37: The Gut-Hormone Connection Every Woman Should Know – Balance Starts Within with Dr. Aaron Hartman

You look at a 45 year old guy today, let's just say, and you compare him to a 45 year old guy 20 years ago and his free testosterone level is half what it was 20 years ago. It's almost 50% lower than it was 20 years ago and it continues to drop about 1% every year.

Welcome back everybody. I'm so excited to be talking today with a friend and colleague, Tracy Gapin. So we're just gonna hop into it. He is, we're talking, we're talking about all things male health, all things peak in performance. So hopefully you'll enjoy this conversation. So after we go through introduction, we'll just hop right into it. So today I'm really super excited to be talking to Dr. Tracy Gapin. He's a leader in men's health and performance optimization. He's a board certified urologist as well as a TEDx speaker and the bestselling author of Mail 2.0. As a founder of the Gapen Institute for Precision Medicine, he has pioneered the peak performance method which integrates precision medicine, epigenetics, which, we'll talk about that a lot, I'm sure, advanced diagnostics, which is one of his passions. We'll kind of dive into that a little bit to help people help men achieve and unlock their potential. His work focuses on enhancing vitality, longevity, overall wellbeing, making him a true visionary in the field. So I'm super excited to have Tracy. He's not only a colleague but also a friend. How you doing?

I appreciate it, Aaron, thanks so much. Glad to finally get to connect with you and spend some time talking today.

Yeah, I mean I've always been intrigued by when you talk about what you do because I feel like sometimes we do something very similar because I do it on then when people are super, super sick and hardly get out of bed and you're doing on the almost like the opposite spectrum, getting people maximized. And so I just want you to briefly talk about your journey as a urologist because obviously you're doing men's performance different than a standard urologist or even a standard medical doctor or hormone specialist would do it. So can you just walk us through just so we get a flavor for you, like what got you from a standard urologist, good at your art, to doing this type of precision personalized medicine.

Yeah, I appreciate that. That background I think is super important to emphasize. So as you mentioned, I spent long time as a urologist, in fact 23 years in clinical practice in urology and doing a lot of the traditional Urology stuff, kidney stones and prostate cancer and enlarged prostate. And after many years, I became very interested in more of the cutting edge advances, such as minimally invasive treatment for prostate cancer, hifu, an ablative therapy, minimally invasive targeted biopsy for prostate cancer, finding new ways to detect prostate cancer that's less invasive, less risk side effects. So I, I always love to be on kind of the cutting edge of urology. About halfway through my career, through my own health challenges, which is always how docs tend to kind of find a new path. You know, I woke up one day and I talk about this in my book Mel 2.0, how I woke up one day and I'm suddenly 330 pounds overweight and I feel like crap and I'm stressed out, I'm not eating well, I'm not sleeping, and I really didn't like who I was. And when I went to one of my colleagues, a traditional primary care doc in town, he had no real answers for me. You know, I just want to feel better. I want a better energy, better focus. I just wanted to be a better dad for our newborn kid and be a better husband. And the answers were, lose weight and eat better, eat more vegetables, exercise, and if you don't get better, I'm going to put you on a statin. And that was it. I was like, wait, that's it? That's all you got? Yeah, I need to lose weight. Yeah, I need to eat better. But there had to be a lot more to it than that. And I left there rather empty. What I realized, that experience is I had to humbly recognize that as a men's health expert at the time, as a urologist, I didn't have the answers either. And we get so siloed. Our traditional healthcare system trains us to get so siloed into our specialty that we can't see the forest for the trees. And I would spend literally six minutes. I had six minutes with a patient and then I had another one booked on my schedule. What can you really accomplish in six minutes? It gets to the point where you're focused on acute care, sick care, disease care, treatments, and typically that means pharmaceuticals. So this got me going down one rabbit hole after another to treat myself, to fix myself. And that's when I found this entire world of precision medicine. And Aaron, you know how flawed and how messed up our healthcare system is. It's failing men and I gave a TED talk about this last year, how we see testosterone levels plummeting and we see obesity worsening for the first time in decades. We're actually dying younger, lifespan's decreasing. So it's clear to me that what we're doing isn't working. And so it, that got me to really focus on what matters. And that's when I really found my true passion and purpose was to really help men optimize their health. Do the advanced testing. You need to find the problems and then correct them. Understanding that it's not as simple as just simply eat vegetables and exercise.

So I think just to play off what you just said, Eric, this is something that I don't think people actually realize if you look decade to decade to decade, I want you to talk to this here briefly. Like when you look at men's testosterone levels, they're dropping almost a hundred points every decade. So, you know, you're probably more up to date with this than I am. But I remember something like, you know, 40, 50 years ago, 700 was a normal level for a man in his 50s. And now it's like three or 400 and it's dropping, sperm counts are dropping. So a lot of people don't realize that if we keep on going our current rate, there's, you know, there's those doomsayers, you know, but like, like it's looking like as a population we might have issues actually with male virity and fertility. What are your thoughts about that? What do you think some of the causes of that are?

