RX Podcast_Tracy Gapin: Audio automatically transcribed by Sonix

RX Podcast_Tracy Gapin: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody and welcome to another edition of Entrepreneur Rx, where we help health care professionals own their future.

John Shufeldt:
Hello Everybody and welcome back to Entrepreneur Rx, today I'm joined by Dr. Tracy Galpin, who is a founder of the Gapin Institute, along with the founder and CMO of MaleVIP, he's a board-certified urologist and a men's health expert, and I am thrilled that you're on the podcast. You're also a, author and speaker and you've written for Entrepreneur Magazine, so you kind of, you're a polymath.

Tracy Gapin:
Yes, I have been very busy to say the least, yes.

John Shufeldt:
That's excellent. Ok, so you know, I always start with this, you know, probably tied love, physician-entrepreneurs. So first off, let's start with the physician thing, how did that come about?

Tracy Gapin:
Yeah, yeah, so I actually knew I wanted to be a doctor back in third grade or so. I remember there was the heart diagram on the ground, you know, made out of tape on the ground and we had a walk through the chambers of the heart, you know, the path the blood goes from the heart to the lungs. And I was fascinated with anatomy from that point on and my mom was a nurse. And so I'm sure that had some aspect of some influence on me. But I knew very, very early I wanted to be a doctor. And I think there was about maybe two days during my undergraduate years at Texas A&M, where I wavered and thought about accounting, but then I came back to reality. That was my ...

John Shufeldt:
I'm so lost.

Tracy Gapin:
I know, right? Yeah, I hated my physical chemistry class at that time. I was thinking, maybe just forget biology, I'll just do accounting. But I stay with it, obviously. And yes, I was dedicated to medicine at a very early age.

John Shufeldt:
Because there's so much physical chemistry in what we do now, isn't there?

Tracy Gapin:
Of course! I use it every day, right?

John Shufeldt:
Yeah, I never. I got out of that class because I was a sociology major.

Tracy Gapin:
Yeah.

John Shufeldt:
And, thank God, I got to take that class ...

Tracy Gapin:
It was so bad. It's bad awful.

John Shufeldt:
All right. So you, so you did medical school, and then why urology?

Tracy Gapin:
Yeah, you know, I was a surgeon from the day I knew I wanted to be a doctor. There was no question in my mind that was my mentality, I didn't know yet what type of surgery I wanted to do, general surgery didn't appeal to me, just doing colon surgery all day, colon and breast surgery every day didn't seem very exciting. You know, it's interesting as physicians for all the other physician listeners, you know, it's interesting to think back to third-year medical school, you have a very short window during which you need to decide what the hell you're going to do with your life. And you have to start doing applications very early in fourth year, obviously. And so you have very little time to make this major decision that impacts the rest of your life. And so to me, it got to the spring, and I still wasn't really sure what I wanted to do yet, and the girl I happened to be dating at the time, her brother was a urology resident, at the time, he was a third-year resident and he was there at UT Southwestern, and so I shadowed him, I went to the VA during my spring break. I did not go skiing like all my buddies did, I instead went to the VA for a week, and because I would otherwise not have gotten any urology exposure, did no rotations in urology, and I loved it. I thought it was an amazing specialty work with men and women, young and old, operate new medical care, and they all seem to love what they're doing, and I really found a passion for it and found what I thought was my calling, and so I jumped into urology.

John Shufeldt:
That's excellent. Yeah, for some reason, you're dead on in medical school, you better choose early, urology never crossed my mind, I mean, I was a definite surgeon mentality. Thought I was into surgical the whole time, never thought about urology, interesting. Ok, so you do urology, but then, as I recall, you know, doing my background check, I knew you were one of the first folks in Sarasota, right, to do robotic surgery.

Tracy Gapin:
Yeah, yeah, exactly right.

John Shufeldt:
That's badass.

