I am so pleased to welcome Dr. Judson Brandeis, America’s favorite urologist, back to the show for a second interview!

His Brandeis MD clinic is at the absolute cutting edge of male sexual wellness and longevity technology, and we talk about some of the treatments and protocols I went through when I was at his office for our first show.

In this episode, we get further into the discussion of sexual health and how sexual function is a reliable indicator for your overall vascular health (in fact, diminished sexual function is a 10-year warning for eventual cardiovascular disease risk!) and talk about blood flow, how and why certain drugs work, and GAINSwave shockwave therapy to improve penile vascular health. You will learn about the science of erections and how you get erections, how to sustain them, where drugs like Cialis and Viagra help, and where they will just be bandaids on your dysfunctional vascular system. 

You will also hear about the benefits of certain drugs (such as Cialis, which decreases the incidence of heart attacks and improves urinary function, and Viagra, which reduces the risk of dementia) and the importance of testosterone optimization, both naturally and through pharmaceutical intervention, for sexual health and penile performance.  

BrandeisMD is a national leader in technology and innovations in sexual medicine. Dr. Judson Brandeis is the National Director of Clinical Excellence for GAINSWave and created the largest study of Shockwave Therapy for ED ever, and BrandeisMD was one of the first offices in California to offer PT-141, Oxytocin, and Apomorphine for erectile dysfunction. Listen to our previous interview here.

TIMESTAMPS:

If you are keeping your muscle mass, if you’re looking good in your body composition, this correlates directly with sexual function.   [00:38]

What tendencies does he see in his clinic at the different ages of the patients? [02:29]

Gainswave is a high frequency shock wave treatment that’s designed for penile function. As you age, you begin to clog blood vessels. [04:45]

You have to optimize the blood flow to the penis. [06:49]

You need an injury response for blood to the penis like damaging the muscles tissue after bicep curl. [10:37]

Nitric oxide boosters are a wonderful way to decrease blood pressure.  [11:40]

The psychological aspect is 50 percent of the whole process of erection. If your relationship is not where you want it to be, then it is not going to work.  [16:56]

If you are developing erectile dysfunction, it is important to see a doctor because taking a pill is not going to fix the underlying problem. [22:40]

Going into Gainswave office because of erectile problems, is not a magical cure.  One has to live a healthy lifestyle. [26:59]

If you are not real active, your body won’t make as much testosterone. [32:43]

The downsides of replacement therapy are growth of the prostate, although it does not cause cancer, and loss of hair. [35:10]

Educate yourself about testosterone.  There are many people harming themselves from misuse of what they think will help them. [38:27]

It is important to understand the effects of testosterone therapy.  You might be telling your testes to stop making their own. What is happening to your muscles? [49:16]

Adequate sleep is most important for overall health. [56:24]

To summarize, what are the messages for the patients from Dr. Brandeis? [58:52]

LINKS:

• Brad Kearns.com
• Brad’s Shopping page
• B.rad Whey Protein Isolate Superfuel – The Best Protein on The Planet! Available in Two Delicious Flavors: Vanilla Bean and Cocoa Bean
• BrandeisMD.com
• GAINSWave.com
• B.rad Podcast Episode 466 with Dr. Judson Brandeis
• The 21st Century Man

LISTEN:

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Welcome to the B.rad podcast, where we explore ways to pursue peak performance with passion throughout life without taking ourselves too seriously. I’m Brad Kearns, New York Times bestselling author, former number three world-ranked professional triathlete and Guinness World Record Masters athlete. I connect with experts in diet, fitness, and personal growth, and deliver short breather shows where you get simple, actionable tips to improve your life right away. Let’s explore beyond the hype, hacks, shortcuts, and sciencey talk to laugh, have fun and appreciate the journey. It’s time to B.rad.

Brad (00:00:38):
Dr. Judson Brandeis. All right. We’re back again. It’s so excited to be back. I had a great response to the first show with lots of questions from males in a certain age group, especially about the amazing things you’re doing here in your clinic. And, one of the themes was the, you know, the harmonious interplay between lifestyle optimization versus the, various tools that we have available now in the high tech world and in the medical care world for long lifelong male sexual function, longevity, and peak performance. And one of the best themes that came out of the last show was how you emphasize that they go hand in hand. So if you’re keeping your muscle mass, if you’re looking good in your body composition, this correlates directly with sexual function.

Brad (00:01:33):
I believe the quote was seeing longevity through the eyes of the penis. You know, something to that effect. So, uh, Ya gonna make it, you know, I was just talking about these AI things where you could create images. Yeah. Yeah. That’s custom. I’m gonna, I’m gonna create an image of me looking through a guy’s penis. <laugh> tell us like the, like the overall health of Yeah. With your cellular clothes.

Judson (00:01:57):
Yeah. Yeah. I mean, for me, it all starts with lifestyle. Mm-Hmm. <affirmative>, you know, if you’re not eat, not eating too much. If you’re not drinking alcohol, if you’re not smoking, you’re not doing drugs, you’re getting enough sleep, you’re nice to other people, you’re stretching, you’re meditating, all these things that we’re doing in the office. I mean, they’re eventually, you’re eventually gonna need ’em, but you’re not gonna come in when you’re 45 and need it.

Judson (00:02:20):
Mm-Hmm. <affirmative>, you’re gonna come in when you’re 55 or 65, or 75 or 85, you know, you wanna push these issues further down the line.

Brad (00:02:29):
Do you see some magic numbers, if you will, in the clinic where, it’s clearly in the decade of the fifties this tends to happen, or the sixties. And I know there’s masters track and field records where they have this really steady progression. So every, every year you lose like 1% of your ability in the 400 meters, let’s say. And then there’s this huge, um, inflection point in the graph at like, around 70 where anyone who’s still standing perhaps is gonna be, you know,

Judson (00:03:00):
It’s interesting ’cause I show a graph of the world record for the a hundred yard freestyle.

Brad (00:03:06):
In swimming.

Judson (00:03:06):
Swimming but for running, it’s, it’s pretty much the same. And as far as I know, uh, from these graphs, the inflection point really is at 60, right? So if you’re doing absolutely everything, right, kind of like what you’re doing, Mm-Hmm. <affirmative>, um, but you know, even more, uh, with, you know, trainers and, and sleep and, you know, all the things that you should be doing, the, you know, you’ll, you’ll decline at a, at a somewhat steady rate between 20 and 60. But even though the world’s best 60-year-old can sort of compete with the world’s best 20-year-old, but after 60, you begin to decline fairly precipitously. And after 80 it things really take off.

Brad (00:03:49):
Um, the where do you think that’s from in, in a healthy-ish individual?

Judson (00:03:54):
You know, there, it’s multifactorial, but certainly testosterone contributes to that. IGF one human growth factor, nitric oxide. Um, and then there are other factors like methylation and, and how the, your DNA, it begins to deteriorate after those alleges, which, you know, I don’t, I’m not really an expert in that kind of stuff, but, you know, it’s clearly it’s not just one thing. And clearly there are things that we can do, like testosterone replacement or human growth hormone that I, I do much HGH replacement, but I do a lot of testosterone replacement that can really turn the clock back for a lot of guys. And that’s what Gainswave does for bone. Gainswave and PRP and a number of the other interventions we do in the office is it turns the clock back for guys five or 10 years.

Brad (00:04:45):
Let’s hit those, briefly, each one. And so the, the Gainswave is the high frequency shock wave treatment that’s especially, um, designed for penile function.

Judson (00:04:57):
Right.

Brad (00:04:57):
And what is it doing when we get treatments?

