essentials：如何优化激素以促进健康与活力 | 卡尔·吉莱特医生

欢迎来到胡伯曼实验室精华版，在这里我们将回顾过往节目，为您提供最有效且可操作的、基于科学的心理健康、身体健康和表现提升工具。

Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science based tools for mental health, physical health, and performance.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科学教授。

I'm Andrew Huberman, I'm and a professor of neurobiology and ophthalmology at Stanford School of Medicine.

现在，让我与吉莱特医生讨论激素健康与优化。

And now for my discussion about hormone health and optimization with Doctor.

凯尔·吉莱特。

Kyle Gillette.

医生。

Doctor.

吉莱特，欢迎。

Gillette, welcome.

谢谢您邀请我。

Thank you for having me.

我非常期待与您交谈。

Well, I'm super excited to talk to you.

你是关于男性和女性一生中激素健康方面的知识宝库。

You are an encyclopedia of knowledge about hormone health for men and for women across the lifespan.

所以我有很多很多问题。

So I have many, many questions.

当有人作为患者来找你咨询激素健康时，你会提出哪些关键问题？你关注哪些方面？

When someone comes to you as a patient, in terms of hormone health, what are the sorts of probe questions that you ask and what are you looking for?

我问这个问题，是因为我希望人们能够自己提出一些类似的问题。

And I ask this because I'd like people to be able to ask some of these very same questions for themselves.

当你进行体格检查和病史采集时，会涉及很多不同部分。

So when you do a physical exam and a history, you have a lot of different parts.

你有当前疾病的病史，如果患者有主诉，也许患者并没有主诉。

You have your history of present illness, if they have a complaint, maybe the patient doesn't have a complaint.

在这种情况下，他们的社会史和家族史就极为重要，因为这能让你了解他们的遗传背景和激素健康状况。

And 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 an insight into their hormone health.

患者会告诉我：‘我感觉还不错’，但问一句‘那你现在感觉怎么样？’会很有帮助。

So patients will tell me, Oh, I'm doing okay, but it helps to ask them, Well, how are you now?

假设患者50岁。

Let's say the patient is 50.

你现在的情况和20岁时相比如何？有什么变化？

How are you now versus when you were 20 and what has changed?

所以我经常被问到，如何让你的医生安排更全面的实验室检查，甚至包括基础激素检测？

So 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?

对此并没有什么神奇的答案。

And there's no magic answer to that.

但真正有帮助的是，你告诉医生：我的精力不如以前了。

But what really helps is you tell them, you know, my energy is not as good as it used to be.

我的专注力也不如以前了。

My focus is not as good as it used to be.

我的运动表现也不如以前了。

My athletic performance is not as good as it used to be.

因此，即使没有病理问题，进行实验室检查也是有依据的。

So you don't have to have a pathology in order for a lab to be indicated.

你只需要有相关的症状即可。

You just need to have that pertinent symptom.

你会说，你刚才描述的这种方法对男性和女性同样有效吗？还是说由于某种原因，男性和女性在试图获取更深入的激素数据时面临不同的挑战和优势？

Would you say that 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.

对于女性来说，存在

With women, there's a

更多的客观数据。

lot more objective data.

所以，如果她们有月经不规律，或者没有月经，或者月经量过多，这些通常是她们会频繁向医生提及的问题。

So if they're having menstrual irregularities, or 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.

男性则更犹豫。

Men are more hesitant.

男性非常想知道自己的睾酮水平，但同时，他们又不太愿意告诉医生自己的性欲或精力状况，因为这几乎让他们感觉失去了男子气概，或觉得自己不像个男人了，即使他们只是在和医生交谈时提到这些。

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.

我真想了解一下，你认为无论男女，从青春期开始，每个人都应该思考或做些什么来优化自己的激素健康？

I'd love to just kind of take a snapshot of what you think everybody should be thinking about or doing to optimize their hormone health, male or female, from puberty onward?

边际收益递减规律适用。

The law of diminishing returns applies.

因此，长期坚持我所说的少量生活方式干预，远比短期内大量干预然后完全放弃更有效。

So 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.

我谈到六大支柱。

So I talk about the big six pillars.

其中最强的两个可能是饮食和运动。

The two strongest ones are likely diet and exercise.

对于激素健康，特别是抗阻训练特别有帮助。

For hormone health, specifically resistance training is particularly helpful.

在饮食方面，热量限制特别有效，尤其是在这个国家以及总体发达国家中代谢综合征持续蔓延的背景下。

For diet, caloric restriction can be particularly helpful, especially with the epidemic of metabolic syndrome that is continuing to on go in this country and in developed countries in general.

这两者是最强大的。

Those are the two most powerful.

对于后四个，我用了一点押头韵。

For the last four, I had a little bit of alliteration.

所以有压力和压力优化。

So there's stress and stress optimization.

这与皮质醇有关，与你的心理健康有关，也与你家庭乃至社会的整体健康有关。

That has to do with cortisol, that has to do with your mental health, That has to do with societal health and collective health of your family as well.

当你和家人或非常亲密的朋友一起努力实现最佳健康状态时，这非常重要。

When you're a member of a family or even a very close friend, trying to achieve optimal health together is very important.

戒烟也是如此。

It's the same thing with nicotine cessation.

激素优化也是如此。

It's the same thing with hormone optimization.

如果以家庭为单位进行，效果会好得多。

If you do it as a household unit, it's far more helpful.

在压力之后，是睡眠优化。

So after stress, have sleep optimization.

睡眠极其重要，尤其是对线粒体健康而言。

Sleep is extremely important, especially for mitochondrial health as well.

然后是阳光，这涵盖了所有户外活动。

And then you have sunlight, which encompasses anything that's outdoors.

