Male Hormones: How Testosterone and Toxins Mess With You! – Tracy Gapin, M.D.

You're listening to the Human Upgrade with Dave Asprey. Formerly Bulletproof Radio.

A state of high performance.

You're listening to the Human Upgrade with Dave Asprey. Today we're going to talk about testosterone. And as you know, I think testosterone is a game changer if you need it. But we're going to talk about why maybe sometimes you don't. And what else is responsible for making your hormones work. And we got to admit, male testosterone has dropped more than 30% in the past 30 years. Thank you, soy boys, PETA plant based diet and big food nonsense and lack of minerals in the soil and blue light pollution and a bunch of other stuff like plasticizers. We're going to talk about in this show and what you're going to learn, so you know it's worth your time, is what creates the epigenetic signals that turn your genes on or off for testosterone and other sex hormones. And testosterone, as you probably know, affects men and women. So this is really important. It affects men and women because we both have it and because if women are low in testosterone, they hate their men and if men are low in testosterone, they tend to hate their women. Maybe hate's a strong word, but bottom line is you get angry and cranky at other people when you don't have enough testosterone because testosterone is the hormone of desire. Not just in relationships, but desire for everything. So I think it's important. And we've got a, an authority on this. His name is Dr. Tracy Gapin and he's already been on the show and is just a fantastic expert in testosterone who works with epigenetic coaching, hormones, peptides, biometric monitoring, nutrition, lifestyle. So it's not just testosterone, it's all the stuff that comes together. He is the founder of the Gapen Institute for High Performance Medicine and created something called the N1 Performance Health Program. Just got a copy of his book. It's actually laying over there by my infrared mat called male 2.0 cracking the code to Limitless Health and Vitality. So here we go. I've got a real doctor who maybe wasn't doing it right himself, who turned it all around when he was 42. Welcome to the show, Dr. Galpin.

Oh, thanks so much, Dave. Glad to be here with you.

All right. You're my favorite kind of doctor because you're a member of the American Academy of Anti Aging Medicine, where I met the mother of my children in 2004 and where I've lectured many times. This is like a group of the most progressive anti aging doctors. So it's where functional medicine took its roots and it's a, being a fellow there is a, is a big thing anyone should look for when you're looking for an anti aging or a functional doctor. All right, tell me about why you write your book about men's health. It's personal for you.

It is, yeah. Dave, you know, I am a brief background. I'm a board certified urologist. I spent 20 plus years in traditional medicine and you know, everything changed for me when I developed my own health issues. About gosh, it was about 10 years ago now, Dave, and, and I went to one of my colleagues here in town in Sarasota, Florida to get help and I had a very eye opening experience when I realized that we don't have health care, we have disease care, we have crisis care here in the US where we're just taught as doctors going through our training how to treat disease and treat symptoms and diagnose you with your ICD10 code and do surgery and give you prescription medications and do nothing to actually optimize your health or promote health or promote longevity. And I experienced that myself when I woke up one day. I'm 30 pounds overweight, I feel like crap and I have no focus, no drive, no energy. And I didn't like who I'd become and as concierge doc couldn't help me. And that got me on this quest to really learn how to transform my own health. And in the process of doing so, I joined American Academy of Anti Aging and I learned about functional medicine and epigenetics and how to incorporate peptides and use wearable technology and take a systems biology approach to health to optimize. And I was able to transform my own health and started transforming the lives of the men I was working with. And I realized, Dave, that I finally found my purpose and passion in life. And so after 20 plus years in traditional medicine, I made the very courageous decision to step away from disease model medicine so that I can focus on what I call high performance health. And that's where the Gabinet was founded.

It takes a ton of courage for a doctor to do that. How much of your traditional medical knowledge do you use when you're doing high performance health? I mean, you're a urologist, you know a thing or two about, well, I don't know what the technical word is for it, but dicks.

That's a great question if you ask me. How much do we learn about testosterone and hormones and peptides and functional medicine in residency and urology resident? I Did six years of general surgery plus urology training, it would be zero. Dave, we learned nothing about what I'm doing now in my urology training. Yes, I still deal with some prostate cancer. Yes, I'd still do some traditional urology kind of stuff. But I would tell you 99 plus percent of what I'm doing is from the extra training and certification courses and education that I went through over the last 10 years. Because it's the passion for me, to help me be the best husband, father, leader that I can be and to help bring that to my patients. And Dave, it's really a completely different way of looking at health. It's no longer about just treating that symptom or treat that problem or that illness. It's about optimizing. It's about taking your life to a whole new level.

All right, so let's go back 15 years. You're in practice, guy comes in, lays his belly on the counter. By the way, I'm allowed to say this stuff because I was 300 pounder, who would have done this and says, doc, don't have a morning kickstand anymore. What would you have done?

Yeah, well, I tell you what, that guy would come in and he'd be asking for two things. He'd be asking for a testosterone shot and a blue pill.

Yep.

And in disease model urology, that's what he got.

Did it work?