Judson (00:05:01):
Yeah, I just add More me feel. Great. 90% of erectile dysfunction, give or take, is vascular eject, meaning it’s related to blood vessels. And as you age, blood vessels begin to get c clogged that undergo down, this is why I keep this in the office, right? So this is a normal blood vessel

Brad (00:05:21):
That was for the outgoing mail or something,

Judson (00:05:24):
You know, as you age, you begin to clog blood vessels.

Brad (00:05:28):
Ah,

Judson (00:05:29):
And then you get to that point. So

Brad (00:05:31):
Those are watching on YouTube is showing a series of increasingly clogged blood vessels.

Judson (00:05:37):
Um, and

Brad (00:05:37):
So not, not looking pretty there at the end with all the yellow and no,

Judson (00:05:40):
The heart pumps. And the two last places that get blood in the body are the toes and the penis.

Brad (00:05:49):
Really? Right? Why is that?

Judson (00:05:51):
Well, they’re the furthest away from the heart.

Brad (00:05:54):
Wow. Okay.

Judson (00:05:55):
But you don’t get toe erections, and when blood flow declines to the toes, you get cold feet, you put socks on, no big deal. Right. It’s not like your feet stop working. If your feet stop working because of vascular flow, you got really, really big problems. Mm-Hmm. But the penis is different, right? The penis moves entirely based on blood flow, and you have to pump enough pressure into the penis that the penis swells and they’re veins that are on the outside of the connective tissue that lines the erectile body. And those veins get squashed, kind of like there’s two layers, kinda like an ice cream sandwich. And the veins live in the ice cream. And when there’s enough pressure, those veins get compressed. And when those veins get compressed, then blood is trapped in the penis, and then you get a erection, and the erection rises.

Judson (00:06:49):
Right? If you don’t get enough pressure in the penis, then blood flow goes into the penis, but then it also exits. And so you get a full penis, but you don’t get a rigid erection. So there’s a threshold blood pressure that you need to achieve in order to get a rigid erection. So, for example, you’re on the roof of a burning building, and there’s another building that’s six feet away. If you jump six feet, it’s a really good day. But if you jump five and a half feet, it’s a really, really bad day. So if you need a hundred millimeters of mercury of blood pressure in your penis in order to maintain rigid erection, if you get 101, it’s a great night. If you get 95, it’s gonna be a really frustrating night. Right? And so, you know, my approach to my patients is you have to optimize all of the aspects of blood flow.

Judson (00:07:44):
And one aspect of blood flow is the signal, which is why you boost nitric oxide and why you take a PDE five inhibitor like Cialis or, or Viagra. And the other aspect is the actual blood vessels, right? So if your blood vessels look like this, then you now generate new blood vessels. And so how do you generate new blood vessels? Right? You generate it through a process called neo angiogenesis. Uhhuh, right? And so what Gainswave does is it introduces a trauma or a sort of situation where there’s the potential for injury in the penis. But what it’s really doing is it’s tricking the body into thinking that there’s an injury. Mm-Hmm. Even though there’s not, like your penis isn’t injured, now, you just like Gainswave, right? Your, your penis isn’t a, yeah. See, your penis isn’t a, a splain, you know, it’s not gonna hurt you.

Judson (00:08:38):
Right. Um, because it’s saw off, say wh and blue. So these shock waves go through the penis, but what they do is they trigger an injury response. Hmm. And part of an injury response is the growth of new blood vessels, right? Because you need blood flow to heal. So when your body is fixing an injury, what it’s doing, one of the things it’s doing is it’s generating new blood vessels so it can deliver oxygen, nutrients, glucose protein, amino acids, all that kind of stuff to the side of the injury. And so that’s the, that’s the, the way that gains weight works. And a lot of people think, well, you’re dislodging plaque. But that’s never been shown or proven in any clinical study, which, you know, I’m a clinical researcher, so I always think of things from a research lens, like, how would you actually do this study?

Judson (00:09:29):
You know, the, the way that they did the study to look at the potentiation of stem cells and the release of proof factors is they had a bunch of rats. This was, the work was done at UCSF by Tom Liu. They did shockwave therapy on, uh, the rats, which, gosh, what, what a job that is <laugh>. Yeah. The, there’s a all sorts of kind of careers, but doing shockwave therapy on rat penises has to rank up there with what, which, interesting. And then they sacrifice the rats and they cut off the penises, and they look at it under the microscope and they see, okay, this, the ones that are getting shockwave therapy have more stem cells, they have more, um, nitric oxide, they have more or nitric oxide synthase, uh, and they have more new, new blood vessels. But how would you do that experiment on 70-year-old guys with cardiovascular disease? You know, you have to shockwave them and they cut their penises off and then look at the penis out of the microscope. And not a lot of guys are lining up with that study. So that may potentially be one of the ways that it works, but it’s never really been proven.

Brad (00:10:37):
So the injury response is that similar to lifting a bunch of bicep curls and, and damaging the muscle tissue and the bicep, and then stimulating the injury response to rebuild stronger and better, better blood flow and so forth?

Judson (00:10:49):
Exactly. You know, it’s the same as muscle building. It’s the same as most aesthetic procedures, right? You go for an IPL laser, right? There’s or a CO2 laser that, that they create a, a bunch of injuries in your face. And part of that injury response is to produce new collagen or microneedling. Right? Same thing. You just take the needle, you stick it in the forehead a whole bunch of times, your body generates an injury response, all of a sudden your face looks puffier and Yeah. More collagen.

Brad (00:11:17):
So could cavalier DIY person take his massage gun and work on the penis to stimulate.

Judson (00:11:25):
Yes.

Brad (00:11:26):
I mean, bump bumping bruising,

Judson (00:11:27):
And then that the, a massage guy might temporarily increase the side of the penis, but it’s not, um, it’s not the right frequency, right. To generate an injury response. Uh, yeah,

Brad (00:11:40):
Man. What’s the role of nitric oxide in the story?

Judson (00:11:44):
Yeah. So nitric oxide is a really, really interesting molecule. Nitric oxide is released by nerves, and it creates a substance called cyclic GMP and cyclic, GMP creates a cascade to open up blood vessels. And as it turns out, after about the age of 40, your nitric oxide levels drop fairly precipitously or your endogenous production, your production that you create. And what that does is it makes blood vessels close. Mm-Hmm. Right? And so when blood vessels close or get more tight, then the heart has to pump harder, right? And we call that high blood pressure. So as you get older, your people are getting high blood pressure. And so nitric oxide boosters are a wonderful way to decrease blood pressure. Right? I routinely take my patients off their blood pressure medications and put them on nitric oxide boosters, which are totally natural and have absolutely no side effects.

Judson (00:12:36):
And the problem is a lot of people don’t know about them because you can’t patent it. So no companies can’t take a nitric oxide booster and make a lot of money on it, and put television advertising on there and hire Lady Gaga to talk about nitric oxide boosters. Right. They’re just, you know, it’s a, it’s a fairly ubiquitous supplement. You know, the supplement that I created was, is called Affirm. And it basically, it uses both pathways for nitric oxide boosting. What pathway is El Citruline, which you get from watermelon, and El Citruline turns D arginine. L arginine is the nitric oxide donor. And the other part are nitrates. Nitrates are in beets and green leafy vegetables. And in the saliva, there’s an enzyme that that transfers nitrate into nitrite. And then in the stomach, there’s an enzyme that transfers nitrite into nitric oxide. And so you get about 50% of your nitric oxide from nitrates, and you get about 50% from the CIT arginine.

Brad (00:13:36):
So a nutritious diet, eating healthy wholesome foods can help you boost nitric oxide, taken a targeted supplement also. And are there other interventions?

Judson (00:13:49):
So, you know, for something like Affirm, you could eat four pounds of fresh watermelon every day,

Brad (00:13:54):
Getting a, a huge boost from diet is gonna be problematic, but you’re, you’re getting your baseline levels as you’re eating a healthy, nutritious diet.