所以你多运动，经历寒冷和高温暴露，这些都属于阳光。

So you move more, you have cold exposure, you have heat exposure, that's sunlight.

最后一个则是精神层面。

And then the last one is spirit.

这大致就是身体、心智和灵魂。

So that's kind of the body, mind, and soul.

如果你其他五个方面都做得非常好，但缺乏精神健康——无论你信仰什么——这都会深刻影响你的身体和心智。

If you have all the other five 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.

到目前为止，我相信你们很多人都听过我说，我已经服用AG1十多年了。

By now, I'm sure that many of you have heard me say that I've been taking AG1 for more than a decade.

这确实是事实。

And indeed that's true.

我早在2012年就开始服用AG1，至今仍每天坚持服用，原因在于据我所知，AG1是市场上质量最高、最全面的基础营养补充剂。

The reason I started taking AG1 way back in 2012, and the reason why I still continue to take it every single day is because AG1 is to my knowledge, the highest quality and most comprehensive of the foundational nutritional supplements on the market.

这意味着它不仅含有维生素和矿物质，还包含益生菌、益生元和适应原，以弥补你饮食中的任何不足，同时为紧张的生活提供支持。

What that means is that it contains not just vitamins and minerals, but also probiotics, prebiotics, and adaptogens to cover any gaps that you might have in your diet while also providing support for a demanding life.

由于AG1含有益生菌和益生元，它还有助于维持健康的肠道微生物群。

Given the probiotics and prebiotics in AG1, it also helps support a healthy gut microbiome.

肠道微生物群由数万亿个微小微生物组成，它们分布在你的消化道内，影响你的免疫状态、代谢健康、激素健康以及其他诸多方面。

The gut microbiome consists of trillions of little microorganisms that line your digestive tract and impact things such as your immune status, your metabolic health, your hormone health, and much more.

持续服用AG1有助于改善我的消化，增强我的免疫系统，并确保我的情绪和精神专注力始终处于最佳状态。

Taking AG1 consistently helps my digestion, keeps my immune system strong, and it ensures that my mood and mental focus are always at their best.

AG1现在推出了三种新口味：浆果味、柑橘味和热带味。

AG1 is now available in three new flavors, berry, citrus, and tropical.

虽然我一直很喜欢AG1的原味，尤其是加一点柠檬汁后，但我现在特别喜欢新的浆果味，味道非常好。

And while I've always loved the AG1 original flavor, especially with a bit of lemon juice added, I'm really enjoying the new berry flavor in particular, it tastes great.

但话说回来，我其实喜欢所有口味。

But then again, I do love all the flavors.

如果你想尝试AG1和这些新口味，可以前往drinkag1.com/huberman领取特别优惠。

If you'd like to try AG1 and try these new flavors, you can go to drinkag1.com/huberman to claim a special offer.

目前，AG1 正在免费赠送六份 AGZ 的试用装，AGZ 是 AG1 的新款睡眠配方，顺便说一句，效果非常好。

Right now, AG1 is giving away six free sample packs of AGZ, which is AG1's new sleep formula, which by the way is fantastic.

这是我唯一服用的睡眠补充剂。

It's the only sleep supplement I take.

它让我不再需要服用这么多药片，我的睡眠质量也从未如此好过。

It eliminates the need for all these pills and my sleep has never been better.

这个特别优惠包括六份免费的 AGZ 试用装，以及您首次订阅时赠送的三份 AG1 旅行装和一瓶维生素 D3K2。

The special offer gives you six free samples of that AGZ, as well as three AG1 travel packs and a bottle of vitamin D3K2 with your first subscription.

只需前往 drinkag1.com/huberman 即可开始领取。

Just go to drinkag1.com/huberman to get started.

你认为看待和安排饮食的最佳方式是什么？

What would you say is a really terrific way to think about and approach diet?

是的，饮食应该是个体化的。

Yeah, diet should be an individualized approach.

如果你有一辆车，每辆车的构造都不同，需要的燃料也不同，无论是赛车还是柴油卡车，它们为了不同的性能表现都需要不同的燃料。

So if you have a car, each car is made different and requires a different sort of fuel, whether it's a race car, whether it's a diesel truck, they have different fuels for different performance outcomes.

所以如果你试图拖拽重物或想快速行驶。

So if you're trying to tow something or you're trying to go fast.

这也取决于你的基因。

It also depends on your genetics.

因此，你可能携带某种基因多态性，即使在没有纤维对抗的情况下，也能更好地代谢碳水化合物和糖分。

So you can have a genetic polymorphism and you metabolize carbs and sugar better, even when they're unopposed by fiber.

你可以通过身体反馈——你的感受——来推测自己能良好耐受的食物，也可以选择进行基因检测，虽然这可能相当昂贵，但最重要的是，它需要医生或懂行的人来

Basically you can use your biofeedback, how you're feeling to guess what you tolerate well, 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

准确解读检测结果。

to interpret the test accurately.

如果有人有能力，你说定期进行血液检测是个好主意吗？

And if someone had the means, you say that getting regular blood testing is a good idea?

如果是的话，什么是定期血液检测？

And if so, what is regular blood testing?

是每三个月一次吗？

Is it every three months?

是每六个月一次吗？

Is it every six months?

为了预防目的，每三到六个月一次。

Every three to six months for preventative purposes.

你应该在空腹和非空腹状态下都进行血液检测。

You should also get a blood test when you're fasting and when you're not fasting.

关于运动的一般建议，根据我所看到的数据，几乎每个人都应该每周至少进行150到180分钟的二区有氧运动。

And in terms of general recommendations around exercise, I'm of the mind based on the data that I've seen that almost everybody should, or everybody should be getting one hundred and fifty to one hundred and eighty minutes minimum of zone two cardio per week.

