Men's Health Tips
Guest : Dr. Judson Brandeis
june 19, 2022
Steve Washuta
Welcome to Trulyfit. Welcome to the Trulyfit podcast where we interview experts in fitness and health to expand our wisdom and wealth. I am your host Steven Washuta, co founder of truly fit and ultimate Fitness Business 101. On today's episode I speak with Dr. Judson Brandeis, you can find everything about him at Brandeis. md.com or Judson Brandeis MD on Instagram, Dr. Brandeis attended Brown University undergrad, he received his MD at Vanderbilt, and he received a Howard Hughes award for his research at Harvard Medical School.
Steve Washuta
He completed his surgery urology residency at UCLA and along his journey, he had a hand in working with some of the most notable physicians in their fields. You're gonna hear a lot about that in his intro, Dr. Brandeis is the author of the 21st century man, which may be the most comprehensive and medically accurate Men's Health book ever written. It is five National Book Awards for both nonfiction health and men's health. In this episode, we discuss his book, obviously, reasons men don't take their health seriously testosterone, his philosophy behind diet and exercise, latest and greatest in research and equipment, and a host of other topics related to men's health.
Steve Washuta
My absolute favorite interviews are those where I get to read the book first, explain what I took from it personally to see if that matches the author's intent. It was an absolute pleasure to do this interview. With no further ado, Dr. Judson Brandeis. Dr. Brandeis, thanks so much for joining the Trulyfit podcast. Why don't you give my listeners a background, a bio on you your credentials, your intellectual pursuits, what you do in the medical field, and then also a little bit of background on your book and sort of the impetus to write this book.
Dr. Judson Brandeis
Awesome, Steve, first of all, thank you so much for having me. I really appreciate it. And you know, I've been blessed with an incredible education. So I went to Brown University for undergraduate I was a history major. And then after Brown, I left and did a year of research at American Red Cross where I worked with Harold T Merryman, the guy who figured out how to freeze blood. And then I went off to Vanderbilt for medical school.
Dr. Judson Brandeis
And during medical school, I got to Howard Hughes Institute Research Fellowship at Harvard Medical School at the transplantation immunology lab where they did the first living related kidney transplant and won the Nobel Prize for that. And then after graduating medical school, I went off to UCLA and trained in surgery and then urology and did research with Dr. Mark Litwin, who's kind of the father of quality of life outcomes research in urology, and then off to Walnut Creek, California up in Northern California, where I joined a urology group, and had the pleasure of starting the surgical robotics revolution. Being we had the second DaVinci surgical robot in the country.
Dr. Judson Brandeis
And I was a super early adopter of that I built a kidney stone center, I built the MRI guided prostate biopsy center. And about three years ago, I became really interested in regenerative urology, so the ability to improve erectile function in men who were past the ages of 50, or 60, or 70, when things didn't seem to work anymore, and I was able to regenerate blood flow in a way that men who weren't previously able to have erections, were now able to have erections.
Dr. Judson Brandeis
And then that led to an interest in hormonal therapy, and then muscular rejuvenation, and then total kind of male wellness and health. And that led to that, and the time created by COVID led to me writing the 21st century man, which is the most comprehensive and medically accurate Men's Health book ever written. And it's not just me, it's 60 of my close friends and colleagues, who are writing about chapters on things that they know about that I'm not necessarily an expert about.
Dr. Judson Brandeis
So I try to stay in my lane, I know what I know. And I know what I don't know. So the 21st century man really is packed with a high information density, kind of the cliffnotes of everything you need to know both physically, mentally, emotionally, relationship wise and sexually, to, to succeed in life after 40.
Steve Washuta
I really enjoyed the book. I think it was a good terminology, you use a good word to describe it a cliff notes, it reads like a journal in some parts, but not these sort of high level esoteric journals that the average person couldn't read. But then you you mix subjective and objective so well, where you have the hero's journey, and then you sort of cap it off with relationships.
Steve Washuta
It's not just about the objective. In addition to that, like you said, you have all these experts coming in that pick out why all of these like sort of interwoven topics mean a lot to men's health, right? People typically just think, okay, it's hormones, and it's exercise. Now, there's so many other things. And it was a very comprehensive, but still an easy and fun read.