Judson (00:14:02):
Exactly.

Brad (00:14:03):
And so the supplementing is really, um, targeting that cardiovascular health, and in this case, um, why you called it Affirm, is helping with your,

Judson (00:14:13):
I love atu,

Brad (00:14:14):
Your frozenness. Yeah. And this is available on Amazon. And Amazon could this there, and I’m trying it now for maybe six months. And it seems like a really effective product.

Judson (00:14:24):
Well, I mean, a lot of elite endurance athletes take metric oxide boosters. It’s not, it’s not any secret. Our bodybuilders use it as part of their pre-workouts. Oh, sure. Or cognitively, especially men or women over the age of 60, 65. It actually improves brain function because you’re improving circulation of the brain. Hmm. It improves blood pressure, but also, you know, it improves erectile function. So anything in your body where you actually need blood flow, which is pretty much everything, Uhhuh <affirmative>, um, will benefit from nitric oxide boosting. Now, the other, the flip side of it is, now you’ve made this cyclic GMP everywhere, but especially in the penis, how do you keep the cyclic GP uh, available? And that’s where PDE five inhibitors like Viagra and Cialis come in. Because they selectively block the PDE five enzyme, which is only in the penis. None. That’s the genius of Viagra and Cialis, is that they selectively block the PD five, which is only in the penis. So a combination of a nitric oxide booster, which boosts cyclic GP and Viagra or Cialis, will maximally improve erectile

Brad (00:15:36):
Keeping it keeping in there. So it’s, uh, uh, uh, sustaining your, uh, ability to have an erection as well.

Judson (00:15:42):
Right.So if you don’t have enough cyclic GMP, you could take a truckload of Viagra, it wouldn’t work.

Brad (00:15:49):
Uh, and you don’t have enough perhaps because, um,

Judson (00:15:54):
Of diet, it,

Brad (00:15:55):
It, it doesn’t have to do with arterial health. It’s,

Judson (00:15:58):
Well, so black

Brad (00:15:59):
Buildup and

Judson (00:16:00):
What, you know, you’re get, this is arginine is a non essential amino acid. Mm-Hmm. <affirmative>. Right? So you have to get it from the diet. And so if you’re not taking in enough from the diet, or you have a problem with what’s called the endothelium, which is the inner lining of blood vessels, which have what’s called Enos endothelial nitric oxide syntase, which is an enzyme that helps your body make nitric oxide. Mm-Hmm. <affirmative>, then you won’t be producing as much nitric oxide. Mm-Hmm. <affirmative>. And a lot of guys that take these medications, right, Viagra and Cialis, they’ll come see me and they’ll say, well, you know, I’m kind of getting tolerized to it. Huh. You know, it’s not that you’re getting tolerized to it, it’s that you’re nitric oxide levels are dropping, so you’re not making as much cyclic GMP. And so these medications aren’t as effective because the cyclic GMP is really the key molecule for creating a cascade of events that keep blood vessels open.

Brad (00:16:56):
And just jumping in here with the psychological aspect, because as you described process in your book, in your articles, the process starts with, um, the brain sending a message down the spinal cord.

Judson (00:17:12):
Yeah. Well, there are three ways that guys can get erections, visual, mental. So you can create fantasy in your mind or touch. Right. Um, but the psychological aspect is, is huge. It’s, you know, it’s 50%, 50 50, I would say 50%. So for example, I had a patient a couple of years ago, he’s like, ah, dog, a hundred bucks down the drain. I’m like, what? He and Jen, he’s like, well, I took my wife out for a nice dinner. I got a really good bottle of wine. I loaded up on Viagra, and then I said, one stupid ass thing, <laugh>. And it was a hundred bucks down the drain. Right? So keep that in mind. ’cause Valentine’s Day is coming up, <laugh>, and you don’t wanna waste a hundred dollars. But I mean, that, that’s the, that’s the issue, right? So if your relationship is not where you want it to be, then it doesn’t really matter if your physiology is a hundred percent, it’s not gonna work. I mean, I think in terms of like, there’s this Maslow’s pyramid that I created in my mind, the

Brad (00:18:21):
Brandeis pyramid.

Judson (00:18:22):
Yeah. I mean, male sexual. Yeah. I mean it, well, it’s, it’s men’s middle aged health uhhuh, right? So in the bottom is you have to be physiologically healthy, right? You have to exercise, you have to have good weight, you know, don’t drink, don’t smoke, get good sleep, all that kind of stuff, right? Because if you don’t have that, you’re not gonna be able to get erection. Mm-Hmm. <affirmative>, right? Then there’s mental health, right? So if you’re depressed, if you’re too anxious, you’re not gonna be able to get erection. Mm-Hmm. <affirmative>, right? If you’re not emotionally healthy, you’re not gonna be able to get good erections. Right? And then if your relationships are bad, you’re not gonna have a partner that’s gonna want to participate with you. And then if you have all those things, then the top of the pyramid is sexual Mm-Hmm. <affirmative>, right? And so, you know, that whole bottom of the period has to work, pyramid has to work in order for you to get <inaudible>.

Brad (00:19:09):
So can someone problem solve, for example, um, you feel like the, the drug’s not working, or it only works once in a while, then we’re gonna go over to the, the psychological side. In other words, if you can get one good erection under pressure or whatever the, the circumstances are then you know that your arterial health is sufficient. And then the rest of it’s gonna be lifestyle oriented or

Judson (00:19:39):
Yeah. I mean, typically when patients come into the office, I’ll do an ultrasound Yeah. And I’ll look with the ultrasound at the blood vessels, and I’ll say, you know, that your blood vessels look fine.

Brad (00:19:49):
And, and 90% of ED is, is blood vessels. Okay? So those, that population is coming in with a complaint that is legit, rather than they’re just an asshole to their, their partner all the time. And so they,

Judson (00:20:04):
Yeah. And you know, one way to, one way, one question I ask all these patients is, do you get erections in the morning? Mm-Hmm. <affirmative>, right? Because erections in the morning have absolutely nothing to do with the relationship. Mm-Hmm. <affirmative>, it has to do purely with physiology. Right? So this is your mother nature’s way of keeping our penis healthy. Mm-Hmm. <affirmative>. So every time you go into REM sleep, which is dream sleep, which is about 30 to 60 minutes every night, you should be getting in a significant increase in blood flow to the penis. So you should be getting nighttime erections. Now, if you’re not getting nighttime erections, then there’s a problem with the vascularity or the blood flow to the penis, and there’s a, there’s a nifty little gizmo called the Firm Tech. Um, gimme one sec. Hang. Right. So this, this Firm Tech ring Oh. Has a little pressure sensor in it. Ah-Huh. And so you put this thing around your penis, I’m not gonna demonstrate here, but you put this thing around your penis before you go to sleep, and then it measures how many nighttime erections you get. Right?

Brad (00:21:02):
Every time it expands, it counts or something.

Judson (00:21:05):
Exactly. Wow. And so we’re actually gonna do a, a study with a firm and the Firm Tech where people are going to record their erections without taking a nitric outside booster for a couple of nights. And then they’re gonna record their erections with taking a nitric oxide booster for a couple nights. And what we expect to see is an increase in vascular flow in the penis at night by taking a nitric oxide booster.