Yeah, I, I've loudly proclaimed a few years ago that in 20 years, if we don't change the current path we're on, our entire male population will be impotent and infertile. And I'm not exaggerating when I say that because studies show, like you said, there, there have been three massive longitudinal studies here in the US and Europe that have all showed the same thing. And that is that drop in testosterone you're talking about. And what that drop looks like is you look at a 45 year old guy today, let's just say, and you compare him to a 45 year old guy 20 years ago and his free testosterone level, we'll talk about free versus total. I'm sure the free testosterone level is half what it was 20 years ago. It's almost 50% lower than it was 20 years ago. And it continues to drop, as you said, about 1% every year. And so we need to wake up and pay attention and realize that things are changing very dramatically, very quickly. And fertility numbers look the same. There's a great study out of Israel that showed that fertility and sperm counts and motility are about 50% of what they were 20, 30 years ago. And it continues to get worse as well. And I think they're all related.

So this is not a US issue versus Europe or a US versus the Middle East. You're seeing this in data in Israel and Europe and the us this is across the board.

It's certainly worse here in the us but it is a worldwide problem. And we can look at all the, the, the causes of low testosterone, you know, diet, crummy diet, and micronutrient deficiencies and sedentary lifestyle and stress and all this other stuff. But without question, in my mind, the studies clearly show that it's toxins, it's chemicals, it's endocrine disruptors in our environment that are truly crushing our hormones, especially testosterone. And that's worldwide.

So it's not just processed food. It's not just inactivity. It's this whole toxic milieu of chemicals, some neurodegenerative disruptors, petroleum based solvents. I mean, all this stuff is just concentrating and affecting men's fertility and sperm count.

You're exactly right. And we're talking about anything you eat. You know, our foods, our crops are sprayed with things like atrazine, which is an herbicide, second most commonly used herbicides behind glyphosate, that's been shown to crush hormone levels. We know that the plastics that are holding our plastic, you know, water bottles and the plastic used to make Gatorade bottles and K cups and food containers, you name it, they're made from phthalates and bpa, two chemicals that have been shown to massively affect hormone production and function. Chemicals in our laundry detergent, in our soap and our shampoo and our sunscreen, you name it. Everywhere you look, you see these chemicals. Now we're seeing. It's not just the chemicals, it's also actual microplastics themselves are being found in testicular tissue, in semen.

And so they're actually finding microplastics in.

Semen, in semen, into, in testicular biopsies earlier this year. They're finding high levels of microplastics. And it's coming in through our bodies from anything we're eating, anything we're drinking, our water supply is tainted, our, our food is tainted, our personal care products, and these chemicals are everywhere. One other layer to this, Aaron, which is a little scary, is studies have shown that there is a transgenerational effect. What I mean, for the listener, that means that your grandfather was exposed to chemicals that we've just mentioned. Those chemicals Affect the sperm, it affects microrna and epigenetic signals, modifications to the DNA of that sperm. Those signals get passed along to your father, and then those signals get passed along to you, and you're gonna pass along similar signals to your son. And it is continue to go downstream. And it's a snowball that's starting to gain momentum now because each generation is getting worse and worse. So we talk about all the natural ways that we can boost testosterone, but some of it, the damage has already been done by previous generations that have already been exposed.

So this is very, very similar to a lot of this whole transgenerational, rational, epigenetic priming from the Dutch bread famine back in World War II, Mao's China. We've seen this, but you're now saying this is not just in 50 years ago, this is actually today. We're seeing this particularly with men, particularly with young boys and how this effect is going from generation to generation downstream.

Yeah. And it's scary that I can't tell you how many men I've seen in my practice in their 20s and in their 30s that have near castrate levels of testosterone. And I'm sure you've seen your practice as well. Twenty years ago, in my, when I was, you know, first starting my urology days back, 25 years ago, that was unheard of. It was for men in their 60s and 70s. Now it's, it's becoming ubiquitous and it's a real problem.

So what would you, what would you consider an optimal free and total testosterone for male, you know, 20 to 40, 40, 60, 60 day? What would you consider? What ranges are you looking at when you're seeing these. Yeah, that you're looking for optimal. And then what are you seeing? Like what's your optimal and what are you seeing?

Absolutely great question. So when we look at levels, the important thing to think about is we want to look at free testosterone, not total. And the reason for that is to understand that your, your testosterone level, when you get it measured, is your total testosterone floating around the bloodstream. It's the concentration of testosterone free floating in the bloodstream. However, 99% of that testosterone floating around your bloodstream is actually bound to other proteins like shbg, which is sex hormone binding globulin, other proteins that are these big fluffy protein molecules that will bind to the testosterone molecule and render it worthless. Because for testosterone to do its job, it has to get into a cell. It then binds to an androgen receptor and then goes into the nucleus headquarters of the cell and does its Job. If it can't get into the cell, none of that can happen. And so we only care about free testosterone. And, and so I'm making this point. So when we're talking about levels, men out there, be sure you're only looking at free testosterone. Your total testosterone, I will strongly argued, just doesn't matter because those SHBG levels, for example, can dramatically affect the free. So you want to look at the free. And now to answer your question, finally, my target for that is 20. 20 picograms per milliliter is the unit there. Okay. Total testosterone is nanograms per deciliter, but free is. Is picograms per milliliter. And you typically want your free testosterone to be around 20, give or take. Now, some men 15 to 18 may be great. Other men need 25 to 30, but 20 is kind of a good target.

