The Truth About Testosterone Collapse | Peak Launch Founder Dr. Tracy Gapin

Speaker A: You talk a lot about traditional healthcare being very reactive. Tell us a little bit about your background, your journey.

Speaker B: I spent 20 plus years in traditional medicine. I'm doing robotic surgery, saving lives every day. I'm so busy that I neglected myself until I wake up one day and I'm suddenly 30 pounds overweight, stressed out, not sleeping well. So I go to a concierge doctor, he's going through my basic labs and he tells me basically you're fine. And I'm like, well, I'm pretty sure I'm not fine. I had to really humbly recognize that here I was as a men's health extraordina and I had no answers for myself. That got me studying, going down rabbit hole after rabbit hole. I learned all the stuff they don't teach in medical school. What was frustrating for me was to finally feel what it's like to be a patient and not be heard, not be seen. All the doctors looking at are these crummy markers that don't tell you anything. I now have a newfound love for medicine again. So fast forward many years later of planning and preparing, I built Peak Launch to help other leaders like myself who are struggling, who want to have the energy and the focus and the resilience to be able to perform at a high level every day. It' about treating biomarkers or numbers. It's about really how you show up and perform every day. Our traditional healthcare system is built around disease and crisis and problems and treating acute situations. Until one day suddenly you realize, what the heck happened to me? How am I 30 pounds overweight? How do I feel this bad? How am I this miserable? But it doesn't happen overnight. It's a gradual decline and we normalize it. Our traditional healthcare system does not address that. And that's the big deficiency.

Speaker A: If you're approaching 40 years old and you're anything like the rest of us, you've probably noticed that you're not feeling like you did back, oh, I don't know, in your 20s or so. Today's guest, Dr. Tracy Gappin, spent 20 years as a board certified urologist. When he started to recognize that he was starting to lose energy and burn out. And after recognizing that, western medicine had no real answer for what we have just accepted as aging or how we feel as we get older, Dr. Gapen quit his traditional practice and started a health optimization practice that has become recognized across the world as one of the best. If you don't quite feel like you did when you were younger or you wonder, what can I do to get back to the way I used to feel. I think you're going to love this episode. Boundary breakers is brought to you by Carter and Clark. I am very excited about this. I want to hear all about everything, but let's just start out. Tell us a little bit about your background and sort of your, your journey for how you got to where you are today.

Speaker B: Sure. Yeah. So I like to say I'm a recovering urologist. So I spent 20 plus years in traditional medicine in that disease focused world, which we'll talk about. But about halfway through that career, I'm busy. I'm treating prostate cancer. I'm doing robotic surgery, saving lives every day. And I'm so busy, focused, grinding, taking care of my patients that I neglected myself until I wake up one day and I'm suddenly 30 pounds overweight. I am, um, stressed out. I'm not sleeping well, I'm not taking care of myself. You know, here I am, the men's health expert, and I was a mess and I was miserable. I didn't like who I was and I knew I needed help, but I was too busy until my wife convinced me, go see a doctor yourself, get a physical. I'm 40 years old now. Family is going to be on, coming soon, kids, uh, on the way. And so I knew it was time to really start to pay attention to my own health. So I go to a concierge doctor here in town. I'm in Sarasota, Florida. And it was a very vulnerable, eye opening experience to be the patient on that doctor patient interaction for a change. Right? And I remember sitting on that exam table and I'm wearing nothing but one of those thin little paper gowns and it's barely covering some very important real estate, if you know what I mean. And he's going through my basic labs and he tells me, basically, you're fine, your cholesterol is high, so you need a statin, otherwise you're fine. And I'm like, well, I'm pretty sure I'm not fine. I don't know what it is, but I know, I know I need help. And I was a mess. I didn't even know where to start myself. And I had to really humbly recognize and acknowledge that here I was as a urologist, men's health extraordinaire, and I had no answers for myself. And so that got me studying, going down rabbit hole after rabbit hole, researching functional medicine and epigenetics and lifestyle medicine and hormones and peptides and really the science around what we now call precision performance medicine. And I learned all the stuff they don't teach you in medical school because we're taught how to treat disease, how to treat, Find the diagnosis code, treat the problem. And typically there's a drug that works for that. Right. And so with all of this newfound knowledge, I was able to get healthy myself, turn things around. And what was frustrating for me was to finally feel what it's like to be a patient and not be heard, not be seen. And all the doctors looking at are these crummy markers that don't tell you anything. He's telling you you're fine, you just need a statin. That wasn't my problem. I didn't have a statin deficiency. I needed help. And so when I was able to turn my life around, that really opened my eyes and made me realize this is my passion. This is why I now have a newfound love for medicine again. And so fast forward many years later of planning and preparing, I built Peak Launch to help other leaders like myself who are struggling, who want to have the energy and the focus and the resilience to be able to perform at a high level every day. It's not about treating biomarkers or numbers. It's about really how you show up and perform every day.

Speaker A: I love it. I love it. And, you know, the. You. You talk a lot about, well, I could call it traditional healthcare system being very. A very reactive approach. Right.

Speaker B: Where that's right.

Speaker A: Sort of wait around and if there's some. Then if something's wrong, our healthcare system sort of just reacts to it and fixes it versus kind of optimizing, getting, getting ahead of it. Right. So let's talk a little bit about that. And then I'd love for you to explain sort of the journey that happens to leaders, other leaders that you've seen over your career when you sort of get to that burnout phase.