Tracy Gapin:
Oh, thanks so much, yeah, I appreciate it. So, you know, when I got out of residency training, at the time, no one was really doing much robotics at, a few academic centers, but otherwise, it was really relatively cutting edge. And I'm always thinking long cutting-edge lines, I like to be a pioneer, I like to really think differently, and I knew that robotics was really the future of medicine. And so I went through some training programs at the time, I pushed the hospital here in Sarasota to get the first robot locally and did the first two cases, that was back in 2006. So did the very first two cases July of 06, and the program exploded from there. And then now that I have like six robots there now and all the other hospitals in town have robots and everywhere around the country, you know, from that day, from July whatever of 2006, when I did those first two robotic prostatectomies, I've never done an open prostate since, and it's really become the standard of care ,that robotic is the way to go, so. So that was that. And then the next realm for me was prostate biopsies as it relates to these prostate cancer patients, I found that there was this cutting edge new tool called MRI guided biopsy or fusion biopsy, where you can take MRI imaging of the prostate and really very precisely identify where the cancer or where a suspicious lesion was and targeted for biopsy. You know, the old-fashioned standard approach is just to do an ultrasound guide, which is, you might as well be blindfolded, just hoping to hit a cancer if it's there, and now suddenly we have MRI technology had improved enough that we can now use that to really precisely pinpoint areas of concern that we had never done before. So I pioneered that in the area, as well as the first doc to do any sort of MRI guidance when it came to biopsies in the area. And now, along those lines, the next technology was HIFU, which is high intensity focused ultrasound, to treat prostate cancer. And what you can do with that is once you've done a very precise targeted biopsy and found that you just have a small tumor, let's say up in the right anterior gland, then you can treat that area, you know, think of it like a partial lumpectomy for breast cancer, you can treat that area with ultrasound-based technology and kill the cancer and minimize side effects. So that got me into HIFU, which was another kind of cutting-edge area. And then I really pioneered completely away from urology into health optimization and longevity, and that's where I am now, for the next leading edge.

John Shufeldt:
So are you still doing traditional urology?

Tracy Gapin:
Urology. I actually exited traditional urology, so I made the massive leap of faith that was December 30th of this year, when I left traditional urology, I cut ties, I have no Medicare contract, I opted out of Medicare, I have no commercial contracts and I officially 100 percent went cash-based. And now that was not without planning, I don't want to say that I was just randomly, flippantly making that decision, it was about eight years in the making to get to that point.

John Shufeldt:
So let's talk about that for a second, because I think that's a rate-limiting factor for a lot of folks and honestly, part for myself included, since I was in the emergency department until 10:00 o'clock last night and I got a few years on you, that had to be, you know, you wake up or, I guess, December 31st and go, see, now, .... because you did all this cool stuff? And you know, God knows if I have a prostate cancer, I probably have flown down to see you, but now it's you're not doing any of that. Was that a tough decision?

Tracy Gapin:
Oh, incredibly tough, John. Yeah, and I actually I had to give my group, I was part of a five-man urology practice, and so I had to give them a one-year notice, actually. So July one of last year, I finally said, today, I just got to do it, today's the day, you know, July one, you know, in medicine, we all know that's kind of a big day as like the next year, so to speak, we went through our training and so I just made the decision once before was, July one to my day, I'm doing it, and I gave my notice that day and I'm like, oh shit, here we go, you know, clock's ticking. And it got closer and closer, you know, I'm losing sleep at night thinking about it, worried about it, and it's a, it's a massive undertaking and it was not without risk and it was a calculated risk, but I'm so glad I did.

John Shufeldt:
That's right, that's awesome. Any advice for people because I know there's a lot of people listening to this who are literally in your shoes like.

Tracy Gapin:
Yeah, yeah.

John Shufeldt:
I want to do this, I'm set up to do this, but God, I studied my whole life, you know, third grade you were walking through the heart diagram.

Tracy Gapin:
Yeah.

John Shufeldt:
And all of a sudden now you're doing.

Tracy Gapin:
Sure.

John Shufeldt:
Cool, other cool stuff, but you don't have a scalpel in your hand anymore.

Tracy Gapin:
Right, so I didn't actually think that we'd be going down this deep, but I'll tell you that I grew many years ago to become disenfranchised, disillusioned, nearly hate medicine.

John Shufeldt:
Really?