是的，大致就是这样。

Yeah, that's more or less the contour.

你进行的二区有氧运动越多，长期热量限制的重要性就越低。

The more you're doing your zone two cardiovascular exercise, the slightly less important a long duration of caloric restriction is.

这就引出了热量限制的话题。

And that brings us to caloric restriction.

一个人如何知道自己是否应该进行热量限制或避免热量限制？

How does someone know if they should use caloric restriction or avoid caloric restriction?

锻炼和热量限制（包括间歇性禁食）的根本原因都是为了健康。

The reason for exercise and the reason for caloric restriction in general, including intermittent fasting is health reasons.

这才是延长健康寿命的方法。

That's how you increase your health span.

它不一定能让体重秤上的数字发生变化，但那其实没那么重要。

It's not necessarily going to make the weight on the scale change, but that doesn't matter as much.

所以，简单来说，如果你肥胖或患有代谢综合征，热量限制会提高你的睾酮水平。

So the easy way to think about it is if you're obese or you have metabolic syndrome, caloric restriction will improve your testosterone.

有一项研究，他们在这篇来自《梅奥诊所学报》的系统性综述中提到了所有这些研究。

There has been a study, and they talk about all these studies in a systematic review from the Mayo Clinic proceedings.

他们指出，有一项针对年轻健康男性的研究，对他们进行热量限制后，他们的睾酮水平确实下降了。

They note that there is a study in young, healthy men and they calorically restrict them and their testosterone does decrease.

因此，如果你年轻健康且没有代谢综合征，那么热量限制可能会降低你的睾酮水平。

So if you're young and healthy and you don't have metabolic syndrome, then caloric restriction will likely decrease your testosterone.

对于体型健康、不肥胖的人来说，间歇性禁食对激素健康来说是个坏主意吗？

For the healthy lean enough person, right, non obese person, is intermittent fasting a bad idea in terms of hormone health?

如果一个人摄入的热量足以维持体重，那么在24小时内交替经历进食和禁食期会不会有问题？

Is oscillating between this period of kind of feast and famine within a twenty four hours a problem if one is getting sufficient calories to maintain weight?

如果他们处于热量维持状态，那么这不会对他们的激素健康造成损害。

So if they're in a caloric maintenance, then it's not going to be deleterious, it's not going to be bad for their hormone health.

我们可以讨论几种不同的激素。

There's a couple of different hormones that we can talk about.

我们可以谈谈睾酮，也可以谈谈DHEA，它们通常是一起变化的。

We can talk about testosterone, we can talk about DHEA, which usually go hand in hand.

我们还可以谈谈生长激素，它不是类固醇激素，而是一种肽类激素。

And then we can also talk about growth hormone, which is not a steroid hormone, but it's a peptide hormone.

它是由一串氨基酸组成的蛋白质，而不是类固醇。

So it's a chain of proteins, amino acids that are put together instead of a sterol.

可以把类固醇激素理解为来源于胆固醇。

Think of sterol hormones as coming from cholesterol.

进食后你的生长激素会略有升高，但夜间你会出现巨大的生长激素峰值，这个峰值更显著、更重要，而间歇性禁食能改善这一现象。

So 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, And that is improved if you are intermittent fasting.

因此，这可能会帮助提升你的生长激素以及随后的IGF-1水平，这对年长人群的帮助比对年轻人更大。

So it's probably going to help your growth hormone and subsequently IGF-one levels, which will help more in older age groups than younger age groups.

如果我在睡觉前两到三小时内避免进食，还能否实现高水平的生长激素分泌？

Can I still achieve a high degree of growth hormone output if I, let's say I avoid food in the two to three hours before going to sleep?

还是必须进行长时间禁食才能实现生长激素的这种提升？

Or does one have to be very deep into a fast in order to achieve this, the increase in growth hormone?

即使你在睡觉前两到三小时进食，生长激素的分泌仍然相当不错。

There's still pretty good growth hormone output, even if you eat two or three hours before you sleep.

这只是一个边际效益递减的问题。

It's just the law of diminishing returns.

你禁食的时间越长，生长激素的分泌就会略微增加、再略微增加。

The longer you go, you get slightly more and slightly more.

但我更倾向于从内分泌角度来思考IGF-1，主要是肝脏合成并释放的IGF-1，而非其他部位释放的IGF-1。

But I think about it in terms of endocrine IGF-one, mostly IGF-one that's synthesized in the liver and released in the liver versus IGF-one that's released.

一个经典的例子是，你的IGF-1水平会在抗阻训练或运动后上升。

Classically an example of this would be your IGF-one levels increase after resistance training or exercise.

而这种IGF-1更多是旁分泌或自分泌作用，主要在局部产生影响。

And that's more of like paracrine or autocrine, and they have more local action.

因此，已有大量研究证明，如果仅给人体补充外源性IGF-1，在生理剂量下并不会改善其身体成分。

So that IGF-one, it's pretty well studied that if you just give people IGF-one, it's not going to, at physiologic levels, it's not going to improve their body composition.

然而，那种在局部组织和肌肉中通过自分泌和旁分泌方式发挥作用的IGF-1，很可能是运动后身体成分得到改善的原因之一。

However, that IGF-one that's autocrine and paracrine just working in those local tissues and muscles is likely part of the reason why you get a improved body composition response after exercise.

是否有任何激素优化的方法可以改善睡眠？

Are there any aspects of hormone optimization that can improve sleep?

我知道睡眠能促进激素优化，但对于那些普遍存在入睡后凌晨三、四点就醒来的群体，我们知道这可能与抑郁有关，那么是否存在某些激素指标可能导致这种情况？

I know sleep can improve hormone optimization, but 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?

