Biohacking Tips to Boost Testosterone with Dr. Tracy Gapin | 1184 | Dave Asprey

Men with low testosterone, they tell me they don't feel like a man. They tell me they're moody, they're cranky, they're irritable. They don't experience the same levels of joy and fulfillment in life that men with optimized testosterone levels feel. They don't have drive. And we could talk about drive as it relates to sex, but also just in life. Their drive to, to perform in the gym, their drive to succeed in their business, their drive to be a dad. And that's, that's where we start to get near and dear to my heart and is that they lose that drive of what it really feels like to be a man.

You're listening to the Human Upgrade with Dave Asprey. You're listening to the Human Upgrade with Dave Asprey. Today we are going to talk about men, we're going to talk about testosterone, and we're going to talk about why people get it wrong. This is a really, it's a really important thing for me because when I was 26, I got my first testosterone test. I weighed as much as £300 for that. I was probably about 270 when I got that test. And the doc called this one of the first longevity doctors before we called it the longevity movement, when it was still anti aging. He ran actually still doing it. His name was Dr. Miller. And he said, dave, I got bad news for you. Your testosterone is lower than your mom's. Because he'd actually run my mom's testosterone. Like, man, this is a problem. And so let's say I was an early adopter of low testosterone in young men. Today it seems like everyone has low testosterone, men and women. And you're a top expert. In fact, guys, I haven't introduced him yet. You being Dr. Tracy Gapin, who's a board certified urologist and founder of the Gapin Institute. If you're a longtime listener, In September of 2022, we talked a little bit about testosterone, but we have a different angle for you this time and we're just gonna go deep. So what's going on? Why is it an issue? And what can you do about testosterone? So maybe your testosterone can be higher than your mom's.

The low bar is set. Welcome.

Welcome to this show.

Tracy, thanks so much. Glad to be with you today.

There's been a renaissance in health tracking. What can people do to measure their testosterone and the associated things today that you couldn't do five years ago?

Yeah, so when it comes to looking at testosterone, I think there's a lot more Awareness now around how do you measure testosterone correctly? What's the right way to test for it, what are the labs that matter and what don't matter and how do you actually interpret it? What do you do with those numbers? So first off, we want to always be looking at free testosterone. I think we talked about this a couple years ago, how most doctors out there, they'll do total testosterone and they'll rely on this ridiculous average of the population as a, as a guide for what's considered air quotes, normal versus not. And we want to always be thinking about how can we be optimized and what's ideal levels for that. And so number one, free testosterone we want typically around 20 or so petrograms per milliliter is what I would aim for.

And is that measure global or Is that a U.S. measure?

That's a U.S. measure. There are different scales using nanomoles internationally. Okay. But here in the US is picograms per milliliter. And when you look at the scale that's on the top end of that range, and the reason is just like you described, you know, for the last 20, 30 years, levels are plummeting internationally. Studies here in the US, Sweden, Finland, longitudinal 20, 30 year studies, all show the same thing, that levels are plummeting. We'll talk about why in a moment, I'm sure. But that what that does is that artificially lowers this ridiculous reference range that you see on the right side of the lab slip. I want to be clear that that's not what's optimal, ideal, where your number should be. That's simply the average of the population. And every year that reference range on that lab slip gets lower and lower. And what do you know, you happen to fall within that range. And I work with a lot of clients who are being told by their regular medical doctor that your levels are fine, you're normal, you don't qualify for testosterone, you don't need testosterone because you're in this ridiculous range. So you gotta look at free testosterone. You need to understand that the range that you're looking at is reference range, which is simply the crummy average of the population. And then you need to know what to, what do you do to fix it?

Are low testosterone men more fearful?

Low testosterone men have a lot of issues. Like what? So men with low testosterone, they tell me they don't feel like a man. They tell me they're moody, they're cranky, they're irritable, they don't experience the same levels of joy and fulfillment in Life that men with optimized testosterone levels feel they don't have drive. And we could talk about drive as it relates to sex, but also just in life. Their drive to perform in the gym, their drive to succeed in their business, their drive to be a dad. And that's where we start to get near and dear to my heart is, is that they lose that drive of what it really feels like to be a man. And so in that sense that they're, they're very different people. Yeah.

I look at that movie Grumpy Old Men as a documentary on low testosterone. Also maybe the last presidential debate.

Very accurate, very fair. Yes.

If you could get presidential candidates to have adequate testosterone, what do you think it would do to the world?

Wow. It, you know, it. For men optimizing testosterone. And I want to clarify that, you know, testosterone is one piece of this much bigger human operating system that we have. And so I want to, I want to honor all the other 50 hormones that we pay attention to as well. But, but testosterone, it changes a man's entire perspective. And, and there's this, this misconception is this fear that it creates rage or aggressiveness, and that's, that couldn't be farther from the truth.

I've never gotten there from it. I've gotten a little hornier. But that's not the primary reason that you use testosterone.

Exactly.

