Essentials: How to Optimize Your Hormones for Health & Vitality | Dr. Kyle Gillett

This Essentials episode opens with host Andrew Huberman introducing his conversation with Dr. Kyle Gillett about hormone health and optimization. Huberman calls his guest an encyclopedia of hormone knowledge for men and women across the lifespan. His first question is practical: when a patient comes in about hormone health, what does Gillett ask, and what is he looking for? Huberman says he wants listeners to be able to ask some of the same questions of themselves.

Gillett describes the standard parts of a physical exam and history. These include the history of present illness when a patient has a complaint. When a patient has no complaint, he says social and family history become extremely important, because they give insight into genetics and hormone health. Patients often say they are doing okay, so he finds it useful to compare the present with the past. A 50-year-old, for example, might be asked how they are now compared with when they were 20, and what has changed.

He then answers a question he says he gets often: how to get a doctor to order a better lab workup or include basic hormones at all. He says there is no magic answer. What helps is describing specific declines, such as energy, focus or athletic performance that are not as good as they used to be.

So you don't have to have a pathology in order for a lab to be indicated. You just need to have that pertinent symptom.

Asked whether this approach works equally well for men and women, Gillett says women's situation involves much more objective data. Menstrual irregularities, missing periods or overly heavy periods are things women discuss with their doctors very often. In his account, men are more hesitant. They want to know their testosterone number, but they are reluctant to tell a doctor about their libido or energy, because saying so seems to make them feel less masculine, even in a medical setting.

Huberman asks for a snapshot of what everyone, male or female, from puberty onward, should be thinking about or doing for hormone health. Gillett frames his answer around the law of diminishing returns. Small, sustained lifestyle interventions over a long period, he argues, are far more helpful than doing a lot and then doing nothing.

He calls his framework the big six pillars and ranks diet and exercise as probably the two strongest. For hormone health, he singles out resistance training as particularly helpful. For diet, he says caloric restriction can be particularly helpful, especially given what he describes as an ongoing epidemic of metabolic syndrome in this country and in developed countries generally.

The remaining four pillars, as Gillett describes them: - Stress and stress optimization, which he ties to cortisol, mental health, societal health and the collective health of a family. He argues that changes such as nicotine cessation or hormone optimization are far more helpful when done together as a household. - Sleep optimization, which he calls extremely important, including for mitochondrial health. - Sunlight, which he uses as shorthand for anything outdoors, including moving more, cold exposure and heat exposure. - Spirit. He argues that even with the other five fully dialed in, missing spiritual health, "whatever you believe," will profoundly affect body and mind.

After a sponsor segment, Huberman asks how to approach diet. Gillett says diet should be individualized and compares people to vehicles: a race car and a diesel truck need different fuels for different performance outcomes. Genetics also matter. He says a genetic polymorphism can let a person metabolize carbs and sugar better, even when they are unopposed by fiber. People can use biofeedback, meaning how they feel, to guess what they tolerate well. Genetic testing is the alternative, but he notes it can be fairly expensive and, above all, requires a physician or someone who can interpret it accurately.