No, Hell no, it didn't work. Did he, he come back again asking for something else? That was the problem. You know, we were just passing the down the line because we literally have six minutes for every guy that walks in the door in that office. And do you think during that time I can talk to him about stress and cortisol and sleep and nutrition and epigenetics and. No, it's a short term band aid fix to that problem because that's all disease model world is set for. Now I spend an hour with that guy going through all of the facets, all the inputs into his human system that are ultimately affecting his sexual performance. That before I didn't have the time or really the wherewithal or knowledge to address it the right way.

When you have your initial meeting with a patient, how long is it?

About an hour.

There you go. So if you're listening to the show right now and you get your first meeting with your doctor and it's under an hour, that's a red flag. Just right there. There's no way a functional doctor or someone who's going to help you manage the system of your biology can even get a basic assessment of you until they get that amount of time. And I've had lots of meetings. Keep in mind, I was pretty sick. And I've seen way more people than the average person because of mold and metals and all kinds of stuff. I've had people. The first meeting is two hours. It's four hours with some doctors. They really have to go in there. How many labs do you typically order after you see someone for an hour?

Oh, gosh, we do a lot. So as part of my, my performance health program, we, first of all, it's understanding, you know, what. What's the guy dealing with? And we work with men and women. So I want to be clear when I say, guys, it's patient, but it's, you know, what are his challenges? What are his goals? Because that's going to kind of direct where we go. But we may do over 250 different blood tests. We're going to do saliva cortisol tests. We're going to do microbiome testing. So that means poop tests. We're going to look at your stool and look at, you know, bacteria, look at signs of, of. Of inflammation, gut health, going to look at a blood test related to organic acids. And that's really the start. Then we do cheek swabs. Looking at genetics, where we're looking at over 700,000 genes, where we will pick and choose the ones that are right, that are. That are most impactful when it comes to this guy's health. And so it's all about data, Dave, and how we can use leveraged and incorporate that data into health.

You know who first opened my eyes to this? I've credited him in a couple of my books. He's written a post on the article. I think he's been on the show a while ago was Dr. Miller from Los Gatos. Years ago, in my mid-20s, he's the guy who showed me I had lower testosterone than my mom. And this was like, I think he had anti. He probably still does antiaging.net or.com like a very early adopter here. And he would do an Excel spreadsheet with all my labs and go, look, they change over time. And I was like, holy crap, that's what I do at work with networking protocols. You can do that. And so I like to credit him with kind of lighting up my data thing. And gee, where did he learn that a 4M he was guy? I think he's still practicing in Santa Cruz, but probably not full time. And it's incredible what happens when you just start saying, I'm only going to do what works. And I just started throwing out all the crap that didn't work. And that's what a good doctor should help you do. And they'll throw out a lot of pharmaceutical crap. But don't some pharmaceuticals work some of the time? Like the little blue pills, don't they kind of give you a kick?

Yeah, you know, you bring up a great point. I think it's the integration, it's understanding when you can use pharmaceuticals, when they might be helpful. You know, for example, metformin. You know, metformin as a pharmaceutical has been around forever for non insulin dependent diabetes, for type 2 diabetes. But there's actually a place in metformin when we're looking at longevity and activating AP kinase. And so there are situations where I do find utility for prescription medications. Now, am I gonna give every guy a statin? Hell no. Am I gonna give every guy prescription medications? No. But there are in certain situations a time and a place for it.

So are you pro metformin?

Great question. I think that it needs to be personalized. I don't typically recommend anything across the board for everyone. I think that, that if you're, if you're older versus younger, if you're an athlete versus non athlete, how active you are, there are a lot of, a lot of nuance that, that goes along with, with metformin. Yes, it activates AMP kinase, but yes, there's definitely, obviously, as you know, controversy around on that. So it's personalized.

Yeah, I was a pro metformin guy starting in 2004 because 2003 the first mouse studies came out. So I'm like, I'll take that out, I'll do everything. And I end up meeting with the biomarker pharmaceuticals guys who did the original research and started a company because metformin mimics caloric restriction. And after several years of doing it, I'm like, I don't think it's right. And when you look at the studies now, it does inhibit mitochondrial respiration, which I think is bad. So if you have diabetes, probably good. But if you're taking it for anti aging, I think the intermittent fasting is a better choice. But I could be wrong too. I'm open to the data, but I.

I tell you what, the TAME trial, if that trial ever comes out, which I hope it will, the next couple years, that's going to be very enlightening and helpful. But, but you're right that, that there's controversy around this nuance and Do I recommend it for everybody know, but there certainly is a time and place for especially someone who has issues with insulin resistance, you know, metabolic health, glucose regulation sort of thing. That's the kind of guy where it could definitely be helpful. Impacting fitness and impacting mitochondrial biogenesis and all that is definitely the downside to it.