Tracy Gapin:
I found that when I, when I be called at 2:00 in the morning because the nurse took out a catheter and now they can't get it back in, I'm having a race to the hospital putting a catheter, I found myself angry. Found when I was in the ER with a guy who overdosed on trimix for the fourth time in the last two weeks, you know, treatment for priapism in the E.R. that I was pissed. When a guy, you know, I would basically find reasons, every, every situation to become more and more angry with the situation. And it wasn't the patient's fault, obviously, it was simply the matter that I grew to no longer enjoy it. You deal with the nonsense bullshit of the nurses and the paperwork and the bureaucracy and the insurance companies and all the stuff that you have to go through, and I had a lawsuit. I had a lawsuit, this was about 10 years ago where I was sued by a guy I did a robotic prostatectomy on him, went beautifully, he's cancer-free, no problems in the hospital. He developed a very rare, weird complication from the catheter, he got a urethra cutaneous fistula just below the meatus, basically, the ventral skin was so thinned out that just putting the catheter in, he developed the fistula there and through no fault of my own, nothing was done out of the ordinary, you know, still, as big shit happens, and he sued me and I had to spend a week in court defending myself in front of a jury, away from work and having to defend all my work and be crushed by this prosecuting attorney, and then the jury comes back at the end of that week, Friday afternoon, saying, I'm, quote, not guilty. Like, think about that. Like, not only did I save this guy's life from prostate cancer and do everything by the book, textbook, and everything's perfect, I'm just simply not guilty, I'm not like innocent, I'm not, you know, nothing like that, and so it hits you hard, even when you've done nothing wrong, you get sued, you have to go through that. And as the plaintiff was walking out of the room, he says to his attorney and friends, next to him, oh, well, like just pure cash grab kind of thing. And so I got to the point where a long story short, I just really got frustrated and fed up with medicine and I lost my passion. And so I found it again. I found it with what I'm doing now again. And so, you know, it's a, it's a tough, massive step to leave traditional medicine, but you got to follow your passion. You've got to love what you do. And I knew that I could not go through the rest of my life doing it if I didn't love it and feel passion, and it started to really affect my relationship with my patients, and I felt that I saw it and it wasn't fair to them either. So I knew it was his time.

John Shufeldt:
Wow, that is really an amazing story, and I think it's going to resonate with a lot of people because particularly over the last couple of years, the moral injury and burnout and where we've all been through, a lot of doing to find a lot of solace in the way you just described it, that they're not alone. I've had, you know, I have a law degree as well, so I help, I try to help a lot of physicians going through this, and you're right, it takes, you know, win, lose or draw, negligent or not, it takes a huge burden, like you said, you know, usually it's two weeks and it's like, you know, walk out of there. And like you said, the guy's like, yeah, oh, well, we gave it a shot, sorry, and to you this is crushing. All right. So let's talk about your entrepreneurial efforts, because that's really what this is about. What got you into this? It's not alternative medicine at all, what got you this alternative path?