Brad (00:21:34):
So if someone comes in with poor arterial health, the ultrasound looks bad, and hence you conclude that’s the reason they have trouble getting erections. Would this also always go hand in hand with overall poor cardiovascular and metabolic health? Well,

Judson (00:21:51):
You know, so that’s kind of the canary in the coal mine, right? So by the time you lose morning erections, it’s about 10 years, you know, 10 year warning, seven a 10 year warning sign till you lose erections in bed. And then from the time you start to lose erections in bed, there’s another 10 years before you develop cardiovascular disease. Right? Because the blood vessels to the penis are one or two millimeters. And remember, it’s pyro squared. So it’s basically the blood vessels in the heart are three to four millimeters. So the lumen of the blood vessels going to the penis are about a quarter of the size of the blood vessels going. They clogged up first before you have a heart problem. Exactly. And remember, their peripheral, right? The first place that your heart pumps blood is back to the coronary circulation.

Judson (00:22:40):
Right? So not only are the blood vessels bigger, but they’re, they’re closer. So, you know, if you’re developing erectile dysfunction, it’s really important that you go see a doctor, because just taking a pill isn’t gonna fix the underlying problem. That’s why lifestyle is so incredibly important. And especially if you have a family history of heart disease, especially a family history of early heart disease, you really wanna get checked up. And the easiest way to do that is to get what’s called a heart calcium score. Mm-Hmm. <affirmative>. So it’s a CAT scan takes one minute to do. It’s usually a couple hundred bucks. And I say it easy

Brad (00:23:20):
Though, ’cause I had to call all around town and no one knew what I was talking about. It was unbelievable. I was looking through the internet and finally found a place. Yeah. I mean, it’s like not a routine test.

Judson (00:23:30):
No, It’s, it’s not a routine test, but it’s actually a fantastic test because it will pick up early cardiovascular disease. Like for example, like we did that VO two max step Mm-Hmm. <affirmative> VO two max will give you a number, it’ll give you an idea of like what your level of cardiovascular fitness is. But if you go to a cardiologist, 99 times out of a hundred, they’re gonna do a stress test. Right. What does a stress test tell you? A stress test will tell you if there are gonna be changes in the electrical polarity of the heart. Mm-Hmm. <affirmative> based on an ischemic event, based on the heart of the heart not getting enough oxygen. So basically, either you’re bad or you’re not bad, is the answer that you get on a stress test. You don’t get a number that says you could crap

Brad (00:24:18):
Out at, um, at a, at a 15 minute mile and be out of breath and done with the stress test. And it looks good, but you’re in shape.

Judson (00:24:25):
Yeah. I mean, what BOT max tells you is like where you are on that continuum of being in, in good shape. And so that’s, that’s really what you wanna know. Mm-Hmm. <affirmative> is the heart calcium score will give you a number anywhere from zero to a thousand. You know, if you’re at a thousand, you should be heading to the operating room for a single vessel cabbage the next day. And if you’re zero, which 50% of people are, you’re doing great. But say you’re 10, or say you’re 40, or say you’re a hundred or 200 guys, in my experience, guys respond to numbers. And so when you get a number that’s not perfect, all of a sudden you kind of scratch your head in and say, oh, I gotta do something about, I got a patient, we did a VO two max test on him, and he was like 40, 41 and it came out, he wasn’t in great shape.

Judson (00:25:21):
So it said his chronological age was 41, but his biological age was 44. Wow. Right. So I said to him, I said, you know, if you keep it up, you’re gonna lose at least three years of your life expectancy with a, and he’s like, oh my God. And he, like, overnight, he started exercising, he started eating better, his habits were better. Like, I didn’t really have to say anything after that. It was just like, there’s the number, I mean, I could lie to you, but, you know, that’s amber. Yeah. You’re gonna lose three years up your life expectancy if you keep things up, or you can Totally, yeah. Or you could totally turn it around and probably in a year or two. He’s gonna fix things that maybe his biologic age will be 38 or 39. I mean, your biologic age was what, 10 years less than your chronologic age?

Judson (00:26:12):
I had a good VO two max score, but yeah, I mean, my biologic age was I think seven or eight years less than that. Like chronological age. I mean, it’s, anyone could do this to us. It’s not like any magic. It’s not like any a hundred thousand dollars pill Mm-Hmm. <affirmative>, just get out on the trails, improve your V two better score. Right. Drop some of your unhealthy habits, sleep better. Yeah. And, you know, there’s a time and a place for interventions like GainsWave or PRP or penile Botox or M cell chair or peptides like PT 1 41 or, you know, all these, these things that I offer in my office and I’m, and I’m researching and so on and so forth. But clearly the cheapest and easiest and best is home grown.

Brad (00:26:59):
And how does that go over in your clinic? I’m assuming that someone who comes through the door is already preselected to have an extreme interest in their health and the budget and the, the discipline to do what you’re gonna say it’s not, you know, it’s off the beaten medical pattern, right? Yeah. I

Judson (00:27:15):
Mean, some, some do, some don’t. I mean, some come in just ’cause they can’t get erections and they think that I have some sort of miracle that’s gonna make them better. Yeah. and I mean, something like Gainswave is, it’s pretty cool. But I mean, if, if you still wanna be fat and smoke and not work out, it’s not gonna work very well. Right? Right. It may give you a bump for a little while, but, um, and what I want to do with my patients is to create a long-term path to living their best life and, and benefit here. I get it. I’m not really that interested in just doing something like Gainswave and then having someone just keep doing the stuff that they’re doing. That’s why we do the body composition. That’s why we check testosterone and all the other labs. Is it, it’s a overall, you know, if your engine’s conked out, why change the tires? Mm-Hmm. <affirmative>. Yeah. It’s like your car’s not gonna run that well, you know, you wanna, you wanna fix the engine and fix the tires and then maybe get a new coat of paint and some fuzzy dice on the right end the dashboard, and then, you know, then you’ll be attracting women. Yeah. But, uh, but if, if you don’t do all those things, it’s not gonna really work out all that well. Mm-Hmm.

Brad (00:28:31):
<affirmative>. Um, so we’re basically trying to get a optimization of the next 10 or 20% by taking advantage of the, the protocols and the, and the medications too.

Judson (00:28:43):
Exactly. And you know, like we talked earlier, testosterone really is an important part of that and that’s something that as you get older, your testosterone declines and

Brad (00:28:56):
Either precipitously or gradually dependant upon.

Judson (00:28:58):
Yeah. I mean, usually it’s, it’s gradually, but can be precipitously. Right. Um, and, and there again, it’s a lot of it’s lifestyle, but it doesn’t necessarily have to be, and you know, some people it’s just genetic. Some people it’s diet. Um, but that’s certainly something that we check. Mm-Hmm. <affirmative>, uh, and if it’s low, uh, and you know, like, for example, I have a supplement called Support, which is DHEA, which is a testosterone precursor. It’s T at Ali, which helps boost free testosterone. Its dm, which blocks the conversion of testosterone to estrogen, and its ashwagandha, which helps boost testosterone. But you know, even something like support can only boost testosterone 15%.

Brad (00:29:45):
Right. Uhhuh.

Judson (00:29:46):
Right. So beyond 15%, if your testosterone’s 250 or 300, or even 350, and clinically you have low testosterone, meaning you have low energy, you’re not thinking as well, you’re not sleeping as well. You have less drive, less sex drive, less libido. Your muscles are beginning to waste away. You’re putting on fat, Testosterone can be, you know, lifesaving could be miraculous.

Brad (00:30:10):
You were talking about, uh, one of your patients where they, they had to replacement therapy, then they had more energy so they could go work out more. And they had amazing improvements in body composition, adding muscle mass, dropping body fat. But first you have to get out of the chair and get going. And a lot of times I think we forget that if you don’t have that natural drive and that baseline energy to go and lift up a weight, it’s gonna be really tough to change your lifestyle.