Yeah, makes, makes sense. It's a double edged sword. All right, so we have an epidemic. There's a lot of obese people right now more than ever before in the US in recorded history. And I just want to make it really clear it couldn't have anything to do with our, you know, chemicals sprayed everywhere or the drugs or big food because those guys are only have our best interests and heart. Try eating crickets. I'm sure it'll fix it. So now that we've exonerated them so that we can maintain our presence here, what's going on?

Yeah, you know, great point. You know, I call it a testosterone pandemic that doesn't get the attention it deserves. Where as you mentioned, you know, testosterone levels over the last 30 years are down by about 30%. Free testosterone, which is bioavailable active form of testosterone, is actually down over 45%. And this is, this is really important. We're not just talking about sex and muscle. We're talking about a man's life and cardiovascular health and cognitive function. And the culprit can be debated, but without question, one of the biggest ones in my mind is endocrine disruptors. You know, toxins, chemicals in our environment that are clearly crushing men's health, clearly crushing testosterone. It's the food we eat, it's the water we drink, it's the personal care products, it's ubiquitous, it's almost everywhere. And it's getting worse.

I'm pretty sure it's those little pine trees where there's 17 of them hanging from your Uber drivers thing that's probably solely responsible for just the amount of endocrine disruptors and stupid stuff like that and Febreze and all these other completely unnecessary and actually harmful things we just keep doing and we're exposed to all day long if you're in those environments. So it's one of those things where it's so complex. There's no one thing that we know is causing it because it's not one thing that's causing it. It's like what one thing causes bread. Like was it the yeast, was it the flour, was it the water? Maybe it was all of them. And the oven. Right. So we've Got to sort of unbake the loaf of bread. And one of the things that we do know is, like you said, you've got a 45% number for the drop in testosterone. I've seen 30%. But one thing I do know, when I go to buy pants, the diameter of the thighs and calves of men's pants has been shrinking for the last 15 years. And I actually have calves because I have testosterone. And most brands of jeans today I cannot wear because I can't get them over my calves. Right. So I am not a bodybuilder. I'm reasonably fit. I don't look particularly different from most men in the 70s. I'm probably a little bit more muscular genetically, but I'm not, you know, the guys who spend two hours in the gym. I spend, you know, 10 minutes at upgrade labs a week and all right, what's going on? I think it's testosterone. Like, literally, we're wearing women's jeans now instead of men's. Have you noticed this? Like, the muscle mass. Amen. Is declining as their testosterone is declining.

You know, you're absolutely right, Dave. It's. It's increasing visceral fat, it's decreasing lean muscle mass, it's declining cognitive function, it. Deteriorating cardiovascular health, it's deteriorating metabolic health. And it's all related. It's all related to this endocrine disruption soup that we're bathing in on a daily basis. And it just doesn't get any attention, which is unfortunate. And so what I am, you know, on the rooftop screaming about is filtering your water and eating clean, organic, fresh fruits and vegetables. But, you know, our drinking water studies show that is laden with toxins, is laden with, you know, estradiol. Women's birth control is at very high detectable levels on drinking water. And so, you know, are you filtering your water that you're drinking every day? You know, this is. These are important little micro decisions that you can make on a daily basis that. That are impacting your health, impacting your performance in every area of your life.

How would someone know if they didn't have a lab, that they were low on testosterone?

Great question. It. You know, a lot of guys come in with low energy fatigue, brain fog, lack of focus, lack of sex drive. But I see so many men who have none of those, Dave, and they will think that they're fine, and they have a random lab test done by their primary, and it shows that it's low. And. And then they come to see me. So it's surprising how many men will have Relatively lack of symptoms now. They'll have signs of low testosterone, they'll have trouble obesity. You know, they'll have belly fat, they'll have issues. You know, we know that low testosterone actually is associated with increased risk of cardiovascular disease. Disease you tend to see got higher LDL levels in guys with low testosterone.

That's really important. If your LDL cholesterol is elevated, it could be because you're low in testosterone or possibly thyroid too. Right?

They're all related. Now, you know, I'm always careful by saying causative, does the low T cause it or is it related to it? You know, it's part of a constellation, a picture. But this metabolic syndrome that we see every day, which is guys who have hyperlipidemia, they have truncal obesity, they have low testosterone, they have insulin resistance, they have sometimes blood pressure issues. They're all related.

Guys like me before I was 30. Yeah, those things.

There you go, right? And these guys are walking around not recognizing that there's a real hormonal imbalance and it's causing problems.

All right, so you go to the doctor, like I've got some of these symptoms. I can't lose weight, I go to the gym. I, I think I eat reasonably healthy. Even though you prob. Probably don't. Maybe you don't always wake up with a normal male experience when you wake up. So you go to the doctor, what labs are they going to run? What's your testosterone? What do you recommend?

Yeah, great question. So I see this all the time. Guys will go to see the primary care doctor and they'll check a total of testosterone and they'll tell them, yeah, buddy, you're normal, your testosterone is normal. And this makes me cringe. And I want to take just a moment just to go through this because this is so such an important point.