Dr. Judson Brandeis
Yeah, Steve, you you totally get it. I mean, you really do. It's, you know, so many of these things are interwoven. But there are a number of themes that go through the book and you hit the nail right on the head in terms of the hero's journey. You know, the first and the last chapters of the book are all about the hero's journey, because, I mean, let's be perfectly honest, we all know, don't eat too much. Don't drink, don't smoke, don't do drugs, exercise every day.
Dr. Judson Brandeis
Get some good sleep. Be nice to people. or do some stretching, do some meditation, right? Like, who doesn't know that. But at the end of the day, most of us don't do all those things. And so what, you know, the question is, why is that and that's a lot of the time that I spend with my patients really is unpacking, you know, what are the roadblocks that are getting in the way of you doing the things that you need to know, you know, to do?
Dr. Judson Brandeis
Once you get through those roadblocks, then the second part of it is, okay, here's the data, here's the science about what you should be doing. But if you don't unpack that roadblock of, you know, why are you eating too much? Why at 1030 at night, are you eating ice cream, you know, or potato chips or whatever, then it doesn't really matter what you know, you have to, to motivate your client or your patient to do the things that you're telling them to do. Otherwise, you're you know, you're both wasting your time.
Steve Washuta
Well, let's start at the beginning. Because in order for you to do that, they actually have to walk through the door, right? You can't book appointments for them. Maybe you can, but they don't have to show up. So why is it that it seems like I don't know if it's just Americans or it's the Western culture are more likely to go to a dentist appointment than they are to book their PCP to get a checkup?
Dr. Judson Brandeis
Yeah, absolutely. Well, I mean, first of all, the thing to know is 100 years ago, women live one year longer than men. And guess what, now women live five years longer than men. Okay? Men are actually living less long than we did 1520 years ago. And that's even before COVID. And that's because of alcohol, opioids and suicide, right diseases of despair, and men are 50% is likely to go to the primary care as they're their spouses. Right?
Dr. Judson Brandeis
And there's this this ethos of, you know, I'm tough, I can take care of myself, I'm the guy that takes care of other people. I don't need any help. I can, you know, I'm, I'm tough. But you know what, with that attitude now is it's passe. It's stupid, right? You have to the same way that you take care of your car, right? What if you said shit on my car doesn't need oil, I'll drive it 100,000 miles, it doesn't need oil. Right, your car's not gonna last that long.
Dr. Judson Brandeis
And your 20s and 30s kind of trick you because you have the capacity to tough it through it. Right? You know, like, when I was in my 20s, or 30s, I did stuff, you know, go out all night or whatever, and then go to work the next day. But I'm 54. Now, you can't do that anymore. And the damage that you do to your body in your 20s and 30s comes back to haunt you in your 40s and 50s and 60s and 70s.
Steve Washuta
Yeah, as a personal trainer, I have to sort of convince a lot of my clients, a lot of whom have a lot of money to say you if you treat your body like a treat at your bank account, you'd be much better off and you're going to have the most amount of money when you're the least capable of using it. Why would anybody want that right? You're going to be you want to take that trip to Italy when you're retired? Well, if you're in a wheelchair, or if you got your toes cut off, because you have type two diabetes, who really cares. You can't walk around Rome. I wish people would look at it that way.
Dr. Judson Brandeis
What if one of my roommates in medical school he called up his father his father's a famous neurosurgeon. And he said, Dad, you know, can you buy me a BMW? And so his father's like, no, Aw, I'm not gonna buy you a BMW. You have to work hard and you know, earn it. This. Yeah. But by that time, I'll be old and bald like you. What are we the purpose of having the BMW?
Steve Washuta
There you go. Oh, that's Yeah.
Dr. Judson Brandeis
Yeah. You know, so one of the things that really helps me motivate men is numbers. Guys love
Steve Washuta
because because we're competitive, we want to beat our labs. Is that what you're saying? We want to come out.
Dr. Judson Brandeis
I think we're, I think in general, we're pretty analytical. Right? So you know, you can look at yourself in the mirror, but I think most guys look at themselves in the mirror, kind of pull their chest up, suck their gut in and say, you know, I look as great as I did when I was 20. But I put people on a body composition scale when they first walked into the office, right and that the body composition scale doesn't lie. It gives you percentage of body fat, left arm, right arm, you know, trunk, left leg, right leg.