Speaker B: Yeah. So you're. You hit the nail on the head there that, you know, our traditional healthcare system, which is suddenly getting a lot of backlash, and some of it's justified, but I believe that any system is designed to give you the outcome it does. Our traditional healthcare system is built around disease and crisis and problems and treating acute situations. So if you have a heart attack, get a kidney stone. If you're in a motor vehicle accident, you need our healthcare system. It's there for a reason, and it does very well at that. But most people, at least the ones who I work with, need a lot more than that. Right. They need cognitive function to be able to focus and make Quick decisions. They need to have, I call it leadership capacity. You need to be able to be resilient and strong and have the focus that you need, the energy that you need to crush your day and to lead your team and to take care of your clients and to build your business and drive revenue. And then at the end of the long, successful, fruitful day, go home and do it all over again for your family and be able to have the same energy and drive that you had all day long as well. And that's what's missing. Our traditional healthcare system does not address that, and that's the big deficiency.

Speaker A: And it's interesting, you know, we were talking, uh, just briefly before we started. I mean, I, I personally sort of fall right into. I, I, I think that the, your, your Target patient, right. Mid-40s. I've got five young children, business executive. And there's something that happens. I'm sure it's different for, you know, different ages, for different people, depending upon biology, but there's something that happens that, you know, I think sort of one day you wake up and, and think, you know, I just don't quite have what I had. Yeah, 22.

Speaker B: Yeah, right.

Speaker A: Is that a common. I mean, is this something that, like, men are too proud to say, but it typically happens to everybody? Is it what you see? Help us understand. Like, that story.

Speaker B: It is nearly universal. Okay? And it can be expressed in different ways. I've lost my edge. I don't feel like myself anymore. I'm just off. I don't, I don't, I don't even know who I am anymore. I don't have the energy I once had. I'm feeling old. All these different phrases around the same decline. And what has happened is this gradual, subtle decline that happens over years. We don't even realize it's happening. Right. It's so imperceptible every day, every week, every month, that we are declining and don't realize it unless we're doing something about it, of course, until one day suddenly you realize, what the heck happened to me? How am I 30 pounds overweight? How do I feel this bad? How am I this miserable? But it doesn't happen overnight. It's a gradual decline. And, and we normalize it. We continually lower the bar and we normalize that decline by saying, yeah, it's just part of aging. It's just the cost of success. It's just how it is. I call BS is not. And the framework that I built to explain why this happens is your biology drives your state Your state is how you think, right? Your energy, how you feel, how you show up every day. That drives performance. Biology drives straight, drives performance. And so many people are focused on, well, how can I optimize performance? What the common question I get, what's your favorite peptide? You're talking about performance. When we want to focus on the underlying biology that's driving the dysfunction that's driving that decline. And when you do that, peptides are great. I love peptides. You know, we can talk all about peptides. They're wonderful in the right context and nuance. But the key is, is that the client you're talking about is real and it's biological and it happens to all of us.

Speaker A: And it's interesting. I think there's probably something that's sort of in the male DNA or psyche, right, that, that doesn't want to admit, you know, weakness or defeat or that there's something wrong or I need something and. But it reminds me of, you know, every time you fly, they talk about, look, there's an emergency, you know, oxygen's going to come down. They always say, make sure you put it on yourself before you help others. You know that while you were talking, that sort of jumped into my mind, thinking, well, if you want to be, you know, optimize performance externally, whether it's a business or family or what have you, you first got to make sure you sort of put the oxygen on yourself and take care of yourself. Is that fair?

Speaker B: Yeah. And you know John Gray, I've heard him speak from Men are From Mars, Women from Venus. Heard him. Amazing, eloquent speaker. Love his books. But I'll, I'll push back on one of the comments. He talks about that men are not supposed to ever complain. Not. Men are supposed to never speak up. Uh, men are supposed to just be tough and resilient and, and, and if you don't have anything positive to say, if it's a, don't say it, don't bring it up at all. I look at it differently. I think that men need to start being in tune and paying attention. Hey, something isn't right here. Raise your hand and step up and get testing done. Find out what's going on, what's driving this. Why is it that my brain isn't the same? Why can't I focus the same? I had a race car driver who came to me because he felt decision making was off on the track. Like something was, uh, very subtle, but something was off for him. It ended up being issues in his gut. Like, you never know what's driving it? Until you step up and raise your hand and say, I need help, I need something. Something isn't quite right here. And so I love the oxygen mask analogy. I think that men need to be more willing to acknowledge, hey, something isn't quite right here. And it's not a sign of weakness to just get tested and see what's going on. And not the traditional blood tests that your primary care doctor does. Those aren't going to tell you anything. But I'm talking about advanced functional testing.

Speaker A: Okay, so let's talk about that. Right, so, you know, nearly universal. Right. So let's just go on the assumption that at some point, if you're trying to sustain some type of exceptional performance, you're going to feel this way. Right. So, so, all right, I don't feel quite right. So, so what is step one? What do you, what do you do about it? What's step one?

Speaker B: So the system that I developed, peak launch system, is test design and track. And it starts with test, really to find are the hidden constraints, the blind spots under the surface that are holding you back. And what's interesting is that almost every man we test, it's shocking to find what the issues are. And it's typically not what you might think. So we can look first at blood testing. And for blood testing, we look at hormones, we look at inflammation, we look at blood sugar control, metabolic health, we look at nutrient levels, we look at cardiovascular health. And there are markers, blood markers of each of those categories that your doctor, traditional doctor, does never check. Things like free testosterone and fasting insulin and homocysteine and apob and other markers that, that your doctor doesn't look for because they're not predicting disease, they're just, they're predicting early dysfunction. They're indicators, uh, of subtle decline. It's not like the alarm bells are going off. It's that something isn't quite working like it needs to. And that allows us to detect, find problems way before it ever happens.

