Podbit · The Peter Attia Drive
In deep infiltrating endometriosis and adenomyosis, up to 37% of lesions carry the same oncogenic mutations (KRAS, PIK3CA) that drive cancer growth. But fibrosis traps them. It is, biologically, a 1,000-horsepower engine inside a golf cart.
Where this was said
At 14:10 · chapter starts 13:25
Tomioka opens this section with a claim that reframes the conversation: adenomyosis is 'the missed disease.' While endometriosis gets most of the attention, adenomyosis — where endometrial-like tissue invades the myometrium — may affect up to 20 to 30% of women, making it potentially two to three times more common. [1] — Renato Tomioka "Adenomyosis prevalence up to 20–30%: Adenomyosis may be even more prevalent than endometriosis, affecting up to 20–30% of women, yet it rem…" 15:46 Though they share molecular features (progesterone resistance, aromatase overexpression, oncogenic mutations), single-cell transcriptomics — citing a paper by Linda Judis — shows they are distinct diseases with different pathways. The mechanism of adenomyosis is described as TIAR (tissue injury and repair): the endometrium breaches the junctional zone, typically after C-section, curettage, or miscarriage, and infiltrates the muscular wall, forming cysts and echogenic buds that enlarge and soften the uterus. Critically, up to 70% of endometriosis patients may have concurrent adenomyosis [2] — Renato Tomioka "Up to 70% of endo patients have adenomyosis: Up to 70% of women with endometriosis may also have some degree of adenomyosis, a comorbidity …" 17:18 — a co-occurrence Tomioka believes has been a hidden confounder in implantation studies. Unlike endometriosis, adenomyosis is definitively cured only by hysterectomy, making fertility preservation a fundamentally different challenge for affected women.
Adenomyosis may be even more prevalent than endometriosis, affecting up to 20–30% of women, yet it remains underdiagnosed and underappreciated.
Up to 70% of women with endometriosis may also have some degree of adenomyosis, a comorbidity with major implications for fertility treatment.
AI nailed Andrew Huberman's vertigo-vs-low-blood-pressure diagnosis because that pattern has been reported millions of times. But every patient's liver is different and data on liver surgeries is scarce worldwide — making solo robot surgery dangerous. The rule is simple: data abundance means AI can help; data scarcity means keep the human in the loop.
Fei-Fei Li's father had liver surgery performed by a da Vinci robot guided by a surgeon. The result: 10 times less blood loss than a typical procedure. This isn't replacement — it's the gold standard of human-machine collaboration, where the human's judgment and the robot's precision combine.
US drug overdose deaths fell from 110,000 to roughly 70,000 — the biggest CDC-recorded single-year drop ever. Men's rates fell 27% in one year, and the steepest decline of all was among 15–24-year-olds, down 37%. The crisis narrative around young men needs to make room for signs of genuine progress.
Kessler thought his grief expertise would protect him. It didn't. When his son David died unexpectedly, he found himself on the floor — and eventually realized that acceptance alone wasn't enough. That unmet need became the sixth stage: finding meaning.
Grief isn't just death — it's any unwanted change. Kessler lectured at Coca-Cola and General Mills not because they had lots of funerals, but because change management is grief management. People who grieve well live well.
Witnessing someone's grief isn't just emotional support — it's an essential act of healing. Kessler argues grief is a severance and connection heals it. But real witnessing has two steps: seeing the pain AND affirming the person's capacity to recover.
Avoiding grief isn't free — it's exhausting. Kessler's beach ball metaphor nails it: pushing a small balloon down is easy, but holding a massive beach ball underwater takes constant, draining energy. Unattended feelings don't disappear; they just consume you.
Most people try to control their environment to avoid triggers. Kessler flips this entirely: triggers aren't problems to manage around — they're a detailed map to your pain and your healing. Every trigger points directly to what needs attention.
Running from pain doesn't leave it behind — it accelerates the chase. Whatever we run from pursues us, and whatever we face transforms us. Both Kessler and Lewis Howes testify to knowing both roads firsthand.
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