Now, there was this debate a while ago when I first did my. Start some of my training, functional medicine, about, you know, bioavailable versus bioactive and different calculations to figure it out. Is that all just more like in the past and just, Just measure free and total.

Great question.

How do you.

Yes. So. So what that was looking at, that's still. That's still true today. You know that when we talk about bioavailable, that means free testosterone. And there's a very micro fraction of your testosterone that's bound to albumin, one of those proteins, and that's actually a reversible bind where albumin may let it go to where it can now potentially have some. Some physiologic effect. If it's bound to shbg, it's a permanent, irreversible binding. You cannot get that molecule back again. So that's what that was all about. But, but for the. The listener, for, you know, to keep it kind of simple and easy for the layperson to understand, only look at your free testosterone, insist that your doctor get a free testosterone, and your target should be around 20. And to give you a. A scale and idea of what I see, I'll have guys come in off the street, and there'll be four, five, maybe six. I have a good buddy in town, a doctor in town who I've golfed with in the past, and he would tell me, yeah, I feel great. Why do I need to check my levels? I'm like, jeff, just. Just check your levels, dude. I promise you, you're gonna. You're gonna be surprised. Sure enough, his level was 5. His free T was 5. And he thought he felt great. And now his testosterone has been corrected. He's like, I had no idea how bad I was because you just kind of get used to it. You kind of fall into a, a situation where you compensate and don't even realize, you know, that slow, gradual decay that you're going through when your levels are low.

So from a, you know, precision medicine, male health perspective, obviously, testosterone is important. So when you look at something, what are some of these more advanced labs on the hormone side? First list that, that you look at to give. You give yourself a big, big picture of, like, what's going on with, with a male.

Yeah. So I, I love the question. I want to emphasize to all the men out there that I know you, you know, you hear all about testosterone, that you got to get your T level checked, and you absolutely do. But I want to emphasize that we have over 50 hormones in our body that we care about. Right. And we need to understand they all act like this symphony. And if you're looking at just testosterone, you're often missing that, the, the bigger picture. And, and I'll see men come in, Aaron, and they'll be like, doc, you know, I. I've been on testosterone for three years, and I still feel like crap. And I can't burn the belly fat. I'm still tired. I still can't get it up. I'm still just. Just tired all the time and can't think clearly. And. And the answer is that testosterone is definitely important, and it's kind of the, the one first step to take. But then we have to look at other hormones. So estrogen, thyroid, cortisol, insulin, melatonin, nitric oxide, vitamin D. And then we go into leptin and adiponectin, all these other, you know, more complex hormones as well that we start to look at. Nitric oxide's a big one. These are all blood tests that you can do. Nitric oxide is a simple saliva test. You put a little test strip in your mouth, and 10 seconds later you can get a reading on nitric oxide. Most of them are blood tests. Cortisol is a saliva testing as you. Four times throughout the day. I know, you know, you do a lot of that stuff yourself. It's important to understand that all these hormones act together and not one single hormone is going to necessarily be the game changer. It's when you look at them all in sum, as a, you know, a comprehensive picture, if you will, that's when you start to really be able to make change.

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So when you, when someone comes in to see you feeling not optimal, brain fog, belly fat, there's like, you know, I guess you call it dad bod. I was at a kid's camp this past summer. I had like dad bod shirts and stuff on there. Yeah, my kids is kind of funny. What, what kind of things are you seeing when people come in, they're like, hey, I feel awful. What kind of things are you diagnosing? Okay, testosterone's off, hormones are off. What other things are you seeing with these people that they didn't expect? For you to find that was like a yeah for you? Was like, yeah, I was looking for this. And for them, like I cannot believe. Yeah, XYZ was going on.