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Because this is such an important point that there is no normal testosterone. So when you look at a lab right when you look at a lab and you look at the right side, forget what your number is for a moment. You look at the right side and you'll see this range. It'll say something stupid like 200 to 790 or something like that at the top it will say reference range. It does not say normal. It says reference. So what is the reference range? Is the statistical bell curve average of the population of all the millions of lab tests that have been done with we just got finished saying 10 minutes ago that studies have shown that free T is down 45% over the last couple decades. And so therefore that reference range just keeps shifting lower and lower. But yet traditional doctors, traditional primary care doctor, even urologists will look at that number and oh, you're in the reference range. You must be normal. And I have to call nonsense. Where should it Be great question. What we want to see is, first of all, we want to take care of any symptoms. But understand, again, a lot of guys have no symptoms, so you can't rely on just that. I look specifically at free testosterone. Total is, is certainly important, but the free is what's most important. That's the bioavailable active. And I'm looking for typically around 200, 250, somewhere in that kind of ballpark. And you got to remember the scales can be different depending on which lab you're using. But peter, grams per nan, per picograms, per nanoliter of free testosterone. 200. 250 is our target for that. And guys will come in, it'll be 60. I have a guy I just saw earlier today. His total testosterone was 273 and his free was 47.

And this guy just didn't have a desire to do anything in life, did he?

He's actually fine. He wants to be a professional golfer, so he's looking to optim. He's like, hey, I want to start getting in shape, doing what I got to do. You know, I got a little bit of belly fat going, otherwise I'm kind of fine. He has no specific symptoms. He has no major complaints other than he just wants to see how he can get better. And he's walking around with, with those kind of numbers. It's so common. That's why we call it a pandemic. Because I tell you, Dave, I can't tell you the last time I had a guy come in and had labs done and they were optimal, ideal where they should be.

Wow. So no one has optimal labs. Is there such a thing as an optimal lab?

Well, if a guy came in with a testosterone of 1200 and a free testosterone of 225, I'd say that's probably pretty damn good, depending on how he's feeling. Some guys may need, you know, different levels depending on, on their symptoms, their quality of life. But most guys come in and the total is like 2, 3, 400. They've been told they're normal and, and they're suffering, and we're doing these guys an injustice.

There's something else that, that's brutal. If you're 55 and you come in and measure testosterone, they compare you to other 55 year olds.

That's, that's wrong. Bell curve.

Exactly. You need to be comparing yourself to other 25 year olds. And the thing that I recommend for young people, the stuff that I wish I had known, is what is the right testosterone Level for you because if you measured yourself when you were 25 and your biology was working, you weren't already overweight the way I was, you would know the set point where you want your Testosterone when you're 105 and that's your number. So I don't know what my number was. I did get my testosterone drawn when I was 26. I know it was lower than my mom's, so there you go. That wasn't very useful because I was obese and I had endocrine disruptors and all kinds of stuff going on. So I figured it out. I like my free to be around 800 to a thousand and or not my free, my total testosterone either. And I actually don't know where my free is right now. I have to look it up on the lab, but I tend to keep the same ratio. So I'd have to check my email.

And one point that you just brought up, I think is important for the listener to understand that the difference between free and total, so total is all the testosterone free floating in your bloodstream. Free testosterone means testosterone molecules that are not bound to other proteins in the blood, like shbg. Sex hormone binding globulin is a protein that will bind to testosterone and make it unavailable. It cannot get into the cell, so now it can't have its actual biological effect. And so the, the free is so important. I've seen guys that, that will have a very high testosterone, total testosterone level, let's say it's 800-1000-1200. But their free is in the tank because their SHBG levels are so high. And that's why it's so important to check both the free and the total teeth.

All right, I've got a real expert here. I gotta ask you an interesting question here. What I've found over the past decade or so guiding people onto the, onto the bulletproof diet, into getting a cyclical ketosis. High saturated fats, you know, low sugar, low toxin kind of diet, low inflammation is almost universally testosterone goes up and SHBG can often go up, especially if they're a little bit low on the amount of carbs they need. So it's not always ketogenic. You can cycle in and out if you need to. You're usually a little bit keto in the morning. So what do people do to lower sex hormone binding globulin? And for listeners, this is something that everyone has that floats around and it steals your sex hormones and your body makes it. So how do we stop that?

Yeah, great question. And there's not a good answer for you there, Dave. I get that question almost every day from, from guys. And the answer is stinging nettle root is a supplement that herb has been shown to help boron may help a little bit, although I think the data is there. Pretty weak sarms, you know, selective and receptor modulators, which is a whole other topic. Those will, will make your SHBG plummet down to zero, which. Now you're wondering, hey, is, is that a good thing, you know, to, to make it.

Which sarms will drop that.

So there are a couple ones, a couple of them that will do that.

Name them.

I, I don't use them myself. I've heard about them. I don't prescribe them because I, I don't like having that much of a, of an effect. I feel like there's something unnatural about lowering SHBG that much. But, but short answer, to answer your question, there's not something great that I can recommend for guys to lower shbg. What we typically have to do is get your T level higher to accommodate, to account for the fact that a lot. There's a lot of shbg.