Speaker A: Gotcha. So I guess in lay terms, I mean, primary care docs or traditional healthcare providers, they're looking to see are there any sort of symptoms or red flags that we need to reactively address. But what you're talking about is expanding the scope and looking for sort of indicators. Right? Or I guess that'd be lagging indicators, if you want to talk business speak. Right. But maybe not necessarily a symptom that you've got something wrong, but an indicator that, that something's out of balance. Or what, what, what are you Looking for.

Speaker B: So, uh, we are, we are trying to find early indicators of a problem. Okay. Lagging indicator is the term you use. I love that for traditional medicine, when they find a problem, it's very, very late in the process. Like you have kidney failure, you're having a heart attack, you have active signs of heart attack, you have gross anemia. You know, you have major problems with the blood work when they detect it. What we're looking at, uh, for example hormones, for example, your doctor is going to look at for men, total testosterone. Your doctor's going to look at it and there's this ridiculous wide range, which is nothing more than the average of the population, which is half what it was 20 years ago, by the way. They're going to tell you you're quote, normal because you fall into this ridiculous average of the population. But in fact it's the wrong marker because free testosterone is the active form of testosterone and total doesn't tell you the whole story. Free testosterone that most doctors don't even look at is a much better indicator. You could have total testosterone, that may be okay, but you're free, may be very, very low. That's an indicator that there's a problem when you have low testosterone. Now, it's impossible to build muscle, it's impossible to burn fat. It affects brain function, it affects memory, focus, concentration, mood, energy metabolism, bone health. And also it puts you at risk of cardiovascular disease as well. So a lot of problems. It's not just about sex and muscle.

Speaker A: Wow.

Speaker B: Um, so that's just one example of how the markers that we need to be looking at, your doctor, your primary care doctor just wasn't trained in. It's not, it's not like they have ill intent, they just.

Speaker A: Right.

Speaker B: We're taught about treating disease when we go to medical school. It's diagnosis and this is the drug to use to treat it. We're talking about early dysfunction and that's a very different story. And that's what's going to affect the things we care about. Energy focus, drive, resilience, strength, body composition, sex, and ultimately longevity.

Speaker A: Yeah, well, so it sounds like despite sort of what, what appears to be very common symptoms. Right. Like burnout, low energy, et cetera. It sounds like there's a variety of, of things that can cause that. Right. Like it's not the same in every middle aged male that's trying to sustain. Is that, is that fair?

Speaker B: Exactly right. There could be a constellation of issues related to hormones related to poor sleep, you know, poor deep sleep. One of the most common Issues I hear is men say they wake up at 2, 2:30, 3 in the morning, and that you think, yes, because you have to pee. It's not. Promise. It's not. You go pee, you get back in bed, you're laying there for half an hour. Why can't I fall back asleep? You're thinking about yesterday, tomorrow, and. And you know, your. Your sleep is gone. So poor sleep. It could be gut health, the microbiome no one talks about the gut, your poop, it controls the whole body, actually, remarkably, controls metabolism and energy systems, neurotransmitters in your brain, immune system, everything. The gut is a common source of problems. The last one I'll give you here, one that you've probably never thought about is cortisol. Stress hormone. Most men say, I'm not stressed. No, no, that's the next guy. I'm okay. I handle stress, Okay. I look at that as capacity, your body's capacity to handle load. Right? And anything that's a stress to your system, not just psychological worrying about business or finance or the kids or whatever. I'm talking about stress of alcohol, of poor sleep, of low hormones, of micronutrient. Deficiencies of all these underlying problems can drive cortisol, our stress hormone, up. I, uh, see it time and time again, especially in professionals. Founders, Wealth Advisors. It's very common where we're so driven, we're so ambitious. And I like to say, you know, that. That that trait is actually our downfall because it drives excess cortisol. And what cortisol does is it breaks down muscle, makes you store fat, it destroys, turns off hormones, turns off neurotransmitters, raises blood sugar, and you're now behind the eight ball. And so it's, it's understanding through testing all of these different facets and all these different things that are happening, and then we can start to understand what do we do about it.

Speaker A: That's so fascinating. So, so give us an idea. You know, in your experience, like, I imagine that there's some audience members that are like, well, yeah, that m sounds a little bit familiar, but I'm okay, right? Like, I'm not, you know, I'm fine. Uh, of. Of if you see a hundred, you know, potential patients. Right. How often is there some type of imbalance or something that needs to be addressed?

Speaker B: Most men who I work with initially think they're fine. Right. I'm okay. I just want to optimize. I want to see what can I do to optimize to be a little better. But I'm Energy's okay. My sleep isn't great, but it's not bad. I'm a little stressed, but it's okay. You know, my body's good. I work out, you know, and then we do the testing, and they're a mess. They're. It's, uh, an utter mess under the surface. And again, what's happening is we compensate, we adapt. We are massive adaptation. And being able to normalize this gradual decline because it hasn't reached a critical mass yet, but it's coming. And depending on where you are in that spectrum, it's going to hit you at some point. And, you know, you can either, you know, deal with it now or you can deal with it later, but I promise it's coming.

Speaker A: Yeah. Well, do you ever. Does anybody ever come that, uh, is looking to optimize, and you. And you sort of look at their results and you're like, you actually, you're.

Speaker B: You're.

Speaker A: You're okay. Like, you don't need anything every now and then.