So. Yeah, I love this. So first of all, I want to be clear. What I do is I don't just do blood tests, I don't just do testosterone, a few hormones because we realize that there's so many other factors that come into play. So what I've done, Aaron, is I put together what's called launch day. And launch day is this amazing one day event. Guys will come into Sarasota, we'll put up a hotel and feed them breakfast and lunch. And we do VO2 max fitness testing and metabolic rate testing and blood testing and genetics and body composition and imaging tests, functional testing, like looking at microbiome and micronutrients and food sensitivities and putting all the stuff together first of all. So that's how I'm able to take a, a, a massive 30, 000 foot view of everything in one day. So I'll give an Example, one of my guys who I work with, he looks amazing. He is actually in great shape. He's very well built. He goes to the gym once. For a while he was going twice a day, goes six days a week. He eats chicken and rice every day and takes all the supplements. He's on testosterone, doing all these things. He thinks he's doing everything right, you know, and he comes in and his lipids, his apob, which is a great marker for cardiovascular health, was elevated. We typically want that. Definitely under 90, preferably even under 70. And his was, I think 110, 115, 112. His blood sugar numbers looked okay. Inflammatory numbers looked okay. We did a calcium score on him, one of the imaging tests we do now. Calcium score for the listener is an imaging test. It's a screening test that you can use to look at the calcifications in the blood vessels of your heart. So it's a general screening tool for early signs of plaque formation in your coronary vessels. You want that to be zero. You wanna have no calcification in your vessels. Now it's not showing you soft plaque. That would be the next test after the, see the, the calcium score. But the calcium goal will show you calcifications. It should be zero. If it's not zero, that's the time to worry. I'll see guys with 8, 10, 15, 20. And that's when we, you know, we want to pay attention and see what we can do to improve and optimize and lower their cardiovascular risk. Well, this client's calcium score was 212. Very high. Yeah, very high. And so this is the kind of thing, these are blind spots I talk about that we find all the time. And for him, it ended up being that he was over training chronic stress. His cortisol numbers were through the roof. His hrv, his heart variability, which is a metric we track with, all the wearable tech that we use, was very low. And he had signs of chronic inflammation that was causing vascular issues. Even though he was think doing what he thought was everything right. Have a race car client who came in and his issue was he couldn't think clearly. He was having issues with, on the track, like, like taking the turns. He felt like his decision making wasn't quite quick enough as it used to be, and it was affecting his performance. Come to find out, in all the testing we did, his testosterone was a little low. And we corrected that. His gut, we did GI map microbiome testing. We found some dysbiosis, some imbalance in The I know you do a lot of work with microbiome as well, so I know you've talked about that in prior episodes, but for him, what we found with Marco, he had food sensitivities to bananas and coffee. Of all things on the list, the two things that, that jumped off the chart were bananas and coffee. And guess what? Marco happened to have her breakfast every single day. Bananas and coffee. He just, he thought he was doing everything right. And so, you know, of course we had to clean up his gut. Of course we had to fix his hormones. But by making that one little change in diet, we were able to make a massive difference. So it comes down to, you know, find your blind spots. I, I like to, to point out Bob Harper. Bob Harper, I gotta meet him personally because I talk about him every day. He's that fitness trainer on the TV show the Biggest Loser. And you may not know of him, but he teaches everyone how to get healthy. He looks like the epitome of great health and he's always helping people get in shape and he looks great. And at the age of 51 a few years ago, Bob Harper had a massive heart attack that almost killed him. He survived, but come to find out he had a markedly elevated lp. LP is lipoprotein, a little A, which is a subtype of ldl. And it's a marker that most primary care doctors have never heard of. They never check, they have no idea about it. But it dramatically increases your risk of major cardiovascular issues, even though your other numbers may be okay. And that was the case for him. And so these are just some of the blind spots that we find when we start to dive deep and, and, and really do the advanced diagnostic and the deep dive to find the issues that may be getting in the way.

I really love the way you say the blind spot because that's one that makes it individual and personal because it's not like you miss everybody's sleep apnea or whatever. It's like it, it says there's something we're being missed and, and, and that your stories are, it's, it's different for every person. The LP Little Thing A is really interesting. There's an article just got published as nih, I think research this past week. It was looking at women, not men, but it was looking at three risk factors that can actually predict 30 year mortality. Cardiovascular mortality. You know, it's LP, HSCRP and LDL. And I actually interviewed Dr. Dayspring about this topic a couple months ago. He's a big lipidologist. And it's something that even cardiologists aren't really. They're starting to do it. Look at now, just because we have a whole new class of drugs called PSK9s. And that's the reason why cardiologists looking at it, because there's a drug to treat it, but it's something that's a big deal. I really love the fact that you look at that. You look at the CAC score. Do you do the clearly test down there?

We do, yeah. So we will often do a clearly test if we have reason to believe that there's soft plaque and that, you know, the calcium score is great for calcified, mature plaque. But I think it's important to emphasize to the listener that cardiovascular disease starts in your childhood, and it takes decades and decades for those lipid particles to get under the surface of the endothelium, the blood vessel, create inflammatory immune response, have oxidation, and then ultimately have plaque formation. It takes decades for that to occur. And so a lot of times, you don't appreciate what's already happening. Again, blind spot that's happening right under your nose without you realizing it. The other test I think is valuable is we do a lot of cholesterol testing, and a cholesterol balance test is a great test that I like to use in men in this situation as well, and it's run by Boston Heart. What's great about it is it helps you understand why are the cholesterol LDL numbers elevated? So the. You know, for the listener, there are two reasons why your lipid numbers may be elevated. It's either production or absorption. It comes down to simply production or absorption. Production mostly by the liver or absorption through the gut and production by the liver. That's typically when you think of statins, that's what it's treating. When you think of PCSK9 inhibitors is basically, you know, preventing breakdown of LDL receptors so that they don't. So they get. They don't get broken down. So the LDL can get better clear from the. From the system. If it's absorption, those drugs don't work. It's Zetia. And I'm actually one of the guys where I myself had elevated lipid numbers my whole childhood and all the way through my training. And I did the cholesterol balance test, and it was all absorption for me. And so that doctor who recommended a statin didn't realize that that's the wrong drug. And I've been on Zetia for 10 years now. My numbers are super low. Because it's appropriate for my issue. And that's you know, again, blind spot to dive deep and understand, you know, how do you correct the issue at hand?

