Natural Treatment For ED with Dr. Tracy Gapin MD

This podcast is for you. The modern man. I'm Dr. Anne Truong, your host. I'm an intimate health medical doctor and best selling author of the book Erectile Dysfunction Fix. I'll do a deep dive into sexual health and performance and how it affects men of all ages and backgrounds. So let's get started and be sure to visit my website@sexualhealthformenpodcast.com for more information and resources from the show. See you on the inside. Hello there. Do you feel like you're not performing at your best? In this video with our special guest, I'm going to share with you some secrets to help you reach peak performance. I'm Dr. Anne Truong and in this video I want to talk about how you can achieve peak performance in all areas of your life. And I'm here with Dr. Tracy Gapen, urologist and sexual health expert. And whether it's work, school, relationship, these tips will help you get there. I will appreciate if you subscribe, leave a comment or stay to the end of the video. So, Dr. Gappens, welcome. Thank you for being here.

Hi Ann. Thanks. Oh, you bet. Glad to be here with you today, huh?

Yeah, I know.

Glad to be here with you today.

Yes. Well, Dr. Gapen does everything for personalized executive health for men's health as well as women's health. And I was so impressed on his website that we had a hard time concentrating what we want to kind of talk about today. But we want to touch upon something that is new and sometimes hard to explain. Can you talk a little bit about epigenetic and what that mean?

Yeah, sure. So the term epigenetics, it literally means above the genes. Now what it really means is we recognize now that our DNA code is not our destiny, so to speak. It's not going to always translate to identical expression. It's affected by our environment, our lifestyle, our actions, our behaviors. And it means there are methylation processes. There are adjustments or alterations to the chemical code of our DNA that will alter its expression. So let me give an example. We know that certain foods can turn on or turn off certain genes. We know that certain behaviors, like exercise, for example, can turn on or turn off different genes. And so by affecting the way these genes are folded and affecting methylation patterns on these genes, it can affect whether genes get turned on or off. And so think of it like a dimmer switch, if you will, to our genetic code. And so what this means is that we have a very clear understanding that our behaviors, our actions, our lifestyle actually matters when it comes to how our bodies perform, and that comes to whether we're looking to lose weight, whether we're looking to regain energy, whether we're looking at better sexual function. We have a very clear understanding that it's not just our genetics that define how our bodies work. Epigenetics means that we can actually affect that.

I see. So it's kind of like, well, here's your genetic code. You don't have to live with it. That depending on what you do with your lifestyle, your diet, your exercise, you can affect the way it will be turned on or turned off.

Yeah, that's right, exactly. And I think a great example would be the APOE gene. And this is a gene that we talk about commonly as a great way to demonstrate how this works. So the APOE gene is a lipoprotein that regulates how our bodies process, metabolize saturated fats. For people who have certain variants of the APOE gene, they're at a markedly increased risk of developing Alzheimer's disease, dementia, cardiovascular disease, at a very young age, based on their DNA genetic code. All right. However, we found that for those people who have that genetic variant who are at risk if they alter their diet such that they have a very low intake of saturated fats, red meat, dairy, for example, or they limit sugar intake, those individuals no longer have that increased risk of Alzheimer's disease, dementia, cardiovascular disease. We are altering that genetic expression simply by our behavior. That is what we're eating. So that's a great example of how our behaviors, based on our genetics and understanding our genetics, we can pivot and adjust our behaviors to match those genes to affect genetic expression. And that truly is how epigenetics works.

Well, that is interesting, because you don't have to be a victim of your genetic code, and you certainly have a say what can be expressed by how.

You.

Control your lifestyle. So, you know, having said that, can you use the epigenetic code and lifestyle to tweak? How do you do that? To tweak performance and for sexual health?