Judson (00:30:40):
Absolutely. And it’s not, it’s not just a question of like, you know, get your ass off the couch and go do it. I mean, testosterone really does affect the brain. And if your testosterone’s low, you won’t have that innate motivation or drive that testosterone gives you. So, for example, I used to treat a lot of patients with prostate cancer. When you have metastatic prostate cancer or prostate cancer that’s spread outside the body, one of the first interventions is to take a medication that will medically castrate you. Because testosterone is at high levels will push the growth of prostate cancer. Mm-Hmm. <affirmative>. And if you eliminate testosterone, it will basically make your PSA go from high number to zero mm-Hmm. <affirmative>. Right. Because it will, will basically stop the growth of prostate cancer. But there are a lot of negative effects of making someone medically castrated, which include putting on fat and getting rid of muscle.

Judson (00:31:48):
Mm-Hmm. <affirmative>. And so it’s really, you know, it’s dramatic. And these guys just don’t have the motivation to go to the gym. And then also they don’t have the signal to build muscle. Mm-Hmm. So for example, you’re 12 years old, right? You’re this little scrawny kid, and then seven years later you’re 19. You put on a lot of muscle, you’ve taken off fat, you’ve grown an inch, your penis grows. You put on, you know, pubic hair, you’re chasing girls around. What’s the difference? The difference is testosterone. Your testosterone went to from 200 to a thousand. Right? That’s the power of testosterone. Testosterone is not a drug, it’s a hormone. We know exactly what the effects of testosterone in. And if you’re in your forties or fifties or sixties or seventies or eighties, and your testosterone’s low, it’s very clear what the benefits of of winning soma hot.

Brad (00:32:43):
So when you say low, we have the generally recognized normal quote unquote range. They just bumped ’em down. Right. Which was a funny story, but it’s something like, 200 to 900 or something. Yeah. I mean, the

Judson (00:33:00):
Range is

Brad (00:33:00):
Huge. Yeah. So that’s why I’m asking, like,

Judson (00:33:03):
It’s like, do you want to be a middle? It’s other people? Well, you know, you could be anywhere between five foot and seven foot. Yeah. Um, but it’s not just a number. It’s clinically how are you doing? Mm. And also, what are you doing? So I treat a lot of first responders, police, fire, SWAT, those guys, those guys need higher levels of testosterone. ’cause they’re chasing around bad guys that are 20 years old that are, you know, high on methamphetamines or whatever. And, they’re doing bad things. And, and these police officers whose testosterones are 400, 450, 500 or less because they’re doing overtime or they’re doing, I just saw a guy the other day that does the night shift. Right. And his testosterone was low. And guess, guess when your body makes testosterone at night. Right. So if you’re up all night expanding energy, guess what? You’re not gonna make testosterone.

Brad (00:33:57):
Yeah. The stress hormones antagonize the production of testosterone.

Judson (00:34:01):
Exactly. Yeah. Well, and that’s when your body actually makes testosterone. That’s why sleep is so important. Mm-Hmm. You know, you build muscle when you’re sleeping. Mm-Hmm. You know, you fix your brain when you’re sleeping. You build testosterone when you’re sleeping. Uh, and so if you’re not getting enough sleep, guess what? You know, you’re not gonna build enough testosterone. So, and I mean, I’ve had dozens of stories from my first responder patients where they’re in life or death struggles with criminals. Mm-Hmm. Where if they didn’t have adequate testosterone levels, they probably would’ve been in big trouble. And so now if you sit behind a computer, you’re not in mortal danger. And you may not need those testosterone levels, which is actually why as a society, our testosterone levels have dropped 30 or 40% over the last 15 years because demand of Well, yeah.

Judson (00:34:58):
I mean, if you’re physical, if you’re like, say you’re a hunter and back in the caveman days Yeah. You needed high testosterone because you are hunting wild animals which don’t like to be killed. Yeah. If you’re a farmer, you’re not hunting wild animals, but you know, you’re tilling the fields and it’s very physical work. You need high levels of testosterone, maybe not as quite as, as high as hunters. But if you sit behind a desk all day and on a computer, and, I’m not criticizing people for doing that, but I’m just saying, your body is smart. Your body is only gonna make what it needs. And so if your body’s like, well, yeah, I’m not out killing animals, and

Brad (00:35:34):
You’re not going to the gym and you’re not competing at anything, and

Judson (00:35:37):
Then your body’s like, well, well, you don’t need that laser testosterone. You know, it takes energy and, and substrate to make testosterone. Your body’s like, I’d rather be something else with Yeah.

Brad (00:35:47):
If, if you’re in a committed relationship, your testosterone drops due to the increase in oxytocin and or when, when a father, when the baby is born, the father’s testosterone drops and all that. Yeah.

Judson (00:35:59):
Isn’t that interesting? Yeah. ’cause mother nature doesn’t want you going to chasing

Brad (00:36:04):
It’s what make whatever you need. Exactly. You got your, you got your, your, your conquest. It’s

Judson (00:36:08):
Like those penguins that keep the baby in there. Ah-huh?

Brad (00:36:10):
Yeah. Yeah. Um, so you’re, you make a good case. And, the subject has become a, a mainstream topic now, uh, about replacement therapy. And for decades, we were informed that there was this, uh, horrible downside of, uh, introducing exogenous male hormone. And now it appears that that downside has been misinterpreted and that there’s not much downside and there’s a tremendous amount of upside. Okay. So

Judson (00:36:40):
I’ll tell you what the downsides are. Okay. Um, and I have a, if you go to my YouTube, which is Brandeis md, I just did a, like an hour long webinar for first responders, which goes through all this stuff. So you don’t have to remember everything I said, just go to my YouTube and look for the testosterone webinar for first responders. But basically it does not cause prostate cancer. Mm-Hmm. <affirmative>. So don’t worry about that. It will make your prostate grow a little bit over time because testosterone’s converted into dihydrotestosterone. But there’s a ton of things as urologists that we can do fixed prostate problems. Mm-Hmm. Also because of DHT, you can lose hair on your head. That’s not what happened to me. But you can lose hair in your head. And so we recommend a biotin based supplement, oral minoxidil, a near infrared light helmet, PRP for the hair.

Judson (00:37:33):
So there are things that you can do to prevent that, that hair. Mm-Hmm. <affirmative>. But that is definitely a concern for some folks. You also can get oily skin. Right. Or, or acne if you’re prone to do that. And remember, this is just like putting people through a second puberty Mm-Hmm. <affirmative>. Right. The other thing that happens is your testicle shrinks Mm-Hmm. <affirmative>. Right. Because you’re bringing in testosterone from the outside. And so your testicles are saying, well, you know, we don’t have to do our job anymore. Someone else is doing it for us, but I put my patients on a medication called Clomophine or Clomid. And that prevents the testicular atrophy. Hmm. You can either be on that or HCG. Hmm. Um, so that’s a fixable problem. Um, the other thing is that testosterone converts into estrogen. So you can have higher levels of estrogen, but there’s a medication called anastrozole, or natural supplement called DIM, which blocks the conversion of testosterone estrogen.

Judson (00:38:27):
Uh, and so I have a compounded medication of a small amount of clomid and a small amount of anastrozole that my patients take every day. And so we prevent that complication. The other thing that can happen is your red blood cell count can go up and if it gets up too high, it can put you at risk for cardiovascular problems. So, for example, there were some Belgian cyclists maybe 10 years ago that were taking EPO evos all.

Brad (00:38:53):
nineties, the middle nineties. So it was, um, 30 years ago.

Judson (00:38:58):
Yeah. Maybe 30 years ago. And they were, they were dropping dead in the middle of the night. Yeah. Well, I mean, well, what was happening is like, so then your, your red blood cell counts are too high. Mm. And then you get into a bike race Mm. And you get dehydrated. ’cause you’re climbing off all these mountains and then all of a sudden your blood turns into sludge, you know, it turns into big mud.