Gotcha. Yeah. The hyper absorbers are people that absorb too much phytosterols. Do you, have you tried to means that dietary wise or do you just go straight to Zetia or do you ever use any binders like well call or things like that to help with minimizing the absorption Absorbers.

Lifestyle first, always. I want to emphasize that, you know, we're talking about different pharmaceuticals or we'll talk peptides, hormones, but it always comes back to lifestyle first. And a lot of it is, is nutrition. And for some people, you know, you'll hear people battling. It's funny Aaron. I'll go on Twitter or Reddit and you'll hear people battling over what's the perfect diet and whether carnivore is good or bad, whether you should be eating paleo or Mediterranean or vegan or plant based or whatever the hell. And it's kind of comical because no one's right, no one's wrong. It depends on the individual. It depends on what's right for you. And the, the, the, the one trigger for most people is saturated fats and red meat and, and dairy and, and for some people that stuff's okay. For some people red meat doesn't cause a problem. For others, those like you're talking about hyper absorbers, those are ones where you gotta be care, be careful and just recognize that may affecting your, your numbers. Yeah. So that's individualization genetics come into play there as well.

Yeah, yeah. I think some of the literature is kind of tricky because there's this one and you're probably familiar with this Silza article, it was looking at one of these more primitive tribes in Columbia that had like these microbiomes that had not been tainted because they hadn't been accessed and the Anabox had not entered the tribe yet. And they looked and evaluated their diets and there's like eating nuts and seeds in a very hunter gatherer diet. And that's where one of the ideas of this is the optimal diet penetrate. Ten years later another group went out to research them and they went a different time of year and they're eating kind of carnivorous and all of a sudden it's like these primitive people groups that we look back and idealize. In many ways, what they ate changed throughout the year. And so it wasn't always nuts and plants. It would change. And sometimes in the wintertime, if you're up north, you don't eat enough fat, you actually get frostbite, not maintain your body temperature. So I think you're individualizing the diet, but also the way you live in the world makes a big difference as far as your body's needs. And that can be potentially, I guess, a blind spot where people think one diet size fits all. It's. You gotta individualize it.

Yeah. You know, you think about tribes in Africa versus families in Italy, Mediterranean countries like Italy, you think of the Japanese and you think of like the Alaskan Eskimos, very, very different genetics, very different climates, environments, etc, and those cultures, those people have adapted their genetics over, you know, hundreds and thousands of years to where they have evolved to eat a certain diet that's right for them and their bodies. And so, you know, you eat the, the, the rice and the seafood is great for the Japanese in Africa, those men who are eating, you know, meat and, and then you look at the Alaskan Eskimos who are eating whale blubber, and you can see how clearly, you know, genetics and environment come into play. And so I, I like to test, not guess. And I think what's probably more powerful than what you're eating is to really instead focus on what you're not eating. And what I like to really emphasize, regardless of whether you're eating meat or not, regardless of how much saturated fat, regardless of whether you're plant or, you know, whatever diet you want to eat, focus on getting rid of the crap, getting rid of the sugar, getting rid of the refined processed foods, getting rid of the seed oils, the, you know, the pro inflammatory oils that are in every restaurant you go in, that's where you're gonna start to really make a difference. When you start to focus on protein intake and focus on, you know, clean quality ingredients, focusing on macro ratios, focusing on the timing of when you're eating and, and eating protein before carbs and that sort of stuff. That's where we're gonna start to see a real difference and to hone in on that stuff and not necessarily pick and choose what's the perfect diet for you because there's so many factors that can affect that.

So a couple things really interesting there. You mentioned cedar oils. I want to come back around to that because seed oils is something that I think has just come to the public consciousness in the last year. I really don't remember a lot of people. I did lipid therapy training with Patricia Kane, who's a big lipidologist and does testing through Kennedy Kruger Institute of Hopkins but outside that world, I never heard people talk about seed oils until maybe about a year ago in the public, you know, arena. Could you just talk about that a little bit? Because I feel like this is like the elephant in the room that is everywhere. That is super easy to miss. Yep. And it's actually potentially worse for your health than smoking. Really? Yeah. So could you like, just take some time to talk about that?

Sure, yeah. So these chemicals, these, they're, they're polyunsaturated omega 6 fats. And we're talking about things like safflower, sunflower, peanut oil, corn oil, canola oil, cotton seed oil, any of these, you know, vegetable plant based oils. They were actually originally created as industrial solvents, as chemicals that they found that they can use to cook. And they're very inexpensive. They could save money. So rather than use the expensive, better quality oils, they started cooking and making food with these oils. What's dramatic is to see the rise in use of these oils from about the 1950s, 60s, 70s around there. When you see the rise in the use of those oils. The increase in obesity is almost identical curve. The increase in cardiovascular disease and chronic illness is almost identical curve to the incidence of use of these oils. We know they're pro inflammatory, we know they cause damage. They know they promote insulin resistance, they promote chronic disease. And I, I would totally agree with you, Aaron, that I think that they're probably worse than sugar.

