derek 的新睾酮优化补充剂，其中含有 Fadosia agrestris 和东革阿里。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Let's talk about Fadosia separately in a moment, but if, let's say someone is only taking tongkat ali for whatever reason, but do they need to cycle off?
让我们稍后单独讨论法多西亚，但如果，假设有人出于某种原因只服用东革阿里，但他们需要停止服用吗？
Kyle Gillett:
凯尔·吉列：
Likely not, but I would just to be safe because it does both affect your aromatase and it's an estrogen receptor modifier.
可能不会，但我只是为了安全起见，因为它确实会影响您的芳香酶，而且它是一种雌激素受体调节剂。
Andrew Huberman:
安德鲁·休伯曼：
And what would be a reasonable cycle off?
什么是合理的休息时间？
So how long to take and how long to stop before taking again?
那么需要服用多长时间以及停药多久才能再次服用？
Kyle Gillett:
凯尔·吉列：
Yeah, there's a couple different protocols that you can do, but 11 months on, one month off for tongkat is pretty reasonable.
是的，您可以执行几种不同的方案，但对于东革来说，连续 11 个月休息一个月是相当合理的。
I guess we'll talk about this later too, but if it's combined with Fadosia, the protocol that I would do is three weeks on, one week off.
我想我们稍后也会讨论这个问题，但如果它与 Fadosia 结合起来，我要做的方案是持续三周，休息一周。
Andrew Huberman:
安德鲁·休伯曼：
So that's tongkat ali.
这就是东革阿里。
But I'm curious what your thoughts are on Fadosia agrestis, this Nigerian shrub, or this extract from Nigerian shrubs, that, at least in my experience and my read of the literature, has the potential to increase testosterone and probably other hormones as well, by way of increasing luteinizing hormones.
但我很好奇你对 Fadosia agrestis 这种尼日利亚灌木或尼日利亚灌木的提取物有何看法，至少根据我的经验和我阅读的文献，它有可能通过增加促黄体激素来增加睾酮和可能的其他激素。
Something that we haven't really talked about much up until now.
到目前为止我们还没有真正谈论过一些事情。
What are your thoughts about Fadosia agrestis?
您对于 Fadosia agrestis 有什么看法？
What are your ideas about the proposed mechanism or mechanisms, and where might this be useful for people on or off hormone replacement therapy?
您对拟议的一个或多个机制有什么想法？这对接受或不接受激素替代治疗的人有什么用处？
Kyle Gillett:
凯尔·吉列：
Yeah, Fadosia agrestis has just reached a point where we have enough evidence to we know it probably helps both with luteinizing hormone release, which stimulates Leydig cells in the testes to produce more testosterone, and probably with LH receptor sensitivity as well, which is a good combination of the two.
是的，Fadosia agrestis 刚刚达到这样一个阶段，我们有足够的证据表明它可能有助于黄体生成素的释放，刺激睾丸中的 Leydig 细胞产生更多的睾酮，并且可能还有助于 LH 受体敏感性，这是两者的良好结合。
It does come from the Nigerian shrub, but there is not quite enough evidence for me to be able to say it's safe for somebody to take this all the time.
它确实来自尼日利亚灌木，但没有足够的证据让我能够说有人一直服用它是安全的。
Which again, full disclosure, that's why we recommended for people to cycle this supplement.
再次强调，这就是我们建议人们循环使用这种补充剂的原因。
So three weeks on, one week off, that's likely safe.
因此，连续三周，休息一周，这可能是安全的。
The only toxicity studies, in general, are in rats, and in humans it looks quite safe.
一般来说，唯一的毒性研究是在老鼠身上进行的，而在人类身上看起来相当安全。
Andrew Huberman:
安德鲁·休伯曼：
My understanding is that the toxicity studies in rats showed toxicity to the testicular cells.
我的理解是，对大鼠的毒性研究表明对睾丸细胞有毒性。
So that's certainly concerning.
所以这肯定令人担忧。
But that the dosages that were used, or translating the dosages used to humans, would lead to a situation where the dosages that humans would have to take would be very, very large.
但是所使用的剂量，或者将所使用的剂量转化为人类使用的剂量，将导致人类必须服用的剂量将非常非常大的情况。
So the amount of ...
那么量...
I no longer take Fadosia, but I took it at 600 milligrams per day for a long time, and I ceased taking it because I was experimenting with other things and I didn't want to confound those things.
我不再服用 Fadosia，但很长一段时间我每天服用 600 毫克，后来我停止服用它，因为我正在尝试其他东西，我不想混淆这些东西。
Not because I had any negative side effects.
不是因为我有任何负面的副作用。
In fact, I was monitoring blood work and other biological parameters that would've told me if there was testicular toxicity.
事实上，我正在监测血液检查和其他生物参数，这些参数可以告诉我是否存在睾丸毒性。
And yeah, let's put it that way.
是的，让我们这样说吧。
Kyle Gillett:
凯尔·吉列：
Yeah, I think it's extremely safe, and I'm just not convinced that there's enough overwhelming evidence for long-term consistent administration.
是的，我认为它非常安全，而且我只是不相信有足够压倒性的证据来进行长期一致的管理。
Andrew Huberman:
安德鲁·休伯曼：
So do you recommend this to people who are not taking TRT, and do you recommend it to men and women?
那么您是否向未接受 TRT 的人推荐此疗法，是否向男性和女性推荐该疗法？
Kyle Gillett:
凯尔·吉列：
Yeah, so if you have a really high LH, then there's probably a gonadal issue, whether it's heat damage to the testes, a varicocele, a history of testicular cancer, where your LH is going to be higher.
是的，所以如果您的 LH 非常高，那么可能存在性腺问题，无论是睾丸热损伤、精索静脉曲张还是睾丸癌病史，您的 LH 都会更高。
So if your LH is already very high, increasing it even more is probably not going to help.
因此，如果您的 LH 已经非常高，再增加可能也无济于事。
However, if your LH is low, then obviously try to find out is low, is it deficient, or is it just a little bit low?
然而，如果您的 LH 低，那么显然要尝试找出低、是否缺乏、或者只是有点低？
Kyle Gillett:
凯尔·吉列：
If it's low and you don't have an issue with prolactin, you don't have an issue with opioid receptor antagonism.
如果它很低并且您没有催乳素问题，那么您就没有阿片受体拮抗问题。
And naltrexone can actually potentially help antagonize that to increase LH as well, especially in people recovering from opiates or likely even alcohol.
纳曲酮实际上也可以帮助对抗这一点，从而增加黄体生成素（LH），特别是对于从阿片类药物甚至酒精中恢复的人来说。
So you're looking for a subclinical secondary hypogonadism, which is essentially ...
所以你正在寻找亚临床继发性性腺功能减退症，这本质上是......
Just think of that as low LH.
只要将其视为低 LH 即可。
So when people with that lower LH and their estrogen is fine and their prolactin is fine, then Fadosia is a particularly good option.
因此，当 LH 较低、雌激素水平良好、催乳素水平良好时，Fadosia 是一个特别好的选择。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
So three weeks on, one week off for 600 milligrams Fadosia; 400 milligrams, tongkat ali, Indonesian tongkat ali, could potentially be good.
三周后，停药一周，服用 600 毫克 Fadosia； 400 毫克，东革阿里，印度尼西亚东革阿里，可能是好的。
And, of course, everyone should always check with their physician, clear this, do blood work, et cetera.
当然，每个人都应该经常咨询医生，明确这一点，进行血液检查等。
I always say.
我总是说。
We don't just say that to protect us, we say that to protect you, meaning that the consumer is very, very important.
我们这样说不仅是为了保护我们，也是为了保护您，这意味着消费者非常非常重要。
You don't want to fly blind with any of this stuff.
你不想对这些东西盲目飞行。
You want to do blood work.
你想做血液检查。
Kyle Gillett:
凯尔·吉列：
That's the catch-22 with supplements: most of them are safer than medications, but the only difference between them and a medication is one's prescribed and one's not.
这就是补充剂的第 22 条军规：大多数补充剂比药物更安全，但它们与药物之间的唯一区别在于是否是处方药。
Andrew Huberman:
安德鲁·休伯曼：
And oftentimes with supplements, it's unclear whether or not what's listed on the bottle is actually what's in the bottle.
通常，对于补充剂来说，不清楚瓶子上列出的内容是否真的是瓶子里的内容。
But I think there are a number of reputable brands.
但我认为有很多知名品牌。
Now, the other supplement I wanted talk about in terms of testosterone augmentation is boron.
现在，我想谈论的另一种在睾酮增强方面的补充剂是硼。
What is boron thought to do?
硼有什么作用？
Does it actually do that?
它真的这样做吗？
And do you ever recommend boron?
您推荐过硼吗？
Kyle Gillett:
凯尔·吉列：
Yeah, so boron is actually an element, and you can find it on the periodic table.
是的，所以硼实际上是一种元素，你可以在元素周期表上找到它。
It's more plentiful in rich soils.
它在肥沃的土壤中更为丰富。
So frequent farming can deplete the soils of boron.
频繁的耕作会耗尽土壤中的硼。
It's very plentiful in the Mediterranean area, like Greece and Turkey.
它在地中海地区非常丰富，例如希腊和土耳其。
So a lot of people will just eat dates or raisins that are grown there.
所以很多人只会吃那里种植的枣子或葡萄干。
Andrew Huberman:
安德鲁·休伯曼：
I thought you were going to tell many people eat dirt, but there are people who eat dirt.
我以为你会告诉很多人吃泥土，但确实有人吃泥土。
Kyle Gillett:
凯尔·吉列：
There are people who eat dirt.
有人吃土。
Andrew Huberman:
安德鲁·休伯曼：
And there's a phenomenon called pica, where people in a ...
有一种现象叫做异食癖，人们在...
And that's not a good thing.
这可不是什么好事。
Kyle Gillett:
凯尔·吉列：
Often a sign of iron deficiency,
通常是缺铁的表现，
Andrew Huberman:
安德鲁·休伯曼：
But they're eating grapes and dates that were grown in soil that has high amounts of boron.
但他们吃的是在富含硼的土壤中种植的葡萄和枣子。
Is that right?
是这样吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So boron can help regulate SHBG, but its effect is mostly acute, so it's unlikely to have a bad effect.
因此硼可以帮助调节性激素结合球蛋白（SHBG），但其作用大多是急性的，因此不太可能产生不良影响。
So a lot of people take boron because it's probably not going to hurt, and it will lower SHBG, even if it is for a short period of time.
所以很多人服用硼是因为它可能不会造成伤害，而且会降低性激素结合球蛋白（SHBG），即使是短期的。
So I guess you could make a case that maybe cycling boron can help too.
所以我想你可以证明循环硼也有帮助。
Andrew Huberman:
安德鲁·休伯曼：
What sorts of dosages are useful for boron supplementation?
什么样的剂量适合补充硼？
Kyle Gillett:
凯尔·吉列：
Three to six milligrams, once to twice a day.
三到六毫克，每天一到两次。
Andrew Huberman:
安德鲁·休伯曼：
Oh, interesting.
哦，有趣。
So that's higher than the amounts that I've been taking.
所以这比我一直服用的金额要高。
I've long been doing this cocktail of tongkat ali.
我长期以来一直在做这种东革阿里鸡尾酒。
Again, I stopped taking Fadosia, but for a long time with Fadosia and boron, I think it was two to four milligrams per day, but maybe I could afford to go higher, although my bloodwork is where I want it, thankfully.
我再次停止服用 Fadosia，但很长一段时间服用 Fadosia 和硼，我认为每天需要两到四毫克，但也许我可以承受更高的剂量，尽管谢天谢地，我的血液检查是我想要的。
So circling back to Fadosia, Fadosia was attractive to me as a supplement because I saw increases in LH testosterone and free testosterone.
回到 Fadosia，Fadosia 作为补充剂对我很有吸引力，因为我看到 LH 睾酮和游离睾酮有所增加。
My estrogen stayed in check, but I also did not see a down regulation of LH when I would cycle off.
我的雌激素一直处于控制状态，但当我停止骑行时，我也没有看到 LH 的下调。
Andrew Huberman:
安德鲁·休伯曼：
Whereas with HCG, human chorionic gonadotropin, which does now arrive in forms not from pregnant women's urine only, but the synthetic forms that people inject, that as I understand it, can actually suppress endogenous hormone output if one takes it for a long period of time.
而HCG，即人绒毛膜促性腺激素，现在不仅以孕妇尿液的形式出现，而且以人们注射的合成形式出现，据我了解，如果长期服用，实际上可以抑制内源性激素的分泌。
So why would a man or woman want to take HCG, and what are the potential risks and benefits of taking HCG?
那么为什么男性或女性想要服用 HCG，服用 HCG 的潜在风险和益处是什么？
Kyle Gillett:
凯尔·吉列：
Yeah, so HCG, or human chorionic gonadotropin, is actually very similar to TSH.
是的，HCG（人绒毛膜促性腺激素）实际上与 TSH 非常相似。
Andrew Huberman:
安德鲁·休伯曼：
Thyroid stimulating hormone.
促甲状腺激素。
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
So when a woman is pregnant, she produces more HCG, especially in the first trimester.
因此，当女性怀孕时，她会产生更多的 HCG，尤其是在妊娠的前三个月。
When you take a pregnancy test, whether it's qualitative or quantitative, you see the HCG rise, and it actually doubles every 48 hours.
当您进行妊娠测试时，无论是定性还是定量，您都会看到 HCG 上升，而且实际上每 48 小时就会增加一倍。
So if you're five weeks pregnant, you can get a HCG level and then two days later, five weeks and two days, you can see your HCG and maybe it went from 500 to 1,000.
因此，如果您怀孕五周，您可以获得 HCG 水平，然后两天后，五周零两天，您可以看到您的 HCG，也许它从 500 上升到 1,000。
So it precipitously increases.
所以它急剧增加。
Kyle Gillett:
凯尔·吉列：
It does a few things.
它做了一些事情。
One thing is it prevents hypothyroidism or hypothyroxinemia of pregnancy, which is one of the most common causes of miscarriage.
一件事是它可以预防妊娠期甲状腺功能减退症或低甲状腺素血症，这是流产的最常见原因之一。
It's also why if you have hypothyroidism and you get pregnant in the first trimester, you want to increase your dose from 25 to 40% to keep your free T4 high as much as possible.