Judson (00:39:19):
And some of these guys were getting strokes. Mm-Hmm. <affirmative>. Uh, and so, but if you’re doing this at a doctor’s office, you can get blood tests and get it checked and it’s totally safe. The problem is people are doing this over the internet or with Jim Bros. Oh. And when they’re doing it over the internet or with Jim Bros, then they don’t have access to testing. They don’t have access to knowledge. So, you know, I wrote a bunch of eBooks. If you go to my website, brandeis md.com, under media dropped out to eBooks, there’s a bunch of free eBooks on testosterone. Download them, please read them. Learn about testosterone. I know so many educated people that really hurt themselves through the use of testosterone. I had a patient the other day, a smart guy. He got some tamoxifen from one of his buddies. Mm-Hmm. <affirmative> tamoxifen, uh, acts as a selective estrogen receptor modulator.

Judson (00:40:22):
So it blocks the negative feedback loop and it can make your testosterone levels go up. But we use it mostly for women with metastatic breast cancer. And he was taking levels of a woman with metastatic breast cancer. And after three days, he lost his ability to get an erection. ’cause I looked it up. 20% of people that are on, men that are on Tamoxifen lose their ability to get an erection. Right. So, and he comes to see me six months later, things still aren’t much better. So the moral of the story is don’t do stupid shit<laugh>. There’s a lot of really good information out there. It’s hiding stupid shit. Yeah. I mean, all my, you can do minor stupid whenever you want. I had a, I mean, I had a patient who was getting testosterone from his Jim Bros. And, you know, I don’t overcharge my patients. So, um, you know, we sell it for a pretty reasonable amount of money. So he came in with one of his friends, um, to get a body composition scan. You heard about that? We were doing testosterone. He wanted to convert it over to me. And I said, I’ll start taking care of you, but the first thing we need to do is to get a full set of labs. Mm-Hmm. <affirmative>. Right. And his hematocrit was sky high over 50, and it was like 58.

Brad (00:41:44):
Now that’s, that’s scary, huh?

Judson (00:41:45):
Yeah. And so I, I sent him a text. I said, you need to go and get two units of blood at Red Cross right away. And he blew it off. Oof. And he ended up, it’s a true story. He, and then doctors

Brad (00:41:57):
Are texting me all the time. I just blow off the doctor texts giving medical advice. Yeah. I listened to my Jim Bros instead.

Judson (00:42:03):
Exactly. Well, he ended up getting a blood clot in his liver Oof. That went to his intestines and infarcted his intestines. And he had to be transferred from Kaiser to either UCSF or Stanford for a higher level of, of care because he was in the intensive care unit. I mean, it’s really bad when your intestines die. Right. That’s a true story. I mean, it doesn’t, it’s the first time I’ve ever heard of it. But if you’re out there taking these medications without someone who actually knows what the heck they’re doing, you can really hurt yourself.

Brad (00:42:42):
So, we hopefully are getting routine blood panels throughout life and, uh, looking at, especially looking at those male hormones. And I’ve talked a lot about, on my show, how frequently I test my, my free T, my serum t and my sex hormone binding globulin focusing on the male hormones. ’cause I think they’re proxy for all the other stuff that are usually fine. And if you’re seeing good numbers, then you’re not really a candidate for replacement therapies the proper term. But just so the listener viewer understands, like when we hear about the dopers and sports, what they’re doing is abusing these substances and putting in super human levels so they can break records. So you’re talking about at your clinic and your patients and people making this decision is, um, hormone replacement therapy to get to a therapeutic level. That’s, that’s gonna make a difference in life. But you’re, you’re not gonna be, um, you know, bashing in car doors and Yeah. And superhuman strength, you know, so

Judson (00:43:41):
You bring up a really, really good point, which is what is actually an appropriate level. Hmm. And when I was doing general urology, you know, just like a regular insurance-based conventional doc, I would say, well, you know, let’s get guys to 500 to 700. Let’s get ’em right in the middle of normal. Right. But that actually doesn’t work. Hmm. Right. Um, now I get my guys between 1,000 and 1400.

Brad (00:44:05):
So that’s, above what almost anyone would deliver naturally, even a studly college athlete. But 1000 would be kind of the upper end of what you see naturally or, or without intervention. You know, if

Judson (00:44:19):
You have a vintage car, you need high end gas.

Brad (00:44:23):
You mean an older patient? Is that what you’re saying? Or what Yeah. I mean,

Judson (00:44:26):
You know, if you, if you wanna get performance out of a guy in the sixties or seventies, you have to push more testosterone into that person in order to build, like for example, there was a study at that out of the Fielding Lab at Tufts that looked at 20 year olds and 50 year olds doing the exact same exercise routine. No, no. And the 20 year olds built three times as much with aole as the 50-year-old.

Brad (00:44:51):
They recover three times faster. Exactly. Minor Achilles tendon issue or whatever. So getting someone from 200 up to seven or 800 is not gonna be a huge bump, not gonna be a huge lifestyle effect. It’ll, it’ll

Judson (00:45:05):
Help. Yeah. But you know, I’ve talked to these people a lot and how you, how you doing, ah, you know, maybe a little bit better. And the part of the reason is most of the treatment modalities are gels, creams, patches, and you don’t get, I have another testosterone ebook on testosterone bubbles. Right. So the, all the testosterone preparations that are gels, creams, you know, anything that’s transdermal will only get your level up to about 450, 500. Right. Because think about this way, right. Testosterone’s a big molecule. It’s a 27 carbon steroid hormone another one. Right. Water H2O, that’s a little molecule, right? Mm-Hmm. <affirmative> when you jump in a pool to get water logged. No, no, of course not. How come? Because your skin keeps little molecules, like H2O from crossing the skin barrier and water locking you. So then think about like a little molecule versus a bigger molecule like testosterone. How does testosterone get into your bloodstream? I mean, there are carrier molecules that carry stuff through the skin, but it doesn’t do it at a high enough level. Mm-Hmm. <affirmative> that’s really gonna move the needle. So really only things that are gonna get your, your testosterone up to 900, a thousand, 1400 are either pellets, testosterone, pellet that we put under the skin that last about five or six months, or injection deck. So

Brad (00:46:40):
The pellets spewing a little bit into the bloodstream over a very long period

Judson (00:46:45):
To the skeleton drips. Yeah. Consistently. And

Brad (00:46:47):
The injections going right into the bloodstream.

Judson (00:46:50):
Well, it goes into the muscle and that, and that it, and that it slowly diffuses into the bloodstream. So there’s subcutaneous injections into the fat, or there’s injections into the muscle.

Brad (00:47:01):
Right. And that’s something that you would do fairly frequently if you’re Yeah. Replacement regimen.

Judson (00:47:07):
So for my patients, I usually try to have them do it twice a week. Right. Because if you do it once a week, or sometimes even people do it once every other week, you get really high peaks and then drops and then peaks, and then drops. That’s when you, you dip into like that maybe that road rage thing where people are getting a little bit more aggressive because of the peak and then before the next injection, you know, they’re, they’re back to being like a lamb and then they sack out to being a, they go from round to that lamb.

Brad (00:47:35):
Oh, <laugh>. So, um, sounds like you are taking this fork in the road where you’re gonna be dependent upon the outside source of testosterone when you make that decision to go on replacement therapy.

Judson (00:47:51):
Well, now, but if you go on cloma feed, right. That keeps your testicle producing uhhuh <affirmative>. So you could get off testosterone at any point in therapy and say, you know, stop for me, um, and your testicles will kick back into making normal route testosterone. But, if you don’t, like I saw this one, um, X Raider all pro guy, just giant 350 pound guy. I mean, like, couldn’t believe how big he was, but his testicles were that big. Ah. ’cause he was, he for a long time because he played in like the eighties and nineties and he was using for a long time and he wasn’t taking something like cloma feet or HCT. And so now his testicles are small and they’re, if you do it for long enough, you’re gonna, they’re gonna stay small.