Speaker B: Yeah. So some men who have really been working hard at it and have everything dialed in, there's only a few things. And, you know, the way I like to look at it, Brandon, is it's like a soundboard. Like, you go to a concert, you know, the guy in the back of the room has a big soundboard. All those dial. You don't know what the hell. Any of those dolls. He knows what everyone means, and they all matter. And if one of them's off, the sound is somehow off, as far as he could tell. I look at it like that, where every man, every woman is working with women as well. But our focus is men. Here we have a sound, and the question is which dials need to be tuned in or tweaked? And sometimes it's just a little tweak, but it can make all the difference in the world. And it may be nutrition for some men, hormones for another. Maybe gut health and maybe cortisol, maybe sleep, maybe toxins in your environment, maybe gut, who knows? But each dial matters. And that's really. That. You know, I would see for years, Brandon. Men would come into my urology practice. Two decades men would come in and they're on testosterone from some tea clinic down the street, and they're like, doc, I still feel like. And back then in my urology day, I didn't know any better. I'm like, yeah, let me. Let me give you more testosterone. I don't know. I didn't know any better. They don't teach us this stuff. In medical school. Right. Residency either. Now, what I recognize is for him, it wasn't cranking up that testosterone dial. It was finding all the other dials that need to be fine tuned.

Speaker A: Yeah. You know, it reminds me, there's a guy, a former Navy seal, who, who's so insightful, he's been on a bunch of podcasts, been on Sean Ryan show, a guy named D.J. shipley, who I follow a lot of his stuff. And he, he has this saying, he's constantly talking about living life with dials, not switches. Right. He says that, you know, we were born the traditional way of looking at things, that things are either on or they're off. Right. It's either a hundred miles an hour or zero. But learning to operate with dials, like it doesn't have to be offer on. You can just dial it down. Right. Uh, that life can be so much better that way. And it just reminds me of your approach, which, you know, you're suggesting the same thing. Right. These are, we have the soundboard, we got all these dials. And I think, you know, traditional medicine, it seems to be much more of switch. You know, it's like, look, nothing's wrong, so all those are off.

Speaker B: Good. That's right. Yep, exactly right.

Speaker A: And just the idea in general of optimizing, I just don't think that's been a part of sort of the general understanding of what we need to do health wise. We just, it's. It's either I'm, uh, I'm healthy or I'm not. If I'm not, I'll go to the doctor. It's becoming very clear, I think to me that I know I haven't been optimizing and that I need to get on this immediately. For those of us in the audience, I mean, I know I already asked what's the first step, but can you give us like a little bit of a better. First of all, if people could go to peak launch, right. Tell us about your practice, where they could go, and then what does this process look like from the patient standpoint?

Speaker B: Thank you. So let me just first circle back to what you just said, because you made a really good point that traditional medic medicine is all about disease or not. Diagnosis code, yes or no, black and white. This is a diagnosis code. And therefore, this is what drug we use to treat you. And it's all pharmaceutical based for that reason, for the most part. And that's really the flaw of western medicine. And again, I love it. For acute situations, when you need it, it still serves its role. But most of us want to perform at a high level. Running our business, leading our team, being, uh, a leader in the community, being a father, being a husband, whatever it is that you're focused, how can I show up and, and, and be what I need to be? And traditional medicine doesn't have an answer for that. It's very black or white, so you're spot on. So, so to answer your question about, about testing, I recommend every man get tested. And that includes blood testing, includes looking at things like the microbiome, which now we're looking at some functional testing, how your body functions, how it performs. So look at the microbiome. It's a simple poop test. We can look at things like cortisol, salivary cortisol, or urinary cortisol to look at your stress patterns, genetics, you know, with a simple cheek swab, we can look at hundreds of thousands of genes related to how your body works and what your body responds best to. So for example, what kind of food should I be eating? One of the most common questions I get is, you know, what's right for me? And there's paleo, there's Mediterranean, there's keto, there's carnivore, there's vegan, there's plant based, you know, all these different options and, and your genetics actually dictate what you're going to respond best to. And for some people, things like, you know, carbohydrates are good. I'm not talking about processed, refined, you know, candies or cakes. I'm talking about, you know, the, the high quality cars, but, but nonetheless, macronutrient ratios. How much carbs, proteins and fats your body needs is actually in your DNA. And we can measure that, we can look at what micronutrients might you need more or less of, how can we help your body clear toxins better? All kinds of amazing insights from the genetics. So I think every person should be getting that done as well. And I even argue that even kids should get that done because now you know your whole life, what your body needs, like your blueprint for your life. So genetics are a big part of it as well. And then we look at body composition, scanning and all kinds of other complex ways of really understanding what's working, what's not. And how can we really take to the next step, which, which is design of how do we create a plan that's going to help you based on your unique biology needs and that's going to be unique for every man.

Speaker A: Yeah. So how does it work? You know, somebody's in Minneapolis, right, Listening or watching this, and they're like, why do I need to find my. Like, how do I find, like, my. The equivalent of Dr. Geppen in Minneapolis? Or is it. Is it like, how does the pace, the doctor patient relationship work?

Speaker B: Yeah, so we do telehealth. We work with patients around the country. So any state. We have ways of working with you, and we. You know, what I really pride myself on at peak launch is it's not just medical care. Let me review your labs. Here's your prescription. Here's your hormones or peptides. I have an integrated team. And so what that means is most of the work is actually done with our coaches, where they work with you continually on refining what you're doing every day. So I mentioned test and design of the system. The third step, which is track, is how do we ensure consistent results? How do we m. Make sure execution is leading to the. The outcomes that we want? And that requires that we continually adapt. You know, life happens, right? You. You miss a workout, you have a bad night of sleep, your kid gets sick, you're traveling, you have cocktail party where you had a too m. Few too many drinks, and. And everything changes. You need to have a plan in place of how do you adapt? How do you dynamically adjust to the situation? And that's what we do, uh, with wearable technology and tracking and continual refinement of the program. Because what it cannot be if you want to get results is I'll see in three months. I'll see in six months. We'll check into the lab, test, and go from there. It needs to be continually adapting to the situation.