这也是为什么如果您患有甲状腺功能减退症并且在妊娠前三个月怀孕，您需要将剂量从 25% 增加到 40%，以尽可能保持较高的游离 T4 水平。
Kyle Gillett:
凯尔·吉列：
And the reason why you have to do that, as opposed to somebody who does not have hypothyroidism, is if you have hypothyroidism, then likely your thyroid will not respond to either TSH or HCG.
与没有甲状腺功能减退症的人相比，您必须这样做的原因是，如果您患有甲状腺功能减退症，那么您的甲状腺可能不会对 TSH 或 HCG 产生反应。
So the increased HCG does not compensate for that.
因此，增加的 HCG 并不能弥补这一点。
So if you take HCG, then it can potentially improve your thyroid function.
因此，如果您服用 HCG，那么它可能会改善您的甲状腺功能。
So that along with selenium are likely the two best things that you can do for thyroid health.
因此，与硒一起可能是您可以为甲状腺健康做的两件事。
Andrew Huberman:
安德鲁·休伯曼：
HCG and selenium.
HCG 和硒。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Well, I definitely make sure I get enough selenium by eating three to five Brazil nuts per day, which I very much enjoy the taste of also.
嗯，我每天吃三到五颗巴西坚果肯定能确保摄入足够的硒，我也非常喜欢它的味道。
Who should take HCG, and can HCG suppress one's normal luteinizing hormone output?
哪些人应该服用 HCG，HCG 会抑制正常的黄体生成素分泌吗？
Kyle Gillett:
凯尔·吉列：
It suppresses LH in a dose-dependent manner.
它以剂量依赖性方式抑制 LH。
So the higher the dose of HCG you take, the more it suppresses LH.
因此，您服用的 HCG 剂量越高，对 LH 的抑制作用就越强。
A common dose for fertility, fertility is usually why HCG is prescribed ...
生育力的常见剂量，生育能力通常是 HCG 处方的原因......
Andrew Huberman:
安德鲁·休伯曼：
In men or in women?
在男性还是女性中？
Kyle Gillett:
凯尔·吉列：
In both.
在两者中。
Is 10,000 IUs all at one time, which is quite a bit.
一下子就10000个IU了，这个量还是不少的。
Andrew Huberman:
安德鲁·休伯曼：
That's a tremendous dose.
这是一个巨大的剂量。
Kyle Gillett:
凯尔·吉列：
In fact, some formulation brand names of HCG come in autoinjector pins to where you cannot even dose lower than 5,000 units at a time.
事实上，某些 HCG 配方品牌采用自动注射器针，您甚至无法一次注射低于 5,000 单位的剂量。
Andrew Huberman:
安德鲁·休伯曼：
Wow.
哇。
But I know a number of people who take HCG to maintain testicular function while on testosterone therapy or augmentation of some sort.
但我知道很多人在接受睾酮治疗或某种增强疗法时服用 HCG 来维持睾丸功能。
Does it work to do that?
这样做有用吗？
Kyle Gillett:
凯尔·吉列：
Yeah, some people are on HCG model therapy.
是的，有些人正在接受 HCG 模型治疗。
It can be slightly better on your lipids than being on TRT.
它对血脂的影响可能比 TRT 稍好一些。
Andrew Huberman:
安德鲁·休伯曼：
So people are using HCG alone as a kind of neither ...
因此，人们单独使用 HCG 作为一种既不...
Sort of a hormone augment ...
某种激素增强...
indirect hormone augmentation.
间接激素增加。
Kyle Gillett:
凯尔·吉列：
Some clinics advertise it as a nonsuppressive alternative to TRT, but it is suppressive of LH.
一些诊所将其宣传为 TRT 的非抑制性替代品，但它会抑制 LH。
Andrew Huberman:
安德鲁·休伯曼：
But it could also increase estrogen pretty potently.
但它也可以有效地增加雌激素。
And is it true that increasing LH and/or HCG can improve sensitivity of the genitals, and is that true for men and women?
增加 LH 和/或 HCG 真的可以提高生殖器的敏感性吗？对于男性和女性来说都是如此吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I've heard this anecdotally.
我听说过这件事。
People say HCG makes sexual activity more pleasurable for people because of some ...
人们说 HCG 使人们的性活动更加愉快，因为某些......
Is it a direct effect on some of the nerve cells in the genitals?
它对生殖器中的某些神经细胞有直接影响吗？
Kyle Gillett:
凯尔·吉列：
Yeah, so LH is also an agonist in the prostate, and in genital tissue in general.
是的，所以 LH 也是前列腺和一般生殖组织的激动剂。
So it's a very common treatment for post-finasteride syndrome, or post-5-αlpha reductase.
因此，这是非那雄胺后综合征或 5-α 还原酶后综合征的一种非常常见的治疗方法。
When you've blocked the conversion of DHT for a long time, it helps re-upregulate DHT.
当您长时间阻止 DHT 的转化时，它有助于重新上调 DHT。
Andrew Huberman:
安德鲁·休伯曼：
Someone who's been taking finasteride to prevent hair loss comes off it, feels ...
那些一直服用非那雄胺来防止脱发的人在戒掉它后，感觉......
Maybe because they felt lousy, but then feels even lousier for reasons you talked about earlier.
也许是因为他们感觉很糟糕，但由于你之前谈到的原因，他们感觉更糟糕。
And then they might use HCG as a transition treatment to transition back to normal hormone health.
然后他们可能会使用 HCG 作为过渡治疗，以恢复正常的激素健康。
Is that right?
是这样吗？
Kyle Gillett:
凯尔·吉列：
Yeah, it's extremely helpful in many cases.
是的，它在很多情况下都非常有帮助。
Now when you come off the HCG, then you need to have a strategy of how to return to your normal as fast as possible as well.
现在，当您停止 HCG 后，您还需要制定一个如何尽快恢复正常的策略。
But it will upregulate those 5-αlpha reductase enzymes you have in your genital skin, both scrotal skin and penile skin.
但它会上调生殖器皮肤（包括阴囊皮肤和阴茎皮肤）中的 5-α 还原酶。
And perineum in general.
和一般会阴。
You have, I believe what's called stratum lucidum.
你有，我相信所谓的透明层。
It's a skin layer that is very, very thin, but it has the highest concentration of 5-αlpha reductase.
这是一层非常非常薄的皮肤层，但它的 5-α 还原酶浓度最高。
Kyle Gillett:
凯尔·吉列：
So you have a lot of activity and after you've been on something that inhibits the enzyme, the 5α-R enzyme in those tissues, then you do something else to upregulate those enzymes, whether it's waiting and taking time, whether it's trying tadalafil, it's trying creatine even, or whether it's trying HCG.
因此，您进行了大量的活动，在服用了抑制酶（这些组织中的 5α-R 酶）的药物后，您会做其他事情来上调这些酶，无论是等待并花时间，无论是尝试他达拉非，甚至尝试肌酸，还是尝试 HCG。
A lot of times those are the go-tos for postfinasteride syndrome.
很多时候，这些都是非那雄胺后综合症的首选。
Andrew Huberman:
安德鲁·休伯曼：
Any risks for women taking HCG on their ability to get pregnant, or risks generally?
服用 HCG 的女性对怀孕能力有什么风险，或者一般风险吗？
Kyle Gillett:
凯尔·吉列：
Yeah, obviously it'll make any pregnancy test positive, so that's a risk that some women don't know.
是的，显然它会让任何妊娠测试呈阳性，所以这是一些女性不知道的风险。
Andrew Huberman:
安德鲁·休伯曼：
One could in theory fake a pregnancy test by injecting HCG.
理论上，人们可以通过注射 HCG 来伪造妊娠测试。
Kyle Gillett:
凯尔·吉列：
Absolutely.
绝对的。
Interesting.
有趣的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I have no motivation to do that.
是的，我没有动力这么做。
I was just curious.
我只是好奇。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What about prolactin?
催乳素呢？
The simple version of this that I was taught, because I was taught mainly from the neuroendocrine perspective, was dopamine is a kind of close cousin of testosterone, and also estrogen, for that matter.
我所学的简单版本是，因为我主要是从神经内分泌的角度学的，多巴胺是睾酮和雌激素的近亲。
Drives appetitive behaviors including pursuit of sexual partner, sex itself, motivated behaviors generally.
驱动食欲行为，包括追求性伴侣、性本身、一般动机行为。
Then postcopulatory, postorgasmic states are accompanied by a prolactin increase, sets the refractory period for mating in males and maybe even in females as well; involved in milk letdown, et cetera.
然后，交配后、性高潮后状态伴随着催乳素的增加，为雄性甚至雌性设定了交配不应期；涉及乳汁分泌不足等。
Andrew Huberman:
安德鲁·休伯曼：
What are sort the general contours of syndromes or things that people could be on the lookout for of having too much prolactin or too little prolactin?
人们可能会因催乳素过多或过少而引起哪些症状或症状？
And I'm aware of a number of people who take a dopamine agonist, L-tyrosine, cabergoline, things like that to really boost their dopamine levels, and that isn't always a good thing, as it turns out.
我知道很多人服用多巴胺激动剂、L-酪氨酸、卡麦角林之类的药物来真正提高多巴胺水平，但事实证明，这并不总是一件好事。
Oftentimes people become kind of hyperdopaminergic, and so they have the drive to do all these appetitive things, fill in the blanks, but they don't always have the ability, because it seems just as testosterone and estrogen need to be in the proper ratios, dopamine and prolactin need to be in the appropriate ratios.
通常，人们会变得多巴胺能亢进，因此他们有动力去做所有这些有食欲的事情，填补空白，但他们并不总是有能力，因为似乎就像睾丸激素和雌激素需要处于适当的比例一样，多巴胺和催乳素也需要处于适当的比例。
So how should we think about and perhaps act on our prolactin systems?
那么我们应该如何思考我们的催乳素系统并采取行动呢？
Kyle Gillett:
凯尔·吉列：
Absolutely.
绝对的。
The way I describe it is the dopamine wave pool.
我描述它的方式是多巴胺波池。
So if you're increasing your dopamine too much, you're going to overflow and then you're going to have that wave crash too much.
因此，如果你过多地增加多巴胺，你就会溢出，然后你就会出现太多的波崩溃。
So you want to have nice, even waves that are not going too far above the pool of dopamine, and prolactin will follow.
所以你想要有一个美好的、均匀的波浪，不要超出多巴胺池太远，催乳素也会随之而来。
Kyle Gillett:
凯尔·吉列：
So prolactin and estrogen are quite close cousins.
因此，催乳素和雌激素是近亲。
Estrogen upregulates a gene called the PRL gene, or prolactin gene, that directly increases prolactin synthesis.
雌激素上调一种称为 PRL 基因或催乳素基因的基因，可直接增加催乳素合成。
So prolactin is going to also inhibit the release of testosterone from the pituitary.
因此，催乳素也会抑制垂体释放睾酮。
So if you're using a dopamine agonist, then you are going to help decrease the prolactin-producing cells, including if you have a prolactin-producing microadenoma in the pituitary.
因此，如果您使用多巴胺激动剂，那么您将有助于减少产生催乳素的细胞，包括如果您的垂体中有产生催乳素的微腺瘤。
Andrew Huberman:
安德鲁·休伯曼：
How common are those?
这些有多常见？
Because I mean, I hear a lot about these hypogonadism, and of course that can be due to an issue at the testicles, or hypergonadism could also be, of course, in ovarian syndromes.
因为我的意思是，我听到很多有关性腺功能减退症的信息，当然这可能是由于睾丸问题引起的，当然，性腺功能亢进也可能是由于卵巢综合症引起的。
And then there's of course the brain side of it ,where the signals aren't coming from the brain.
当然还有大脑方面，信号不是来自大脑。
You're ...
你是...
not enough gonadotropin, not enough luteinizing hormone.
促性腺激素不足，黄体生成素不足。
And there are ways of teasing this apart through with an endocrinologist ,that are quite elegant, in fact, using stimulating hormones.
事实上，有一些方法可以通过内分泌学家来解决这个问题，这些方法非常优雅，使用刺激性激素。
Too much to dive into here, but how often does one actually have one of these pituitary tumors?
这里要深入探讨的内容太多了，但是一个人实际上患有这些垂体瘤的频率是多少？
Andrew Huberman:
安德鲁·休伯曼：
I have heard that people that play a lot of high-contact sports: so boxing, football, people that headed the soccer ball quite a lot; sadly, people whose jobs forced them to take head blows for ...
我听说人们经常参加高接触性的运动：拳击、足球、经常头球的人；可悲的是，那些工作迫使他们承受头部打击的人......
could be military, and so they were firing 50-caliber guns, and the kind of wood peckering of the brain inside of the skull; and construction workers; or just a concussion can cause the pituitary to go malfunctional.
可能是军事用途，所以他们发射的是 50 口径的枪，还有那种在头骨内啄木头的方式；和建筑工人；或者仅仅是脑震荡就可能导致脑下垂体出现故障。
Is that really common or is this something that is a rare like 1%?
这真的很常见还是像 1% 那样罕见？
Kyle Gillett:
凯尔·吉列：
Yeah, it's extremely common.
是的，这非常常见。
It's another one of those conditions where a lot of people never know they have it.
这是另一种很多人都不知道自己患有这种疾病的情况。
They just feel a little bit more fatigued.
他们只是感觉有点累了。
They have that high-prolactin feeling all the time.
他们一直有那种高催乳素的感觉。
Pituitary microadenomas can be nonproducing as well.
垂体微腺瘤也可能不生产。
So your prolactin can be totally normal.
所以你的催乳素可以完全正常。
Your growth hormone and IGF-1 can be totally normal.
您的生长激素和 IGF-1 可能完全正常。
That's the second most common producing microadenoma is growth hormone, causing either acromegaly, which is growth of cartilage, or gigantism.
第二个最常见的微腺瘤是生长激素，它会导致肢端肥大症（软骨生长）或巨人症。
Andrew Huberman:
安德鲁·休伯曼：
This is the big brow.
这就是大眉毛。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So those are fairly common causes of adenomas, but a lot of people that have a very small adenoma, much less than one centimeter, it's hard to see on imaging even if you have a contrast that specifically looks at the pituitary.