主要有三个因素。

There's three big ones.

第一个因素虽然不常见，但关联性非常直接。

The first one is not super common, but it's a very direct correlation.

如果你患有生长激素缺乏症，无论是成人还是儿童，你的睡眠很可能都会受到影响。

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.

假设你是一个患有生长激素缺乏症的孩子，一旦通过治疗补充了生长激素，你的睡眠就会显著改善。

And let's say you're a child with growth hormone deficiency, once that is replaced with therapy, your sleep is going to get significantly better.

第二种情况非常常见，那就是你正在经历更年期或男性更年期的血管舒缩症状，后者也同样适用。

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.

这就是为什么许多更年期女性感觉自己的睡眠质量变得更差，是因为她们体内孕激素的活性降低了。

That's why a lot of women in menopause feel like their sleep is much worse, is because they have lower activity of those progestogens.

对于男性在所谓的男性更年期中出现的低睾酮，这也是导致睡眠不佳的原因之一吗？

And for men in so called andropause, low testosterone, is that also one of the causes of poor sleep?

低睾酮可能导致睡眠质量下降，但我提到的第三种情况是，当男性开始接受睾酮替代疗法时，会因睡眠呼吸暂停而出现睡眠问题。

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.

这会大幅增加一个人患上睡眠呼吸暂停的风险。

It drastically raises the risk that somebody is going to have sleep apnea.

许多人在刚开始治疗的头一两个月会进入一种过度交感神经兴奋的状态，这是因为他们的雄激素受体过于活跃，尤其是在长期处于性腺功能减退之后。

And then a lot of people, especially when they first start it in the 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.

然后他们接受了生理剂量的睾酮替代疗法，这反而直接引发了睡眠问题。

Then they have a physiologic dose of TRT, and that causes the sleep issue itself.

对于那些不是低睾酮但使用TRT的人，情况也是如此吗？

Is that also the case in people that are using TRT who are not hypogonadal?

如今，坦白说，很多人即使睾酮水平在正常范围内，也会服用睾酮，因为这个范围太宽了，主要是为了应对其他症状。

Many people nowadays, let's be honest, are taking doses of testosterone, even though they are in the sort of standard range, because the range is so large because of other symptomology.

对吗？

Is that right?

如果你在开始使用睾酮之前是正常睾酮水平——什么意思？

If you're eugenadal before you start testosterone- Meaning?

意思是，你原本睾酮水平正常，然后开始使用TRT或自行注射睾酮、类固醇，无论你怎么看待，你的睡眠呼吸暂停风险仍会随着剂量增加而上升。

Meaning 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.

所以剂量越高，风险越大。

So the higher the dose, the more risky.

我想谈谈女性的睾酮。

I want to touch on testosterone in women.

我想知道，对于女性来说，了解自己的睾酮水平，其价值是否与了解孕酮和雌激素水平相当、更低或更高？因为我认为人们对睾酮在女性体内的作用存在很多误解。

I'd like to know whether or not knowing a woman's testosterone, 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.

为了健康优化，了解睾酮同样重要。

For health optimization, testosterone is just as important to know.

为了预防病理，例如乳腺癌和骨质疏松症，了解雌激素和孕激素更为重要。

For pathology prevention, for example, breast cancer, osteoporosis, estrogen and progesterone are more important to know.

当你考虑女性时，女性认为她们的睾酮水平非常低，因为检测时大多数人检测的是游离睾酮，即未结合的睾酮，而这只是睾酮中最小的一部分。

When So you're thinking about women, women think that they have such a tiny amount of testosterone, because you test it, most people test a free testosterone, so a testosterone that's unbound, which is by far the smallest proportion of testosterone.

任何雄激素都与多种类固醇结合蛋白结合，但最相关的是性激素结合球蛋白（SHBG）。

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.

它最强烈地结合雄激素类固醇，例如双氢睾酮（DHT），与前列腺增大和男性型脱发相关。

And that binds the androgenic steroid, for example, DHT or dihydrotestosterone, it's associated with prostate enlargement, associated with male pattern baldness.

它对双氢睾酮的结合最强，其次是睾酮，然后是雄烯二酮或脱氢表雄酮（DHEA），最后是对雌激素如雌二醇的结合最弱。

It binds that the most strongly, and then it binds testosterone next most strongly, and then it binds things like androstenedione or DHEA, dehydroepiandrosterone, and then it binds the estrogens, the weakest like estradiol.

因此，如果你看总睾酮水平，实际上几乎所有女性——并非所有女性，但绝大多数女性——的睾酮水平都显著高于雌二醇，但这是因为测量单位不同。

So 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.

雌二醇通常以皮克每毫升为单位，而睾酮则是以纳克每分升为单位。

So estradiol a lot of time is, you know, picograms per mil, as opposed to nanograms per deciliter.

因此，女性体内的睾酮比雌激素更多，而DHEA的含量则远高于两者。

So women have more testosterone than estrogen, and significantly more DHEA than either.

我想短暂休息一下，感谢我们的赞助商 Maui Nui 麋鹿肉。

I'd like to take a quick break and acknowledge our sponsor Maui Nui Venison.

Maui Nui 麋鹿肉是目前营养最丰富、味道最美味的红肉。

Maui Nui Venison is the most nutrient dense and delicious red meat available.

Maui Nui 麋鹿肉的所有肉类均来自毛伊岛野生采集的鹿。

All of the meat from Maui Nui Venison is also a 100% wild harvested access deer from the island of Maui.

我在这档播客中多次谈到食用高质量蛋白质的好处。

Now I've talked a lot on this podcast about the benefits of eating high quality protein.

它对肌肉修复和肌肉合成至关重要，同时也对整体新陈代谢和健康至关重要。

It's critical for muscle repair and muscle synthesis, but also for overall metabolism and health.