Tracy Gapin:
So, you know, going back about eight years or so ago, that was, you know, shortly after that lawsuit when I realized that I could not do this for the rest of my life and I realized, you know, what am I going to do? How am I going to transition? You know, I actually thought for a brief time of leaving medicine completely, and I worked with some business coaches, I worked, I went through some conferences on non-clinical careers in medicine, looked to do some consulting, all this kind of different options, and you mentioned a moment ago about all the training we go through, and I realize that I have this incredible education and knowledge base and experience that is honestly a shame to waste, as that got me to the point where now how can I leverage and use and not waste everything I've been through for the last, you know, now it's 6 years of training, plus 17 years of practice, that's 23 years of medical training and practice that I would be throwing away if I decide to be a real estate agent, for example. And so I spent time looking into how can I use what I've learned to fulfill my entrepreneurial spirit? Because along the way there, my wife and I, we got married nine years ago actually, we just had our anniversary a couple of days ago, so nine years ago, shortly after we got married, we opened because I'm such an entrepreneur, we opened a local restaurant delivery service, and that was my attempt at being an entrepreneur, and it was a disaster, we lost money, we lost, we lost, I mean, I spent Mother's Day one-year delivering food, while my wife was at home running the dispatch on the computer, and it was a disaster of a business and you have to rely on delivery drivers who don't care, they just quit in the middle of the shift and take your food home and eat the food. Customers are calling, where's my food? And the delivery driver's at home eating it, they don't care. So that was, so that was my entrepreneur attempts. So I realized that if I'm going to do something entrepreneurial, it really needs to somehow be a passion that I can do it long term. And so I started diving deep into what's my passion and how can I tie that into my career? And what I realized, John, was that my passion was being a dad, you know, my real passion, and I get, I get like actually emotional every time I start talking about this, but I had a shitty childhood and my parents divorced at a very young age and I really had no father figure growing up. And so my kids, my boy just turned eight last week, and my daughter is six, and to me, like they're everything to me, like, it's like, how could I be the best? This got me to how can I be the best man? How could I be the best dad? How could I be the best person so I can be around to be the dad for them that I never had kind of thing, that kind of became a big deal to me. Well, how do you do that? How do I fulfill this void that I had in my life for my kid? And that's to make me the best person I can be. And so that got me to personal development and optimizing my health, and I was, at the time, 30 pounds overweight, and I went for my first physical because of this kind of stuff, and my cholesterol was sky high, my creatine was 1.4, my CRP was three and I was a mess on paper and I have a strong family history of cardiovascular disease, and so I kind of freaked out and thought, oh shit, you know, I need to do something. And so that got me down the road of epigenetics and that got me to, you and I were talking off-camera about ... and the epigenetics training program and learning how to use genetics to personalize health and about the tenets of aging and how to actually look at ways of reversing aging, which sounds crazy, but it's actually possible and optimizing health and understanding a lot of functional medicine components that we used to scoff at as a medical group, doctor groups, but there's a lot of real science behind understanding functional medicine and how I talk a lot about it with my MALE framework, which I coined, you know, the MALE framework focusing on mental health and as Mindset, A is aging, looking at hormones and cellular efficiency and mitochondrial function and stuff like that. L is lifestyle, nutrition, sleep and fitness, and E is environment like gut health and detox and immune function, and understanding how all these inputs to our human system really have a dramatic effect on our health. And I started rolling with that, I started realizing, well, all this stuff helped me, I mean, I completely transformed my health, and I'm probably the best health I've ever been now, from learning all this stuff and implementing it on myself, and I started thinking of how can I use this information to help men also? And I created a cash-based model program in my urology practice, where I was on the side, in the evenings, and during lunch, I was having zoom calls just like this with guys, and they paid me cash and I'd run their genetics and say, well, your genetics show, John, you should be eating this, not that, you should be doing this for your detox, this supplement may be off, we should check testing on that, this, this is the best type of exercise for you. All these different aspects of health, and John, let me tell you, man, I suddenly fell in love with medicine all over again. Like, I freakin love this stuff. And the more I learn about longevity and epigenetics and call it anti-aging, call it functional medicine, it all kind of intersects, and I leveraged that newfound passion with my 23 years of experience with my entrepreneurial spirit, and put it all together to create this cash-based business that I now have, and I'm on the tipping point now that really exploding.

John Shufeldt:
That is awesome, man, was your aha moment when you went and got, you know, basically got a physical, got your labs drawn, it was that your aha moment where like, I have to do something different?

Tracy Gapin:
Yeah, I, actually I wrote a book last year also, John, took me about, almost two years to write this book called MALE 2.0, Cracking the Code to Limitless Health and Vitality, and I started that book actually with that experience of talking about sitting in that doctor's office, you know, suddenly I'm the patient, not the doctor, and sitting there with that stupid paper gown on and getting a rectal, my first rectal exam ever for myself, you know, giving a billion of them, having, having it done yourself, it's weird, and having to sit there while he looks at your labs and you're on the screen like, what is it? You know, it's a totally different experience and opened my eyes to, to this vulnerability and how we need to take charge and take control of our health. And that got me into the focus on disease model medicine like what we learned in medical school is all about this disease, diabetes, you treat it with insulin and metformin. This disease you treated with that, this is you treat with that. And once you get to neutral, once you get to baseline, you're good, you're out of here, I'll see you next time. And I use the analogy or the point of NED, no evidence of disease. We talk about that, as physicians, we talk about all the time that that's great. And we get, we get somebody's cancer free, NED, you're no evidence disease, you're great, I'll see you in a year, you're out of here. There's nothing else discussed, stress, sleep, fitness, hormones, detox, movement, mindset, nothing. And so that really got me down this path of optimization and so when people ask me, what do I do? It's mental optimization, its longevity, it's performance, it's, it's this new area of health that is really exploding right now that is exciting.

