Ep. 662 Testosterone Decline and Healthy Longevity with Dr. Florence Comite | Testosterone, Healthy Longevity, Hormone Health

Today, I’m delighted to welcome Dr. Florence Comite, a clinician, scientist, endocrinologist, and global authority on healthy longevity. She founded the Comite Center for Precision Medicine and Healthy Longevity, with locations in New York, Palo Alto, and Miami Beach, and spent 25 years as a graduate and faculty member at Yale School of Medicine. She is also the author of Invincible, one of my must-read books for 2026.
In our conversation, we discuss why medicine focuses on urgent care, the missing provider relationship, and the hallmarks of aging. We explore how our biological function peaks between 27 and 30, why testosterone is the first hormone to decline in both men and women, bio-individuality, testosterone in women, optimal ranges, and heart disease risk. We explain why midlife is one of our biggest metabolic shifts, how to track it, and why heart disease diagnostics are important. We also cover sarcopenia, GLP-1s for longevity, and the relevance of bioimpedance readings versus BMI.
Stay tuned for today’s fascinating conversation. It’s one of my favorite conversations of the year, and I know you’ll want to listen more than once.
IN THIS EPISODE, YOU WILL LEARN:
Why modern medicine focuses on urgent and emergency care
How the missing provider relationship influences patient care
How genetically similar people can have different health risks, body composition, and responses to medications
What testosterone does for memory, cognition, executive function, bone, muscle, and the heart, and what women need to understand about testosterone ranges
Changes in metabolic health women should be paying attention to in midlife
Dr. Comite compares CAC, CCTA, Cleerly, and HeartFlow, and explains how these diagnostics contribute to heart evaluation
What women need to consider when assessing heart disease risk
Why Dr. Comite suggests starting with small lifestyle changes initially
How to maintain muscle mass, particularly when using GLP-1s
Why BMI does not provide an adequate reflection of body composition
Bio:
Florence Comite MD is a Yale- and National Institutes of Health-trained physician-scientist, a pioneering force in precision medicine, and the world’s leading expert in longevity and endocrinology, who is renowned for her expertise in leveraging proprietary clinical and wearable data collected at her private clinical and virtual practice to detect, predict, and reverse biological aging, disorders of aging, and optimize healthspan and vitality for life.
A graduate of Yale School of Medicine, where she was a faculty member for twenty-five years with a triple appointment in Endocrinology (Internal Medicine and Pediatrics) and Reproductive Endocrinology (Gynecology and Andrology), Dr. Comite trained at the National Institutes of Health and founded Women’s Health at Yale, the nation’s first women-only clinic.
In 2005, Dr. Comite founded the Comite Center for Precision Medicine & Healthy Longevity in New York City, establishing a clinically proven, academic approach to personalized healthcare structured around the individualized clinical process known as Nof1TM, where each patient is treated as a single-subject clinical trial. Her global clientele spans the population, from forward-thinking physicians to industry-disrupting executives and health-enthusiastic entrepreneurs. Each patient benefits from insights and interventions tailored to their physiological make-up. The Center has expanded to Palo Alto and Miami Beach in the last several years.
Dr. Comite has published original research and articles in numerous clinical journals, including the New England Journal of Medicine, JAMA: The Journal of the American Medical Association, and the Journal of the Endocrine Society. She is known for her seminal research on children, women, and men, recognizing that our entire system is critical in aging and disease. In 2013, she authored the bestselling book Keep It Up: The Power of Precision Medicine to Conquer Low T and Revitalize Your Life, fo...