Transcript from Tim Ferris Show 2015: Peter Attia's supplementation.
I wonder how much his supplementation has changed if at all in the last 3 yrs?
From:
https://www.transcripts.io/transcripts/tim_ferriss_show/2015/03/11/peter-attia.html
In the previous Tim Ferriss interview, you mentioned discussing what supplements to take, but ran out of time. What are your top 10 supplement recommendations, and do you describe to periodization even for everyday supplements such as vitamin D?
I mean, I’m certainly happy to answer what supplements I take. I’m not sure how relevant it is to the listener because there’s few things that I believe just taking out of the gate for everybody. In other words, I sort of, with my patients at least, take a very tailored approach to what they should or shouldn’t take.
So what do I take? I take vitamin D, I take a baby aspirin, I take methylfolate, I take B-12, I take EPA and DHA Omega 3 fatty acids, and I take berberine. I think that’s all I take, and you could argue baby aspirin is not really a supplement, but I count it as one I guess. Okay, so why do I take those? What do I not take? I do not take a multivitamin, I do not take vitamin A, I do not take vitamin C, I do not take vitamin E, I do not take vitamin K, although I have flirted with vitamin K a little bit and I have some interesting thoughts on that for certain people.
Oh, I also take a probiotic, which I do actually periodize, and I actually deliberately cycle the dose of that throughout the week. So on the ones I do take, the reason I take them is basically all I’m managing to certain levels. So I have target levels for vitamin D, and I can’t get to them without supplementing, so I supplement. I have an MTHFR mutation, which means, and these are not that uncommon by the way, so it’s not like I’m a two-headed freak, but that mutation means I don’t do a good job methylatingfolic acid, and so as a result, I take methylated folate to get around that problem. I also can’t seem to get my B12 levels to where I want them to be. I can get them into the “green zone,” but I aspire to actually have a slightly higher level, so I need a very low dose of that supplement. And again, to the point about periodization, I do take my vitamin D every day. I sometimes double up on days that I know are going to be brutally stressful. On the methyl folate and the B12 and I also take B6 for another reason, I do actually rotate those, but that’s less because I believe that periodization is necessary and more just to minimize the number of pills I take a day, and because I don’t need them every day I generally only take them twice a week.
And again, I’m doing this to titrate to a very specific dose. So I’m really using my blood levels to determine how much or how little I need of these. I think the only one I haven’t addressed is berberine and baby aspirin. So baby aspirin I take because my aspirin works test lights up. What that means is, if I’m not on a baby aspirin, I pee into a cup, the lab does a test on that to determine how sticky my platelets are, the answer is very sticky. So a baby aspirin, which is just a quarter dose of an aspirin, actually inhibits the functionality of platelets in a way that doesn’t lead to massive bleeding if I get a cut, but takes the “edge” off that feature. And actually what I will do there is I will increase that to a full aspirin, meaning four baby aspirin, any day that I’m doing a cross-country flight, which is usually once or twice a week. So most days I’m just taking a baby aspirin, any day that I’m flying, because I want to minimize even the smallest chance of a blood clot, I’ll take four of those.
Okay, so the last one is berberine. So berberine is a vegetable extract that actually is kind of a natural mimicker of metformin on one hand, which is to say it activates AMP kinase, and what the net effect of that is, and I’m sorry I’m going a little quick. We could obviously spend an hour just talking about why AMP kinase activation is important in health, but suffice it to say one of the net outcomes is the suppression of hepatic glucose output, which maintains lower levels of insulin and therefore lower levels of IGF 1, which is something I place a huge premium on. The other thing that berberine does that metformin does not do is it inhibits PSCK9. So PSCK9 plays a very important role in the metabolism or breakdown or processing of lipoproteins, those LDL particles, and about 10 to 15 percent of the population if I have my numbers right, and I might be a bit off, tend to over-express PSCK9, and we have a genetic test for this that I frankly don’t do that often in people. I tend to just put them on berberine, and if their LDL particle level drops on berberine by 10 to 20 percent, then I know that they’re an over-expressor of PSCK9. If they have no response, then I know that they’re not, but they still may benefit from it from a glycemic and insulin level.
So anyway, that’s where I am on the supplement front.