因此，这些是腺瘤相当常见的原因，但很多人的腺瘤非常小，远小于一厘米，即使您有专门观察垂体的造影剂，也很难在成像中看到。
And many people aren't symptomatic.
而且许多人没有症状。
So it's one of those things, along with PCOS and prediabetes, that are much more frequent when it comes to prevalence, which is the amount, the percentage of people that have it in the general population.
因此，就患病率而言，它是与多囊卵巢综合征和糖尿病前期一样更为常见的疾病之一，即患病率，也就是总人口中患有该病的人数和百分比。
Andrew Huberman:
安德鲁·休伯曼：
I'm glad you mentioned the dopamine wave pool.
我很高兴你提到多巴胺波池。
I know nowadays there's a lot of interest in augmenting dopamine.
我知道现在人们对增加多巴胺很感兴趣。
I know a number of people that do this through prescription drugs — Adderall, Ritalin, modafinil — and those drugs, of course, hit many transmitter systems, but dopamine is certainly involved.
我知道很多人通过处方药——阿得拉、利他林、莫达非尼——来做到这一点，这些药物当然会影响许多神经递质系统，但多巴胺肯定参与其中。
People taking antidepressants like Wellbutrin tap into that system.
服用维布特林等抗抑郁药的人会利用这个系统。
And of course people are trying to inhibit prolactin and promote serotonin or reduce serotonin.
当然，人们正在尝试抑制催乳素并促进血清素或减少血清素。
Andrew Huberman:
安德鲁·休伯曼：
To me it all seems like a very delicate dance.
对我来说，这一切似乎都是一场非常微妙的舞蹈。
I mean to just imagine the arousal arc for mating behavior for sexual reproduction is such an elaborate dance between sympathetic drive and parasympathetic drive.
我的意思是想象有性生殖的交配行为的唤醒弧是交感神经驱动力和副交感神经驱动力之间如此复杂的舞蹈。
Even across the span of minutes.
即使跨越几分钟。
I mean I've talked about this before on the podcast, that the arousal is kind of more parasympathetic.
我的意思是我之前在播客上谈到过这一点，唤醒更多的是副交感神经。
Orgasm itself is a sympathetic response, a completely different set of neurons.
性高潮本身是一种交感神经反应，是一组完全不同的神经元。
And so where do you see people getting into trouble just trying to hit the gas pedal on dopamine, and where do you think there is a place for people who perhaps are experiencing low drive and motivation, not just sexual, but in general, to increase the amount of dopamine circulating in their brain and body?
那么，你认为人们在哪里会因为试图踩下多巴胺的油门而陷入麻烦，你认为对于那些可能经历低动力和动机的人来说，不只是性方面，而且一般来说，在哪里可以增加他们大脑和身体中循环的多巴胺量？
How do you think about that given this wave pool analogy?
考虑到这个波浪池的类比，你如何看待这一点？
Kyle Gillett:
凯尔·吉列：
Yeah, so it's important to parse it out and start with the least powerful interventions.
是的，所以重要的是要分析它并从最弱的干预措施开始。
So if someone's concerned about dopamine, or maybe they have a slightly higher prolactin, then they eliminate things that could be increasing that prolactin.
因此，如果有人担心多巴胺，或者他们的催乳素水平略高，那么他们就会消除可能增加催乳素的物质。
Andrew Huberman:
安德鲁·休伯曼：
Such as.
比如。
Kyle Gillett:
凯尔·吉列：
Casein or gluten, which are opioid receptor agonists, or any opioid receptor agonist in the gut.
酪蛋白或麸质，它们是阿片受体激动剂，或肠道中的任何阿片受体激动剂。
Andrew Huberman:
安德鲁·休伯曼：
Casein, so milk protein, can increase prolactin.
酪蛋白，即牛奶蛋白，可以增加催乳素。
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Kyle Gillett:
凯尔·吉列：
In addition to that, they should, if they need a pituitary MRI, then they should get a pituitary MRI.
除此之外，如果他们需要垂体 MRI，那么他们应该接受垂体 MRI。
If they don't have an adenoma or if they don't have a high enough prolactin level to where they need an MRI, if they're having visual symptoms or if they're having olfactory symptoms with the nose, then it's more likely that they do.
如果他们没有腺瘤，或者催乳素水平没有达到需要 MRI 的水平，如果他们有视觉症状或鼻子有嗅觉症状，那么他们更有可能患有腺瘤。
But if they don't, a lot of times a prolactin under about 40 is not too big of a deal.
但如果不这样做，很多时候催乳素低于 40 也没什么大不了的。
Kyle Gillett:
凯尔·吉列：
They can take dopamine agonist, that agonize that D2 receptor.
他们可以服用多巴胺激动剂来激动 D2 受体。
Like P5P, which is essentially vitamin B6, it's pyridoxine 5-pyrophosphate, and pyridoxine is vitamin B6.
与本质上是维生素 B6 的 P5P 一样，它是吡哆醇 5-焦磷酸盐，而吡哆醇就是维生素 B6。
So that can help, 50 milligrams once to twice a day.
因此，每天一次至两次 50 毫克会有所帮助。
Vitamin E can also help, especially if it's mixed tocopherols.
维生素 E 也有帮助，尤其是混合生育酚时。
A lot of people have the high levels of vitamin E, but low levels of the gamma form of vitamin E.
许多人的维生素 E 含量较高，但伽马型维生素 E 的含量较低。
So that can also help.
所以这也有帮助。
Andrew Huberman:
安德鲁·休伯曼：
Fascinating, I'm so glad you mentioned vitamin B6 and P5P.
令人着迷，我很高兴你提到维生素 B6 和 P5P。
I have heard that one can shorten the refractory period after orgasm, essentially to be able to have sex again, to be quite direct about it, by way of vitamin B6 blunting of the prolactin response, which turns out to be quite potent.
我听说可以通过维生素 B6 减弱催乳素反应来缩短性高潮后的不应期，本质上是为了能够再次发生性行为，这非常直接，事实证明这非常有效。
But I've also heard that vitamin B6 can be neurotoxic, especially in the periphery, that it can cause peripheral neuropathies if it's taken at high doses.
但我也听说维生素 B6 可能具有神经毒性，尤其是在外周，如果服用高剂量，可能会导致周围神经病变。
But that P5P is the safer form.
但 P5P 是更安全的形式。
Is that true?
这是真的吗？
Kyle Gillett:
凯尔·吉列：
It's preactivated, so it does not build up.
它是预先激活的，因此不会积聚。
Think of it as an allegory to how folate can build up.
将其视为叶酸如何积累的寓言。
It's not methylfolate, but it builds up and it can increase levels of homocysteine.
它不是甲基叶酸，但它会积聚并增加同型半胱氨酸的水平。
Or if you have too much vitamin B12, another water-soluble B vitamin, you can have too much methylmalonic acid or MMA.
或者，如果您的维生素 B12（另一种水溶性 B 族维生素）过多，则可能会摄入过多的甲基丙二酸或 MMA。
So depending on what your enzymatic conversion is to the active form of the enzyme, often it's just safer to take the active form of the enzyme.
因此，根据酶促转化为酶的活性形式的情况，通常服用酶的活性形式更安全。
Andrew Huberman:
安德鲁·休伯曼：
Very interesting.
非常有趣。
Well at risk of going down every hormonal pathway and talking about supplementation lifestyle factors, I think touching on, as we have, testosterone and estrogen and now prolactin, I'd love to chat a little bit about L-carnitine.
冒着沿着每一条荷尔蒙途径走下去并谈论补充生活方式因素的风险，我想，正如我们所拥有的，睾酮和雌激素，现在还有催乳素，我想谈谈左旋肉碱。
Andrew Huberman:
安德鲁·休伯曼：
We talked about this earlier, but I want to raise this discussion about L-carnitine, not in the context of L-carnitine itself, but in the context of fertility because my read of the literature is that L-carnitine can be very beneficial for enhancing sperm quality and egg quality and even rates of conception.
我们之前谈到过这一点，但我想提出关于左旋肉碱的讨论，不是在左旋肉碱本身的背景下，而是在生育的背景下，因为我读到的文献是，左旋肉碱对于提高精子质量和卵子质量甚至受孕率非常有益。
What forms does L-carnitine come in that people can reasonably consider?
人们可以合理考虑左旋肉碱的哪些形式？
Again, talk to your doctor, folks.
伙计们，再次和你的医生谈谈。
What is it doing, and do we know how it's doing it?
它在做什么，我们知道它是如何做的吗？
And do you often use this in your patients?
您经常在患者身上使用这种方法吗？
Kyle Gillett:
凯尔·吉列：
Yeah, so the way I think about L-carnitine, and I'll try to tie this in with creatine and other things as well, is if your cell is an energy factory or a car, then L-carnitine is the shuttle that helps get the fuel into the motor to use the motor.
是的，所以我对左旋肉碱的看法是，如果你的细胞是一个能源工厂或一辆汽车，那么左旋肉碱就是帮助将燃料进入发动机以使用发动机的穿梭机，我也会尝试将其与肌酸和其他东西联系起来。
Kyle Gillett:
凯尔·吉列：
The motor is mostly due to lifestyle factors.
电机主要是由于生活方式因素造成的。
So your diet and your exercise and the type of fuel itself is NAD plus.
因此，您的饮食、锻炼以及燃料本身的类型都是 NAD plus。
We don't need to get into NAD precursors, or NMN or NR or anything.
我们不需要研究 NAD 前体、NMN 或 NR 或任何东西。
And then the accessory fuel tank is creatine phosphate.
然后副油箱是磷酸肌酸。
So creatine is your accessory fuel tank.
所以肌酸是你的辅助燃料箱。
Your NAD status, which is largely determined by your REM sleep and quality sleep and exercise along, with supplementation, is the fuel.
您的 NAD 状态很大程度上取决于您的快速眼动睡眠、睡眠质量和锻炼以及补充剂，它是燃料。
The carnitine shuttle is carnitine palmitoyl coenzyme A, and that takes medium chain fatty acids; it takes different molecules of fat.
肉碱梭是肉碱棕榈酰辅酶A，摄取中链脂肪酸；它需要不同的脂肪分子。
You have two main energy sources other than ketones.
除了酮之外，您还有两种主要能源。
You have your glucose or carbs, you have your fat or fatty acid, and that takes it across the layer of the mitochondria so that it can be utilized.
你有葡萄糖或碳水化合物，你有脂肪或脂肪酸，它们会穿过线粒体层以便被利用。
So upregulates that.
所以上调了这一点。
That's why things that have flagella, in general, the flagella are going to work better, like sperm.
这就是为什么有鞭毛的东西，一般来说，鞭毛会更好地工作，比如精子。
Andrew Huberman:
安德鲁·休伯曼：
Flagella being anything sort of the wavy little tendrils on cell types, of which they're everywhere, in the gut too.
鞭毛是细胞类型上的波浪状小卷须，它们无处不在，在肠道中也是如此。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So those are going to work significantly better.
因此，这些措施的效果会更好。
And in general, your mitochondria are going to work better.
一般来说，你的线粒体会更好地工作。
So the worse your mitochondria are off the bat, the better they're going to be helped by the shuttle that shuttles them across.
因此，你的线粒体状况越差，运送它们的穿梭机就越能帮助它们。
It also slightly increases the density of the androgen receptor as well.
它还会稍微增加雄激素受体的密度。
Andrew Huberman:
安德鲁·休伯曼：
And is that a local effect?
这是局部效应吗？
So if L-carnitine is injected into a particular muscle, will it increase the density of androgen receptors in that muscle?
那么，如果将左旋肉碱注射到特定的肌肉中，它会增加该肌肉中雄激素受体的密度吗？
Kyle Gillett:
凯尔·吉列：
Likely so.
很可能是这样。
Andrew Huberman:
安德鲁·休伯曼：
How are people taking L-carnitine, there are capsule forms and there are injectable forms?
人们如何服用左旋肉碱，有胶囊形式和注射形式？
Most people are going to be taking the capsule forms because that's all they're going to have access to.
大多数人都会服用胶囊形式，因为这是他们所能获得的全部。
And then we should also ask, can you get L-carnitine from food?
那么我们还应该问，你能从食物中获取左旋肉碱吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So L-carnitine is just a combination of, it's actually a very small peptide.
所以左旋肉碱只是一种组合，它实际上是一种非常小的肽。
So glutathione is just three amino acids.
所以谷胱甘肽只有三种氨基酸。
L-carnitine is the smallest peptide too.
L-肉碱也是最小的肽。
So peptide is just a protein that has amino acids between two and about 200, and L-carnitine is just two amino acids.
因此，肽只是一种具有 2 到 200 个左右氨基酸的蛋白质，而左旋肉碱只是两个氨基酸。
Andrew Huberman:
安德鲁·休伯曼：
Amazing.
太棒了。
So it's like a micropeptide.
所以它就像一个微肽。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So your body synthesizes enough, it likes to absorb the amino acids by themselves and then if it puts them together there, it makes L-carnitine.
所以你的身体合成了足够的氨基酸，它喜欢自己吸收氨基酸，然后如果它把它们放在一起，就会产生左旋肉碱。
It's not very bioavailable if you take it.
如果您服用的话，它的生物利用度不是很高。
A lot of people will take L-carnitine, L-tartrate, or acetyl-L-carnitine, and that's about 10% bioavailable.
很多人会服用左旋肉碱、左旋酒石酸盐或乙酰左旋肉碱，其生物利用度约为 10%。
So if you want one gram or 1,000 milligrams of L-carnitine, you can take 10 grams of oral L-carnitine.
因此，如果您想要1克或1000毫克左旋肉碱，则可以口服10克左旋肉碱。
Andrew Huberman:
安德鲁·休伯曼：
Is the one gram the typical dose you recommend, one gram per day?
一克是您推荐的典型剂量吗，每天一克？
Kyle Gillett:
凯尔·吉列：
For fertility and androgen receptor.
用于生育和雄激素受体。
upregulation.
上调。
Andrew Huberman:
安德鲁·休伯曼：
So that means taking 10 grams of the capsule form.
这意味着服用 10 克胶囊。
Kyle Gillett:
凯尔·吉列：
So it's about 15 to 20 capsules, which is a lot.
所以大约有15到20粒胶囊，这是很多。
Andrew Huberman:
安德鲁·休伯曼：
That is a lot.