Got it. So raising testosterone. I've also seen a couple studies on egcg, which is a green tea extract, and probably calcium D glucarate, which is great for getting rid of excess estrogen. Anyway, we don't have any idea what having no SHBG does to you. It could be, I mean, you could grow a tentacle coming out of the back of your neck. Actually, I want to try that.

That's a common approach where people get so focused on one single thing. I want to lower shbg. And, and from a systems biology perspective, we have to understand that everything is connected. And when you're making that change, you don't know. Know how it's affecting other systems and you don't know what other impact that may, that could potentially have. And so, you know, I would just caution people trying to impact one particular protein, not knowing how it may affect the whole system.

Okay. I, I love it. And it's totally true. If you become focused on just one number. Yeah. Other weird stuff is going to happen that you think about the big pharma way of thinking there must be one cause. And, and bottom line is, you know, if you move zinc, copper is going to move. You move copper, zinc is going to move. There you go. Testosterone, estrogen is going to move. So if you understand, you're conducting an orchestra and you can't just have all tuba all the time, otherwise it's polka. So there you go. Okay, so I think we've, we've hit testosterone pretty well and it feels like there's a bunch of stuff that's lifestyle that we haven't talked about as much. And I like it that you pay a lot of attention to lifestyle and your medical practice. So if you had to pick like three things that the average listener could do that are most likely to improve their hormones, what would it be?

Yeah, great question. Number one would be sleep. You know, sleep is one of the most underest, underappreciated aspects of our health. We know that poor quality sleep, not quantity. Poor quality sleep crushes your hormones specifically, it raises cortisol levels, pulse chronically elevated, cortisol is going to crush growth hormone, it's going to crush testosterone, it's going to crush thyroid, it's going to promote inflammation, it's going to promote insulin resistance, and it has a cascading effect that, that is incredibly harmful. I see so many high performing men who are executives, entrepreneurs, have a race car driver, I have baseball players. And those who don't focus on good quality sleep, they struggle. You can't burn fat, you can't build muscle, you can't get in shape, you can't optimize when you're not sleeping. I, I love having a data driven perspective on everything I, I, I talk about. And with sleep, it's so easy to get a wearable device. I don't care if it's a ring, a watch, a strap. I'm like, you know, I'm agnostic to brand, but track rem, track deep sleep specifically and make sure you're getting the good quality sleep.

And how much, how much REM and how much deep per night do you need?

So, and this is, you know, in general, typically about an hour deep sleep, about two hours of REM sleep is your target. And that may require different total quantity of sleep depending on the individual, depending on genetics. You know, we have clock genes that really regulate how, how quickly you can fall asleep, your risk for sleep disruption, and how much, much sleep do you actually need. And so it can be anywhere from six and a half to eight and a half hours that you need to get that good quality sleep.

So it's interesting, I'm looking at the comments from my mentorship group from the Upgrade Collective. They're in our live audience and they're like, that's it. So I get an hour and a half of each, even if I sleep five hours a night. And quite often I usually don't hit two hours of rem. That requires a lot of lions. And in order to get there for me, I had to get an hour and a half. But so only an hour is enough to raise testosterone in the the people.

An hour of deep sleep is really the target. I know it doesn't sound like very much, and, and remember, deep sleep tends to be in the first half of the night. And so that's when you're going to get that, that one hour. And then REM typically tends to be in the second half of the night.

Yeah, absolutely. Absolutely. The case in the first half is deep and the second half is rem. We've got Jeff here is like I get an hour of the deep and three to three and a half of rem. Everyone else here, hour and a half of each. Yeah. So it's possible to go beyond that even in a normal amount of time. For sure. For sure. And that leads to the question you've written. Male 2.0. Is female 2.0 coming next?

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You're listening to the human upgrade with Dave Asprey. Now he's you. The question you've written. Male 2.0 is female 2.0 coming next?

So Dave, I, I think it's worthy of brief mention here. So male 2.0 was my introduction to a new perspective on men's health. So male 1.0 is reactive. It's waiting until you're sick. It's waiting until you have symptoms so you have problems, until you have a heart attack, until there's some IC10 code that needs to be treated with a prescription medication. It's one size fits all model. It's, you know, typical disease model medicine. Male 2.0 is thinking differently. It's taking a very proactive approach. It's personalized. It's using genetics to individualize. It's taking a systems biology, data driven perspective. To me, that's what 2.0 is all about, is having an entirely fresh approach, approach. And we're behind the women, you know this, that the women are drivers of health care, health decisions. And most men, you know, we rely on our women to say to tell you go see a doctor already, damn it. Because most men just don't pay attention. So that's what it was all about.