I have gotten pimples from using too much, but it's not going to turn you into testosterone poisoning. In fact, that's, I think, a made up word as far as I can tell.

Yeah. So it improves a man's quality of life, his energy, his sense for. Sense of vitality, his sense for enjoying what he actually enjoys. And I think that men with low testosterone, they lose that. You can see it in their eyes. And you, when you correct it, you see how everything changes in their, in their mind, in their body and in their life.

I'm responsible for tens of thousands of men in their 40s deciding to start testosterone therapy. And some of my functional medicine friends are like, dave, are you sure that's what you want to do? And once you go on testosterone, you can't go off of it. Is that true?

I get this question all the time. I love this question. So let's look at, let's take a typical situation. A guy comes in off the street, he has low energy fatigue, brain fog, cognitive decline, belly fat and low sex drive, et cetera, et cetera. And you check his levels and his free tea is 4, 5, 6. See this every day, all day. Men off the street have levels around 4 or 5, and it should be a 20. Should be a 20 to show you how far off they are. Now, the, the, the lifestyle approach to this would be to, you know, focus on strength training, resistance exercise, especially the quads and the hamstring and the core and the back. Focus on good quality sleep, reducing stress, lowering cortisol because it crushes testosterone production, making sure you're getting the right micronutrients, make sure you're eating the right good, healthy foods, healthy fats, getting some sunlight, especially sunlight on your balls, which, believe it or not, we thought I did it this morning. Hell, yeah. So there are all these natural ways of boosting testosterone people talk about, and they're great, and everyone should do that. And no one's gonna be religious doing that for, consistently, for long periods of time. But let's say someone, let's say a man did that consistently every day for six months.

And he's also got to go to bed at 9 and he's got to eat enough saturated fat and have good quality sleep, which means no young children in the house.

Very difficult to do it. To do it exactly. To do it the right way. Yeah. Life gets in the way. And so even if you did it perfectly, that 4, 5, 6, make it up to 9, 10, 11, ish, kind of somewhere on there, you're still only halfway there.

Yeah.

And so when we then have that conversation about testosterone replacement therapy or trt, or the question then is, how else are you going to get your levels up to where they need to be? Now, we can give medications, HCG or Clomid to boost your own body's production testosterone, which is another route. And especially for men out there who are still looking to preserve fertility and have children. Children still, that's a better way to go so that you don't suppress sperm production. Okay. You don't suppress fertility.

When I went on testosterone under a doctor's care at age 26 to get my levels up to those of a healthy young man, I took Arimidex and Clomid, and I had two kids very successfully, no issues at all. So it's easy enough to do that. But years later, when I said, I'm going to try hcg, I used it again under a doctor's care for about 60 days. I started growing man boobs and a bubble butt. And I, I went in and the doctor said, what the hell? I've never seen this before. Like, your body thinks you're pregnant. Like, stop taking this right now. And that was A psychologically odd time. This is many years ago. Yeah, but HCG doesn't always work, so.

Sometimes the dosing matters. There's nuance to how you dose HCG and Clomid and. And there's also nuance to the balance between testosterone and estrogen. So a lot of guys talk about, you know, estrogen's the enemy, is bad for you, you need estrogen. It's healthy. It, it, it's a very important part of a man's function and performance. And a lot of guys with very low estrogen from blocking it from things like Remedex, they have ED and low sex drive and can't burn fat, and they have the same problems that you would think of for low T. So it's the ratio of the balance that matters.

So having enough estrogen but not too much.

That's right. And that balance with testosterone, so as testosterone gets metabolized, is going to turn into estrogen. And so having a healthy increase in estrogen is okay. And a lot of guys I see with very high estrogen levels with no symptoms, and it's fine, it's okay, because.

Their T is also because their T.

Is high as well.

That's the ratio.

But to get back to your question of, you know, if I take testosterone, does that mean I'm gonna have to be on it for the rest of my life? Is it going to suppress my own testosterone? And my response to that is really, when Your level is 4, 5, 6, or you've done the natural stuff for six months, is now at 9 or 10, and then I get your testosterone, your free T, up to 20, where it needs to be your ideal, optimal level, and, and you feel amazing. Quality of life is awesome. Your drive is back, you're burning fat, you're building muscle, you're having sex, you're loving life and everything longer. Everything's the way it's supposed to be. The question actually switches to, doc, you're not ever going to stop this, are you? Not going to make me ever stop this, are you? And the reality is that your body was not making enough before. And so when I give you testosterone, yes, it's going to suppress the pituitary secretion of LH luteinizing hormone, which is going to turn off your own internal production. But it wasn't enough to begin with. You had crappy production as it was. And so we're giving you the testosterone your body wasn't making, but needs. And so most men, once they get to that point, they will turn that question around, say, can I take this forever now and the answer is, well, yeah, why not?

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Probably for around 10 or so.

Yeah. And that was not enough. Yeah. So I said, screw this noise, I'm going back on it. And I've been really public about that.