Dr. Judson Brandeis
And visceral fat is Yeah, visceral fat versus, you know, superficial fat. So, it really is an eye opening experience for people that think that they're still 20 years old, but then they look and you know, their legs are 90% of norms. They have 40 pounds that they need to lose, and I looked guys in the eye and said, Listen, if I put a 40 pound backpack on my back all day, I'd be exhausted by the end of the day. My knees would hurt. My hips would hurt. My feet would hurt I'd be pissed off. I said that's what you're doing every day.
Dr. Judson Brandeis
And then on top of that, a lot of guys walk in right because everyone like loves working out beach muscles, right? Everyone loves beach muscles, biceps, triceps, but when you get older and I deal with a lot A lot of guys who are in their 50s 60s 70s, I show them the world record for the 100 yard dash. And from 20 to 60, it's pretty stable from 60 to 80, the slope dramatically increases. And from 80 up, you know, it's it's pretty close to vertical.
Dr. Judson Brandeis
And I tell them, you know, the quality of your life, the ability to travel, your ability to go upstairs, your ability to keep your balance and not fall is going to be dependent on how much weight you're carrying, and the strength of your legs. And if your legs are weak, and you're fat, guess what you're going to fall and when you fall 50% of guys die within five years.
Steve Washuta
Yeah, I've heard that statistic before, I've had a lot of clients who've we've had that issue, unfortunately, and have, you know, fractured or shattered femurs or tibias or something. And then again, they get in a wheelchair, and they get what we call deconditioned, right? Because they can't do anything. And then it just spirals out of control. And exactly, I've told the story a lot in this podcast, I had a client come to me who was in the early 60s.
Steve Washuta
And they said, my only goal is to get down on the floor to play with my grandchild and to get back up. And to me, it was so disheartening to hear that that you're in your early 60s. And that is your that's sort of your athletic prowess at this point. And it's because we let ourselves deteriorate, we don't go to the PCP and we don't do these things. And, you know, I think what, what are the other motivating factors that you use outside of numbers? Do you try to use scare tactics in sort of a positive way?
Dr. Judson Brandeis
You know, I'm very, I've been doing this for a long time, and I deal almost exclusively with men. And my office is very unique. You know, I have Eric Clapton guitar up on the wall, and Peyton Manning, Eli Manning football and Muhammad Ali boxing glove, you know, my patients like to give me these kind of cool things. And it's, it's a very masculine, but not hyper masculine environment. And it's very non judgmental.
Dr. Judson Brandeis
And I look guys in the eye, and I don't take insurance, right. So I can spend a lot more time with my patients than than regular Doc's do. And, and I tell them like this, and I can create the path to health, like nobody else in this country almost. And but I'm not going to follow you home, I'm not your mother, I'm not going to tell you what to do. It's entirely up to you what you do, and the results that you get. And you can come in anytime you want, and you get, you can get a body comp, you can get this, you can get that.
Dr. Judson Brandeis
But in the end, it really has to come from you. And sometimes I have to wake people up, you know, I have to really tell them, things that they don't want to hear. But I do it in a way that's it's, it's sort of non judgmental. Sometimes you have to be a little harsh with people because because you accept that they need it. You know, I one time I said something really not. I used some colorful language with a with a guy. And he was the CEO of a big company, it really was taken aback. And then the next week he came in, and he hugged me. And he said, You know what, that's what I needed. And I'm going to make a change.
Steve Washuta
Yeah, much like a good coach or a good a good leader, you have to kind of assess each person individually, and then adjust accordingly. Right, you might have a client where you have to be pushy with them, because you know, their personality and another client were you don't have to be patient, excuse me. But let's jump into some of the science here. Low tea, that's a reason why men start gaining weight into old age, as far as I know, can you explain sort of the ranges of testosterone when it starts to dip down? And why exactly. It's maybe overlooked by the general population to not look at these numbers more closely.
Dr. Judson Brandeis
Yeah, so you know, I always start with my son who's 15 and a half years old. So two, three years ago is testosterone was probably around two or 300. Right. And now he's almost 16, as testosterone is probably close to 1000. And he turned from this scrawny kid into this big muscular kid in two, three years. And then testosterone peaks at about 20 years old. And every year after that, it'll go down one or 2%. You know, on top of that, you know, you have IGF one, you have human growth hormone.