John Shufeldt:
Yeah. Now, you know, I've been on that path for, I don't know, probably five or six years, I'd mentioned, I'm thinking, you know, they've been taking metformin forever and I'd read about lifespan so they've all .... And now, I can't do what you do, I don't want to be a coach for it, but it's funny, I was the emergency department literally last night and I have this guy who comes in, he had already left AMA earlier today and his opponent was up, and for the non physician's listening to this meaning is, he's probably had some sort of heart, heart issue and he's, so he's back, and as far as that, you know, he's short of breath, he's overweight and he smells like cigarettes, it smells like alcohol, you know, did you get the vaccine? No. Are you still smoking? Yes. Are you still drinking? Yes. You're doing this? No. I'm like, I was like, dude, why are you here like the, exactly as you said, he's here about the disease, but had he done anything before that day to care himself, may not be there. So here's the question, so I get people aren't paying you, if they're coming to you, they have some motivation to, right? But what is your, what do you think your uptake is? So you give people this great advice on lifestyle modification, mindset modification, all these things, what do you think there? What do you think the uptake is?

Tracy Gapin:
So I actually I do a lot more than that, John. So to clarify, I prescribe hormones, I prescribe not just testosterone, but thyroid and DHEA. And looking at vitamin D, looking at estrogen, looking at all the other hormonal, functional lab testing that we do like Dutch hormone testing, we look at cortisol and neurotransmitter and organic acids and all these other key hormones that we never freakin learn about in medical school, never learned about it in traditional medicine, I'm prescribing a ton of peptides as well. Peptides are signaling molecules, they're short proteins that are amazing for reducing inflammation or optimizing immune function or helping musculoskeletal repair or gut health, peptides like BPC or CJC, or thymus and alpha, thymos and beta, mody c, things that we never even heard of when we were in medical training, and they're amazing, and I do a lot of work with wearable tech. So like my clients wear a garment or an aura ring, there you go, and CGM, you know, I'm a huge proponent of continuous glucose monitoring. You got one, too?

John Shufeldt:
Yes.

Tracy Gapin:
Love it, awesome. So it's not just for diabetics, it's for high performance. And so what I do, John, is I integrate the cutting edge medical management with wearable tech, with genetics. I have health coaches that work for me as well, that focus on the lifestyle modification and the accountability and stuff. And I put that all together with a concierge rapping on it, so I have a concierge team that provides patients with all the support that they need for getting prescriptions and supplements mailed to their door, and guys love it and guys feel amazing. And we talk about, you know, reversing aging and all the studies that show that that extending longevity is possible. And we're seeing that. So it's fun.

John Shufeldt:
Yeah, no. It sounds like, it sounds really cool. And I think you're, I mean, I think what you describe is going to give a lot of physicians hope that it may not be doing what you do, but it may be finding another passion still within medicine.

Tracy Gapin:
Yeah. So I've opened here, The Gapin Institute, that I have kind of a two pronged approach to my business, from a business model perspective, I have The Gapin Institute for Men's Health, which is the brick and mortar here, which we are launching as I speak here building, you know, the buildouts complete and putting furniture and stuff now and finally, seeing patients, will treat, you know ED, will treat low testosterone, obviously, we have a weight loss program, hair loss program, I have a nurse practitioner doing aesthetics and typical men's health management as well for typical men's health needs. All cash-based, there's no insurance, all cash, I have a high ticket year long program as well that incorporates all those pieces that I talked about earlier. I have an executive health evaluation so guys can fly in for a day and get white glove service with limo support, limo drive over to the imaging center for their full body CT, and corners, calcium score and carotid ultrasound, and then they get their labs in genetics and body composition done here in the office and a bunch of coaching and full day immersive experience. So I have all these high ticket and low ticket offerings in the brick and mortar, and then I'm also working with a company that I partnered with on a national offering as well so other doctors can run similar program for their client in their state as well, so there's a virtual angle to it, as well as the brick and mortar angle.

John Shufeldt:
So you have the licensing model where if I want to start one here in Scottsdale, I could basically use everything you've already developed.

Tracy Gapin:
That's right.

John Shufeldt:
Basically licensed your, licensed your, not franchised but licensed it, that's interesting.

Tracy Gapin:
Exactly. So you know, there's a huge, I call it a men's health pandemic, you know, when I speak about this on stage or in podcasts and stuff, I talk about how there's this solid men's health pandemic that's not getting the attention it deserves, with low testosterone and obesity and cardiovascular disease, sexual health and shortening lifespan, and the only answer out there is testosterone. You know, all these men's health clinics out there is bullshit, you know that, it's just testosterone shots. And so I put all these pieces together with the genetics and the wearable tech and the functional medicine and the health coaching and the fitness, all of that into one package, and that's been called Male 90X. My program that I, we're going to rename that because we're afraid P90X will get pissed off.