Yeah, sure. So when we look at sexual performance, it comes down to ultimately our systemic health. Okay. Oftentimes, sexual function is thought of as an island functioning by itself, but in fact, you need healthy vascular flow. You need blood flow. An erection, after all, is nothing more than just increased blood flow to the penis. And so we think about, well, how did that happen? Well, you need a hormone called nitric oxide. Nitric oxide is a hormone in our body that will cause the blood vessels to vasodilate or relax, allow increased Blood flow. We need nitric oxide when we're exercising to increase blood flow to our heart. We need to increase blood flow to our muscles that we're training. And so nitric oxide is a key hormone that will cause this vasodilation. Well, when we have problems like insulin resistance, which is related to how our bodies process and handle glucose, that doesn't work. It doesn't work. You can no longer produce the nitric oxide levels that you need to produce that vasodilation that's required. And so that's the connection how our lifestyle, our behavior, specifically in this example, simply glucose regulation, blood sugar regulation affects nitric oxide production, which is what's needed for an erection. And so this is why it's so important that we understand that a systems approach to health, systems approach to sexual health specifically even, is so critical because stress and sleep and our toxins and our nutrition, they all matter and directly affect that function.

Well, I love the way how you correlate the diet and insulin resistance, which means that, you know, insulin is not as sensitive and moving the blood sugar into your cells anymore, but it's more blood sugar stays in the bloodstream, affect nitrous oxide and then nitrous oxide will affect the blood flow and therefore you're not getting an erection as you used to be. Because Viagra works by, in, by increasing nitrous oxide as well. So does that mean that if you have insulin resistance, you take Viagra? The Viagra doesn't work as well or not really.

Exactly right. Yeah, you're relying on the endothelium itself. The lining of that blood vessel is what is actually secreting the nitric oxide. And when that's disrupted, that would be one of the reasons why those oral medications may not be as effective as otherwise.

Very, very good point. So for our listeners, what you eat will affect your blood flow and therefore your erectile function. So having said that we're talking about blood flow, let's talk about some regenerative. My favorite area to talk about regenerative treatment for erectile dysfunction. And to clarify, regenerative treatment is innovative treatment that kind of help your body heal yourself and treating the cause of the problem. So can you discuss about some of the method that you use?

Yeah, absolutely. And I want to just emphasize what you just pointed out, that there is a very clear distinction between short term band aid solutions for ED and long term restorative regenerative options. So when we look at the band aids, those are things like, you know, a vacuum erection device or Viagra cialis oral medications, injection therapy. But those are all short term solutions for just simply, guy wants to have an erection tonight, what do I do to turn it on right here, right now? I don't care about fixing it long term. And those may or may not work for you, but that's a short term solution. When we're looking at long term, how do we fix the underlying root cause or the culprit here that's causing the sexual dysfunction so that I can function normally long term? That's the regenerative solutions that we're talking about here. And so some examples of those would be, number one, low intensity shockwave therapy. Now, low intensity shockwave therapy is the technology that we use to treat kidney stones. It's the same technology where we can deliver sound waves through the skin, through the body, deep below the skin, below the surface, to focus on a target. Now, you can do that for kidney stones, but what they found also is when you do that to vascular tissue, what does it do? They found that it actually promotes stem cell activation, which will effectively produce new blood flow, lay the foundation, lay the pipe, so to speak, for new blood vessels to form a process called neovascularization. That neovascularization will increase blood flow to penis. And that has been shown clinically to improve sexual function. And so gainswave is a treatment out there that adopts that approach, that technology of low intensity shockwave therapy to stimulate repair of blood flow to the penis. There are two other regenerative options that we have as well. The next one would be prp, which is platelet rich plasma. A lot of people are familiar with PRP because it's very popular in the orthopedic arena as well. It has a lot of regenerative properties. What we do with PRP is we draw a person's blood, we spin that blood down in a centrifuge so that we can separate or isolate out the growth factors, the platelets, which are very concentrated in cytokines, chemokines and growth factors. And then we can inject that into an area of the body to effectively promote growth, healing, repair. And so this is often done in joints. I had elbow surgery three months ago, and that was a treatment that was part of the surgery to put these growth factors at the area of the surgery. It's done in knees, done in shoulders, and it's also done in the penis in this case, for sexual function, for repair and recovery of sexual function. It's often combined with gainswave as an adjunct to that to improve the quality of the repair if you will. The third regenerative option that is available is what's called exosomes. Exosomes can be thought of as simply the secretions from stem cells. What are stem cells? Stem cells are the progenitor cells in our body from which all the cells come from. When you're an embryo, you're made of stem cells that are pluripotent cells that can produce any other cell it needs to, whether it's a skin cell, liver cell, bone cell, whatever you need. These exosomes are secretions from stem cells that can adapt to create whatever tissue is needed at the site of repair. And in this case, it helps, especially when combined with these other modalities, to improve neovascularization or increase blood flow creation to the penis. So long answer to the regenerative options for ed, right?