Speaker A: Yeah. That's interesting. That was my next question. Uh, I was going to say, what. So surely you don't talk to every patient every day, but you're getting. You're. You're. It's almost the next best thing if you've tracked their. That's right. So, so, yeah, what. What. What type of wearable? Or like, what are we talking about? The track that. What's needed.

Speaker B: Yeah. So, uh, we meet you where you are. The answer is what are you willing to use consistently? So if you are a man who hates to wear rings, you won't wear a ring for anything. Then an aura ring may not be right for you. It may be that you're better using some sort of chest strap. So it depends on. On. On what you want to use. My devices are charging here, but, you know, I have an apple watch. I have an aura ring. I have a Garmin. I have a Morpheus chest strap. I m. Have all kinds of devices that I can use, but it comes down to what are you going to use consistently based on what we're trying to track? So, depending on what your unique biological needs are, we may recommend certain trackers. And then we have an amazing app, uh, peak launch OS app, where you can real time see your data. We can see your data. Coach can see my team can see your data real time. Whether we're tracking your blood sugar or tracking your sleep or stress or anything, I reach out. Hey, Brandon, alarms are going off here. What's going on? You're like, well, I had three. Three drinks last night, and, uh, my stress is high. I'm sorry. It's not. Not to point fingers, but to really help to guide you back, get you back on track and make sure that you don't lose momentum.

Speaker A: Yeah, that's. That's really fast. I mean, I. I imagine. I don't know what I'm talking about clearly, but I imagine, at least for me, that in. That would be a motivator in and of itself to push me to be healthier. Right. Like, if I know that somebody sort of everything's being tracked and I'm going to get, like, what happened on the 12th, that, you know, what'd you do there? Then? That would. That would not even subconscious. That would consciously make me try to make better decisions. Is that. Do you guys see that?

Speaker B: Yeah.

Speaker A: Yeah.

Speaker B: You know, it gamifies it to some extent, but also what it does is it gives us real, actionable data. So I'll give you two examples. So one is Ken, my. My longtime client. He told me how he slept just fine. Okay, let's see. Wearing our ring. And he comes back, you know, the next week. And his sleep scores look okay, for the most part, except for one metric. So he was getting about seven to seven half hours of sleep every single night, which is perfect, right?

Speaker A: Great.

Speaker B: Somewhere seven and eight hours is what we want. But did you know that the most important part of sleep is deep sleep? That's the stage of sleep where your body repairs and restores and the brain flushes toxins. And very important things happen during deep sleep. You need about an hour of deep sleep every night. One hour, 60 minutes. He got one minute of deep sleep. In those seven hours of, uh, total sleep, you would never know that that was why Cam was waking up in the morning feeling like crap. Even though I slept seven hours. Why do I feel like this? That was why he was getting none of the restorative benefits of sleep because that deep sleep wasn't happening. So we could see things like that. Another example is a woman. She could not lose. Diane could not lose weight. She had tried, you know, in air quotes, everything. Well, we use a, uh, blood sugar monitor, a continuous glucose monitor on her arm, a small little sensor where we were able to track blood sugar 24 7. And we can see her data real time. And she had this spike one night after dinner. Her blood sugar, you should never go above 140, or if so, not for very long. She had a spike way over 200 for three hours after dinner. Like, holy cow. Dan, what did you eat? Sushi. For her, sushi was kryptonite, and she thought she was eating the right foods. But for her in particular, sushi was not ideal. And so sometimes it may be that the order blood sugar was spiking through the roof. And what may be the case is if you eat your fiber and your vegetables and then your protein first before the carbs, like the white rice, you may have no significant blood sugar spike at all. So sometimes the sequence matters. Sometimes how you're eating is just as important as what you're eating. But we would never know that without tracking. And so this is the really the power of wearables. And our team can see the data real time to help guide her. Hey, Diane, do not eat sushi.

Speaker A: That is remarkable. Right? I mean, I'm sort of. I'm blown away with the level of detail. I mean, the sequence of how that you eat the food on your plate can matter.

Speaker B: That's right.

Speaker A: I mean, it just makes me feel totally exposed. Right. Like, I never once thought of that. 46 years old, never once thought, well, if I eat this first and then that, then maybe that's healthier, but. Shows you how ignorant I am about optimizing.

Speaker B: It's just. It's just lack of recognition. And it may be that that's not the case for you, but we just don't know. You'd be guessing. Yeah, I have no idea. Without guess, without testing. Yeah. Yeah. Well.

Speaker A: So before we move on from the wearables thing, do you have a favorite? Is there something that provides more data points than others in terms of wearables, or are they all generally the same?

Speaker B: I've always been a fan of aura. Uh, I have no financial motivation when I say that I found it's comfortable, it's easy, specific for track sleeping, for. For sleep tracking, uh, for recognizing the stages of sleep, because I think sleep is really underappreciated how important it is when it relates to almost every system in the body. So I really think sleep is critical. I love the Morpheus is a, a chest strap that you can use to measure your heart rate variability, which is a measure of stress. You know, most people refuse to accept that stress affects them. And so I appreciate that. I say, okay, let's measure it. Let's just see. And so, uh, chest trap like the Morpheus helps you seed from day to day when your HRV is 50, 48, 51, 52, 49, 27. Holy cow. What happened? Oh, I had a couple glasses of wine for date night. We can see it stressing your system. We can see the real outcome and the data doesn't lie. And it can help you make better decisions, help you understand how your behaviors, your lifestyle is affecting your biology.