John Shufeldt:
Yeah, yeah, yeah.

Tracy Gapin:
But that's a program that we have, a training, a certification program. So docs like you in Scottsdale, we have Greenburg, he's a urologist in Arizona, I think he's in the Phoenix area, Scottsdale area also. He's going through that program right now, I have docs in different states who are getting involved, and then they'll be able to manage a guy in your area who calls in and says, hey, yeah, I feel like shit, I want to lose weight, get better energy, better sex life. Well, we have the solution for you as a cash-based model, and it's all virtual from where they are and you're licensed in that state so that you would fulfill that licensing requirement.

John Shufeldt:
That's very cool. When did you start that business model?

Tracy Gapin:
Well, I've been doing that for about two and a half, three years now in my urology practice and just in the last year, we've been working on those those certification program for other providers to learn how to do what I'm doing. A lot of it is like you asked, offline before the call here, about about the epigenetics training and how do I go through that and you've got to get these other docs kind of up to speed on that as well, so there's some easy parts to it and some heavy lifting as well.

John Shufeldt:
Isn't it funny looking back how much we did not learn in medical school? We learned a lot about disease, but not a lot about prevention and.

Tracy Gapin:
Yeah.

John Shufeldt:
lifespan, which is what we're all really here for. Day-to-day that's we're trying to do, is prolong functional life.

Tracy Gapin:
You're right, and there's honestly nothing I'm doing right now that I ever learned in medical school. It's all stuff that I learned on my own in the last five, six, seven years. Going through all these different training programs, I've gone through 84M, and I've gone through AMG, I've gone through the .... I've done some functional medicine training as well, and it's following your passion.

John Shufeldt:
What was your biggest aha moment doing this? Like, what did you say? It was like, holy crap, how did I not know this before? Given everything I've done and thinking physical chemistry, how did I not know this previously?

Tracy Gapin:
You know, I think the biggest thing would be mindset. So there is this deafening voice in our heads that tells us, you're stuck, you're trapped, this is it, you can't get out, you know, the money's too good, you can't leave. And it kept me in medicine longer than I wanted to be. And I've been in several mastermind groups that helped me more with the mindset than any of the actual tactics or strategies to learn that we can do whatever the hell we want to do. There is no limit to what we can do once we believe it. And once I had that mindset shift where I believe I could do whatever the F I want to do, suddenly urology was just it was a stepping stone. And so I don't see that I wasted any time, I find tremendous value in that experience because it got me to where I am now, and so, to any other doctors listening, think of everything you've done up until now, a stepping stone to the next phase of your life, but you've got to believe that you can do it. And for me, that was the massive step transition point for me.

John Shufeldt:
that was a switch, that was a switch flip for you. Like, I got this and I completely agree with you. I see so many people that are, that are physicians who are stuck for all the reasons you've said, and they're like, well, I don't have a business degree, I don't know how to do this, and I'm trapped. And I was like, dude, if I can pull this out, you can figure it out. And it's not all that hard and blah blah. Let me ask you one more question, this isn't really about being an entrepreneur, but it's something I was, when I was researching you, what is this low T epidemic? What's the what's the root? What is the most of the root cause of it? Because that's I've never heard that before.