Dr. Judson Brandeis
So there are a number of other hormones that decline testosterone being really the most important. And it's almost like a dimmer switch. You know, if you if you're in a room and someone every hour turns the dimmer switch down one or 2%, you're not going to notice, right and from 20 to 40, you're kind of cruising through life, and then you hit 40 and, and testosterone is really starting to drop a little bit more. And the other thing is we live sedentary lifestyles, right?
Dr. Judson Brandeis
So if you're a hunter and you're out on the plains trying to kill deer or wildebeest or wall or water buffalo, whatever your testosterone is, got to be super high because you have to kill something a big animal to eat. If you're a farmer, I mean, farmers are tough too. But, you know, sowing seeds is a little bit different. And if you're an office worker who's just sitting in an office chair all day, your body's not incentivized to make that much testosterone because your body is smart, right? Why would your body make something you don't really need? And then a lot of men are obese or fat, right? So 40% of men are fat or obese, the estimates are by 2030, half of men will either be obese or fat, right? And fat actually converts testosterone into estrogen.
Dr. Judson Brandeis
Right? It's called aromatization. So everyone thinks, you know, men are from Mars, Women are from Venus, testosterone and estrogen are vastly different hormones. But if you look at the chemical structure, the only difference between testosterone and estrogen is one single hydrogen molecule atom, right? The smallest unit of matter is the difference between a male hormone and a female hormone. And so it's, it's easy for your body to flip testosterone into estrogen. And most people think men have testosterone, women are have estrogen. But no, we have both hormones just to different ratios.
Dr. Judson Brandeis
Right. So the star storm begins to creep down faster, and some people less fast than other people. And then you get to a point where you're in your 50s, or 60s or 70s. And you develop what's called hypogonadism, or low testosterone, right. And so testosterone gives us muscular strength. So you lose muscle, it gives us the ability to burn fat, so you start to put on fat, you lose libido, you lose motivation, you lose focus, you lose drive, it's hard to sleep, you start to get aches and pains, because your muscles aren't as strong. So your bones and joints and ligaments need to work a lot harder.
Dr. Judson Brandeis
And that's clinically when men get low testosterone. And so there's a difference. I have guys who have a testosterone of 200. And they're happy as a clam, and they're having sex with their wives, and they look reasonably physically fit, and I wouldn't touch their testosterone. And I have guys that have testosterone of four or 500. That, you know, once you rule out other stuff. So the reason you actually go to a doctor, is because if you go to one of these online services, they're just going to put you on testosterone.
Dr. Judson Brandeis
But if you have obstructive sleep apnea, guess what those symptoms are the same as low testosterone, if you have hypothyroid, you have the same symptoms. So you have to make sure that you rule out some of those other things before you put someone on testosterone.
Steve Washuta
You talk about some of those variables, maybe it is receptor sensitivity and things of that nature, why somebody at 200 could potentially feel great, and why somebody at 750 might feel like they have low tea.
Dr. Judson Brandeis
You know, humans are complex first. So there are physiologic reasons. So for example, there's something called sex hormone binding globulin so only one or 2% of testosterone actually is active, it floats free in the blood system. And the rest of it is bound to either albumin, which is type of protein, or more tightly at blind binds to what's called sex hormone binding globulin. So even if your testosterone is high, as you age, you make more sh, pg. So you have a lower percentage of, of free testosterone, which is the more active form of testosterone. The other thing is, you know, we're all motivated differently, some people sort of their engines a little bit more wound up and other people are a little bit less motivated. And so, you know, people's personality types play into it.
Dr. Judson Brandeis
The other thing is, you know, there's there's other hormones like thyroid hormone, so some people's metabolisms higher, some people's metabolism is lower. There's sleep factors, right, I had a patient the other day, 42 years old, came into my office look reasonably healthy, but he had obstructive sleep apnea for 20 years. And guess what, he's not getting REM sleep. So he's not getting erections. He's tired all day. So he doesn't feel like working out. And so there's so many other factors that come into play. What you eat your family history, and so it's humans are complex. And you really have to unpack everything in somebody's life before you make some of these these big treatment recommendations.
Steve Washuta
And if you believe this question, for some reason is out of your area of expertise, you can you can pass on this, but is the normal recommended? Is it still hCG? Why somebody is on testosterone therapy? Or is it some sort of other AI or depends on who you are specifically and what your levels are?