Speaker A: Got it, Got it. So how often somebody starts with your program, they've made it through test design. So how often are they talking with their coaches during the measurement phase or the, I guess the ongoing phase?

Speaker B: We touch base with our clients on a weekly basis where we're looking at data, but we may reach out. Something jumps out. We may reach out more often than not, but at least once a week we will. At least in our app we have ability where clients can actually text our team through the app, text the coach, have a conversation just like SMS text. You could directly text my team and, and we could touch base and see what's going on and be able to make real time dynamic adjustments.

Speaker A: Goodness. I mean this is, it's the, the, I knew that what, what you're doing is very different from. My brother is an anesthesiologist, so he, I mean, I'm not a doctor at all, but I sort of live vicariously through him and everything he tells me. But I knew it's, you know, very different from traditional medicine. I had no idea how, like I said, detailed and involved it is to do this at a world class level like you guys are doing. But I'd love to take a minute. There's two things that I think have been at the forefront recently. Testosterone and peptides. So what is going on with the world's male population and you know, testosterone, fertility, like is there something in the water? I mean, what are your thoughts on what in the world's happening?

Speaker B: Yes, and yes. So what we are seeing is a significant decline in testosterone levels worldwide. So three longitudinal studies, one here in the US, two in Europe, looked at testosterone levels in men for 20 plus years. And what they found was that free testosterone again, the bioavailable active form that we really care about is almost 50% lower and it continues to drop by about 1% every year. Now we know as you age, testosterone levels get lower. That, that's known, but that's not what we're talking about here. I'm saying a 46 old man today has a testosterone level half what a 46 year old man had 20 years ago. And so your levels are likely lower than what your grandfather's levels were. And so that's the real problem. We're seeing a similar decline in fertility as well, where sperm counts and sperm function are about 50% lower as well. A great study out of Israel showed us this parallel decline that really matches the decline we're seeing in testosterone. And so we really believe that it is damage to the testicles. That's ultimately, I, uh, I believe the, the single most significant contributing factor here. And, and our environment is the culprit. So it's, we can look at our drinking water. We have massive levels of chemicals and synthetic estrogen. So women's birth control, women pee it out, it does not get filtered very well from our, our water treatment plants. And so we're drinking synthetic estrogen in our, in our tap water, it's in our food, it's in our cr. You know, our crops are sprayed with chemicals like atrazine or eating, from eating and drinking from plastic food containers and water bottles made of BPA and phthalates. And studies show all these chemicals are crushing testosterone, crushing fertility. They're causing all kinds of other endocrine hormone problems as well. So it's a big problem. Personal care products, your laundry detergent, your deodorant, you're absorbing it through your skin every day and these chemicals are leaching into your body, through your skin, and they're causing real long term consequences. And so it's a big problem that just doesn't get enough attention.

Speaker A: Yeah, that's, but that's crazy. You, uh, just to make sure I understand, you're, you're not saying that the Average person loses 1% of testosterone, like 1% of testosterone a year. You're saying that like sort of the, the, the worldwide mean or average for men is going down 1% a year because of some external factor that we don't know exactly.

Speaker B: Not only are you losing testosterone as you age, which we've known for a long time as a, as a, a, uh, a standard unfortunate process of aging, that testosterone levels decline, but we're also seeing in aged matched populations that a 50 year old man today has levels much lower than a 50 year old man 20 years ago and it continues to worsen every year.

Speaker A: So how are they handling sort of the recommended average then? I mean, are they just lowering that along with it?

Speaker B: So if you look at a Lab slip from LabCorp or Quest, you look on the right side of the page, you'll see a reference range. Below that you'll see a reference to the travison study from 2017. Okay, Travis and study looked at testosterone levels across the country. Okay, Hundreds, thousands, millions of testosterone levels across the country. Well, guess what? Those levels were half what they were 20 years before that. Right? And so now what we're seeing is that reference interval is nothing more than that average. So they look at the standard, you know, the median, two standard deviations above and below statistical average, if you will. And you are now being compared to the sick, inflamed, unhealthy, obese population. And that range is stupid. It is like 265 to 880 or something like that. And if your testosterone is 267, you're quote, normal. Your doctor can tell you you're normal, you're fine, you don't need testosterone. That's ridiculous. It's going to give you a heart attack. It's going to cause problems you don't need. I call utter bs. You're not normal, you're not fine. And it's a real problem. And so, so first of all, testosterone is the wrong number. You want free testosterone. But number two, you cannot look at those if reference intervals because it's just the average.

Speaker A: So how, so how do you determine what the target is? Is that personalized from each person to person or like, what do you shoot for?

Speaker B: Yeah, general target. First of all, we want to be looking at free. So I, I've had. So to answer your question, we generally want a free testosterone of around, give or take, 20 picograms per milliliter. Okay, 20, that's for LabCorp. If it's quest is going to be 200. Okay, don't ask me why. They're different, this technique, but still the same unit. Picograms per milliliter, but for LabCorp is 20. Some men may be okay with 15 to 18ish, other men may need 22, 25ish. That's, that's unique, that's personalized. But somewhere around 20. Most men coming in off the street, their free tee is around 6. I've had NFL players, NFL wide receivers, I've worked with their free T was five and a half. Like, real, like every day. It's crazy.

Speaker A: A quarter. A quarter of what?