我特别喜欢 Maui Nui 麋鹿肉的地方在于，除了味道绝佳之外，它的蛋白质与热量比非常高，意味着你可以摄入大量蛋白质而无需摄入过多热量。

What I love so much about Maui Nui Venison is that in addition to its awesome taste, it has a very high protein to calorie ratio, meaning that you can get a lot of protein without having to eat a lot of calories.

Maui Nui 最新推出的产品之一是他们的夏季香肠。

One of Maui Nui's newest products is their summer sausage.

它含有20克蛋白质，仅110卡路里，且无糖，味道也极其出色。

It has 20 grams of protein with just 110 calories and no sugar, and it also tastes spectacular.

我最近早上把这种夏威夷香肠加到鸡蛋里，也放进沙拉中，几乎每顿饭都吃。

I've been adding the summer sausage to my eggs in the morning, to my salads and to pretty much everything I'm eating these days.

真的太好吃了。

It's just so good.

目前，Maui Nui 正在为 Huberman Lab 的听众提供首次订单满79美元即可免费获得一份鹿肉棒试用装。

Right now, Maui Nui is offering Huberman Lab listeners a free venison stick starter pack with your first order over 79.

这些鹿肉棒也同样出色。

These venison sticks are also fantastic.

请访问 mauinewivenison.com/huberman，首次订单满79美元即可免费获得这份鹿肉棒试用装。再次提醒，网址是 mauinewivenison.com/huberman。

Just visit mauinewivenison.com/huberman to get this free Venison Stick Starter Pack with your first order over $79 Again, that's mauinewivenison.com/huberman.

我想问一下男性体内的DHT。

I'd like to ask about DHT in men.

我们经常听到男性体内的睾酮和游离睾酮——当然，这是未结合的形式，但二氢睾酮到底起什么作用？

So often we hear about testosterone in men and free testosterone and being the unbound form of course, but dihydrotestosterone, what is it doing?

DHT是一种非常强效的雄激素。

DHT is a very androgenic hormone.

因此，无论你讨论的是弱雄激素DHEA，还是相对较强的雄激素睾酮，还是非常强效的雄激素DHT，它们都会在男性和女性体内与雄激素受体结合。

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 to the androgen receptor in both men and in women.

因此，这三种物质的作用都是通过雄激素受体介导的。

So the effect of all three of those is mediated by the androgen receptor.

有趣的是，它位于X染色体上。

Intriguingly, it is on the X chromosome.

所以男性从母亲那里获得雄激素受体基因。

So men get their androgen receptor gene from their mother.

DHT之所以有帮助，原因和睾酮一样。

So DHT helps a lot for, same reason why testosterone helps.

它能让努力的感觉变得更好。

It helps effort feel good.

因此它具有激励作用。

So it can be motivating.

你现在可能正在做的许多饮食改变和补充剂都会影响你的DHT水平。

There's lots of dietary changes and supplementation that you're probably doing right now that's affecting your DHT.

你的意思是

You mean

我本人吗？

me personally?

我是说所有人，所有听众，比如你摄入的饮食中含有大量植物多酚。

Well, everybody, all of the listeners, because let's say you have a diet high in plant polyphenols.

许多这类物质会抑制将睾酮转化为DHT的酶。

Many of those inhibit the enzyme that converts testosterone to DHT.

你能给我们举一个例子吗

Could you give us an example of

这些物质中的一种，无论是补充剂形式还是食物形式？

one of those, either in supplementation form or in food form?

是的，姜黄和黑胡椒提取物。

Yeah, turmeric, black pepper extract.

你建议人们因为这个原因避免姜黄素和姜黄吗？

Do you recommend that people avoid curcumin and turmeric for that reason?

如果某人的DHT水平已经偏低，或者由于遗传或生活方式导致雄激素受体反应迟钝，那么我建议他们避免使用生物可利用的姜黄素，比如生物可利用的姜黄和黑胡椒提取物。

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.

我知道很多人想避免与DHT水平过高相关的脱发。

I know many people want to avoid the hair loss that can sometimes be associated with DHT levels going too high.

如果有人担心或正在经历脱发（男性或女性），他们有哪些方法可以缓解脱发，同时又不会对其他对DHT敏感的组织产生负面影响？

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 tissues sensitive to DHT.

我在这里想说的是，我完全可以想象服用某种DHT抑制剂，比如药片或注射剂，来缓解脱发，甚至促进头发生长。

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.

显然我没有这样做，但我认识一些这样做的人。

It's clear that I'm not doing that, but I know people that do.

但随后会经历抑制DHT带来的其他负面效应，比如情绪低落、性欲下降、动力减弱、前列腺功能紊乱，甚至整体性功能障碍。

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.

那么，如果人们希望维持或再生头发，但又不想承受所有这些其他副作用，他们能做些什么呢？

So what can people do if they want to maintain or grow back hair, but they don't want all those other effects?

他们应该避免什么，又应该考虑和医生讨论哪些措施？

What should they avoid and what should they perhaps consider talking to their doctor about?

你需要一种策略来降低雄激素受体的活性。

You want some sort of strategy to decrease the activity of that androgen receptor.

有很多你可以采取的局部方法。

There's a lot of different things that you can do that are topical.

最有前景的是称为度他雄胺间质疗法的方法。

The most promising is called dutasteride mesotherapy.

本质上，这是一种针对易发生男性型脱发区域的局部注射，无论男女，它仅在局部起作用。

Essentially what it is, is it's very localized injections in areas that are prone to male pattern baldness, whether they're female or a male, and it acts locally only.

你需要定期重复这些注射。

And you repeat these injections from time to time.