Dr. Judson Brandeis
You know, so I can only speak for myself. Yeah. And I have very long discussions with my patients about putting them on testosterone because there are negative effects of being on testosterone. First of all, it'll grow your prostate. Second of all, if you have aggressive prostate cancer, you know, it'll make that worse. It will shrink your testicles unless you put someone on something like Clomid.
Dr. Judson Brandeis
You'll, some people will lose their hair, you know, for you, and it doesn't really matter. But and the other thing is, you know, after you've put someone on testosterone for three, four or five years, your body will really lose its ability to make testosterone. So you're basically committing that person for it to testosterone for life.
Dr. Judson Brandeis
And the other thing is, I always have patients talk to their their partners or spouses on because there's an equilibrium in relationships that occurs. And if you're upsetting that equilibrium, because you know, all of a sudden, you're going to be on testosterone, it may upset you know, a lot of a lot of us in the medical community forget about relationships.
Dr. Judson Brandeis
But wait, if you look at the Harvard longevity study, which is the longest study of men, their health, and not just physical health, but psychological health, emotional health, relationship, health, etc, etc. The single most important finding of the largest study, and probably the best done study ever, in the history of men, is the quality of your relationships is the most important factor in your health.
Steve Washuta
And for anybody who might not understand exactly what you're saying, I'm going to try to unpack it. And you can, you can jump in at any time. But let's say somebody is on decides to go on testosterone, because their numbers are low, and they're they're feeling sluggish. And you know, Doctor Brandeis says, Okay, I think this is right for you. And then their sex drive goes up. But there used to be sort of equivalent to their wives.
Steve Washuta
And now it's not. And now that could throw a wrench in your sort of relationship. Right? And I think that's, these are things that I would hope that physicians sit down with their patients and say, Listen, this could change your personality slightly. Things like your sex drive, or maybe your urge to work out and all of these other things, which can in turn, almost be like building a new relationship, and your partner has to be ready for that.
Dr. Judson Brandeis
Yeah, absolutely. Well, I'll give you a great example. So I was at UCLA when Viagra came out. And some of my professors actually won the Nobel Prize, and published the original research on nitric oxide and also how PDE five inhibitors like sildenafil or Viagra actually worked. So we were one of the first places in the country in the world to get Viagra.
Dr. Judson Brandeis
And there were people streaming into UCLA to get Viagra. And guess what happened like some people, six months later, were deliriously happy, because they were able to have physical intimacy, I, once again with their partners, and the other half of the people were really pissed off, right? Because their wife just accepted, you know, like, this is not going to be part of our life anymore. I'm gonna go drink wine with my friends and play tennis or something like that. And the guy's like, Well, I'm just gonna go play golf. And then all of a sudden, he's coming into the bedroom with an erection but the wife's like, you know, who the hell are you.
Dr. Judson Brandeis
And so, it anytime I make an intervention with my patients, I talk to them about the effects on the spouse. In fact, I had a patient who got she was like 65 years old, he came in, was having a lot of difficulty getting an erection, we did a lot of work, you know, low intensity shockwave therapy and PRP and nitric oxide boosting supplement PDE, five inhibitors, vacuum erection device, you know, the whole nine yards. And three months later, you know, he's raring to go. And, you know, I love getting stories back from patients that to me, that's like the most rewarding that's like how patients pay me back as they they bring me great stories. And that's kind of what keeps me going.
Dr. Judson Brandeis
Right. And so I'm waiting for my good story, and I don't get a good story. And it's two, three weeks go by, and finally I see him come back. And his head's kind of hung low. And, you know, I was like, Joe, what's going on? And he's like, you know, I was, you know, I was all ready to go and I had penetrative intercourse with my wife. And she said, it hurt a lot. And she had some bleeding and she never wants to have sex again. Right.
Dr. Judson Brandeis
And I didn't ask, you know, is your spouse on estrogen? You know, is she postmenopausal? What do you guys use for lubricant? And so now, that's part of what I talk to patients about and the average physician visit is 16 minutes and 14 seconds, there was a huge study on 100 million charts done by Cerner, one of the largest electronic medical record companies in the world, you got 16 minutes and 14 seconds. So if you're talking to a guy about a million different things, you're probably not going to have time to ask him about what lubricant he uses.