And treating the root cause of the problem, which is mainly restorative blood flow to the penis again by your own blood, which is platelet rich plasma. And using low intensity shockwave therapy or gainswave, which is delivering sound wave technology to restore blood flow. And then exosome is tapping into progenitor or stem cell therapy with little, these little vesicles that are being produced from the stem cell and putting healing superpower, healing to restore the function of the penis again as well. So that's exciting. What about peptides?

Yeah, peptides are truly amazing. So peptides for the listeners are nothing more than signaling molecules. They are chains of amino acids. They're short proteins, if you will. So what that means is a chain of amino acids over 100amino acids in length, is technically called a protein. That's the definition of protein is a long sequence of amino acids. A peptide is simply a short protein. Anything less than 100amino acids is considered a peptide. Peptides are amazing at a variety of very individualized, personalized functions. For example, growth hormone is a peptide. Insulin is a peptide. The thymus gland, as it when we're a baby, a thymus gland is very important for producing immune cells that our body needs to provide promote normal immune function. As we get older, the thymus gland will shrink, will involute. There are peptides that come from the thymus gland that are amazing for helping our bodies boost our immune function. So that's an example very specific use for peptides. We have peptides that come from stomach enzymes that are very effective at reducing inflammation, especially in the gut. We found that same peptide, when given sub Q or intra articular in a joint, can massively reduce inflammation. This peptide is called bpc BPC can also actually be used. And some studies have shown that it may actually be helpful for erectile dysfunction by again, reducing inflammation, systemic inflammation. These physiologic processes that are happening throughout our body, inflammation, insulin resistance, oxidative stress, all these processes just affect our body, don't just affect our belly and our brain, they're affecting our sexual function as well. And so these peptides can be used for very precise indications for patients who need them to aid in reducing inflammation, to reduce visceral fat, to boost repair and recovery, to help sleep, to help reduce anxiety, improve cognitive function and memory and focus sexual function. Libido. There's a peptide for almost anything you could imagine, they've isolated a peptide. And so it's a great arena of precision medicine. I'll caution everyone that peptides are not magical. And you got to have the foundational aspects first. You got to have your hormones properly balanced, you have to have your nutrient levels optimized. You need to take care of all the foundational nutrition, stress, sleep, fitness, all those kinds of really important aspects of your health as well. But peptides can give you that added edge as well.

That's wonderful. Yes. When peptides first came out, I thought it was a great tool for physician to use and adjunct to all the tools that we use as well. And I like how you mentioned that, hey, let's really look at the basics and start at treating the root cause from the inside out instead of just a short term solution of medication for something and just treating the symptoms itself. So for a man to be in peak, not only sexual health, but even in peak health, what would you recommend as some key basic things that he can do now? You know, if you're a man in his, you know, mid-40s, he in good health and he exercises, but he want to maintain feeling that way till his 50s and 60s. What are some quick steps that he can kind of do, you know, two, three steps he can do now to kind of maintain his peak performance?