那是很多。
Kyle Gillett:
凯尔·吉列：
It can also potentially increase TMAO.
它还可能增加 TMAO。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I wanted to ask about that because TMAO on your blood chart is ...
是的，我想问这个问题，因为你的血液图表上的 TMAO 是......
When that's elevated, that's going to cause some concern.
当这个数字升高时，就会引起一些担忧。
You taught me a trick however, that one can take 600 milligrams of garlic capsule for the allicin.
不过你教了我一个窍门，服用600毫克大蒜胶囊就可以得到大蒜素。
Is that what it's called.
是这么叫的吗。
Kyle Gillett:
凯尔·吉列：
Oh, allicin is in it.
哦，里面有大蒜素。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, it's like the name Allicin, but with two Ls.
是的，它就像大蒜素这个名字，但有两个 L。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
And that had a remarkable effect in reducing TMAO, so that's quite potent.
这对于减少 TMAO 具有显着的效果，因此非常有效。
And also was it just coincidence that it really brought my LDL down as well?
而且它确实也降低了我的低密度脂蛋白水平，这只是巧合吗？
Kyle Gillett:
凯尔·吉列：
I'm not sure if the LDL is a coincidence, but depending on your gut microbiome or your microbiota, some microbiome beneficial bacteria will convert carnitine and also choline.
我不确定低密度脂蛋白是否是巧合，但根据您的肠道微生物组或微生物群，一些微生物组有益细菌会转化肉碱和胆碱。
So any choline precursor like alpha GPC or phosphatidylserine, it will convert them more or less to TMAO.
因此，任何胆碱前体，如 α GPC 或磷脂酰丝氨酸，都会或多或少地将它们转化为 TMAO。
So TMAO is something that you can get measured in a blood test and see if it's high or low.
因此，您可以通过血液检查来测量TMAO，看看它是高还是低。
Some people might not even need allicin.
有些人可能甚至不需要大蒜素。
Some people do benefit from it.
有些人确实从中受益。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Although I think it was you that also told me that allicin in garlic can have positive effects on cardiovascular tone and blood flow generally.
虽然我认为是你也告诉我大蒜中的大蒜素通常可以对心血管张力和血流产生积极影响。
Is that right?
是这样吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Okay.
好的。
Andrew Huberman:
安德鲁·休伯曼：
So is 600 milligrams garlic an excessive amount, or can I just eat garlic?
那么600毫克大蒜是否过量，或者我可以只吃大蒜吗？
Kyle Gillett:
凯尔·吉列：
You can just eat-
你可以直接吃——
Andrew Huberman:
安德鲁·休伯曼：
I mean I like eating garlic.
我的意思是我喜欢吃大蒜。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
So one could also just eat garlic.
所以人们也可以只吃大蒜。
If one were going to take L-carnitine in injectable form, how much of that is bioavailable?
如果要服用注射形式的左旋肉碱，其中有多少是生物可利用的？
Kyle Gillett:
凯尔·吉列：
A hundred percent, if you inject it.
如果你注射的话，百分之一百。
So it is in an aqueous solution, so it's bacteriostatic water, essentially.
所以它是水溶液，所以它本质上是抑菌水。
So it's not in a carrier oil.
所以它不在基础油中。
So it really, it's going to burn a lot if you inject it subcutaneously.
所以，如果你皮下注射的话，确实会灼伤很多。
So it's going to be absorbed faster and more evenly and also just hurt a lot less if you inject it into a muscle.
因此，如果将其注射到肌肉中，它会被吸收得更快、更均匀，而且伤害也更少。
Andrew Huberman:
安德鲁·休伯曼：
But one could then just take one gram per day injected, or divide it up into a couple doses.
但人们可以每天注射一克，或者分成几剂。
Kyle Gillett:
凯尔·吉列：
Or 500, the minimally efficacious dose for injectables is probably around 200 when it comes to sperm motility and androgen receptor upregulation.
或 500，就精子活力和雄激素受体上调而言，注射剂的最低有效剂量可能约为 200。
So it really depends on why you're taking it.
所以这实际上取决于你服用它的原因。
Andrew Huberman:
安德鲁·休伯曼：
In terms of fertility, and in terms of blood tests generally, I always say that if possible, either by way of insurance or by way of some other way, affording it, it would be great for people to have blood tests to know what their hormone levels and other levels of other things like metabolic markers and lipids were in their twenties, also in their thirties, also in their forties.
在生育能力方面，以及一般的血液检查方面，我总是说，如果可能的话，无论是通过保险还是通过其他方式，只要负担得起，人们最好进行血液检查，以了解他们的激素水平以及代谢标记物和血脂等其他物质的水平，无论是在二十多岁，还是在三十多岁，还是在四十多岁时。
Andrew Huberman:
安德鲁·休伯曼：
I think there's this idea that you only take a blood test when you have a problem, but then of course one can't actually do the comparison that you mentioned earlier or state the comparison to one's physician that things are changing over time.
我认为有这样一种想法，即只有在出现问题时才进行血液检查，但当然，人们实际上无法进行您之前提到的比较，也无法向医生表明情况随着时间的推移而发生变化。
And it seems to me that basically everyone should get at least a once-a-year blood test.
在我看来，基本上每个人都应该每年至少进行一次血液检查。
Is there the hope that insurance will someday just cover it for everybody?
是否有希望有一天保险能为每个人提供保险？
This will be standard care.
这将是标准护理。
I would think that everybody should know what sorts of things are floating around in their bloodstream and what they need more of and less of in life.
我认为每个人都应该知道他们的血液中漂浮着什么样的东西，以及他们在生活中需要更多和更少的东西。
Kyle Gillett:
凯尔·吉列：
I doubt it will ever be covered by insurance.
我怀疑它是否会被保险覆盖。
In many cases you could make an argument that it's indicated.
在许多情况下，您可以提出一个论点，表明它已被指出。
As insurance begins to cover more of the population for pathologies.
随着保险开始覆盖更多人口的疾病。
The things like FSAs or HSAs or care credit will likely cover this advanced testing, which, it continues to come down and down in price.
FSA 或 HSA 或护理信贷之类的东西可能会涵盖这种高级测试，其价格不断下降。
So it'll be affordable, but it won't be free.
所以它会是负担得起的，但它不会是免费的。
Andrew Huberman:
安德鲁·休伯曼：
Got it.
明白了。
I'd like to shift gears slightly and talk about social interactions and relational effects on hormones.
我想稍微改变一下话题，谈谈社交互动和对激素的关系影响。
Something that I just find fascinating, we touched on this a little bit earlier in terms of oral contraception, but now that we have the backdrop of what these various hormones do, some involvement in neurotransmitter systems like dopamine and prolactin and associated pathways.
我觉得很有趣的一点是，我们之前在口服避孕药方面谈到过这一点，但现在我们已经了解了这些不同激素的作用，以及多巴胺和催乳素等神经递质系统以及相关途径的一些参与。
Prolactin, of course, being a hormone, not a neurotransmitter.
当然，催乳素是一种激素，而不是神经递质。
Andrew Huberman:
安德鲁·休伯曼：
But there's a phenomenon in human beings where people get very excited about a new partner.
但人类有一种现象，人们对新伴侣感到非常兴奋。
And that excitement no doubt is related to the dopamine system, among other systems.
这种兴奋无疑与多巴胺系统以及其他系统有关。
And that excitement can be maintained or can wane over time.
随着时间的推移，这种兴奋可能会持续下去，也可能会减弱。
And here I'm talking about attraction, but I'm also talking about just general excitement in the sense of novelty, because that's what dopamine's associated with.
在这里我谈论的是吸引力，但我也谈论的是新奇意义上的一般兴奋，因为这就是多巴胺的相关之处。
Andrew Huberman:
安德鲁·休伯曼：
Given that you work with human beings, and they have lives and relationships and lifestyles, and they have hormones, and all these things interact, what are some of the ways that we could think about adjusting our relationships in order to optimize hormones, as opposed to just thinking about how to optimize hormones for sake of our relationship?
鉴于你与人类一起工作，他们有生活、关系和生活方式，他们有荷尔蒙，所有这些东西相互作用，我们可以考虑通过哪些方式来调整我们的关系以优化荷尔蒙，而不是仅仅考虑如何为了我们的关系而优化荷尔蒙？
Because it's bidirectional, of course.
当然，因为它是双向的。
And this assumes, I should say, that one is already paying attention to the six pillars talked about earlier, that people are doing most things.
我应该说，这是假设人们已经关注了前面提到的六大支柱，即人们正在做大多数事情。
How should we think about relationships and hormones, friendships, romantic relationships, new partners, long-term partners?
我们应该如何看待人际关系和荷尔蒙、友谊、浪漫关系、新伙伴、长期伙伴？
How do you think about this kind of stuff?
您如何看待这种事情？
Kyle Gillett:
凯尔·吉列：
So if you have a new partner, then it is largely regulated by the dopaminergic system, which changes over time.
因此，如果你有一个新的伴侣，那么它很大程度上受到多巴胺能系统的调节，该系统会随着时间的推移而变化。
So people may have heard the saying that you have to go through a full calendar year with someone that you're in a relationship, so that you-
所以人们可能听说过这样一种说法，你必须和一个正在恋爱的人一起经历一整年的时间，这样你——
Andrew Huberman:
安德鲁·休伯曼：
Very good advice by the way.
顺便说一下，非常好的建议。
Kyle Gillett:
凯尔·吉列：
So that you really know what to do and what not to do.
这样你才能真正知道什么该做、什么不该做。
But because you experience both of your families in the holidays and all the different situations.
但因为你在假期中经历了你的两个家庭以及所有不同的情况。
But I would argue until you have moved in together, had a baby and then raised that baby, preferably breastfeeding because that's when you get the prolactin spikes, you haven't really gone through every stage in life yet.
但我认为，直到你们同居，生下孩子，然后抚养孩子，最好是母乳喂养，因为那时你的催乳素会达到峰值，你还没有真正经历人生的每个阶段。
Now you can't really do that with every person that you're considering.
现在你不能真正对你正在考虑的每个人都这样做。
Andrew Huberman:
安德鲁·休伯曼：
Some people do, but it can be quite costly in terms of time and finances and emotionally costly.
有些人会这样做，但这在时间、金钱和情感上可能会付出相当大的代价。
And then here, I'm definitely not referring to any personal experience of having done all that many times over.
在这里，我绝对不是指任何重复做过这么多次的个人经历。
But what would you suggest people do or think about as they enter relationship, or for people that are in long-term relationships where they feel like something has shifted and indeed those shifts may reflect the output of different hormone systems and neurotransmitter systems.
但是，您建议人们在进入关系时做什么或思考什么，或者对于那些处于长期关系中的人来说，他们感觉某些东西已经发生了变化，而实际上这些变化可能反映了不同激素系统和神经递质系统的输出。
It almost certainly has to be the case.
几乎可以肯定，情况一定是这样。
Kyle Gillett:
凯尔·吉列：
So just like women who spend a lot of time together, whether they're coworkers or whatever, a lot of times their menstrual cycles will align.
因此，就像花很多时间在一起的女性一样，无论她们是同事还是其他什么人，很多时候她们的月经周期都会一致。
There is a lot of pheromonal and hormonal crosstalk, including prolactin, between men and women.
男性和女性之间存在很多信息素和荷尔蒙的串扰，包括催乳素。
So spending a hundred percent of the time together; this is why people think it's so hard to work together and live together.
所以百分之一百的时间都在一起；这就是为什么人们认为一起工作和生活是如此困难。
They're around each other 24/7.
他们 24/7 都在彼此身边。
You don't have the reprieve where you let that dopamine settle down and then you're excited when you see them again.
你没有办法让多巴胺稳定下来，然后当你再次见到他们时你会很兴奋。
Kyle Gillett:
凯尔·吉列：
A lot of guys know that if they've gone on a hunting trip, or if they've gone on a trip for a long time, they come back and they see their partner and it's a new ...
很多人都知道，如果他们去打猎旅行，或者旅行了很长时间，他们回来后会看到他们的伴侣，这是一个新的......
not quite like a new relationship, but almost like a new relationship.
不太像一段新的关系，但几乎就像一段新的关系。
And they have that excitement again.
他们又恢复了那种兴奋。
And purposely building that into every relationship can help significantly, especially if you choose to have a child or get pregnant or be breastfeeding, because you just plan ahead for both of your prolactins to be high, and both of your dopamines to be low, and both of your testosterones to be low.
有目的地将这一点融入到每段关系中都会有很大帮助，尤其是当您选择生孩子、怀孕或母乳喂养时，因为您只需提前计划，让您的催乳素升高、多巴胺降低、睾丸激素降低。
So there's a lot of planning that you can do.
因此，您可以做很多计划。
Essentially every relationship goes through ...
基本上每一段关系都会经历...
Kyle Gillett:
凯尔·吉列：
Essentially every relationship goes through a crisis, and that crisis is personal between the two of you.
本质上，每段关系都会经历危机，而这场危机是你们两人之间的个人危机。
And you can plan ahead and figure out a way.
你可以提前计划并找出方法。
Maybe it's not supplementation, maybe it's not even the amount of time you spend away from each other, but plan ahead to have good times if you know you're about to go into a crisis.
也许这不是补充，也许甚至不是你们分开的时间，但如果你知道自己即将陷入危机，请提前计划好度过美好时光。
PART 4 OF 5 ENDS Andrew Huberman:
第 4 部分（共 5 部分）结束 Andrew Huberman：
Got it.
明白了。
So it sounds like time apart and time together, which is actually built into a number of cultures, where men and women will purposefully avoid each other for some period of time, avoid physical touch and maybe proximity, and then will reconvene.
所以这听起来像是分开的时间和在一起的时间，这实际上已经融入到许多文化中，在这些文化中，男人和女人会在一段时间内有目的地避开对方，避免身体接触，甚至避免接近，然后会重新见面。
And yet those are very stable relationships over time often.
然而，随着时间的推移，这些关系往往非常稳定。
Andrew Huberman:
安德鲁·休伯曼：
Is the inverse also true, for instance, for people that are in long-distance relationships, where they're only seeing each other three or four days a week, or two days a week?
反之亦然，例如，对于异地恋的人来说，他们每周只见面三四天，或者每周两天？
Does this explain the fact that some of those relationships can go on for a very long period of time without ever actually entering the, let's call it the hyperprolactin phase of actually moving in together and et cetera, et cetera?