Yeah, they are crazy toxic. It's kind of interesting how rapeseed oil back in the 1800s was used as a motor. It was actually used as a motor oil. And when they realized they could add it in the food, rapeseed oil didn't sound too good. So it was being grown in Canada. So Canadian oral canola oil is rapeseed oil. And it's really interesting how, you know, 100 years ago, my great grandfather would have known it as rapeseed oil, as an engine oil lubricant. And now it's a common food additive. And so I, I think when you say like that people maybe it starts clicking like, wait a second, this used to be used as a engine, literally used as an engine oil. And now it's. Yeah, kind of sort of everywhere. It's a little insane. It's, you can't make this stuff. You literally can't make this stuff up sometimes. Like, it's just like, really, we're doing that.

Yeah. Whereas oils like olive oil, we know olive oil has incredible health benefits. We know that it is anti inflammatory. We know that it helps Improve metabolism, it helps blood sugar regulation. We know that, that there are incredible at a cellular level benefits of olive oil. And so what I would suggest all you out there is instead of using all these pro inflammatory seed oils is really do everything you can to convert over to olive oil. Avocado oil is another great one as well, much better than any of the, the canola, cottonseed, et cetera.

Now you had mentioned as well protein intake. I want you to talk about that because there's been a debate, you know, do a lot of the vegetarian, vegan kind of literature about hey, we're eating too much protein. Where's a protein excess when you cut back on protein. Then there's a carnivore diet where it's like, you know, you're eating like almost exclusively protein with animal fats. Could you just talk about that briefly because I think people get on the extremes and don't realize, don't talk about like actually protein as a way that our body is detoxified. It's not just building muscle, it's also all our hormones need these little protein receptor molecules. So could you talk about clean protein a little bit then like actually for you know, a middle aged male, what, what a recommended amount of protein would be?

Yeah, so in general men don't eat enough protein. And when we look at, at you know, tracking intake, most men don't have any idea what they're eating. And so I always tell my patients when we first start working together is just document everything, is just write it down or they're great apps. We know we use Chronometer with our clients or a lot of other ones out there. Most of them are free. My F PAL and Chronometer, free versions of those that you can simply take pictures of your food or enter what you're eating. And what most men find is they're eating way too many carbs and not enough protein and made way too much fat as well. And, and that's gonna affect caloric intake, but it's also going to affect metabolism and energy systems and hormone production, et cetera. And so for protein we want to focus on that as the key macronutrient when it comes to being anabolic, when it comes to building muscle, when it comes to burning fat, when it comes to regulating blood sugar and reducing inflammation. And the, the number that I like to use for men as a simple, easy number to remember is 150. Now to be a little more accurate, it's technically 0.8 to 1 gram of protein per pound of body weight. So for example, if you weigh 200 pounds, that means 160 to 200 grams of protein per day. Now that really is, should be your ideal body weight. So let's say your ideal body weight is 160, then that's getting you about 140 to 160 grams of protein. That's why to make it easy for most men, just think 150 is a great, easy target for you and you gotta eat that much protein every day. Now I'll emphasize it's very hard to do that. It's very hard to get 150 in unless you're working at it. Most guys are not. And the first couple times, you know, you track it, you'll be like shocked when you find out you're eating 45 grams of protein in a day. And it's not even, you know, it's barely a, barely a quarter of what you're supposed to be eating. And so great foods that you can eat to, that are clean and easy to eat that can help give you that protein in the breakfast in the morning. Breakfast can be Greek yogurt, you know, organic Greek yogurt. And I do either no sugar or 2 grams of sugar yogurt and they're 12 grams of protein. For one of those, you could do cottage cheese which has 15 grams of protein in one of those little tiny packs. You could do eggs. You could do any kind of lean meat. Lean. And I always recommend grass fed meats. Organic if you can, if at all possible be. If you're a vegetarian. Beans are a good source of protein as well. And you can eat all these foods that are very clean on a daily basis and make those your priority, make the protein your priority. I, I eat meat myself and one of the, my great sources is whey protein. And I, and I eat real food as well. I'll have chicken breast or I'll have fish, or I'll have some other source of proteins along the way. But a whey protein smoothie is a great way to add in enough protein. So I will take two scoops of, of powder, which is, which is 40 grams of protein right there. Throw in some strawberries, throw in some blueberries, mix it with ice and water and you're good to go. And you've just hit 40 grams of protein right there. And so it can be done by just being a little intentional each day.

Yeah, I think that, I think being intentional is the key because it's hard. It's. Unless you're thinking about it, you're just not gonna get that much protein. I think when people hear that for hormone health. And the same with women, women need one to two mix per kig per, per their body weight, which, you know it's gonna be less than a man, but still you're looking at 120, 140 grams of protein a day for a female. It's just these numbers are much, much higher than numbers people talked about in the past. Now there's some discussion about that's too much protein on the kidneys, and your kidneys might not be able to handle it. Could you talk a little bit about, you know, back potential concerns? Sometimes I hear people talk about that.