Brad (00:48:35):
It’s irreversible.

Judson (00:48:37):
Yeah. For me to be do it long enough, it’s

Brad (00:48:39):
Irreversible. Yeah. however, today with advanced medical science, we can remain on, replace some therapy for a lifetime, I suppose.

Judson (00:48:49):
Yeah. I mean, you know, it’s like that expression. Everything’s better with bacon <laugh>, everything’s better with testosterone. Right. Like all the benefits of testosterone, even there, you know, it’s heart healthy or it’s just a big study that came out confirming that testosterone reduced the risk of cardiovascular disease. It actually reduces the risk of diabetes and type two diabetes. I mean, it does so many beneficial things.

Brad (00:49:16):
I mean, isn’t it arguably prostate healthy too? In in some ways.

Judson (00:49:22):
In in some ways,

Brad (00:49:25):
Yeah. Which is the, in case you’re not familiar, that was the dire warning that we’ve heard for decades, that, um, testosterone will drive the, especially, reproductive cancer. Yeah. I mean, if

Judson (00:49:36):
You think about it, what is your testosterone highest in your twenties? When is your risk of prostate cancer almost zero in your twenties? When is your risk of prostate cancer highest? In your seventies. When is your testosterone lowest? In your seventies. So, you know, there’s, there’s an inverse relationship between testosterone levels and your risk of prostate cancer.

Brad (00:50:00):
And also if you arguably maintain fitness muscle mass VO two max, you’re gonna be resilient against all kinds of, uh, cancer and, um, you know, metabolic breakdown thanks to doing what you’re doing.

Judson (00:50:14):
Yeah. I mean, exercise fixes almost everything.

Brad (00:50:18):
So I’ve, you know, I’ve, I’ve long, I’ve had a longstanding belief and, and behavior system of, of avoiding all outside, um, intervention, prescription drugs, anything. And I’m very open-minded to the topic, especially when we get deep into this and realize that the adverse side effects that, you know, we’ve heard about are, are, are, are not really, um, validated by science. But I’m also believing that I’m gonna do the best, my best I can with every lifestyle category, test frequently. And if I see I’m seeing a good result, so I, I’m not even a candidate. And also that lifestyle part where you say, how are you performing? And I’d love to perform better, and if I, if I got my testosterone up to 1400, I probably would. But at a certain way

Judson (00:51:05):
Absolutely. I mean, you know, we all, there’s that, that performance card that we were talking about. Yeah. Where at 60, at least in the data that I have, you’re, you decline, it’s like, life is like walking up an escalator, right. When you’re younger, you can get up the escalator, but as you get older, the escalator gets faster and faster and faster. And so, you know, at a certain point, all you wanna do is maintain, and then at a certain point, you just don’t wanna decline as fast as you’re supposed to declare. You’re talking

Brad (00:51:35):
About walking up the down escalator. Yeah. Oh yeah. That’s when I got in trouble for when I was a little kid. I loved doing that. You, if you go fast enough, you can get up to the top. Yeah. But, but you just wanna still, when you’re 70 put Yeah. You can’t do that anymore. Yeah. Don’t get sucked out the back. That’s all you want. Exactly. Yeah. Yeah. Okay. I know

Judson (00:51:51):
You, you don’t wanna be sprawled on your ass. Yeah. Off the escalator. Yeah. You know, ’cause it goes, it, it goes faster and faster. Like when we’re after the age of, I think 30, we lose 0.8% of our muscle mass per year. Mm-Hmm. <affirmative>. Um, but after the age of 70, it goes to 1.5%. Ooh,

Brad (00:52:09):
That adds up.

Judson (00:52:10):
I know. Per year. Yeah. And that’s just the way nature is Now. If at 70 you start taking testosterone, you may actually build muscle. I mean, I have all my in bodies. I can show you lots and lots of patients who are patients here who I put on testosterone and I put on my sculp machine Mm-Hmm. And then three months later we, we check their, their muscle mass and lo and behold, it’s higher by some very significant three to five pounds of new muscle that we can build based on testosterone. And some of the other technologies I have, like emco, you actually can build muscle on guys that are in their seventies.

Brad (00:52:51):
Um, well certainly if they dedicate the time and energy to it, which maybe they have arguably better than other decades where they’re immersed into career and family.

Judson (00:53:00):
Well, but If you get testosterone’s two 50, it doesn’t matter how often you go to the gym and how much you do. Mm-Hmm. <affirmative>, you’re not gonna do pill loss.

Brad (00:53:08):
Uh, I suppose if, if you’re walking into a gym with low testosterone and some metabolic problems and low VO two max and just outta shape, and in the older age groups, you’re gonna progress to a certain point. And it’s not gonna be terribly impressive is what you’re saying.

Judson (00:53:26):
I mean, no, or you may not progress at all. You know, the other thing is diet, right? Mm. Muscles made outta protein. So if your diet is mostly carbs and you don’t have much protein mm. Guess what? Your muscles are gonna waste away. Mm. If you’re not adequately hydrated when you’re exercising, you’re more likely gonna get hurt because your tendons and ligaments are gonna be dried out. Um, and your blood pressure, you gotta have to work harder to maintain blood pressure. Your performance is gonna be weak. So, you know, maintaining adequate hydration when you’re working out something like creatine. Right. So creatine, I mean, it’s a supplement. Creatine monohydrate, it’s typically for younger guys who recommend five grams a day. Mm-Hmm. <affirmative> almost every pro athlete. Um, and, and amateur high school, college athlete is taking creatine. But then after we stop competing, we forget about it. Right?

Judson (00:54:21):
<laugh>, but it, we still have the same physiology. Right. Creatine, basically just regenerates a TP. And what do we need a TP for? Anything that involves energy. So anything that’s a very energy intensive activity like exercising or even if you’re, um, you know, doing something mentally, like taking a test for three four. Yeah. It helps refresh the brain. It helps, yeah. Being refresh the brain neurons by building, rebuilding, or regenerating a TP and then also a nitric oxide booster. Like if running right is gonna help boost circulation. So you deliver oxygen and blood to where it needs to go. So these are all things when you’re twenties or your thirties, you can get away with a lot of stuff. Right.

Brad (00:55:07):
You’re still, you’re still have, have a lot in the bank, I say,

Judson (00:55:11):
And you know, once you cross that 50 barrier Yeah. You really have to begin to think much more intelligently about building muscle, burning the fat, not getting injured, you know, and, and tailoring your exercise. Like, I love running, we were talking about it before, but you know, it messes up my back and it screws up my legs. And so now I do elliptical. What I’d like to go out, run on the trails. Yeah, you bet. But my body can’t take it anymore. Or, you know, biking, you know, I’d love to be out on a road bike, but too many people I’ve seen get dead or know too many people I know got crashed on a mountain bike and I just, in my life, I can’t afford that right now. Right. You Well, I get on my, I get on my spinner bike and I put YouTube on, and I’m riding through the house one day and I’m riding through Hawaii the next day. So, you know, it’s, it’s okay. And I get a really good workout because I’m not to stop for stop signs or any of that kind of stuff. And you, you,

Brad (00:56:08):
You get to finish the workout and, and, and live to tell about it. Yeah.

Judson (00:56:12):
Yeah. So, I mean, it’s, it’s more boring, but that’s, that’s what you, that’s what I have to do in order to maintain a level of fitness that will keep me go. Yeah.

