Paul's self experimentation

David H Doesn't Attia prefer berberine over metformin?

MAC I will try for 20-25  as per LEF recommendations. The only reason my free  is in the current range is due to interaction with DHEA which increases free from 1-2% to 4-5 %. My total T is in range of 200 - 300 and has decreased from 400 - 500 in last 3 years. .  My DHEA is 500.  This is reason I am looking at clomiphene.

I am on strict mediterrenean diet with chicken 1-2 X per week with a vegetable stir fry. The rest of the time I am a vegetarian which includes fruits and a lot of berries. I practice intermittent fasting with 16  - 8 window. Tried 5: 2  for two years but concluded there are adverse impacts to cholesterol and testosterone and some other issues and stopped in June. Am heavy into pre and probiotics as it appears this has many benefits. Make my own yogurt, keifer and red cabbage sauerkraut.

My EPA/ DHA intake is ~ 5 grams /day and this keeps my triglyceride/HDL ratio at ~ 1.0. The literature suggests that this ratio eliminates any chance for a cardiovascular event. I am also of the opinion that there are a multitude of other benefits  which includes minimizing epigenetic changes due to reductions in inflammation.

Again, good luck 

Peter H. Howe What type of EPA/DHA do you take? Yes, TG/HDL < 2, and closer to 1, is very anti-atherosclerotic...it's a surrogate for many things, especially LDL-P. I don't know about eliminating "any chance" of CV event, but definitely in lower percentile for sure. My DHEA is just above the upper lab level. Re inflammation, my hsCRP is basically zero, the last several lab tests 0.1-0.2. Re diet, I do strict keto, OMAD for the myriad of benefits of ketones. So so many, an entirely different subject/thread.

MAC  I take Natures Bounty from Costco. One capsule is 0.9 gm EPA/DHA and I take 6/day. It is cheapest and one of the best quality  I could find. Problem is that Consumer Lab did not test this brand in its last go around. Previous tests found it to be one of the  best in terms of quality and price.

I have always had  relatively high CRP (~ 1.0)) and it is going higher ( last was 3.1)-- and is age effect. Average value of centenarians is greater than 5.0  My other inflammation markers such as IL-6 are almost zero. This can be attributed in part to DHEA and resolvins from the fish oil breakdown . 

Do not disagree with you on ketones. However you should be aware that seniors need ~ 1 gram protein/kg body weight to help prevent sarcopenia. Am of the opinion that seniors in general may need to see diet a little differently. I note that both calorie restriction and metformin significantly reduces testosterone. You can verify this with google search. I also try to get ~2.5 grams of polyphenols/day which is difficult on ketone diet due to the need for fruits and berries.

Our dietary needs change as we age. In middle age you need only ~ 0.5 grams per day of protein but this is not adequate in old age based on the literature. I get ~ 1/2 my protein needs from whey protein isolate which also boosts my immune system. This in general is the system (in addition to some form of dementia) that will fail us if we make it past major killers of cardio and cancer.

The landscape is always changing.  In addition to the triglyceride/hdl marker, another key indication that things are going well is whether or not the opposite sex still rings your bells. This is not a sexist comment. Another biomarker of aging is that old people talk a lot. Thought I should get that in before someone else does.

Take care

Peter H. Howe I take daily 5ml of Carlson ELITE DHA/EPA liquid, which is 2920 total DHA/EPA (2270 DHA/430 EPA). You quote "centenarians"...that made my day! Fully aware of all the science re protein intake and sarcopenia. But what drives sarcopenia is not lack of protein but hyper mTOR and lack of resistance exercise. You do NOT need amino amino acids to build muscle...you need resistance exercise. 

From a personal communication with Blagosklonny:

"Amino acids do not make muscles stronger, exercise does!"

https://www.mikhailblagosklonny.com/how-rapamycin-prevents-muscle-loss-and-sarcopenia-first-draft/

My strict keto keeps my protein at about 20% of total calories. For my weight and build and exercise routine, I take in max 50 g/kg of animal protein. But I have grown grown my muscles massively at such LOW protein intake...this has been quite a surprise, and confirmation of Blagosklonny. So my focus re frailty and sarcopenia avoidance as I get older is not focused on protein but RESISTANCE EXERCISE. 

Re polyphenols and ketone diet...very few people actually understand a proper and true ketogenic diet. First of all to be classified as "ketogenic", you must generate ketone metabolites. So a "low carb" diet does NOT = ketogenic. If one takes in too much protein (ala Atkins diet), it will kick you out of ketosis. Secondly, since my fats comprise approx 70% of calories, and being in a "clean" ketogenic diet (vs. animal fats), I eat only avocado/nuts (loaded with MUFA/PUFA) and typically 30-50mL of high quality EVOO daily. There is "no need" for fruits and berries in a ketogenic diet...they are full of sugar, and kick you out of ketosis! I do eat low glycemic blueberries though for the nutrients, and 100% dark chocolate which is a super food. So I am heavily loaded with polyphenols.

MAC MAC, if it works for you that is what you should do. I fully understand the benefits of keto,  what it involves and acknowledge that it has significant benefits, but question its merit for seniors.  I would never disagree with you on merits of exercise. My opinion is that for seniors, maintaining one's hormones in upper favorable range is critical and doing so along with exercise will curtail frailty development and sarcopenia along with inhibiting osteoporosus and dementia. There are multiple studies which confirm this.  There is further enhancement to the antiaging scenario if you  exert some control on calories, use  time limited  eating periods, use beneficial foods and consume lots of fish oil. You can google protein requirements for seniors and find a number of peer reviewed papers that suggest protein intake should be in range of 1-1.2 gm/kg. 

In terms of the protein, I get about 35 of my 70 grams per day from whey protein in a smoothie of low fat yogurt, 1 cup frozen wild blueberries, 1 oz almonds and  10 grams of sugar free non dutch treated cocao.  I note that you eat chocolate and advise you to be careful as it has high levels of cadmium. See references in the Consumer Labs reports if you have access.

I use whey protein due to its immune system enhancements which is critical to seniors. Suggest you google this topic. One of the biological conflicts on this topic, as there is in every biological issue,   is that males who are neutered due to some accident, cancer treatment  etc, will typically live typically live 5 - 10 years longer than the average male due to the fact that testosterone contributes to the thymus involution.

 In relation to mTOR and Blagosklonny, check out a difference of opinion.

https://link.springer.com/article/10.1007/s40520-019-01146-1

According to this paper, in  seniors with frailty and and muscle degradation you may want to increase mTOR with fish oil to improve muscle growth etc. This discussion is at end of the paper.

Also note at end of the Blagosklonny is a reference to anabolic steroids increasing muscle growth. 

In summary, what may be beneficial in middle age may not be so when your 80.

Based on Paul B and Fred Clouds just posted comments I am going to order DNA test from epiaging usa this weekend.  MY chronological age is 80 and my Levine est DNAAm Age is 71.28. Let see what happens.

MAC, Are we having fun. Thanks for the stimulation. 

Michael peter attia actually called berberine "the poor mans metformin", and prefers metformin between the two