Yeah, I think that risk is overblown. You know, if someone has chronic kidney failure, very different story. But you know, 99% of people who are listening to this, that's not an issue at all. Anyone who has normal kidney function, as long as you're hydrating, you know, another part of we talk about nutrition is hydration. And a lot of, A lot of men I see who are fatigued and dragging later in the day may actually be from dehydration often. So if you're hydrating enough, and I will always have with me filtered water. You'll see. You know, I have a yeti here with filtered water throughout the day. That's gonna help. There you go. That's gonna help you. But I just, I think that's overblown. I think that's used as a reason to, to, to get in the way of you getting enough protein. And I just don't ever see that really being a problem in my practice.

Yeah, yeah. I think as long, to your point, as long as your kidneys are working fine, you know, it does make it a little difficult to alkalinize or keep your bio alkaline. But if you're getting. That's where I think the next thing I want to ask about is minerals. You know, trace minerals, magnesium, potassium, rare earth minerals. Could you talk a little bit about those? Because I feel like that's another thing that people don't emphasize enough. That's super critical for our basal metabolic rate for our kidneys to work to balance out heavy metals in the environment. People just don't realize, you know, we are massively deficient in minerals. So could you kind of go down that rabbit hole a bit for us?

Yeah, it's a great point. And I, I think it comes down to testing. You know, I, I think that there are all kinds of supplements out there. People trying to sell. You take this powder, take this capsule, and you get all the micronutrients that you need. But it comes down to everyone's different and genetics come into play. Environment come. Comes into play. If you're out there sweating a lot. I have one of my clients, he's actually a professional golfer, and, and he has severe issues when he sweats with losing key nutrients, and then he gets dehydrated and has to replace himself on a regular basis. So I think the only way to know that's gonna be to test. And I, you know, looking at things like magnesium, looking at things like selenium and, and zinc and all these other key micronutrients that we test for that, that can really come into play for so many systems in your body that you need.

Yeah. So when someone comes and works with you, you know, what are the four or five major takeaways in general that you see having the biggest impact on people after they've come? You've done testing, you've done this advanced stuff, precision medicine, these really cool tests. What are the top four or five takeaways that you see moving the dial in men's health more or the most or most profoundly? Maybe that's a different way to say it. Sure.

I look at it as, what are the systems that need to be fixed, that need to be corrected to. To get your human operating system working properly? I typically find hormones are a big one. I find blood sugar regulation is a big one. And, and a lot of time that's diet. Sometimes that's chronic stress. And guys hate to ever admit stress as a factor, but I'll, I'll give you one of the biggest factors that cause stress in your body is poor sleep. And almost every man I work with has issues with sleep that will raise your blood sugar just by itself. And so I'll see guys with fasting blood sugar is 110, 120, 130. And that's not from diet. It' fasting blood sugar is 110, 120, 130. And so blood sugar from internal physiologic stress from, from poor sleep. I want to emphasize people talk about longevity. Well, that starts with not. So everything that we can do to limit and reduce cardiovascular disease is a big one. Gut health is really common, super common. I find that most of the men I work with have major issues with dysbiosis, with leaky gut, with issues with digestive function. And that's one of those blind spots that guys don't realize. And most of the men in your practice, most of men who have those problems have no complaints. They don't have abdominal pain, they don't have irregular bowels, they don't have any issues. But major issues with your gut can cause things, can cause inflammation that can result in brain fog and immune function issues and allergic issues and issues with your hormones. You know, it can affect thyroid and cortisol, et cetera. And so it could have a lot of downstream impact that people don't even realize is somehow connected back to the gut. Those are the big. I would say. What's that?

You did mention, you did mention sugar. Just a little bit. Do you use some continuous glucose monitors or CGMs?

We do.

With your patients.

Yeah.

And how do you, how do you, how do you utilize those and how to.

Sure.

Patients, like, utilize that information.

So once we get started with my clients, we are obsessed with wearable technology. We track sleep with. Typically we'll use an aura for that. We'll track heart rate variability, which is a direct surrogate or marker for stress. We will track intake, as I mentioned, with devices that can just simply measure what you're, what you're taking in. We use a continuous glucose monitor, cgm. THEA is who we use. And I, I love their dashboard, their client dashboard and how we use that. One in particular is clients put it on and it lasts for two weeks at a time, and it will track your blood sugar 24, 7 real time for 14 days. And we'll have our clients just simply track what they eat, what they do. They're, you know, any major events. And what we find is that there are these massive blood sugar spikes throughout the day that men don't even realize is happening that's directly impacting your energy, your metabolism, your hormone, your drive. You know, guys want to burn the belly fat, they want the six pack, they want to look great with their shirt off. But when you're dealing with chronically elevated blood sugar or these spikes where your blood sugar is elevated for three or four hours, you're never going to get there. You're never going to accomplish your goals. And it's right under your nose. It's a blind spot again. And so what we do is, is we track blood sugar and we'll see that things like, like sushi, for example, someone, this is me, I've had this with other clients as well. You eat sushi? Yeah, I'm eating healthy. And then you look at the blood sugar data and holy cow, my blood sugar went through the roof for three hours. However, you could experiment and realize that I was Able to eat salmon or chicken and then eat the rice, the white rice, and have a negligible effect on my blood sugar. Simply by adjusting the order of your food, you can see real time how it has an impact. So for some people, you know, a white potato may be a problem. For other people, maybe red wine. Other people, it's rice. Who knows what that carb is that may be affecting you. And that's how you can start to really, you know, instill lifestyle changes. Aaron, you know that to instill change, someone has to recognize the value of it. Why am I doing it? Why, why should I eat this? Not that, why should I eat, you know, certain foods in certain orders? But when you see the data, it's much more impactful and it gives you an understanding of it.