Yeah, that's really mine. I've really kind of created that and owned that that kind of concept because there's no one out there talking about it. So and actually applying, by the way, for a TED talk to discuss this topic, actually, I'm glad you actually asked it. So I call it a men's health pandemic in the fact that several huge studies show that testosterone levels are plummeting by about one percent a year. So over the last 20 years, testosterone levels have dropped by about 30 percent. That means that for a guy who's 50 years old today, his testosterone level is about 30 percent lower than a 50 year old guy 20 years ago, and it's getting worse every year. So it's not just testosterone lowers as you age, of course, every guy every year drops a little bit, but it's also from generation to the next is plummeting. The Male Massachusetts Aging Study showed it here in the U.S. and then there's a mass of Sweden and Finland study that all three showed the same thing, that testosterone levels are plummeting, fertility is dropping by about the same rate as well, it's actually almost 50 percent over the last 20 years. Free testosterone is down by about 45 percent over the last two decades as well, so massive decline in testosterone. We know that cardiovascular disease is worsening, and we know obesity is worsening, metabolic syndrome is out of control and worsening, and sexual health is deteriorating, we see more and more guys struggling with sexual health issues in their 20s and 30s and 40s now, dude, I see guys, John, in their 20s that have near castrate levels of testosterone on a regular basis, it's just scary and no one's talking about it. And the other part is lifespan. Our lifespan, as long as we've known, it's been increasing every year, we're learning more about extending life and lifespan. Our lifespan is actually decreasing right now for the first time in a long time. And so all of that is what I call is the men's health pandemic that's getting no attention and it's scary. And I say that in 20 years, if we don't do something, our entire male population is going to be infertile and impotent. And so we can look at causes of it but suffice it to say, it's very clear that there's this massive men's health crisis that's happening and and the only answer out there is here, take some testosterone.

John Shufeldt:
Has there been a reason for the lower decrease in testosterone level? I know it gets, as you said, lower as you age, but just lower across the board?

Tracy Gapin:
Yeah. So and it's funny you said that as I was drinking from my stainless steel water bottle because we know that the biggest culprit and tons of science behind this is not just my theory, is endocrine disruptors. So endocrine disruptors are chemicals toxins, toxics in our environment that we know crushed our health. They cause immune problems, autoimmune disease, they cause inflammatory conditions, they cause issues with hormones such as testosterone, thyroid, estrogen, we know that endocrine disruptors cause cancer, and it cause mood issues and depression and precocious puberty and on and on and on, and so tons of studies show that there are chemicals specifically related to low testosterone. So, for example, atrazine, atrazine is a chemical that sprayed on our crops, especially our corn crops in the Midwest, and the studies on atrazine show that they massively impact testosterone levels. There's a frog study that frogs were exposed to very low levels of atrazine, like infinitely lower than what we have in our drinking water and in our food, and these male frogs actually turn female and they laid eggs and reproduced.

John Shufeldt:
Wow.

Tracy Gapin:
Pretty crazy. We know that BPA, Bisphenol A is used to make plastic water bottles has a massive impact on testosterone production. We know that phthalates they later are used to make plastics, make plastics bendable and flexible, crushed testosterone. We know that phytoestrogens like soy, most of the soy here in the U.S. is processed and refined and doesn't even resemble the original soybean. And we know that all that that processed phytoestrogen crushes testosterone. We know that estradiol, you know, women are taking birth control with synthetic estrogen estradiol, and it's a very resilient molecule, does not get filtered by the municipal treatment plant, and it's our drinking water and we drink it and it gets into our fat and it doesn't clear, and all these studies show that these toxins upon toxins and toxins are layers of endocrine disruption is happening in us. And it's not just us. There's actually very clear evidence that there's a transgenerational effect as well. So we know that, like women in the nineteen forties were given DES, ... estrogen, a synthetic estrogen for preventing premature labor and stillbirth. And we know that that was stopped when we found that the women offspring, the female offspring, were getting clear cell vaginal cancers. Well, the boy offspring, the boys, the male offspring were having testicular dysgenesis and disruption of normal testicular function. And that's not just that one generation perpetuates over future generations, and so we can look at increased stress, we can look at poor sleep, we can look at the crummy diet nutrition that we have, but you can account for all that stuff, account for the obesity. And I believe that the endocrine disruptors in our society are way more responsible for it than anything else.

John Shufeldt:
That is amazing. So basically a new zero of that. So thanks, thanks for that education, Tracy. Hey, Trac, where can people find out more of you, more about, and where can they come down and visit you?

Tracy Gapin:
Yeah, sure. So my website is DrTracyGapin.com, and my center is The Gapin Insitute, GapinInstitute will have its own website shortly, right now still redirects to mine, but we'll have a separate website for that because I do plan on scaling that brick and mortar center as well to multiple other locations too. So my website, DrTracyGapin.com, and I'm in Sarasota, Florida.

John Shufeldt:
Thanks a lot. Folks who put all this in our show notes. Tracy, thank you very much. This was hugely, hugely interesting and I think very inspiring for a lot of folks. I really appreciate it.

Tracy Gapin:
You got it, John, glad to be with you today.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com Thanks for listening.

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