If it's not bleeding or maybe seeping pus or something, guys typically won't go to the doctor until it's already been a lot. And I'm guilty of that too, especially when I was, when I was younger, you know, you just put it off and it becomes really expensive and difficult to fix. So yeah, you're right. Just in a typical family that, that can, that can be the case. So, but that, that said, I mean, it feels like the basic practices are similar for men and women. Yes, we both need sleep for hormones to work, we both need certain kinds of diets. People shouldn't eat at night. Right. But there are definitely monthly differences in Fasting that I wrote about and fast this way. And women need their testosterone too, but they don't break it down the same way as men. Do you. You said you do see women in the practice, too. Are women universally deficient in testosterone the way men are? Have they had a 45% decline?

So those studies were specifically looking at men. But we know that there. There is definitely deficiencies in women as well. And. And it's interesting you bring that up because most women don't even think about testosterone, how important it is when it comes to sex drive and muscle mass and cognitive function, that it's incredibly important for them as well. I haven't seen studies that show it's plummeted as much as it has in men, but it's definitely something that I think is underlooked it.

It's not looked at enough. And once women hit perimenopause and menopause, quite often, testosterone goes very, very low. And they're wondering, why do I not like my life? For sure, testosterone, yes, it makes you horny as a woman when you have enough of it and not too much of it, but it also just makes you, like, want to go do stuff. Like, that's actually the point in. In life for women who successfully transition through perimenopause. They report actually really substantial improvements in happiness when they're in menopause. Like, I finally, like, kind of have my wisdom, and I don't have some of the hormonal swings. Like, I feel like I've got things dialed in. And when you do that with enough testosterone, it is actually a really potent and powerful phase of life. But if you're low on thyroid and you're low on testosterone, it's the time in life where you're tired all the time and you grew the largest bud of your entire life, which happens. You have enough thyroid and enough testosterone. So I want women to think about testosterone as much as men, because women love to have strong, lean, powerful bodies as much as men do. We just need different doses. So. And I think it's possible. I know way too many women friends who solve this problem, and they're so incredibly happy with their bodies and with their lives, with their energy levels. And I know ones who haven't or just won't. And generally speaking, these are the two biggest variables that I know of. And yes, they're tied to sleep and nutrition and all of that.

Yeah. And, you know, it's like a symphony. You know, it's that we. We tend to focus on just one hormone, like Men and testosterone, you know, testosterone, men, estrogen in women. But it's understanding that it's, it's thyroid, it's cortisol, it's growth hormone, it's vitamin D, it's nitric oxide, it's insulin, it's, it's all these other hormones that, that get overlooked and it, they all come together in this milieu. This, this system that is complex and to try to simply simplify to one single hormone is really doing our patients a disservice.

It is. And to counter the disservice, you're doing something really cool. I don't think anyone's done this on the show before, but you're giving away the digital version of your book and another like 10 secrets to high performance. All you have to do is text the word Health to 26786. So you gotta pick up your phone, type in 6 in your text messaging thing and just type health. And he'll send you the whole book, which is a short and easy to read book that's talking about here's what's going on with it. I'm not going to say it's an advanced hormone hacking biohackers guide to everything, but it's, here's what you need to do. So you're listening to the show. Maybe you haven't taken action on things or maybe you're just thinking about it. This is exactly what to do. So text 26786 and send the word health to it and you'll get the book as just a gift I like to ask guests to give back to the audience. So there you go, you got something back. What else have we not talked about? Like lifting heavy. Is that a big part of testosterone?

You know it is, yes. You know, when, when you look at where the natural ways that you can boost testosterone, it's sleep, it's reducing, you know, chronically elevated cortisol, it's insulin sensitivity, it's strength training, it's, you know, proper healthy nutrition. But I'll tell you, Dave, if you have a guy who has a testosterone of 270, if I got him to start aggressive strength training and sleeping and controlling cortisol and fixing micronutrient imbalances all and fixing it. We haven't talked about microbiome at all, all these other aspects of his health, am I going to get that testosterone level to a thousand? No, there's no freaking way.

Even if he lives on a dozen egg yolks a day, there's no way. A bunch of butter by the Way I did that, I got my levels to 700 when I went off testosterone testing out the bulletproof diet. You have to sleep like crazy. You weightlift twice a week like it's, it's insane. And I couldn't get it up.

So, so the answer question, yes, it improves sustainability. Testosterone guys are always saying, well, can I naturally improve?

Yeah, you can improve.

You'll get from 270 to let's say 480. Yeah, awesome. Now it's time for testosterone therapy because you're not where you need to be.

Or you can start testosterone therapy right away and then do the actions and enjoy your life better and get more results in less time.

Yeah, yeah, but, but I also talk about going beyond testosterone because we know that from a systems biology approach, you need to look at all these other aspects of health and you know, microbiome. For example, I've seen so many men who have issues with dysbiosis and issues with Candida and issues with leaky gut and they had no idea. And they were on testosterone and they're coming because of Doc. I'm on T and I still feel like crap.

Yeah, right.

And there's all these other things you got to look at. It's complex.

Yeah. Okay. Are you hopeful about where medicine is going to from this perspective?