这是否可以解释这样一个事实：其中一些关系可以持续很长一段时间，而没有真正进入，让我们称之为实际同居的高催乳素阶段等等，等等？
In other words, is that a way in which people are spiking and troughing dopamine that keeps them attached?
换句话说，这是否是人们通过增加和减少多巴胺来保持依恋的一种方式？
This kind of elusive ...
这种难以捉摸的...
What is it called?
它叫什么？
I think it's called a cat string.
我想这叫猫绳。
Andrew Huberman:
安德鲁·休伯曼：
If you play with a cat and you move the string away, they'll keep reaching, but you throw the string on their own and they're totally uninterested in it.
如果你和猫玩耍，你把绳子移开，它们会继续伸手，但你自己扔绳子，它们对此完全不感兴趣。
Is that what's going on?
是这样的吗？
Because that's a dopaminergic phenomenon, the cat string example, we know this experimentally.
因为这是一种多巴胺能现象，以猫绳为例，我们通过实验知道了这一点。
Kyle Gillett:
凯尔·吉列：
In those cases, the relationship hasn't really progressed, in many of those cases, past the dopamine spike, the fun initial stage, honeymoon stage, whatever you want to call it.
在这些情况下，这段关系并没有真正取得进展，在许多情况下，已经过了多巴胺峰值、有趣的初始阶段、蜜月阶段，无论你怎么称呼它。
So it's almost kind of like a roommate, if you're looking for a roommate, if it was for college or after college or whatever, you can fill out forms and look for common interest.
所以这几乎有点像室友，如果你正在寻找室友，如果是为了大学或大学毕业后或其他什么，你可以填写表格并寻找共同兴趣。
But until you're actually together a significant proportion of the time, you're not really going to know if you're going to be compatible or not.
但直到你们真正在一起的时间很长，你才真正知道你们是否会兼容。
Andrew Huberman:
安德鲁·休伯曼：
And is there evidence that the appearance of an infant changes, obviously, that they're going to be hormonal shifts?
是否有证据表明婴儿的外观发生明显变化，这将是荷尔蒙的变化？
We know actually that for in both women and men, there's a prolactin increase when couples are expecting a child.
事实上我们知道，无论是女性还是男性，当夫妇怀孕时，催乳素都会增加。
It's almost like a brooding phenomenon.
这几乎就像是一种令人沉思的现象。
You see this in birds, where it's actually called brooding, and it's caused by prolactin increase.
你可以在鸟类身上看到这种情况，这实际上被称为育雏，它是由催乳素增加引起的。
Andrew Huberman:
安德鲁·休伯曼：
But it turns out, this also occurs in humans.
但事实证明，这种情况也发生在人类身上。
And some people would argue this causes the "dad bod" phenomenon because actually prolactin's involved in laying down a body fat, preparing for sleepless nights.
有些人会认为这会导致“爸爸身材”现象，因为实际上催乳素参与释放体内脂肪，为不眠之夜做好准备。
And presumably that spike in prolactin is there also to suppress sexual activity because there are periods of time immediately near childbirth where sexual activity is not advantageous.
据推测，催乳素的激增也是为了抑制性活动，因为在临近分娩的一段时间内，性活动并不有利。
Kyle Gillett:
凯尔·吉列：
Yeah, you see a prolactin spike right after breastfeeding.
是的，母乳喂养后您会看到催乳素激增。
So if you think about it, often when you have an infant, you'll breastfeed, put the infant to bed, and then immediately go to bed with your partner, which is not particularly conducive.
所以如果你想一想，通常当你有了婴儿时，你会母乳喂养，让婴儿上床睡觉，然后立即和你的伴侣一起上床睡觉，这并不是特别有利。
It's almost like trying to have intercourse back-to-back and it's very difficult.
这几乎就像尝试连续性交一样，而且非常困难。
Andrew Huberman:
安德鲁·休伯曼：
Because in the prolactin sense?
因为在催乳素意义上？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Kyle Gillett:
凯尔·吉列：
Low dopamine, high prolactin.
多巴胺低，催乳素高。
Oxytocin is also increased significantly to help with milk let-down as well.
催产素也显着增加，有助于排乳。
So yeah, as far as brooding, there's definitely a human equivalent of brooding.
所以，是的，就沉思而言，人类肯定有类似的沉思。
Some humans call it nesting instinct, which is both helpful, but it's not necessarily a bad change in relationship, it's just a change.
有些人称之为筑巢本能，这既有帮助，但不一定是关系中的坏变化，它只是一种变化。
Kyle Gillett:
凯尔·吉列：
And as long as you know that it's coming, you're going to do better with it.
只要你知道它即将到来，你就会做得更好。
Just like any medication, if you are aware of the side effect and that it might happen, then when it happens, it's not only less severe, it also happens less often if you tell the patient.
就像任何药物一样，如果您意识到副作用并且可能会发生，那么当它发生时，如果您告诉患者，它不仅不会那么严重，而且发生的频率也会降低。
Andrew Huberman:
安德鲁·休伯曼：
Very interesting.
非常有趣。
Well, as a neuroscientist, I come from the framework that of course hormones impact perception and behavior, but perception and behavior also impact hormones.
嗯，作为一名神经科学家，我的框架是，激素当然会影响感知和行为，但感知和行为也会影响激素。
I find this fascinating.
我觉得这很有趣。
Andrew Huberman:
安德鲁·休伯曼：
I also really like the example you gave of people taking time apart, but also these affiliative bonds that are nonromantic bonds can serve as kind of a reservoir to replenish dopamine, that is then released upon going back to one's partner, or some sort of regular feature of home.
我也很喜欢你举的人们分开一段时间的例子，但这些非浪漫的亲密关系也可以作为补充多巴胺的水库，然后在回到伴侣身边或家庭的某种常规特征时释放多巴胺。
Very interesting.
非常有趣。
Andrew Huberman:
安德鲁·休伯曼：
And of course, this should exist on both sides.
当然，这应该是双方都存在的。
I'm guessing that from both the male and female side, there's an interest in kind of separation and reunion as the theme.
我猜男女双方都对某种离别与重聚的主题感兴趣。
And I guess the frequency will vary for different couples in different situations.
我想不同的夫妇在不同的情况下，频率会有所不同。
Kyle Gillett:
凯尔·吉列：
Yeah, and I don't want to make it seem like prolactin is all bad.
是的，我不想让人觉得催乳素全都是坏事。
So prolactin does help with the nesting instinct, it helps with breastfeeding as well.
因此，催乳素确实有助于筑巢本能，也有助于母乳喂养。
A lot of women are diagnosed with luteal phase defects, which is basically the phase after ovulation but before a period or giving birth.
许多女性被诊断患有黄体期缺陷，黄体期基本上是排卵后、月经或分娩之前的阶段。
The pregnancy's kind of a prolonged luteal phase, and a lot of them will go on progesterone for this.
怀孕期间的黄体期会延长，很多人会为此服用黄体酮。
Kyle Gillett:
凯尔·吉列：
Progesterone can also decrease prolactin, and prolactin is also helpful for the maturity of lungs in infants, so it helps the sphingomyelin-to-lecithin ratio.
黄体酮还会降低催乳素，而催乳素也有利于婴儿肺部的成熟，因此有助于鞘磷脂与卵磷脂的比例。
If your prolactin's too low through pregnancy, it spikes up very high during pregnancy, then it can lead to increased risk of respiratory distress of the newborn.
如果您的催乳素在怀孕期间过低，则在怀孕期间会飙升得很高，然后可能会导致新生儿呼吸窘迫的风险增加。
Andrew Huberman:
安德鲁·休伯曼：
Really interesting.
真的很有趣。
So we certainly don't want to paint a picture where prolactin is the bad hormone to avoid.
因此，我们当然不想描绘出催乳素是需要避免的不良激素的情况。
Without prolactin, none of us would be here.
如果没有催乳素，我们就不会在这里。
Of course, it's so vital.
当然，它是如此重要。
Andrew Huberman:
安德鲁·休伯曼：
I realize that earlier, I raised the question about whether or not cold exposure could modify hormone output, in particular whether or not ice baths or ice applied to specific tissues of the body, as people are doing one way or the other, can change testosterone levels, estrogen levels.
我意识到早些时候，我提出了关于寒冷暴露是否会改变激素分泌的问题，特别是冰浴或对身体特定组织施加冰块（正如人们所做的那样）是否会改变睾酮水平、雌激素水平。
In other words, does taking ice baths and cold showers increase testosterone or estrogen?
换句话说，冰浴和冷水淋浴会增加睾酮或雌激素吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So taking an ice bath or a cold shower or a cold exposure in general, it's not going to correct the vitamin D deficiency or a metabolic syndrome.
因此，一般而言，冰浴、冷水淋浴或寒冷暴露并不能纠正维生素 D 缺乏症或代谢综合征。
So there's a lot of things that it will not correct that are causes of hypogonadism or low testosterone, but it will help acutely, specifically the application of cold to testes that are too warm.
因此，它无法纠正很多导致性腺功能减退或睾酮水平低下的原因，但它会显着帮助，特别是对太热的睾丸进行冷敷。
Kyle Gillett:
凯尔·吉列：
So if you have a varicocele or if you have a little bit of a primary hypogonadism, which is where testosterone is not released by the testes but your LH and FSH signals are sufficiently high, then you'll likely respond to cold exposure better.
因此，如果您患有精索静脉曲张或患有一点原发性性腺功能减退症（即睾丸不释放睾酮，但您的 LH 和 FSH 信号足够高），那么您可能会对寒冷暴露做出更好的反应。
And there's actually undergarments that are designed specifically to help with fertility, and there's probably going to be more and more of that in the future.
事实上，有些内衣是专门为帮助生育而设计的，而且未来可能会越来越多。
You just need to be careful not to get frost bite, because it's a particularly bad spot to get frost bite.
你只需要小心不要被冻伤，因为这是一个特别容易被冻伤的地方。
Andrew Huberman:
安德鲁·休伯曼：
Noted.
注意到了。
Could you define varicocele?
你能定义精索静脉曲张吗？
You mentioned it a few times, that's a varicose vein?
您多次提到过，这是静脉曲张吗？
Kyle Gillett:
凯尔·吉列：
Yeah, so it's essentially a varicose vein.
是的，所以它本质上是静脉曲张。
It brings warm blood, and the venous flow or the flow back to the heart is not as good.
它带来的是温热的血液，静脉血流或流回心脏的血流就不那么好了。
Just like in the legs, it can happen in the scrotum.
就像腿部一样，它也可能发生在阴囊中。
Usually about 20 to 25% of people have one grade of varicocele.
通常大约 20% 至 25% 的人患有一级精索静脉曲张。
There's grades one through four, one through five.
有一年级到四年级，一年级到五年级。
And most people just have a very mild one, usually on the left side because the blood has to go through further to get back to the heart ,and it raises the temperature of the testes.
大多数人只有非常轻微的症状，通常在左侧，因为血液必须进一步流回心脏，并且它会升高睾丸的温度。
Temperature is the enemy of testes, so they like to be 5 to 10 degrees cooler than the rest of the body.
温度是睾丸的敌人，因此它们喜欢比身体其他部位低 5 到 10 度的环境。
Andrew Huberman:
安德鲁·休伯曼：
So are saunas particularly bad for sperm production?
那么桑拿对精子的产生特别不利吗？
Kyle Gillett:
凯尔·吉列：
They can be, yeah.
他们可以是，是的。
Andrew Huberman:
安德鲁·休伯曼：
When you say can be, I mean, how long could one safely be in the sauna, or would you want to go back and forth between the cold and sauna?
当你说可以时，我的意思是，一个人可以安全地在桑拿浴室呆多久，或者你想在寒冷和桑拿之间来回穿梭吗？
Are there any data?
有数据吗？
Kyle Gillett:
凯尔·吉列：
If someone is having infertility, then I tell them to avoid all saunas empirically.
如果有人不孕，我会告诉他们根据经验避免所有桑拿。
If they're not infertile but they have a low sperm count, I also tell them to avoid.
如果他们不是不育但精子数量低，我也会告诉他们避免。
However, it's mostly warmed water that can raise the temperature of the testes faster than the sauna.
然而，它主要是温水，可以比桑拿更快地提高睾丸的温度。
Andrew Huberman:
安德鲁·休伯曼：
So hot tubs and things of that sort?
那么热水浴缸之类的东西吗？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So hot tub and a jacuzzi, those are enemies number one and number two of sperm.
因此，热水浴缸和按摩浴缸是精子的第一和第二敌人。
Andrew Huberman:
安德鲁·休伯曼：
What about ice baths and cold showers for women?
女性可以用冰浴和冷水淋浴吗？
Any evidence that it can shift hormone output in women?
有证据表明它可以改变女性荷尔蒙的分泌吗？
Kyle Gillett:
凯尔·吉列：
Yeah, it can.
是的，可以。
It increases the activity of the beta-adrenergic receptors, even in the central nervous system and the astrocytes as well.
它增加了β-肾上腺素能受体的活性，甚至在中枢神经系统和星形胶质细胞中也是如此。
Kyle Gillett:
凯尔·吉列：
So it can do a few things.
所以它可以做一些事情。
It can slightly decrease the drive for food, which astrocytes and beta-adrenergic receptors have.
它可以稍微降低星形胶质细胞和β-肾上腺素受体对食物的驱动力。
Some medications that are weight-loss medicines also do similar things, but it can be beneficial in women too.
一些减肥药也有类似的作用，但它对女性也有好处。
Andrew Huberman:
安德鲁·休伯曼：
But no evidence that it changes estrogen output in women, correct?
但没有证据表明它会改变女性雌激素的分泌，对吗？
Kyle Gillett:
凯尔·吉列：
Not that I know of.
据我所知没有。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, me either.
是的，我也是。
Peptides, lot of discussion these days about peptides.
肽，最近有很多关于肽的讨论。
Peptides, of course, just being strings of amino acids, as you mentioned.
当然，正如您提到的，肽只是氨基酸串。
Very small ones, like two amino acids, like L-carnitine, all the way up to polypeptides, which just mean many amino acids.