Speaker B: It should be much, much lower. But I've seen men with a total testosterone of 900 and a free T of 20. Sounds great. And. Or a total testosterone 900 and a free T of 6. You see why total testosterone just doesn't matter? Yeah, it's not telling the whole story. It's not the full picture, but doctors will look at that. They'll see, Finn, you're fine. You're normal.

Speaker A: Is that just laziness? Why. Why are we using the wrong number?

Speaker B: It again, is lack of education, because we're not talking about disease. So when you go to your doctor, even endocrinologists, I'll battle with them because they're treating disease and they're looking for a diagnosis in which now you have an actual diagnosis code. Insurance will cover it. It's very different game. Yeah. You know a question that, that I was taught from my mentors said, where do you want your levels to be? I want them to be optimized. Right. Because I know the benefits of having optimized testosterone. And so the goal, therefore, is free t of around 20. If you're. If you're 16, 18. Great. You're probably okay at that level.

Speaker A: Yep, Got it. All right. Peptides. The. The. From my perspective, right? And who am I? But from my perspective, this is a newer or more recent, uh, phenomenon's not. Not the right word, but this has just come up on my radar. I've just heard about this in the last three or four years. What are they? Give us, give us, Give us everything.

Speaker B: I actually trained in peptides and started prescribing peptides around 10 years ago now. That's how long they've been around. Okay. It's crazy that they've now suddenly finally gained mainstream attention, right? And now it's becoming the Wild west, and everyone's selling peptides online. I'll share my thoughts with that. But peptides are simply signaling molecules. They're short proteins. Okay. There are specific sequence of amino acids, and anything under 50amino acids in sequence is called a peptide. Ending from 50 to 100 is a polypeptide. Anything greater than 100amino acids at length is called a protein. So it's purely just a simply, uh, a short protein. That's all it is. But they come from our own bodies. So most peptides that we talk about, thymus and alpha and beta, BPC157, GLP ones like semaglutide, tirzepatide retatrutide. Your body makes these peptides normally. And so what we're trying to do is replace peptides that maybe your body isn't making quite as well anymore and are trying to amplify the effects of these peptides. And so peptides, and there's now hundreds, thousands of peptides being sequenced and identified and studied. And it's an amazing field now. And peptides can be useful for reducing inflammation, helping with, you know, musculoskeletal soft tissue repair, and help with anxiety and mood and even depression. It can help with sleep. It can help with gut health. It can help with hair, skin and nails and sexual performance and almost anything you could think of. There are peptides that can help you get there faster. Okay, that's the, that's the pro. Now the con. I have an analogy that will make my point. You're baking a cake, right? You bake a cake. You have flour, sugar, eggs, you have all these key ingredients, right? And when you bake your cake, you put on the drying rack and it cools. What do you put on top? Frosting, icing. That's how I view it. Okay. Peptides are the frosting. It's the sexy stuff, is the, it's the, the shiny object that everyone wants. The key ingredients of your cake are what matters. And if you miss the baking soda, I don't care how good that frosting is, that cake's going to be a mess. It's going to be a disaster. And so I love frosting. Don't get me wrong, I love peptides. But there's sequencing that matters, there's context, there's nuance that comes into play as part of a bigger system. We integrate them and use them all the time. But when you try to treat performance again, it's um, the, it's the biology state performance framework I started with. When you try to use peptides just to fix performance, that's when people say, God, that peptide didn't work for me. Or why does that peptide work for some people but not others? That's the answer because it's the frosting when you haven't looked at the cake first. And so that's really the key around peptides. Finally, my big issue with peptides is sourcing. There's a study that came out about three months ago now that showed that it looked at generally available peptides from online stores and over 70% of them had toxins, had contamination, and I think a 20 something percent of them had no active ingredient in them. As well. And so you have no idea what the hell you're getting. You cannot. If you can go online and buy it with a, uh, just a swipe of a credit card, I would not trust it. There's no quality assurance. I don't care what certificate they show you, you cannot confirm it matches the bottle that you're getting. And so I would only, only, only ever take a peptide if it comes from a compounding pharmacy, which requires an actual doctor or medical professional prescription.

Speaker A: Got it. That is unbelievable. More than 20%, uh, didn't even have anything in it.

Speaker B: Absolutely. It's the wild west. It's crazy. And it's a money grab right now. And these companies are trying to sell them and, and they all come from, from overseas. Russia or China is where they're all. They'll say made in the U.S. no, the raw ingredients came from China or Russia and then the lyophilize, which means make it into a powder here in the US and call it made in usa. But they all originate from overseas. Unless they were sequenced by compounding pharmacy.

Speaker A: Gotcha. That, uh, drives me crazy. I mean, we, we can figure out how to regulate the most absurd things, every part of our lives, but right when we need it the most, you know. Yeah, nobody's there to regulate, but hopefully something will catch up and get the fraudsters off there. But that was a fantastic description. Very, very helpful. You answered all of my questions, I think, with your description, the first of which is, are they potentially harmful? Assuming that you get from a compounding pharmacy from a physician's, um, prescription. And correct me if I'm wrong, but you know, you said earlier that these are things that are actually made by our own body. Right. So if it's, maybe you could have too much or too little, but if it's made in our own body, then, you know, I was thinking it was like a foreign substance that you were trying to, you know, I don't know, change something. But, but, but if they're made naturally, it doesn't seem like that something that's made inside our body could be harmful. Yeah.

Speaker B: And, and there are more and more peptides being synthesized and produced that are tweaks on peptides from our own body. There are changes, they're chemical modifications. So you have to be careful. And this is where again, the nuance and the context matters. And too much of a good thing can certainly be harmful. So dosing matters. And, and there's nuance to it. And, and there's also seasonality. Something that no one Talks about is, you know, from an evolutionary perspective, our bodies are made to adapt throughout the year, through the, through the cycle of the year, the seasons. Our bodies are in different stages, whether we recognize it or not. And the peptides you're using should actually match that as well. So there's a lot of science that goes into how and when do you use which peptides?