它仅在头皮部位减少睾酮向DHT的转化。

It decreases the conversion of testosterone to DHT just in the scalp.

女性如何知道自己是否患有PCOS（多囊卵巢综合征）？

How does a woman know if she has PCOS, polycystic ovarian syndrome?

我知道你治疗过很多PCOS患者。

I know you have treated a lot of PCOS.

哪些年龄段的女性应该考虑PCOS？

What age women should be thinking about PCOS?

什么是PCOS？

What's PCOS?

请给我们讲讲PCOS。

Teach us about PCOS, please.

是的，PCOS就是多囊卵巢综合征。

Yeah, so PCOS is polycystic ovarian syndrome.

这是一种被低估的疾病。

And this is one of those conditions which is underdiagnosed.

它的实际患病率比我们想象的要高得多。

So its prevalence is much higher than we think it is.

已经有很多研究，有些研究认为患病率为10%，有些则认为是20%。

There's been a lot of studies, and some studies say prevalence of ten percent, some say twenty percent.

它并不是完全具有临床表现的。

It's not completely clinically penetrant.

所以大多数人直到出现不孕或生育力下降时才意识到自己患有PCOS。

So most people don't know they have PCOS until they have infertility or subfertility.

PCOS在

And is PCOS happening at

20岁、30岁、40岁及以上的女性中发生频率如何？

this frequency in 20 year old women and 30 year old women and 40 and onward?

大多数女性在30多岁时才发现自己患有PCOS，尤其是它像许多其他疾病一样是一个谱系或连续体，可能表现为较轻或非常严重的版本。

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.

症状有哪些？

What are the symptoms?

有一个叫做鹿特丹标准的诊断标准。

There's a criteria called the Rotterdam criteria.

根据鹿特丹标准，有几种不同的方式可以诊断PCOS。

And in the Rotterdam criteria, there's a couple of different ways that you can diagnose it.

你需要寻找雄激素过多、胰岛素抵抗，也可以检查多囊卵巢。

You're looking for androgen excess, insulin resistance, and you can also look for polycystic ovaries.

你实际上并不需要有多个囊性卵巢或做卵巢超声检查才能确诊。

You don't actually have to have polycystic ovaries or get an ultrasound of your ovaries to be diagnosed.

如果你有雄激素过多，比如雄激素性痤疮或激素性痤疮，或者出现毛发增多，比如下巴长毛，这被称为多毛症。

If you have androgen excess, for example, androgenic acne or hormonal acne, If you have hair growth, like a hair growth on the chin, it's called hirsutism.

或者如果你出现声音变粗、女性型脱发等症状，这些也是多囊卵巢综合征的表现。

Or if you have, you know, like deepening of the voice, any symptom of too much male pattern baldness, if you're a female, that's a symptom of PCOS as well.

你也可能存在胰岛素抵抗。

Then you can also have insulin resistance.

这包括肥胖、糖尿病前期、空腹胰岛素水平高、HOMA-IR超过2、空腹胰岛素超过6。

So this is obesity, it's prediabetes, a high fasting insulin, a HOMA IR over two, a fasting insulin of over six.

如果你有显著的胰岛素抵抗和雄激素优势，这就是一个信号。

So if you have significant insulin resistance and also androgen dominance, that's a sign of it.

雄激素优势常会导致所谓的稀发月经。

Androgen dominance often leads to what's called oligomenorrhea.

所以，如果你的月经周期间隔超过35天，或者一年内月经少于9次，这可能是寡月经的迹象，'寡'意味着过少，'月经'指的是经期。

So if you're having more than thirty five 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.

这是多囊卵巢综合征非常常见的表现。

So that's a very common sign of PCOS.

如果你有不孕问题，比如你不到35岁且已尝试怀孕超过一年，或者你超过35岁且已尝试超过六个月，这也可能是多囊卵巢综合征患者常见的主诉。

If you have infertility, 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, it's a very common presenting complaint when somebody presents with PCOS.

如果患者胰岛素抵抗较为严重，那么改善体成分、减少体脂并治疗代谢综合征会有帮助。

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.

很多人会问：所有患多囊卵巢综合征的人都需要服用二甲双胍吗？

So a lot of people ask, well, does everybody that's on, like does everybody need to be on Metformin that has PCOS?

不一定，但二甲双胍是帮助改善胰岛素敏感性的一种手段。

Not necessarily, but Metformin is one of the tools that can help with insulin sensitization.

其他有助于改善的手段包括肌醇。

Other tools that can help are inositol.

肌醇是一种胰岛素增敏剂。

So myo inositol is an insulin sensitizer.

它的近亲，D-手肌醇，是一种弱抗雄激素。

Its cousin, D chiro inositol, is a weak antiandrogen.

许多类型的肌醇都含有这两种成分。

A lot of types of inositol have both of those in it.

因此，根据你是女性还是男性，以及你是否服用肌醇，肌醇的类型确实很重要。

So depending on if you're a female or a male and you're on inositol, the type of inositol does matter.

大麻。

Marijuana.

我听说它会降低男性和女性的睾酮水平。

I've heard that it can decrease testosterone in men and women.

我听说它会增加睾酮。

I've heard that it can increase testosterone.

酒精，我认为普遍共识是，高酒精摄入、高巴比妥类摄入确实会降低睾酮。

Alcohol, I think there's general consensus that high alcohol intake, high barbiturate intake does in fact reduce testosterone.

我不是饮酒者，所以问这些问题不是为了我自己。

I'm not a drinker, so I'm not asking these questions for me.

我不吸大麻，很坦率地说，我从来就不喜欢大麻或酒精，它们不是我的风格。

I don't smoke pot, quite open, I just never really liked marijuana or alcohol, they're not my thing.