I am incredibly excited at the direction we're heading. I am looking for more providers, more doctors, more practitioners who embrace high performance health and take a personalized, data driven approach, knowing that disease model medicine doesn't work and we're failing. And you look at the, you know, the healthcare expenditures and the deteriorating health that's going along with that and something's got to change. So I'm very excited. And where we're heading, Dave, I think.

We'Re heading in a direction where the government's going broke. Medicare, Medicaid don't work. Like literally, people go to the doctor. We're all fighting to make our employers pay more health care costs, but we already spend way more money than everyone else. We just aren't getting results.

It's not working.

So the politicians ultimately are going to get blamed because, well, they're the ones in charge and they can print more money to give more money to drug companies that don't solve the problem. But if people are continuing to be fat and tired and sick, ultimately it is the government's fault. I'm not saying it's one person in government. It's the entire system of government. We're going to have to fix that in order to fix this problem. So I am not a particularly political guy. I don't think governments solve problems. It's their job to keep people from killing you so you can get stuff done. But I am not happy with the current situation because the amount of money that we're spending is enough to put every person in the US and actually in all of developed, all of the developed world right now on appropriate hormones. It's enough money. Just what we spent in the last two years on very, very small risk things was enough to fix the food supply for all kids in the country permanently. That kind of like incredible scale of stuff is just being wasted. So I'm. I am hopeful that we now have the knowledge and the ability, and I'm a little skeptical that we're going to deliver it to everyone at the cost that it should be. And that will happen because we need you and we need lots of other people like the A4M leading the way. We need people listening to the show who show up at the office 40 pounds lighter when everyone turns their head and goes, what the hell did you do? And why are you so happy all the time? And why did you just get a raise going? Yeah, I stopped eating omega 6 oils and I started taking the right hormones. And magically, I like my life. Because when you see this, it doesn't matter how many drug ads you see on the radio, you're going to see the people change. And my call to you listening to the show is that if something really made a big difference for you, don't be that guy who tells everyone what to do. Instead, be that person who just waits until someone asks. And when they ask, offer it and offer it freely in a helpful spirit. You'll find that the people ask care. The people who don't ask feel criticized by your success, and they'll sabotage you so you can silently get lean and strong and thin. And when people go, oh, my God, what did you do? That's your permission slip to evangelize. All right. The other thing people can do, if they are in Florida, they could certainly go see you. You said you're in Sarasota. And if. And if they missed it, you just can text the number 26786 in the code Health to it and get a copy of your book. And so we've talked about food and we've talked about exercise, talked about testosterone. We've talked about thyroid. We've talked about men and women. I feel like we've covered most of the big topics, all these other things that are going on, but When I asked you for three things people could do, you talked about sleep.

We got distracted. Yeah, we did. And I'll just mention, yes, I'm in Sarasota, Florida, but we do a ton of telehealth. I work with men around the country, men and women around the country, high level program. We actually fly patients into Sarasota if we need to see them in person. But we do a lot of work throughout the country via telehealth. So for the listeners, but, but yeah, to go back to those three things, the first one I would say without question would be sleep. The second one would be, you know, as it relates to cortisol becoming resilient to stress. And when I say that we know that that stress is killing us and, and it's not that we need to eliminate stress from our life because you can't distress everywhere. It's understanding how to put it in a different perspective and how to frame it differently. There was a great TED talk from Kelly McGonagall years ago, talks about how stress can actually be a of part positive thing. It can be a good thing if you frame in the right way and understand that stress is a positive. And so it's, it's, you know, incorporating mindfulness practices, incorporating meditation, incorporating ways of reducing stress, creating a work life balance that's so important for a lot of high performers where they're working 16 hours a day and you're not going to get optimized when you're, you're living that kind of life. And so there's definitely a need for balance and how to regulate the effects of stress on your life. And then the third one, I, I would, I would say that if we're looking specifically at lifestyle here, I would really say create consistent behaviors. And when I talk about that, it's this high performance mindset of living with intention. So everyone knows what to do. You know, you're supposed to eat. Well, we could talk about bulletproof diet. We could talk about getting rid of all the, the, the seed oils and all of the, the sugars and all the, the crap in our diet. We can talk about strength training, exercise. Everyone knows how to do that, Dave. You know, you know, everyone knows what to do, but no one does it. And so what it comes down to is living with intention. And how do you do that? How do you get someone to create consistency in their life? Well, it's focusing on your why. What is your why? What drives you? You know, for me, it's my beautiful wife and amazing two little kids that's my life. That's everything. And so every micro decision I make is how can I be the best husband, father, and leader that I need to be? And when you become clear about your why, dude, every micro decision becomes so easy.

Tracy, I'm going to argue that that's only your why. Because you have enough testosterone. You would not say what you were saying with the conviction you say it. If your Testosterone levels were 200, you would not feel those things.

Well, I, I tell you what, it's a, It's a chicken or the egg. It's, It's a cyclical. I, I get what you're saying, but those are still, for me, Dave, what is most important in my life? And that when I make decisions, it's around my why. You know that it's being centered. It's living.

It's.