Brad (00:56:24):
Yeah. Well, uh, and sleep. Right. And, and sleep. Sleep is, uh, it seems like everything flows downstream from getting adequate sleep because we’re talking about male hormones and things that are gonna get destroyed if you’re, if you’re sleep habits are off, even if you’re on replacement therapy, I suppose.

Judson (00:56:42):
Yeah. And that’s why a single intervention doesn’t move the needle. Mm-Hmm. Because you need a whole bunch of stuff to move the needle, and then when the needle’s not moving well enough, then you need interventions like an nitric oxide booster or testosterone supplement or Gainswave or PRP, um, in combination with those lives. Yeah.

Brad (00:57:05):
That, that’s just respecting the differences in, in aging over the decades and doing something about it. But I meanwhile, you know, supporting that, that graceful aging from the, from the bottom of the pyramid. Yeah.

Judson (00:57:18):
Yeah. According to my patients, there’s really no such thing as graceful aging. Aging is rough.

Brad (00:57:24):
It’s, if you, um, if you don’t do anything about it, it’s even more rough. Yeah. But I will say it’s rough anyway, when you’re talking about t difference. Oh yeah. I mean, you and I were getting away almost

Judson (00:57:35):
The injuries. Yeah. Like little minor injuries that you have that, that, you know, wouldn’t, wouldn’t really bother most folks. But when you’re a competitive athlete Yeah. And you’re trying to do the things that you were doing when you were 20,

Brad (00:57:48):
It’s different. Yeah. Tough. I remember my son in a middle school track me in, in the four by one, and he’s, he’s cranking around the curve and all of a sudden he pulls up lame, like you see the guys in the Olympics, and he is grabbing his, his left hamstring, and he’s in excruciating pain. He is lying on the track. And I’m like, oh no. There goes the track season and the basketball team’s headed to the championships. This is a disaster. And I help him off the track. We go home, we ice it, and then like three days later he’s getting dressed for basketball practice. And I’m like, wait, are you think you can practice already? How’s your leg? And he goes, he forgot which leg. It’s fine. And you sure. And he was like, yeah, he’d forgotten, you know, it was completely healed in three days and you know, I’m looking at 13 weeks or whatever with all those things. So, um, it’s a careful balance to respect that instead of when these people say aging is just a number. And I heard someone strongly refute that, and I appreciated that take for a moment. ’cause it’s not just a number. You better respect the crap out of it and do everything you can.

Judson (00:58:50):
Yeah, exactly.

Brad (00:58:52):
So we have some, uh, assignments here that we’ve, we’ve, uh, received during this, this great show. Maybe we could just summarize and, uh, when you’re, when you’re dealing with these real people coming in here every day, what are the, you know, the biggest payoffs and the biggest send offs that you give your patients to maximize the results of what you do?

Judson (00:59:10):
Yeah. Well, and there’s really some simple stuff. Don’t drink alcohol. Don’t smoke cigarettes, don’t eat too much. Don’t do drugs. Make sure you exercise every day. Try to stretch every day. Try to meditate every day. Right. Get a good night’s sleep. Be nice to other people. Love it. Like, I mean, those like nine or 10 things, that’s just like a, like a no brainer.

Brad (00:59:35):
Yeah. And if you’re watching, and not listening, I’m showing his book, the 21st Century Man, this beautiful gigantic volume that you can get on YouTube And, tell us how you came up with this project. ’cause it’s quite a unique book with the different chapters and all. Yeah.

Judson (00:59:51):
So, you know, we all got Covid and so I had had on my, I had just look that hang,

Brad (00:59:56):
This guys

Judson (00:59:56):
Do for two, three months. And I’m not one of those people that can just sit around and, and play mini golf, and so, or real golf. Or real golf. Yeah. Um, well, I think the golf courses were pretty much closed too at that time,

Brad (01:00:08):
For whatever reason. And the hiking trails were closed in the, in the county of LA I’m like, wait a second, are you kidding me? This is exactly what we want people to do is get out in the outside, but whatever.

Judson (01:00:17):
So, you know, it started as a, a small book on sexual medicine, but, you know, as I would see patients and they would come and talk to me about their issues, like, well, sleep problems or relationship problems or addiction problems or physical problems, I began to add chapters to the book and to the point where it got to be 101 chapters and really is the most comprehensive men’s health book ever written. And it’s written not just by me, um, because I, I only know a certain amount of stuff, but me and 60 of my other, uh, men’s health physician and, and expert colleagues about every aspect of men’s health that potentially can affect health, longevity, and sexual health. Uh, and don’t be intimidated by the length of the book. ’cause it’s really 101 little books rather than one book that you’re supposed to continuously read. Because like, there’s nothing that annoys me more than reading a 300 page book and realizing there’s about two pages of information in the book. In fact, that’s why I had like a, this thing called Blinkist, right?

Brad (01:01:20):
Yeah. Summary

Judson (01:01:21):
Record. It summarizes recorded. But you know, if you did a blink of this book, it would still be 900 beat.

Brad (01:01:26):
It would still be a longest, it would be the longest blink. It would be like the longest

Judson (01:01:28):
Blink ever because every chapter is fully condensed and just pure information. So like, I have a lot of respect for people’s time and, uh, none of these chapters will waste your time.

Brad (01:01:41):
And the, the diversity of the topics are great. You can pick and choose what you want. I, I was jumping to the relationship section and realizing how that’s a driving factor in your physiological health. And then there’s a specific one about foot care and dietary matters

Judson (01:01:57):
Exercise. Yeah. I mean, I had a podiatrist, right? The chapter. Yeah. Yeah.

Brad (01:01:59):
So it’s a great, great. I

Judson (01:02:00):
Had, I pair a famous hair transplants version writing the, the chapter on hair replacement. There’s some really, really unique chapters in the book that I don’t think you’ll find anywhere. One is a chapter written by a healthcare executive on health insurance. No. Right. The healthcare system in this country is really, really, really messed up. And very few people actually understand health insurance and how it works. And this chapter is essential. You know, a lot of us buy health insurance for our employees or our families. And you, you have to know what you’re buying. And I mean, health insurance for my family this year is over 30,000 bucks. So to buy something for 30 grand and not know what you’re buying is a big deal. Wow. Right. You wouldn’t buy a car with no knowledge of what you’re buying. Right. Another chapter is what men need to know about menopause.

Judson (01:02:51):
Wow. Right. That’s up big deal. Like, you know, you and your wife have a great relationship. You’re in the mid fifties, all of a sudden your wife comes home one day and she’s like off a rocker, and you’re like, what the hell’s going on? That you could either go out to the golf course and forget about it, or you could read in a chapter, understand what’s going on, be empathetic with your spouse and your relationship will actually get stronger. No. Uh, and so that’s really an essential chapter. Susan Bratton wrote an amazing chapter on how to please a woman. Right. So, I mean, that, that’s enough said.

Brad (01:03:24):
Go get it on Amazon. You can get your Affirm supplements too and get that nitric oxide going and the testosterone boost, all kinds of good things coming outta the Brandeis MD Medical Clinic here in the East Bay of the San Francisco Bay area. If you’re around, come in and check ’em out. Uh, otherwise check out all the offerings on the website. Thanks for those free eBooks and, and those types of resources too.

Judson (01:03:49):
Yeah. I mean, I love educating kipa. That’s what I, that’s what I do.

Brad (01:03:54):
Thanks everybody. Da da da.

Brad (01:03:58):
Thank you so much for listening to the B.rad Podcast. We appreciate all feedback and suggestions. Email, podcast@bradventures.com and visit brad kearns.com to download five free eBooks and learn some great long cuts to a longer life. How to optimize testosterone naturally, become a dark chocolate connoisseur and transition to a barefoot and minimalist shoe lifestyle.

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