但很多人想知道这些问题的答案。

But many people want to know the answers to these.

那么大麻呢？

So what about marijuana?

它是否会显著降低睾酮水平？

Does it reduce testosterone to a significant degree or not?

大麻素本身，无论是THC还是CBD，都不会单独降低睾酮水平。

Cannabinoids itself, whether it's THC or CBD, are not going to reduce testosterone by themselves.

如果是吸食大麻，那么它很可能增加你的芳香化酶活性，从而提高雌激素水平。

If it's smoked marijuana, then it's very likely to increase your aromatase, which increases your estrogen.

也就是说，它会将睾酮转化为雌激素。

You know, it's aromatizing from testosterone.

因此，这会导致睾酮水平下降。

So that is going to decrease testosterone.

当你体内的雌激素（如雌二醇）升高时，它会作用于垂体，减少促使睾酮释放的激素。

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.

因此，你的LH和FSH都会减少。

So you're going to have less LH and less FSH.

这就有点像阿片类药物，众所周知，阿片受体激动剂会。

So it's almost kind of like, you know, opiates are well known to opiate agonists.

它们会降低LH和FSH，进而降低睾酮。

They're going to decrease LH and FSH and subsequently testosterone.

吸食大麻也会产生同样的效果。

Smoked marijuana will as well.

至于

As far

酒精方面，大量饮酒会降低睾酮，任何强效的GABA激动剂——无论是巴比妥类、苯二氮䓬类、非苯二氮䓬类还是酒精——都肯定会降低睾酮。

as alcohol, high alcohol will decrease testosterone, as will any very potent GABA agonist, whether it's a barbiturate or benzodiazepine or a non benzo or alcohol, they're definitely going to.

让我们来谈谈男性的睾酮。

So let's talk about testosterone in males.

我知道很多人正在考虑通过补充睾酮来提高睾酮水平。

I'm aware that a lot of people are considering increasing their testosterone by taking testosterone.

几年前，这还被认为是使用类固醇，观点非常极端。

A few years ago that was considered steroid use and it was really extreme kind of stance.

如今，似乎关于这个问题的讨论更多了。

Nowadays, it seems like there's more discussion about it.

睾酮补充剂——这里我指的是医生开具的处方——是否会增加患前列腺癌的风险？

Does testosterone supplementation, and here I'm talking about prescription from a doctor, does it make one more prone to prostate cancer?

这似乎总是

That seems to

人们最先问的问题。

always be the first question that comes out.

睾酮不会导致前列腺癌。

So testosterone is not going to cause a prostate cancer.

然而，正常衰老会导致前列腺癌，而睾酮会促进前列腺癌的生长。

However, normal aging causes prostate cancer and testosterone will grow your prostate cancer.

所以，如果你是一位80岁的男性，进行尸检时，至少有百分之五十的概率发现你患有前列腺癌。

So if you're a 80 year old male and you have an autopsy, then there's at least a fifty percent chance that you have a prostate cancer.

如果你活到90岁或100岁，这个概率至少达到百分之九十。

If you're 90 or 100 years old, there's at least a ninety percent chance.

因此，对于拥有前列腺的人类来说，患上前列腺癌只是时间问题。

So for humans with a prostate, it's only a matter of time until you get a prostate cancer.

这就引出了一个问题：你真的希望在已经患病后，再服用某种肯定会促进其生长的东西吗？

So that begs the question, do you want to take something that's going to grow it for sure once you have it?

所以这需要个体化评估。

So it's an individual assessment.

随着年龄增长，你知道，快速衰老是不正常的。

With aging, you know, fast aging is abnormal.

非常缓慢的衰老才是正常的。

Very slow aging is normal.

在这两者之间有一条微妙的界限需要把握。

There's a fine line to walk between those two.

那催乳素呢？

What about prolactin?

就像睾酮和雌激素需要保持适当的比例一样，多巴胺和催乳素也需要维持合适的比例。

Just as testosterone and estrogen need to be in the proper ratios, dopamine and prolactin need to be in the appropriate ratios.

我们该如何看待并可能干预我们的催乳素系统？

How should we think about and perhaps act on our prolactin systems?

我把它描述为多巴胺的波浪池。

The way I describe it is the dopamine wave pool.

如果你过度提升多巴胺，就会溢出，导致波浪剧烈冲击。

So if you're increasing your dopamine too much, you're going to overflow, and then you're going have that wave crash too much.

你希望拥有平稳均匀的波浪，不要远远超出多巴胺的池面，催乳素会随之变化。

So you want to have nice even waves that are not going too far above the pool of dopamine, and prolactin will follow.

催乳素和雌激素是非常接近的近亲。

So prolactin and estrogen are quite close cousins.

雌激素会上调一种名为PRL基因（催乳素基因）的基因，直接促进催乳素的合成。

Estrogen up regulates a gene called the PRL gene or prolactin gene that directly increases prolactin synthesis.

因此，催乳素还会抑制垂体释放睾酮。

So prolactin is going to also inhibit the release of testosterone from the pituitary.

所以，如果你使用多巴胺激动剂，就会帮助减少催乳素的产生细胞。

So if you're using a dopamine agonist, then you're going to help decrease the prolactin producing cells.

因此，如果有人担心多巴胺，或者他们的催乳素水平略高，他们就会避免摄入可能增加催乳素的食物。

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.

比如哪些？

Such as?

酪蛋白或麸质，它们是μ阿片受体激动剂，或任何在

Casein or gluten, which are mu opioid receptor agonists, or any mu opioid receptor agonist in

肠道中的μ阿片受体激动剂。

the gut.

酪蛋白，也就是牛奶蛋白。

Casein, so milk protein.

没错。

Correct.