非常小的氨基酸，如两个氨基酸，如左旋肉碱，一直到多肽，这意味着许多氨基酸。
Andrew Huberman:
安德鲁·休伯曼：
There's so many peptides that we should probably just do an entire episode about peptides.
肽的种类太多了，我们可能应该制作一整集关于肽的内容。
But I think one of the reasons I'm hearing so much about peptides these days is that they are not called steroids.
但我认为这些天我听到这么多有关肽的原因之一是它们不被称为类固醇。
The name steroids I think has come to be associated with anabolic steroids in the context of acne, testosterone rage, et cetera.
我认为类固醇这个名字已经与痤疮、睾丸激素愤怒等背景下的合成代谢类固醇联系在一起。
But of course, estrogen is a steroid hormone, right?
但当然，雌激素是一种类固醇激素，对吧？
There are other steroid hormones, as we both know, but peptides are gaining increasing popularity.
我们都知道，还有其他类固醇激素，但肽越来越受欢迎。
Andrew Huberman:
安德鲁·休伯曼：
I'm willing to go on record saying that you can be sure that many of the incredible transformations that you see in Hollywood are the consequence of peptide use.
我愿意公开表示，您可以确信，您在好莱坞看到的许多令人难以置信的转变都是肽使用的结果。
And I'd put my name behind that because I'm well aware of people that use these to prepare for roles, but athletes use them.
我会把我的名字放在后面，因为我很清楚有人使用这些来为角色做准备，但运动员却使用它们。
And then everyday people are using them too, for instance sermorelin, tesamorelin, ipamorelin to stimulate the release of growth hormone rather than taking growth hormone.
然后日常生活中人们也在使用它们，例如舍莫林、替莫瑞林、伊帕莫林来刺激生长激素的释放，而不是服用生长激素。
BPC 157, which is essentially a synthetic gastric juice that normally repairs the gut that is being used to treat injuries.
BPC 157，本质上是一种合成胃液，通常可以修复肠道，用于治疗损伤。
And there are other ones as well.
还有其他的。
Andrew Huberman:
安德鲁·休伯曼：
What can we say generally about peptides?
关于肽，我们一般可以说些什么？
Are they safe?
他们安全吗？
Are they not safe?
他们不安全吗？
What about sourcing?
货源呢？
And are there any peptides that you think could be of particular use for people?
您认为有哪些肽对人类特别有用？
And we should probably also touch on peptides that people shouldn't go anywhere near with a 10-foot pole.
我们或许还应该讨论人们不应该用 10 英尺长的杆子靠近的肽。
Kyle Gillett:
凯尔·吉列：
Yeah, definitely.
是的，绝对是。
So peptides are very heterogeneous, there are very dangerous ones and very safe ones.
所以肽是非常异质的，有非常危险的和非常安全的。
My favorite peptide is the original peptide, which is insulin.
我最喜欢的肽是原肽，也就是胰岛素。
So insulin is a peptide, and less than a hundred years ago, there was a scientist studying insulin, and at some point they saw that an animal had its diabetes cured by insulin injection.
所以胰岛素是一种肽，不到一百年前，有一位科学家研究胰岛素，在某个时候他们看到动物通过注射胰岛素治愈了糖尿病。
Less than a year later, they were injecting insulin into every type 1 diabetic because it was saving their lives.
不到一年后，他们给每一位 1 型糖尿病患者注射胰岛素，因为这可以挽救他们的生命。
Andrew Huberman:
安德鲁·休伯曼：
And yet insulin can kill you if you take it at the incorrect dose, right?
然而，如果您服用的剂量不正确，胰岛素就会杀死您，对吧？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
So just like insulin should be prescribed by a doctor, there is over-the-counter insulin, ReliOn or NPH.
就像胰岛素应该由医生开处方一样，也有非处方胰岛素、ReliOn 或 NPH。
But ideally your insulin is prescribed by your doctor for your diabetes as it's lifesaving.
但理想情况下，您的胰岛素是由您的医生为您的糖尿病处方的，因为它可以挽救生命。
Peptide should be prescribed by doctors as well.
肽也应由医生处方。
And there's several that are FDA-approved.
其中有几种已获得 FDA 批准。
Kyle Gillett:
凯尔·吉列：
So you mentioned a lot of different ones, let's start with tesamorelin.
所以你提到了很多不同的，让我们从tesamorelin开始。
So tesamorelin was recently FDA-approved for something called lipodystrophy.
因此，替沙莫林最近获得 FDA 批准用于治疗脂肪营养不良。
It happens where body fat is displaced into abnormal areas, often as part of AIDS or severe burns, things like that.
当身体脂肪转移到异常区域时就会发生这种情况，通常是艾滋病或严重烧伤等的一部分。
And it helps redistribute this body fat and give people their quality of life back.
它有助于重新分配体内脂肪，恢复人们的生活质量。
Tesamorelin is a GHRH, which I kind of loop into the category of GHRPs, so growth hormone-releasing peptides.
Tesamorelin 是一种 GHRH，我将其归入 GHRP 类别，即生长激素释放肽。
So it's only a couple amino acids different from endogenously produced growth hormone-releasing hormone.
因此，它与内源产生的生长激素释放激素只有几个氨基酸不同。
Kyle Gillett:
凯尔·吉列：
So growth hormone itself is also a peptide.
所以生长激素本身也是一种肽。
It's a peptide hormone, not a steroid hormone.
它是一种肽激素，而不是类固醇激素。
So you have different somatotrophs, which are very similar to growth hormone.
所以你有不同的生长激素，它们与生长激素非常相似。
Another fun fact is that hPL, which is human placental lactogen — we love acronyms, right?
另一个有趣的事实是 hPL，即人类胎盘催乳素——我们喜欢缩写词，对吧？
Human placental lactogen is nearly identical to growth hormone.
人胎盘催乳素与生长激素几乎相同。
The growth hormone in pregnancy is not what causes the sugar spike and gestational diabetes, it's the human placental lactogen.
怀孕期间的生长激素并不是导致血糖飙升和妊娠糖尿病的原因，而是人类胎盘催乳素。
Kyle Gillett:
凯尔·吉列：
So if you look at twin pregnancies, if they have two placentas or more placental tissue making more human placental lactogen, the risk of gestational diabetes is exponentially higher.
因此，如果你观察双胎妊娠，如果她们有两个胎盘或更多胎盘组织产生更多的人类胎盘催乳素，那么患妊娠期糖尿病的风险就会成倍增加。
So this hPL is only a couple molecules different from growth hormone.
因此，这种 hPL 与生长激素只有几个分子不同。
It is interesting that these different GHRHs and GHRPs actually have pretty different mechanisms of action.
有趣的是，这些不同的 GHRH 和 GHRP 实际上具有截然不同的作用机制。
Kyle Gillett:
凯尔·吉列：
Ghrelin is also a hormone that's released when you're hungry.
饥饿素也是一种在饥饿时释放的激素。
This is probably one of the reasons why you have more growth hormone release overnight.
这可能是一夜之间释放更多生长激素的原因之一。
And there's a lot of peptides that are very similar to ghrelin.
还有很多肽与生长素释放肽非常相似。
So these peptides are not bioidentical peptides, but they just have a couple different amino acids change.
所以这些肽不是生物同质肽，但它们只是有几个不同的氨基酸变化。
So they're almost identical and they're probably going to be used in the future for growth hormone deficiencies, including in kids they've been studied.
因此，它们几乎是相同的，并且它们可能会在未来用于治疗生长激素缺乏症，包括对它们进行研究的儿童。
Andrew Huberman:
安德鲁·休伯曼：
So if somebody wants to increase their growth hormone now, but in addition to not eating within two hours of sleep, getting good deep sleep, doing all the other things in the six pillars that you mentioned earlier, especially resistance exercise at some point earlier in the day, what are the risks and benefits of taking a growth hormone-releasing hormone peptide like sermorelin?
因此，如果有人现在想增加生长激素，但除了睡后两小时内不吃东西、获得良好的深度睡眠、做您之前提到的六大支柱中的所有其他事情，特别是在一天早些时候的某个时间点进行抗阻锻炼外，服用舍莫林等生长激素释放激素肽的风险和益处是什么？
Prescribed by a doctor, of course.
当然是由医生开的。
Andrew Huberman:
安德鲁·休伯曼：
What should one be concerned about?
一个人应该关心什么？
How long could one take these?
一个人能接受这些多久？
I've even heard that they can modify gene expression so that they really are changing your hypothalamus in very long-lasting ways.
我什至听说它们可以修改基因表达，从而真正以非常持久的方式改变您的下丘脑。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
There's definitely a lot of risk: tumor growth and cancer.
肯定存在很多风险：肿瘤生长和癌症。
So you look at a type 1 diabetic, they have very high incidences of various types of cancer.
所以你看看 1 型糖尿病患者，他们患各种癌症的几率非常高。
They have very high growth hormone, but low IGF-1 paradoxically.
它们具有非常高的生长激素，但矛盾的是 IGF-1 却很低。
So they would likely give you a similar cancer risk to a type 1 diabetic that has very high growth hormone.
因此，它们可能会给您带来与生长激素非常高的 1 型糖尿病患者类似的癌症风险。
However, the benefits of it, you think of lipolysis, decreased body fat, increased lean body mass.
然而，它的好处，你会想到脂肪分解，减少体内脂肪，增加去脂体重。
Kyle Gillett:
凯尔·吉列：
A lot of those, you can use other things to get those benefits.
其中很多，您可以使用其他东西来获得这些好处。
So then you don't need growth hormone for those benefits.
因此，您不需要生长激素来获得这些好处。
It just leaves cosmetic benefit, to which you can usually use topicals to get your hair and your skin and your nails.
它只留下美容功效，您通常可以使用外用药物来护理您的头发、皮肤和指甲。
There's a lot of other things that you can do other than growth hormone.
除了生长激素之外，您还可以做很多其他事情。
Kyle Gillett:
凯尔·吉列：
So a lot of people just don't need these GHRPs, if they don't have lipodystrophy or if they don't have growth hormone deficiency.
因此，很多人如果没有脂肪营养不良或没有生长激素缺乏症，就不需要这些 GHRP。
There are other uses of them, specifically in injuries.
它们还有其他用途，特别是在伤害方面。
So I know that they've been studied, I'm not sure if it's in the military.
所以我知道他们已经被研究过，我不确定是否在军队中。
We mentioned the woodpecker or the coup-contrecoup injury.
我们提到了啄木鸟或政变-对抗伤害。
So that-
那么——
Andrew Huberman:
安德鲁·休伯曼：
Resulting back-and-forth and the brain basically slamming up against the front of the skull.
结果来回移动，大脑基本上撞到了头骨的前部。
So football, heading the ball in soccer, definitely people who use the 50-caliber in military, although that's a fairly small population, and I think anyone that's hit their head hard more than once.
因此，足球、足球中的头球、军队中肯定会使用 50 口径的人，尽管人数相当少，而且我认为任何人都不止一次地用力击中头部。
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
We can talk about BPC-157 for a bit, GHK copper peptide for a bit, TB500 or a thymosin beta-4 analog.
我们可以谈谈 BPC-157、GHK 铜肽、TB500 或胸腺肽 beta-4 类似物。
And then we can also talk about bremelanotide, which is melanotan III.
然后我们还可以谈谈 Bremelanotide，即 Melanotan III。
They have melanotan I and II, and then they also have melanotan III and IV.
他们有黑素 I 和 II，还有黑素 III 和 IV。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, let's talk about BPC-157 and melanotan because I think those are the ones that most people are eyeing, so to speak.
是的，我们来谈谈 BPC-157 和 Melanotan，因为我认为可以说，大多数人都在关注这些。
Kyle Gillett:
凯尔·吉列：
Yeah, so BPC-157 is body protective compound 157.
是的，所以 BPC-157 是身体保护化合物 157。
It's identical or bioidentical to gastric protective compound 157 that's produced in the stomach.
它与胃中产生的胃保护化合物 157 相同或生物相同。
So as you age, you get atrophic gastritis very often.
因此，随着年龄的增长，您经常会患上萎缩性胃炎。
That's why you have less intrinsic factor, which is kind of another peptide that binds to vitamin B12.
这就是为什么您的内因子较少，内因子是另一种与维生素 B12 结合的肽。
That's why you can get age-related B12 deficiencies.
这就是为什么您可能会出现与年龄相关的维生素 B12 缺乏症。
Kyle Gillett:
凯尔·吉列：
So that's one reason why you have more colitis, more diverticulitis as you age.
这就是为什么随着年龄的增长，结肠炎、憩室炎会增多的原因之一。
You don't have that gastric protective compound.
你没有那种胃保护化合物。
It increases VEGF, vascular endothelial growth factor, which basically makes your blood vessels grow more, so that's what causes your body to form a blood vessel.
它会增加 VEGF（血管内皮生长因子），这基本上会使您的血管生长得更多，这就是导致您的身体形成血管的原因。
Kyle Gillett:
凯尔·吉列：
So another medication known as Avastin, it's on the WHO's list of essential medications for cancer.
另一种药物阿瓦斯汀 (Avastin) 已被列入世界卫生组织的癌症基本药物清单。
So many different types of cancer, including colon cancer, you treat it with Avastin, which is a VEGF inhibitor.
许多不同类型的癌症，包括结肠癌，都可以用阿瓦斯汀（一种 VEGF 抑制剂）来治疗。
So if you have cancer or a high cancer risk, you probably don't want to be taking a medication that's the exact opposite mechanism of action as your essential anticancer med.
因此，如果您患有癌症或癌症风险较高，您可能不想服用与您的基本抗癌药物作用机制完全相反的药物。
Andrew Huberman:
安德鲁·休伯曼：
In other words, if you have cancer or you're at risk of cancer, avoid BPC-157?
换句话说，如果您患有癌症或有患癌症的风险，请避免使用 BPC-157？
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
A lot of people prescribe it for six weeks, and BPC-157 — so bremelanotide, that is FDA-approved for a hypoactive sexual disorder.
很多人会开六周的处方，还有 BPC-157（布雷默诺肽），FDA 批准它用于治疗性功能减退症。
Tesamorelin, that's also approved for lipodystrophy.
Tesamorelin，也被批准用于脂肪营养不良。
Interestingly, another one of the melanotans is also approved for lipodystrophy and also deficiency in the melanocortin receptor.