Now, I love the way you use wearable so much because it's, it's, you know, someone sees me and they see me 12 weeks later or whatever it is, and it's like that's so much time to forget about stuff. But that daily, you know, seeing the data after a meal for sugars or for me, I track my, use my OR ring to track my sleep and I'll see the heart rate availability change based on what I ate before I went to bed. It just, it gets people's more skin the game. It also helps them realize you can make small changes throughout the day. They can have massive impacts on sleep quality, sugar levels, and ultimately those are two big things that are going to affect hormone levels, affect brain fog effect, your weight.

Yeah, absolutely right. And it's data that is easy to gather and it can have a massive impact. You know, you mentioned sleep. A lot of guys will first start out by telling me how great they sleep. I sleep seven hours a night, no problem. And then you put an R on them, you put a tracker on them. And there are a lot of trackers out there. I just, I think R is most validated on literature. And you'll find that they're only getting maybe 12 minutes of deep sleep. Even though they're sleeping for 7 hours and 20 minutes, their deep sleep should be about an hour and they're getting 12 minutes. And that's something that you can only detect with a tracker. And now you can start to again, another blind spot. When you start to identify these issues, then you can address them that you would otherwise have no idea are causing a problem.

So I want to wind things down a little bit. This has been a great, great conversation. You know, where do you see the future of precision medicine going because you've been in this, you're doing all these really cool things. What are the, in the next one to three to five years. Where do you kind of see the future in this kind of personalized precision medicine going?

Yeah, I, I see it all coming together in a very integrative, cohesive approach and, and using all of the, you know, the whole arsenal of diagnostic tests that we now have. We have genetic tests, we have amazing functional tests that I know you use a lot of as well. We have all kinds of cutting edge blood tests. We have ways of measuring fitness level with VO2 max and metabolic rate testing. We have amazing peptides. We have amazing understanding from a lifestyle perspective what works and what doesn't and how to individualize that we understand how everything connects together. And so I really believe the future of medicine is relying less on the doctor, like me, like you, and relying more on a team. And I feel that my patients get the best results because I have a team around me and I have nutrition experts and I have fitness experts, I have genetics folks and I have, you know, concierge team who can react real time to wearable data. When we see issues going on that like you mentioned, if you see someone every 12 weeks, what can you really accomplish in that short time you have, that short window you have. Whereas if you could teach your patient how to fish, they're going to do a lot better on their own. When you teach them how to use and interpret the data real time on a daily basis, give them the tools, that's where you can start to enact change. One more thing I'll add in here, Aaron is I, I'm obsessed with personal development. I love all things business development, but personal development and how you can tie that into what we are doing when we, you know, here on the cutting edge of medicine and healthcare. And I think of Tiny Habits by BJ Foggy. I love that book. James Clear wrote Atomic Habits is great as well. I like them both. But BJ Fogg, Tiny Habits I think everyone should read. It's a must read. And the point is here is you have to enact change. It has to feel good and it has to be micro baby steps that you can do on a daily basis, consistently, every single day, every single time. And he talks about having an anchor and then a behavior and then celebrate. Abc, read the book, those of you who haven't read it. But that's how we enact change is by starting small and continually adding to that and not expecting one magic pill to fix all of our problems and that's what a lot of people are doing. They're looking for the magic bullet and it's just not out there.

Yeah, I mean I, that, I love that, you know, you have to know where you are, know where you're going and then take these little baby steps and tiny habits. That's a great, great book. It's one my wife and I have both read and we're trying to apply that to our business actually.

Yeah. That's awesome.

Tiny changes with that to change people's lives, you know.

Yeah.

So I really, you know, I really enjoy talking to you. I think there's a lot of great information. I think people out there, if people want to know more about you, what you're doing, follow you your book, you know, where can they find more about you and learn more about what you're doing?

Yeah. So I would address, I would have your, your listeners go to gapin institute.com that's G A P I N institute.com forward/launch and what that's going to give them is going to give them a bunch of freebies. I like to give away stuff for free. So you're going to get a free copy of my best sell book Mel 2.0. You're getting a copy of my TED Talk with a transcript. You're going to get my high performance health handbook which has 15 strategies and tactics that you can leverage starting today to have more energy, burn fat, have better sex, live longer. You're gonna have a copy of my Peptide guide and you'll also there get a link if you want to learn more about how I can help anyone. You'll get a link to get on a free call with my team as well. All for free again gabinstitute.com launchpad awesome.

Well thank you so much for that. I'll definitely make sure we put that in the show notes and where to put stuff on my team. I have a team do all the magic for so so thank you so much for your time. Really appreciate it. Again, check out Tracy's information thegapinstitute. Com Launch Great information there and we'll see you soon.

Thanks Aaron.