会增加催乳素。

Can increase prolactin.

正确。

Correct.

有趣。

Interesting.

我想短暂休息一下，感谢我们的赞助商Function。

I'd like to take a quick break and acknowledge one of our sponsors Function.

去年，我在寻找最全面的实验室检测方案后，成为了Function的会员。

Last year, I became a Function member after searching for the most comprehensive approach to lab testing.

Function提供超过100项先进实验室检测，帮助你全面了解身体的健康状况。

Function provides over 100 advanced lab tests that give you a key snapshot of your entire bodily health.

这份检测报告能为你提供关于心脏健康、激素健康、免疫功能、营养水平等多方面的洞察。

This snapshot offers you with insights on your heart health, hormone health, immune functioning, nutrient levels, and much more.

Function不仅提供超过100项对身心健康至关重要的生物标志物检测，还会分析这些结果，并由相关领域的顶尖医生提供专业解读。

Function not only provides testing of over a 100 biomarkers key to your physical and mental health, but it also analyzes these results and provides insights from top doctors who are expert in the relevant areas.

例如，在我第一次使用Function进行检测时，我发现我的血液中汞含量偏高。

For example, in one of my first tests with function, I learned that I had elevated levels of mercury in my blood.

Function不仅帮助我发现了这个问题，还提供了降低汞水平的最佳建议，包括减少金枪鱼的摄入。

Function not only helped me detect that, but offered insights into how best to reduce my mercury levels, which included limiting my tuna consumption.

我那时吃了大量金枪鱼，同时也在努力多吃绿叶蔬菜，并补充NAC和乙酰半胱氨酸，这两种物质都有助于谷胱甘肽的生成和解毒。

I'd been eating a lot of tuna while also making an effort to eat more leafy greens and supplementing with NAC and acetylcysteine, both of which can support glutathione production and detoxification.

我还想说，通过第二次使用Function检测，我发现这种方法是有效的。

And I should say by taking a second function test, that approach worked.

全面的血液检测至关重要。

Comprehensive blood testing is vitally important.

有许多与你的身心健康相关的问题，只有通过血液检测才能发现。

There's so many things related to your mental and physical health that can only be detected in a blood test.

问题是，血液检测一直非常昂贵且复杂。

The problem is blood testing has always been very expensive and complicated.

相比之下，我对Function的简便性以及其低廉的价格印象深刻。

In contrast, I've been super impressed by function simplicity and at the level of cost, it is very affordable.

因此，我决定加入他们的科学顾问委员会，并且很高兴他们赞助了这个播客。

As a consequence, I decided to join their scientific advisory board and I'm thrilled that they're sponsoring the podcast.

如果你想尝试Function，可以访问functionhealth.com/huberman。

If you'd like to try Function, you can go to functionhealth.com/huberman.

Function目前有超过25万人的等待名单，但他们正在为Huberman播客的听众提供优先访问权限。

Function currently has a wait list of over 250,000 people, but they're offering early access to Huberman podcast listeners.

再次提醒，访问functionhealth.com/huberman即可获得Function的优先访问权限。

Again, that's functionhealth.com/huberman to get early access to Function.

我想稍微转换一下话题，谈谈社交互动和人际关系对激素的影响。

I'd like to shift gears slightly and talk about social interactions and relational effects on hormones.

对于刚进入一段关系的人，或者那些在长期关系中感觉某些方面发生变化的人，你建议他们做什么或思考什么？这些变化可能确实反映了不同激素系统和神经递质系统的输出。

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.

这几乎肯定是事实，对吧？

It almost certainly has to be the case, right?

是的。

Yeah.

就像经常在一起的女性，无论是同事还是其他关系，她们的月经周期常常会同步。

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.

男性和女性之间存在大量的信息素和激素互动，包括催乳素。

There is a lot of pheromonal and hormonal crosstalk, including prolactin between men and women.

所以如果全天候待在一起，这就是为什么人们觉得一起工作和生活如此困难，因为他们几乎24/7都待在一起。

So spending 100% of the time together, this is why people think it's so hard to work together and live together, they're around each other 20 fourseven.

你没有机会让多巴胺水平平复下来，然后再次见到对方时重新感到兴奋。

You don't have the reprieve where you let that dopamine settle down, and then you're excited when you see them again.

很多男性都知道，如果长时间出差，回家后见到伴侣时，感觉就像重新开始一段关系，虽然不是完全全新的关系，但几乎就像新的关系一样。

A lot of guys know that they've on a trip for a long time, they come back and they see their partner and it's like a new, not quite like a new relationship, but almost like a new relationship.

他们又重新感受到了那种兴奋。

And they have that excitement again.

有意识地在每段关系中融入这种模式会非常有帮助，尤其是当你选择生育、怀孕或母乳喂养时，因为你需要提前规划，让双方的催乳素都升高，而多巴胺和睾酮都降低。

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 dopamine's to be low and both of your testosterone's to be low.

因此，你可以做很多预先的规划。

So there's a lot of planning that you can do.

本质上，每段关系都会经历危机。

Essentially every relationship goes through a crisis.

这种危机是你们两人之间独有的，你可以提前规划，找到应对方式——也许不是靠补充剂，甚至也不是减少相处时间，而是提前规划好在即将进入危机时如何创造美好时光。

And that crisis is personal between the two of you and you can plan ahead and figure out a way, 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.

肽类物质，最近有很多关于肽的讨论。

Peptides, lot of discussion these days about peptides.

我们一般能对肽说些什么呢？

What can we say generally about peptides?

它们安全吗？

Are they safe?

它们不安全吗？

Are they not safe?

关于来源呢？

What about sourcing?

你认为有哪些肽对人们特别有用？

And are there any peptides that you think could be of particular use for people?