Speaker A: Yeah, well, you didn't. Maybe you did say. But it's very, very clear that don't mess with this stuff without going to a legitimate professional that knows what they're doing.

Speaker B: Absolutely.

Speaker A: I love it. Of course, I, uh, just glance at the clock and I know we don't have that much time left. We focused mostly on men. Talk to us a little bit about sort of the, the menopause perimenopause. Women like it. It fascinates me daily, you know, with my wife and my two daughters, like how different men and women are. They do. So there's so many things that happen in their bodies that we, we don't have to do. Talk to us about women. And what is it, Is it a similar progression to, like, this, the, the loss of peak performance for women?

Speaker B: Yeah, women have a little more of a crescendo of an acute collapse, if you will, because of. Known as menopause. Right. That's where you have ovarian failure. You have shutdown, um, of these massive levels of hormones that women once had, and suddenly their body can't adapt and adjust to it. And it's not just estrogen, it's testosterone as well. You know, we talk so much about testosterone in men, but women need testosterone as well for mood and energy and metabolism and, and function and, and their ability to burn fat and, and think clearly and, and everything is related to testosterone in women, as is in men. Other hormones, thyroid hormone, progesterone, even things like nitric oxide and growth hormone, all these hormones are declining. But that rapid collapse around menopause will cause a lot of women to feel like they're going crazy. Right. They, they, they lose their, their sense of who they are. They lose their sense of identity. It's not just energy and focus. It's really their, their sense of, of connection to their partner, and it, it's a complete change in their life. And so for women, a lot of the same things we talked about with men apply. And especially in women, the hormone changes are so critical around that time period.

Speaker A: Yeah. So you have coaches that special, I mean, that accept women patients as well.

Speaker B: Oh, yeah. And, and, and men are from Mars. Women are from Venus. Very, very different creatures as it comes. And, uh, relates to hormones, for sure. Yeah.

Speaker A: Gotcha. So what's, what's the average age of your, your patients?

Speaker B: Yeah, we work with anyone from 40 to 60. In general. Most people are around 50 or so. And that's around when people start to really notice that decline that, hey, I'm just no longer even remotely close to, to who I once was. What's going on here? And those changes that we talked about that were imperceptible at first are now really noticeable.

Speaker A: So what's the one thing, or maybe two things that you feel like is currently the most misunderstood or the most unacknowledged? Like what, what just drives you crazy? Like, I can't believe people don't realize this.

Speaker B: Yeah. I come back to the concept of, uh, leadership capacity. Right. And we think about, you know, leadership coaching and training on the right mindset and the right, you know, framework organization in your mind, and eos and all these other frameworks and systems that I love, they're amazing. But if the biology, the foundation of it all is not in place, and you wonder, God, why can't I. Why am I not getting anywhere? Why? You know, it's not willpower. It's not a lack of motivation. It's not that you're lazy. It's not that, that you don't have the knowledge. It's that there are key fundamental areas, deficits, constraints that are holding you back. And so I think that, that it's not always a matter of grinding and pushing harder because all that may be doing is making it worse.

Speaker A: Gotcha. So if you, if you had, like, for, I mean, I guess practically you do. Right now you're talking to a room of 5,000, you know, potential patients. Right. Potential customers, and you. And they've only given you, uh, you know, a minute or two to say something. What, what do you, what message would you like to give them?

Speaker B: Yeah, sure. I, I would say find what may be holding you back. Start with testing. Identify what may be those blind spots that may be getting in the way of, of where are you now and where are you supposed to be and what might be creating that gap. And what you find is often not what you think it is. And it's not a matter of simply taking a peptide or injecting a bunch of testosterone or, you know, some other molecules. It's a matter of really identifying what are your unique constraints that are holding you back. And, and, and when you do, this is not just about fixing numbers. And you know, the, the concept of longevity I don't ascribe to. I don't think most people are focused on living to 150 or whatever, you know, number you pull out of your hat. It's how do I perform at a high level today for my business, my team, my friends, my family, my kids? And that's what it's really all about. That's what precision performance medicine is really all about.

Speaker A: Got it, Got it. So peak launch, how do we get there? What's the website?

Speaker B: Thanks so much. Yeah, so peaklaunch.com check it out if you want to jump on a call with my team, there's a link. I also have a gift for the listeners. It's called the High Performance Health handbook. It is 15 strategies and tactics that take everything we talked about today to the next level. Just go to peaklaunch.com forward/guide, that's G U I D E and download a free copy of that. I also have a bunch of other gifts. I, ah, have a peptide guide there. I have a digital copy of my bestselling book Mel 2.0 and a bunch of other freebies there as well.

Speaker A: Fantastic. So peak launch.com P E A K L A U N C-H.com you got forward slash guide guide.

Speaker B: You got it.

Speaker A: And there's your free gift. Dr. Gavin, I, I, I can't thank you enough. Uh, you took me to school and all of us to school and frankly, you know, probably changed, certainly change the way that I hope to feel going forward as I, as I go down this journey. So appreciate you and appreciate what you're doing as well.

Speaker B: Absolutely.

Speaker A: Don't forget, everybody. You can find Boundary breakers in a lot of places. You can watch our episodes on the Boundary Breakers YouTube channel, or you can listen to each podcast on Spotify, Apple Podcasts, or any of the other major podcasting platforms. Thanks for listening, Sam.