有趣的是，另一种黑色素也被批准用于治疗脂肪营养不良和黑皮质素受体缺陷。
So the receptor that receives the alpha-melanocyte stimulating hormone, it's a very rare condition.
因此，接收α-黑素细胞刺激激素的受体是一种非常罕见的情况。
It's also approved for that because if you don't take it, then you get obesity.
它也被批准用于这一点，因为如果你不服用它，你就会变得肥胖。
Kyle Gillett:
凯尔·吉列：
But BPC-157 is not FDA-approved, but it is essentially standard of care at this point.
但 BPC-157 尚未获得 FDA 批准，但目前它基本上是护理标准。
I would say if you're not counting insulin or growth hormone as peptides, it's one of the most commonly used peptides.
我想说，如果您不将胰岛素或生长激素算作肽，那么它是最常用的肽之一。
And anecdotally and in some clinical literature, it's fairly well-tolerated for short periods of time.
有趣的是，在一些临床文献中，它在短时间内的耐受性相当好。
Kyle Gillett:
凯尔·吉列：
I'm not in the camp that everybody needs to do it two to three times a week, or even daily for six weeks no matter what.
我并不认为每个人都需要每周做两到三次，甚至六周内每天做一次，无论如何。
The major benefit is when you're going to take it early on, because it's going to allow your body to increase blood flow to the injured area.
主要好处是您尽早服用它，因为它可以让您的身体增加流向受伤部位的血液。
And the less blood flow it has, for example, cartilage, ligaments have horrible blood flow, especially as people age, it's going to make a significant difference.
而且它的血流量越少，例如软骨、韧带的血流量就很可怕，尤其是随着人年龄的增长，就会产生显着的变化。
So I would wager that that Russian gymnast that Achilles healed in one month and completely from a full rupture was likely taking BPC-157 or something very similar.
所以我敢打赌，这位俄罗斯体操运动员的跟腱在一个月内就痊愈了，并且完全从完全断裂中恢复过来，他很可能正在服用 BPC-157 或非常类似的药物。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I'm willing to wager on that as well.
是的，我也愿意打赌。
A remarkable recovery.
康复效果显着。
Andrew Huberman:
安德鲁·休伯曼：
So because it is prescription ...
所以因为它是处方...
there are nonprescription forms.
有非处方形式。
My understanding of the nonprescription forms and the danger of going after nonprescription forms is that oftentimes they will contain what they claim they contain, BPC-157 in this case, but they are not adequately cleaning out the LPS, the lipopolysaccharide, which can cause inflammation.
我对非处方形式以及追求非处方形式的危险的理解是，它们通常会含有他们声称含有的东西，在这种情况下是 BPC-157，但它们没有充分清除可引起炎症的 LPS（脂多糖）。
Andrew Huberman:
安德鲁·休伯曼：
In fact, in the laboratory we use LPS to deliberately induce fever and inflammation to study systemic inflammation.
事实上，在实验室中我们使用LPS故意诱导发烧和炎症来研究全身炎症。
So this is a warning to people, if you're interested in peptides, you absolutely need to work with a physician, in my opinion.
所以这是对人们的一个警告，在我看来，如果你对肽感兴趣，你绝对需要与医生合作。
Get it from a really good compounding pharmacy that cleans out the LPS.
从一家非常好的复方药房购买，可以清除脂多糖。
Because if you're buying it through a source that a lot of people, I don't want to name sources, but there are these common sources on the internet that everyone knows about.
因为如果你是通过很多人的来源购买的，我不想透露来源，但互联网上有这些人人都知道的常见来源。
They're buying these sources, they'll ship it to anyone, essentially, but then the LPS is really causing inflammation.
他们购买这些来源，基本上将其运送给任何人，但 LPS 确实会引起炎症。
Andrew Huberman:
安德鲁·休伯曼：
And many people experience a kind of mild fever or tingling from that when they inject it, and they're like, "Oh, I can feel it working." That's probably LPS action, which is not good for the brain.
许多人在注射时会感到轻微发烧或刺痛，他们会说，“哦，我能感觉到它起作用了。”这可能是脂多糖的作用，对大脑不利。
I don't know about on other peripheral tissues.
我不知道其他外周组织的情况。
I haven't heard of people dropping dead from this stuff yet, but I certainly wouldn't want to be ingesting any LPS unnecessarily.
我还没有听说过有人死于这种东西，但我当然不想摄入任何不必要的 LPS。
So would you agree that you should work with a doctor — after all you are a doctor?
那么您是否同意您应该与医生一起工作——毕竟您是一名医生？
Kyle Gillett:
凯尔·吉列：
Yeah, definitely talk to your doctor about this, and talk to them about the dosing regimen as well.
是的，一定要和你的医生讨论这个问题，并和他们讨论剂量方案。
So if they have you doing it for six weeks, ask them, "Why am I doing it for six weeks?
因此，如果他们让你做六周，问他们：“为什么我要做六周？
Why not two weeks or why not as soon as I feel better?
为什么不两周，或者为什么不等我感觉好一点了呢？
Can I just stop it?" Yeah, there's a lot of good questions like that that you should ask your doctor.
我可以停下来吗？”是的，有很多类似的好问题，你应该问你的医生。
Kyle Gillett:
凯尔·吉列：
And if somebody's trying to prescribe you a bunch of different things, then see, is this what they prescribe everybody or is this individualized for me?
如果有人试图给你开一堆不同的药方，那么看看，这是他们为每个人开的药方，还是针对我个人的药方？
There are peptides like GHK copper peptide, which is produced endogenously in the liver, more at younger ages.
有一些肽，例如 GHK 铜肽，是由肝脏内源产生的，在年轻人中更多。
That's why the liver can regenerate fully, the GHK copper peptide helps.
这就是为什么肝脏可以完全再生，GHK 铜肽有帮助。
Kyle Gillett:
凯尔·吉列：
And if you're copper-deficient, which not a whole lot of people are, but a lot of people that have had bariatric surgery are copper-deficient.
如果你缺铜，虽然不是很多人都缺铜，但很多接受过减肥手术的人都缺铜。
GHK copper peptide can help significantly with your nervous system, and it's also synergistic.
GHK 铜肽对您的神经系统有显着帮助，并且具有协同作用。
So any growth agonist like thymosin beta-4, made in kids in the thymus, which shrinks; that's another reason why kids heal really well.
因此，任何生长激动剂，如胸腺素 beta-4，是在儿童胸腺中产生的，胸腺会收缩；这是孩子们康复得很好的另一个原因。
That and GHK is somewhat synergistic with BPC, but if you don't need all three, you don't want them.
这和 GHK 与 BPC 有一定的协同作用，但如果你不需要这三个，那么你就不需要它们。
And if you don't need it for more than a week, you don't want it for more than a week.
如果您超过一周不需要它，那么您就不需要它超过一周。
Andrew Huberman:
安德鲁·休伯曼：
I really appreciate you saying that.
我真的很感谢你这么说。
I often say that sometimes the best dose of something to take is zero.
我经常说，有时某种药物的最佳剂量是零。
It's often the case that the best dosage is zero.
通常情况下，最佳剂量为零。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned melanotan, there are several kinds of melanotan.
你提到了黑素，黑素有好几种。
I find it a little bit of a funny conversation because I first learned about melanotan from reading about peptides and discovering that people were injecting melanotan to get tanned because it's in the melanin synthesis pathway.
我觉得这是一个有点有趣的对话，因为我第一次了解黑素是通过阅读有关肽的内容，并发现人们注射黑素来晒黑，因为它位于黑色素合成途径中。
Andrew Huberman:
安德鲁·休伯曼：
They also discovered ...
他们还发现...
This isn't in an individual.
这不是一个人的事。
This is reading about this in various manuscripts and peer-reviewed papers, that it could cause things like priapism, like sustained erection.
这是在各种手稿和同行评审的论文中读到的，它可能会导致诸如阴茎异常勃起之类的事情，比如持续勃起。
That might be the last one that anyone would ever have because of damage to the vasculature.
由于脉管系统受损，这可能是任何人都会经历的最后一次。
Also, women taking melanotan as a way to get tan and lose body fat, so this sounds all very recreational.
此外，女性服用黑素作为晒黑和减少体内脂肪的一种方式，所以这听起来很有趣。
Andrew Huberman:
安德鲁·休伯曼：
Are there any clinical usage of melanotan?
Melanotan 有临床用途吗？
So separate from the kind of extreme biohacking cosmetic world, which is really not the main focus of this podcast, more in terms of pursuing health optimization.
因此，与那种极端的生物黑客化妆品世界分开，这实际上不是这个播客的主要焦点，更多的是追求健康优化。
Kyle Gillett:
凯尔·吉列：
Yeah, there's actually three FDA-approved indications, believe it or not.
是的，不管你信不信，实际上 FDA 批准了三种适应症。
Many people know about this, but there's three well-accepted indications.
很多人都知道这一点，但有三个被广泛接受的迹象。
One of them is the hypoactive sexual disorder, and more in women, that's for bremelanotide.
其中之一是性功能减退症，尤其是女性，这与布雷默诺肽有关。
So-
所以——
Andrew Huberman:
安德鲁·休伯曼：
Those are women that have essentially no libido whatsoever?
那些基本上没有性欲的女性？
Kyle Gillett:
凯尔·吉列：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But other hormones are in check?
但其他激素是否受到控制？
Kyle Gillett:
凯尔·吉列：
Yeah, classically, it's before menopause.
是的，传统上，这是在更年期之前。
So those hormonal issues are not contributing.
所以这些荷尔蒙问题不会造成影响。
And when you give them this peptide, it's also known as PT-141, it helps significantly.
当你给他们这种肽（也称为 PT-141）时，它会有很大帮助。
A lot of times you use it in nasal spray, it goes straight into the central nervous system and acts centrally.
很多时候你用鼻喷雾剂使用它，它会直接进入中枢神经系统并集中发挥作用。
You can also inject it and you can also take it via troche.
您也可以注射，也可以通过锭剂服用。
Andrew Huberman:
安德鲁·休伯曼：
Men and women take it?
男人女人都吃吗？
Kyle Gillett:
凯尔·吉列：
Correct.
正确。
It's approved for women, but it can also help men and it's relatively safe.
它被批准用于女性，但它也可以帮助男性，而且相对安全。
The only relative contraindication that I tell people ...
我告诉人们的唯一相对禁忌症......
And a lot of people say, "Oh, there's no side effects that I know of." But if you have a family history of melanoma or potentially have a melanoma and don't know about it — that's why I'm a big advocate of dermoscopy as well and regular skin checks — then theoretically it's going to increase that alpha-melanocyte-stimulating hormone, and it can grow that, so that's definitely not a good thing.
很多人说：“哦，据我所知，没有副作用。”但如果你有黑色素瘤的家族史，或者可能患有黑色素瘤但不知道这一点——这就是为什么我大力提倡皮肤镜检查和定期皮肤检查——那么从理论上讲，它会增加α-黑色素细胞刺激激素，并且可以促进这种激素的生长，所以这绝对不是一件好事。
So be very careful about long-term administration of it.
因此，长期服用时要非常小心。
Kyle Gillett:
凯尔·吉列：
It's also approved for lipodystrophy, which is the same exact thing as tesamorelin, which I believe is also known as Evista or Egrifta.
它还被批准用于治疗脂肪营养不良，这与 Tesamorelin 完全相同，我相信 Tesamorelin 也被称为 Evista 或 Egrifta。
And then it's also approved for the rare genetic condition where your receptors or your melanocytes don't proliferate as well, so you usually have hypopigmentation.
此外，它还被批准用于治疗罕见的遗传性疾病，即您的受体或黑素细胞也不能增殖，因此您通常会出现色素沉着不足。
It's not true albinism, but it's associated with morbid obesity and poor outcomes from that in childhood.
这不是真正的白化病，但它与病态肥胖和儿童时期的不良后果有关。
So it's used in kids, actually.
所以实际上它是用在孩子身上的。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Well, peptides are a fascinating landscape, but thank you for that deep dive into several of them.
嗯，肽是一道迷人的风景，但感谢您对其中几个肽的深入研究。
We will probably return to you to talk about peptides again in the near future because I know there's a lot more there and a lot of interest.
我们可能会在不久的将来再次与您讨论肽，因为我知道那里还有更多内容并且有很多兴趣。
Andrew Huberman:
安德鲁·休伯曼：
I want to talk about the sixth pillar, all right?
我想谈谈第六支柱，好吗？
So just to remind people, you said diet; exercise; where appropriate, caloric restriction; managing stress; sleep; and sunlight are critical for everyone at all ages to manage and optimize hormone health.
所以只是提醒人们，你说的是饮食；锻炼;在适当的情况下，限制热量；管理压力；睡觉;阳光对于所有年龄段的每个人管理和优化荷尔蒙健康都至关重要。
Then you have this sixth category, which is a really intriguing one, which is spirit, which is a kind of unusual thing to hear coming from a medical doctor, except that I have many colleagues, and indeed, our former director of the National Institutes of Health, Francis Collins, has talked about this notion of spirit.
然后是第六个类别，这是一个非常有趣的类别，即精神，从医生那里听到这是一种不寻常的事情，除了我有很多同事，事实上，我们的国立卫生研究院前院长弗朗西斯·柯林斯也谈到了这个精神的概念。
We've talked about belief effects on this podcast before with Alia Crum, how one's understanding of the things that they do and their world in general really creates an important effect on everything, at the level of physiology, not just psychology.
我们之前在这个播客中与 Alia Crum 讨论过信念的影响，一个人对自己所做的事情和整个世界的理解如何真正对一切事物产生重要影响，在生理学层面，而不仅仅是心理学层面。
Andrew Huberman:
安德鲁·休伯曼：
So as a physician, how do you conceptualize this spiritual aspect, and how do you talk to patients about this, given that people walking into your clinic, presumably, you have a bunch of different religious and areligious backgrounds.
因此，作为一名医生，你如何概念化这个精神方面，以及你如何与患者谈论这一点，考虑到走进你的诊所的人，想必你有很多不同的宗教和宗教背景。
I'm sure some are atheists, some are probably strong believers.
我确信有些人是无神论者，有些人可能是坚定的信徒。
How do you deal with that and how should people think about this?
您如何处理这个问题？人们应该如何思考这个问题？
Kyle Gillett:
凯尔·吉列：
Yeah, I believe it is surprisingly well received.