So my center is not called Gavin Institute for High Performance Medicine for nothing. So I love the question you just asked. So I really believe that the success that you achieve in any area of your life is really completely dependent upon your health. And so when we talk about high performance, what does it really mean? It means optimizing your body and your brain so that you can really operate at its highest level. And so when we look at things that we can do, it's understanding that our body is this complex system, system, and we need to treat it that way. And we need to understand how everything interrelates. We've already talked about nutrition, we've already talked about how inflammation, all these other physiologic processes can affect things. And so I look at things like sleep. First of all, you know, I work with so many high performers who have crummy sleep and what that's doing to give you a sneak peek behind the scenes in your body. When you have crummy sleep, whether it's intentional, you're staying up too late to, to grind those few extra hours and you're not getting enough good quality sleep, or it's unintentional because other processes affecting your sleep that you either can't fall asleep or waking up throughout the night. But if you have disruptive sleep, what that's doing is that's raising cortisol levels, that's crushing DHEA levels, that crushes testosterone levels, that crushes thyroid, that causes you to store fat, that promotes inflammation, that affects your mood and it has a trickle down effect. So you see, all I touched on so far is just sleep. And we see the dramatic cascade of events that results from nothing more than just crummy sleep. And so focusing on good quality sleep is paramount. A lot of sleep hygiene, I could spend an hour on that. But in general, limiting blue light devices at least two to four hours before bedtime, limiting foods that are high in potential amino acids and glut, specifically glutamate, that can affect neurotransmitter production at night is important. Getting good sunlight exposure first thing in the morning has been shown to be very effective for our sleep centers at night, believe it or not, focusing on temperature of your room, focusing on EMF near your bed, focusing on any light that's in your room. What kind of mindfulness relaxation techniques are you adhering to in the evening? You know, I like to say within two hours of bedtime, there should be no phone, no iPad, no laptop, no tv. You have a couple things you can do in those two hours before bed. You can read, you can meditate, or you can have sex and pick which one you want. But those are great ways to get you in a state for relaxation, for sleep.

Oh, well, definitely think about sex if you can, right? And reading will stimulate your mind. And I have to say last night I was not abiding through that quality of sleep. I was reading and my mind started racing and didn't get the quality of sleep that you say. But I love the tips on and you know, almost like resetting the circadian rhythm again and getting your Mind to slow down right before you go to bed and trying to restore the cortisol level. So it's amazing how sleep really create a cascade of hormone affecting the thyroid, thyroid, the sexual hormones, and then your cortisol level and then contributing to weight gain on top of that as well. So the number one thing to do is make sure you get good quality sleep. So how do you find good quality sleep? Is it just a quantity of time that the person is sleeping or the amount of time he has to be in rem?

So I am a huge believer in metrics and tracking data. And to do that, we need to have technology. We need to take advantage of technology and leverage it to gather that data. And so I'm a believer in wearable technology. I have a device that I always wear. I have three devices that I'll rotate between, but there's one that I always wear.

What is that? What are the three things you always wear?

Oh, so I happen to have a Garmin right now, which I love, and that's probably the one I wear the most. I have an Oura ring that I wear as well. And then the third one I played with Whoop. I played with Biostrap, I played with Fitbit, I played with the Halo. And I try to be agnostic when it comes to devices, and I'm not here to sell any particular brand. Each of them have their pros and cons, and I'll have patients who will not want to wear a certain device. One of my clients is, he's a race car driver and he just will not wear a ring, for example, and he hates watches. Well, that creates a challenge. So we got to figure out what will he wear. And so it's whatever device you're going to wear consistently and reliably is the best device for you.

Oh, I like that. I only wear an Apple watch, and that's the only thing I can wear because I tried the OURA ring and it's just too uncomfortable for me to wear. And I have small fingers. But I love wearable. And so having said that, I think that Dr. Gapen has given some really great tips and advice that the listeners can start right away to continue your peak performance, whether sexual health or just general health, and maintaining your longevity and just wellness. Start with simple things such as sleep and wear your favorite wearable technology to monitor that. And I always kind of stress, you know, at least seven hours. And if you're dreaming, that's good because you're in REM sleep, so you're resting there as well, too. So with that, I like to stress to our listeners, how can they get ahold of you or find out more about you? Dr. Galpin?

Yeah, sure. So you can have your listeners text the word Health to 26786. And I'm going to share with you a couple things when you do that. Number one, you're going to get my secrets to high performance health, my top 10 key drivers to high performance health. You're also going to get a digital copy of my best selling book mail 2.0 and you're going to get a link. If anyone wants to jump on a call with me and my medical team to see how we can help you take your health to the next level, you'll get that information as well.

And what number did they text that to?

You text health to the number 26786. That's health to 2678.

All right. So we'll definitely put that in the show notes as well. So that way you can get the book. Right. And I think that those are also on your website as well too. Right.

You can, you can get a copy of the physical copy of the book if you like, from my website, drtracygappen.com limitless. Absolutely. And that's just free. Free. Just cover the cost of shipping.

Well, thank you for being on this episode. We have so much to value bombs that you give us today. And we'll see you next time. Thank you.

You got it.

Thank you.

Sam.