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Peter Attia, M.D., is a physician specializing in the science of longevity and optimal performance. He is the founder of Early Medical, host of "The Drive" podcast, and author, along with Bill Gifford, of "Outlive: The Science & Art of Longevity.
Worth putting in mind that, and this is sort of my pet peeve with this whole drug and sport thing is like, I mean, personally, I don't really give a shit. I mean, I just have bigger things I care about than like how many steroids Barry Bonds took to hit all those home runs. But what really does chap my ass is when people don't actually understand how steroids work. Right. Like it bugs the shit out of me when people assume that if you take steroids, you will have, you know, you will hit that many, you know, home runs or you will run this fast or lift this much. The only thing that steroid is doing is enabling you to recover faster from the brutal work that it takes to actually do those things. So, you know, all the, if I shot myself full of EPO, I mean, you've probably seen Icarus, right? Mm-hmm. I mean, I thought that was, I thought he did it. I thought, Brian Fogel. Yeah, I thought Brian Fogel did a really good job of showing like, I mean, and he was a pretty good responder to the EPO. I think he did growth hormone testosterone and EPO. I mean, you saw in the end of the day, he finished worse the second year round because... Yeah, but his bike ran out of juice. Exactly. That's my point. You see, like people don't realize like one little thing makes all the difference. Right. From a performance standpoint, yeah, he probably would have done a little bit better, but it's not because the drugs were in him per se. It's because the drugs that were in him allowed to train more. So the reason he was a fitter rider the second year was because his watts per kilo were higher because of how much more he trained. The drugs enabled him to train that much harder. Yeah, that's what it does. It allows you to train harder so you recover better, so you have more output. Correct. But we don't want young kids to think that the only way to do this is to start taking steroids and fuck up your endocrine system. And that's... No, of course not. But we also want to keep in mind, like, see, it almost requires like a broader discussion, which is like, why do we care? Well, we care in combat sports because it allows you to inflict more damage on your body. No, no, no. I'm saying like, why would... why do... let's just say I'm not a professional athlete. Okay. Why do I actually care how fast I run or how fast I ride or any of these other things? Well, because you want to brag about it. Okay. So maybe... Say if you're a weightlifter. Right. So maybe therein lies the problem. I mean, I mean, I... You know, when I stopped cycling competitively, I think a big part of it was I just realized that performance and longevity stopped being collinear. They started to become somewhat orthogonal. They started to deviate. In other words, the things that I was doing that were enhancing my performance, and I'm not even talking about drugs, I'm just talking training wise, it seemed to come at the expense of what I believed was going to make me live longer. So specifically, the thing I cared most about was cardiovascular health. Now, the incidence of atrial fibrillation in highly trained athletes is 10 times higher than that of non-athletes. So like, that's a little counterintuitive, right? Yeah. Why would people who have such amazingly fit cardiovascular systems have 10 times the risk of this horrible condition called atrial fibrillation, which yeah, many people have it, but not young. You're not supposed to have that when you're 40. And it's usually associated with cardiovascular disease. And yet people are, you know, showing up with these... I mean, I have four patients who have had to get ablations for atrial fibrillation. What is an ablation? An ablation is a procedure where they stick a catheter up through the femoral artery or in the vein, and then they burn pieces of the heart, specifically around the pulmonary veins. And they basically are trying to burn away and create... or remove the ability of the electrical system to move in this way. So what's basically happening with this type of athlete's heart is when your heart is constantly being exposed to that high stretch, high ejection fraction load, you're basically stretching out the electrical system, because the electrical system of the heart runs within its muscles. So as you stretch it out, a certain group of people... and we don't know why certain people are susceptible and certain are not, but they just develop this dysrhythmia. So you're soldering the motherboard, as it were? Yeah, yeah. You can effectively think of that, right? You're like creating new lines to block the connection. Whoa.