It's having. It's having intention and having purpose. And so many guys don't have that. They don't have that direction and they're lost. I, I see so many guys who will have four, five, six drinks a night. Is that a problem? Yeah, of course it crushes you. And, and so it, you know, when it comes to lifestyle, it's the boring stuff that no one wants to hear. And they're like, yeah, yeah, I know I'm supposed to sleep, I'm supposed to eat clean, I'm supposed to exercise, supposed to med. Yeah, yeah, yeah, I don't have time for that. But that's what's so important. It's slowing down and recognizing that creating that consistency is the key.

Yep. I love consistency. It's a big one. So you've got, in terms of things to do, you've got sleep, you've got consistency, and what is food?

The third one, we talked about stress. We talked about the, the.

Okay, so stress is the other one. So it's. But it's okay. Yeah. So stress and consistency are your big three. Okay. What does porn do to testosterone?

Porn. And, and this is interesting. When, when there's arousal, testosterone will go up. When there's climax and completion, it will come down. And so it, it, it does have a detrimental effect in excess. The, the biggest problem with porn is it crushes you from a, a neurotransmitter perspect dopamine sensitivity in the brain, and it affects your relationship with your partner. It creates these unrealistic expectations where you need more and more stimulation. And so that's really the bigger effect that porn has is at a central level, affecting you.

I've seen some studies that show that cold exposure helps with dopamine sensitivity and even that caffeine can help you have more dopamine receptors. So if you do cold exposure and drink coffee, is that a permission slip for a little porn?

I think you know the answer to that sarcastic question.

I tried, guys, I tried. For you, porn is bad for you. Generally over time it'll probably suppress desire, which will probably suppress testosterone. We don't really know. So it's, it's pretty funny. Anything else that you would want people to know about hormones, about your high performance perspective on medicine that I haven't asked you? Yeah, thanks.

I think that the take home message is really to understand that we are complex and that there's never one simple single answer. And it's about diving deep, finding the hidden blind spots that are holding you back. And it may not be what you think it is. You may think it's testosterone, but it may in fact be thyroid or growth hormone or vitamin D. Or it may be your microbiome or maybe cortisol or maybe organic acid issues. It may be so many other things that you gotta dive deep and find the hidden blind spots to really achieve.

The results you're looking for algorithmically, if you just play the odds without being customized at all. I feel like if you just take an average person who is fat and not feeling good, thyroid, testosterone, cortisol would be the first three things I would look at. And after that I look at toxins. Sure, right. Am I kind of, I mean, it could be vitamin D. And by the way, you, of course you want to take vitamin D, but you know, it could be lots of other things, but it feels like if you could do those, you're going to get like 60% of people well on their way before you have to start dealing with the stuff further down from there. Is that kind of a good filter?

I'll say. There are certainly things that are, that are more common than others, but when you do that, you run risk of missing some really big hidden blind spots are holding you back.

Yeah.

You know Bob Harper, trainer on biggest lure. 51 years old, guy has a heart attack earlier this year. He's in the best shape you can imagine and he has a heart attack.

51 doesn't stop heart attacks. That's so weird.

Imagine that. Right. So, but that's a great example of how you think you're doing okay. But you have no idea what's going on under the hood.

Yeah.

And so you know what I do? I work with high performers. I'll plug your race car in the computer and I find out exactly what's going on and what systems need help. And typically a system that you had no idea that there was a problem.

That is a hundred percent true. And that's why I recommend if you can afford it, go to a functional medicine doctor. If you can't and you're gonna sell, you're gonna do it yourself. Like an at home biohacker. Like I was in college, you know, working at Baskin Robbins to pay your way through before you start a little e commerce company. Well, it's okay to find a discount thyroid test online and you know, do do your best, right? And so if I just tell people with a lack of data, you can go with the odds. Your best bet is to get the data, like I said, plug it into the computer, see what's really going on and do it. And as you progress in your life, your risk of all this stuff goes up and your ability to take control of it goes up as well because you have more means, more knowledge and all that. So my recommendation there is, if you can afford it in your 20s, get a testosterone panel and a full hormone panel because then you'll know your healthy numbers. And it's entirely possible, like one of my friends, she's got very high testosterone, almost high enough to be a man, but she's a very feminine woman. So for her, her testosterone level, knowing that in her 20s, when she's in her 60s, she'll be able to have the right testosterone for her that no doctor would recommend unless they knew that data. And if you're a young guy and your normal testosterone level is actually 1500, which is relatively high in today's world, if that's your number, that makes like, yeah, this is just when I'm living my life. Well then when you're 55, you're still going to be living your life instead of going, I wonder why it doesn't work when I'm at half my normal level because that's what most guys need. So the customizations and important and we've got to focus on that. So, so Tracy, I, I really appreciate it. And guys, if you're listening, it's Dr. Tracygappen.com G A P I N. Thank you very much for being on the Human Upgrade guys. I will see you on the next episode or maybe at the biohacking conference.

Thanks Dave.

You're listening to the Human Upgrade with Dave Asprey.

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