是的，我相信它受到了令人惊讶的好评。
You wouldn't think at first glance that a patient really wants to talk about their spiritual health with their doctor.
乍一看，您不会认为患者真的想与医生谈论他们的精神健康。
But the way I think about it and the way that it really is is it's like a Venn diagram, and you have a body and a mind and a soul, and you can't have one healthy without the other healthy.
但我的想法以及它的真实情况是，它就像维恩图，你有一个身体、一个思想和一个灵魂，如果一个人健康，另一个人也健康，你就不可能拥有一个健康的人。
Even if your mental health is phenomenal, and even if your physical health is phenomenal, the mental aspect of spirituality, if that piece is not there, then that's going to affect your body physiologically as well.
即使你的心理健康状况非常好，即使你的身体健康状况非常好，但灵性的心理方面，如果不存在那部分，那么它也会在生理上影响你的身体。
Kyle Gillett:
凯尔·吉列：
And Alia Crum has done some excellent work.
Alia Crum 也做了一些出色的工作。
There's also been a lot of other studies regarding prayer, and I'm a Christian, I believe in God, and that gives me a lot of that resilience and motivation.
还有很多关于祈祷的其他研究，我是一名基督徒，我相信上帝，这给了我很多韧性和动力。
It gives me the cornerstone or the groundwork, how I can interact with life.
它为我提供了如何与生活互动的基石或基础。
Kyle Gillett:
凯尔·吉列：
And regardless if someone's an atheist or regardless of what someone believes as far as religion or the origin of the species, they can know that their spirituality is going to have a profound effect on their mental, and physical health as well.
无论某人是否是无神论者，或者无论某人相信什么宗教或物种起源，他们都可以知道他们的灵性也会对他们的心理和身体健康产生深远的影响。
People like to compartmentalize it, so they like to talk to their doctor only about the physical health because it's comfortable to do that.
人们喜欢将其分开，因此他们喜欢只与医生谈论身体健康问题，因为这样做很舒服。
They only talk to their pastor or a mom or Reiki healer for their spiritual health, and they just talk to their therapist or psychiatrist about their mental health, but you need to bring all three of those things together.
他们只与他们的牧师或母亲或灵气治疗师谈论他们的精神健康，他们只与他们的治疗师或精神科医生谈论他们的心理健康，但你需要将所有这三件事结合在一起。
Kyle Gillett:
凯尔·吉列：
It's well known that interdisciplinary clinics lead to improved patient outcomes, and that's just disciplines within medicine.
众所周知，跨学科诊所可以改善患者的治疗效果，而这只是医学领域的学科。
So that's just doctors that are specializing in this or this.
所以这只是专门从事这个或这个的医生。
So this takes a step back in the upper part of that tree, before you reach those dichotomies or the split offs.
因此，在到达那些二分法或分裂之前，这会在该树的上部后退一步。
You have your body and your mind and your soul, so your spiritual health and your mental health and your physical health.
你有你的身体、你的思想和你的灵魂，所以你的精神健康、你的心理健康和你的身体健康。
So if you're in line in all three of those things, that builds a cornerstone for the rest of your health and life.
因此，如果您在所有这三件事上都符合，那就为您的其余健康和生活奠定了基石。
Andrew Huberman:
安德鲁·休伯曼：
So if someone comes into your clinic and they say they're feeling one way in their body, they're feeling one way in their emotional life, you run their charts, you get their blood work, and they're an atheist or they're agnostic, what are some of the sixth-pillar practices that they can consider that are in keeping with their atheism or agnosticism?
因此，如果有人来到你的诊所，他们说他们的身体有一种感觉，他们的情感生活有一种感觉，你运行他们的图表，你让他们进行血液检查，他们是无神论者或不可知论者，他们可以认为哪些第六支柱实践符合他们的无神论或不可知论？
Because I have to assume that people who participate or feel that they belong to particular religious sect will have particular prescriptives from those religious sects that will direct them towards particular types of prayer.
因为我必须假设，参与或认为自己属于特定宗教派别的人将会有这些宗教派别的特定规定，引导他们进行特定类型的祈祷。
But how would somebody who doesn't have a prescriptive coming to them from some other source, what could they do or would they do?
但是，如果没有其他来源的规定，他们会怎么做，他们可以做什么或会做什么呢？
Kyle Gillett:
凯尔·吉列：
Yeah, so I certainly don't force prayer on anybody or anything like that, but it's my belief that especially being an agnostic, it's almost the hardest thing, because if you're an atheist, then you have some groundwork and you have some spirituality, even if it has to do with the human spirits' interaction with the environment, things that can't be physically explained well, phenomenon like the work that Alia Crum does.
是的，所以我当然不会强迫任何人或类似的事情祈祷，但我相信，尤其是作为一个不可知论者，这几乎是最难的事情，因为如果你是一个无神论者，那么你就有一些基础，你有一些灵性，即使它与人类精神与环境的相互作用有关，那些无法从物理上很好地解释的事情，像阿莉亚·克拉姆所做的工作这样的现象。
Kyle Gillett:
凯尔·吉列：
But if you're agnostic, you're still trying to find that.
但如果你是不可知论者，你仍然在努力寻找这一点。
So I hope that everybody does find what they truly believe in as far as their own spirituality.
所以我希望每个人都能找到自己真正信仰的东西。
But yeah, that's a personal journey.
但是，是的，这是一次个人旅程。
From a physician's standpoint, and even if I'm friends with them as well, from a friend standpoint, I don't like to push anybody in any specific direction.
从医生的角度来看，即使我也是他们的朋友，从朋友的角度来看，我也不喜欢将任何人推向任何特定的方向。
So I don't think that everybody should believe what I believe, and I don't feel like there should be any pressure for them to believe something different.
所以我不认为每个人都应该相信我所相信的东西，我也不认为他们应该有任何压力去相信不同的东西。
So I think that there can be excellent physician-patient rapport, regardless of what we believe and what our backgrounds are.
因此，我认为，无论我们的信仰是什么、背景如何，医患关系都可以保持良好的关系。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, that's wonderful to hear.
是的，很高兴听到这个消息。
I can say, without revealing any names, that I have close colleagues in every bin of this spectrum, like hardcore atheist, hardcore religious, in different domains, different religions.
我可以说，在不透露任何名字的情况下，我在这个范围的每个方面都有亲密的同事，比如铁杆无神论者、铁杆宗教人士，在不同的领域、不同的宗教。
I don't know if I know many, I'm agnostic as to whether or not I know any agnostics, I should say.
我不知道我是否认识很多人，我应该说，我不知道我是否认识任何不可知论者。
Andrew Huberman:
安德鲁·休伯曼：
It's not something that people commonly discuss, but in the context of science and medicine, it's starting to happen more and more.
这不是人们普遍讨论的事情，但在科学和医学的背景下，这种情况开始越来越多地发生。
And certainly this issue of spirituality is one of the areas in which neuroscience is asking a lot of questions, like what spiritual experiences really are in terms of how they're grounded in the brain or not grounded in the brain?
当然，灵性问题是神经科学提出很多问题的领域之一，比如灵性体验到底是如何扎根于大脑或不扎根于大脑的？
I think it's a really interesting area for discovery, and I appreciate that you bring it up and you bring it up in the nonpressured way that you do.
我认为这是一个非常有趣的发现领域，我很感激你提出这个问题，并且以一种没有压力的方式提出它。
I think it will stimulate a lot of thinking, which is ultimately the goal of this podcast.
我认为这会激发很多思考，这也是这个播客的最终目标。
Andrew Huberman:
安德鲁·休伯曼：
Well, I have one final question that a listener insisted I ask, and it's a very straightforward one.
好吧，我还有最后一个问题，一位听众坚持要我问，这是一个非常简单的问题。
It's not at all a curve ball and not at all related to what we were just talking about, but it was the most common question when I told people that I was going to be talking to you which is, is caffeine problematic for hormones?
这根本不是一个曲线球，也与我们刚才谈论的内容完全无关，但当我告诉人们我要和你谈话时，这是最常见的问题，即咖啡因对荷尔蒙有问题吗？
Andrew Huberman:
安德鲁·休伯曼：
It's amazing.
太棒了。
I received hundreds of the same question about caffeine, and since it's probably the most commonly used drug on the planet, I know it's taking us back into the very practical.
我收到了数百个关于咖啡因的相同问题，因为它可能是地球上最常用的药物，我知道它让我们回到了非常实用的状态。
We're not quite there yet, but in closing, is caffeine having an effect one way or the other on testosterone, estrogen, or other hormones that is positive, negative, or neutral?
我们还没有完全做到这一点，但总而言之，咖啡因是否会对睾酮、雌激素或其他积极、消极或中性的激素产生某种影响？
Kyle Gillett:
凯尔·吉列：
Only if it affects your sleep.
仅当它影响您的睡眠时。
So it works on adenosine, and it can actually slightly improve allergies as well, but negligible effect otherwise.
所以它对腺苷起作用，实际上也可以稍微改善过敏，但其他方面的效果可以忽略不计。
Andrew Huberman:
安德鲁·休伯曼：
Great.
太棒了。
Well, sorry to end on such a practical brass tacks type of question, but I did promise the listeners that I would ask that question.
好吧，很抱歉以这样一个实际的大头针类型的问题结束，但我确实向听众保证我会问这个问题。
Andrew Huberman:
安德鲁·休伯曼：
Listen, I want to sincerely thank you.
听着，我要真诚地感谢你。
We covered basically an endocrinology textbook, a neuroendocrinology, textbook's worth of information, a ton of practical tips in there.
我们基本上涵盖了一本内分泌学教科书，一本神经内分泌学，教科书的信息价值，里面有大量的实用技巧。
Where can people find out more about you?
人们可以在哪里找到有关您的更多信息？
We will certainly provide links.
我们一定会提供链接。
And I guess the other question is are you taking patients?
我想另一个问题是你会收治病人吗？
I'm sure you'll hear that in the various venues where people can contact you, but where are you active in terms of public-facing work?
我相信您会在人们可以联系您的各个场所听到这一点，但是您在哪些地方积极参与面向公众的工作？
Kyle Gillett:
凯尔·吉列：
I'm active on Instagram, kylegillettmd.
我在 Instagram 上很活跃，kylegillettmd。
I'm also active on the social medias of my brand new clinic, which is Gillett Health.
我在我的全新诊所 Gillett Health 的社交媒体上也很活跃。
It's @gilletthealth on Instagram or gilletthealth.com.
Instagram 或 gilletthealth.com 上的@gilletthealth。
Andrew Huberman:
安德鲁·休伯曼：
Great, we'll provide links to those.
太好了，我们将提供这些链接。
And I should say that the content you've been putting out on Instagram is terrific because you actually point to specific studies, and you put things into actionable context, which is very meaningful for me.
我应该说，你在 Instagram 上发布的内容非常棒，因为你实际上指出了具体的研究，并将内容置于可操作的背景中，这对我来说非常有意义。
Kyle, Dr. Gillett, I should say, thanks so much for your time.
凯尔、吉列博士，我应该说，非常感谢您抽出时间。
I really appreciate it and I know the listeners will too.
我真的很感激，我知道听众也会的。
Kyle Gillett:
凯尔·吉列：
Thank you, my pleasure.
谢谢你，我的荣幸。
Andrew Huberman:
安德鲁·休伯曼：
Thank you for joining me for my discussion about hormone health and optimization with Dr. Kyle Gillett.
感谢您与凯尔·吉列博士一起讨论激素健康和优化。
As you just heard, he is a treasure trove of actionable clear information.
正如您刚才所听到的，他是一个可操作的清晰信息的宝库。
And again, you can find him teaching more about hormones and other aspects of health on Instagram at kylegillett, that's Gillett with two Ts and two Ls but no E, kylegillettmd on Instagram and Gillett Health on all other platforms.
再说一次，你可以在 Instagram 的 kylegillett 上找到他教授更多有关激素和健康其他方面的知识，这是 Gillett，有两个 T 和两个 L，但没有 E，Instagram 上有 kylegillettmd，所有其他平台上有 Gillett Health。
And if you would like more information about his practice, you can find that at gilletthealth.com.
如果您想了解有关他的实践的更多信息，可以在 giletthealth.com 上找到。
Andrew Huberman:
安德鲁·休伯曼：
If you're learning from and/or enjoying this podcast, please subscribe to us on YouTube.
如果您正在学习和/或喜欢此播客，请在 YouTube 上订阅我们。
That's a terrific zero-cost way to support the podcast.
这是支持播客的绝佳零成本方式。
In addition, please subscribe to the podcast on Spotify and Apple.
此外，请订阅 Spotify 和 Apple 上的播客。
And on Apple, you have the opportunity to leave us up to a five-star review.
在苹果上，您有机会给我们五星级的评价。
If you have questions or comments about this or any episode of the Huberman Lab podcast, or if you'd like to suggest topics that you'd like us to cover or guest that you would like me to talk to, please put that in the comment section on YouTube.
如果您对本播客或 Huberman Lab 播客的任何一集有疑问或意见，或者如果您想建议您希望我们报道的主题或您希望我交谈的嘉宾，请在 YouTube 上的评论部分提出。
Andrew Huberman:
安德鲁·休伯曼：
In addition, please check out the sponsors mentioned at the beginning of today's episode; that is the best way to support the podcast.
另外，请查看今天节目开头提到的赞助商；这是支持播客的最佳方式。
If you're not already following us on Instagram and Twitter, please do so.
如果您还没有在 Instagram 和 Twitter 上关注我们，请立即关注。
It's Huberman Lab on both Instagram and Twitter.
Instagram 和 Twitter 上的名称均为 Huberman Lab。
And there I cover science and science-based tools, some of which overlap with the contents of the Huberman Lab podcast, but much of which is distinct from the contents of the Huberman Lab podcast.
在那里，我介绍了科学和基于科学的工具，其中一些与胡伯曼实验室播客的内容重叠，但其中大部分与胡伯曼实验室播客的内容不同。
Thank you once again for joining me for today's discussion with Dr. Kyle Gillett.
再次感谢您参加今天与凯尔·吉列博士的讨论。
And as always, thank you for your interest in science.
一如既往，感谢您对科学的兴趣。
PART 5 OF 5 ENDS
第 5 部分（共 5 部分）结束