Steve Washuta
But guess what, it's important. Yeah. And that's advantage to you of not having to deal with that. I know my wife's a pediatrician. I talked about this a lot. You know, a kid will come in supposed to be just your regular checkup, well, child checkup and he goes,
Steve Washuta
Well, my teacher thinks I've add, my mom thinks I have depression, and I'm starting to have sex and I sprained my ankle. Well, now I got 11 minutes left. And I have to deal with 40. Which Which one do I pick? And that's why it's great that you you have a different business model. You're able to help patients out and not be so structured and limited.
Dr. Judson Brandeis
Yeah, but I help doctors out too. And I'll tell you why. Okay, so I wrote a chapter in the book on how to make the most of your doctor visit, right? Because I was, you know, I had insurance based practice for 20 years. So I understand all this stuff, right. And so if you go to the 21st, century man.com, so all written out in letters, you can get it as like a free ebook.
Dr. Judson Brandeis
And as there's also a video, so this is, you know, this is really important, because we all go to the doctor, we all should go to the doctor, and it's important to get the most out of your doctor's visit the same way. Like my lawyer, he's 750 bucks an hour, right? Lawyers are expensive in the Bay Area, right? So every minute, I'm there as $11.
Dr. Judson Brandeis
That's like lunch for me, right? Every minute is lunch. And so I want to kind of make the most of the time I have at my at my attorney, right, you got to make the most of the time you have in your doctor's office. So don't talk about the weather. Don't talk about sports, don't talk about your pet cat. Okay, first of all, come in there with your whole medical history, typed and printed out. Second of all a list of your medications with their doses and maybe even medications that you've been on in the past that didn't work, right.
Dr. Judson Brandeis
Why should a doctor put you on a medication you already tried? But if you don't tell them that you've been on that medication, and it didn't work or get side effects from it? How would they no Third of all, all imaging studies you've had, maybe ever or at least in the last two years, right? So why if he's going to order an MRI, and you had one, three or four years ago, first of all, maybe it's normal. Second of all, it's something you can compare? What was it like three, four years ago? To what, what is it now?
Dr. Judson Brandeis
Any other diagnostic studies? Have you had an EKG an E, G, any of that kind of stuff, right? Then write up your history of present illness? Right? So my I heard my back three, three weeks ago, you know, it started out 10 Out of 10. I heard it lifting a sack of concrete, right? It was just like it happened five years ago. And I ended up needing an epidural. And then it got better. But I had an MRI back in those days. So as much detail as you possibly can put in there. And then make a list of questions.
Dr. Judson Brandeis
Right, sit before you come to the office, write down, type it up a list of questions you want answered, and hand that packet to the doctor, I guarantee you, you'll have a big smile on the doctors face. Like I have a voice dictation system, I dictate all the pertinent positives, everything that I need, that'll take me about three or four minutes. And guess what, you got 13 minutes and 14 seconds of my time to go to the next level with you.
Steve Washuta
That's great information. And knowing you know, my wife's some struggles, a patient may assume that a fax came through for one particular thing or another. But it doesn't always happen. Right. So then that could wait two or three minutes, the patient assumes that they have the facts of let's say the EKG, but we don't know what that is. And then that that changes the whole conversation and dialogue.
Steve Washuta
So to have that information, I'll also say, from to expedite anything to kind of have the sounds bad. But to have the questions there leaves the sort of emotions aside. And that expedites things to because people will come in very emotional to the doctor, they want to explain all the little details. This is what happened, like with this whole scenario, before, you know what you've had seven minutes discussing, basically what the question is, is my ankle broken? And you've wasted all that time. So I think having those questions in advance takes a little bit of the emotions out of it and gets quicker to the point.
Dr. Judson Brandeis
Absolutely. And you know, the thing is, there's it's a different relationship now between doctors and patients, right. So 20 3040 years ago, the doctor sat on the top of a tall mountain and controlled all medical information. But now, you know, so I'll give you an example. When I was doing research at Harvard Medical School, Harvard Medical School Library was the biggest medical library in the world that had a million volumes, right journals, and books and all that stuff. And people from around the world would fly to Harvard Medical School, pay a lot of money to be in the library.
Dr. Judson Brandeis
And because that was the that was the place to be now on your little cell phone. It says it's the equivalent of, you know, 10 Harvard libraries. And so patients I love actually, when patients come in with like, well, this is what I think it is, or, you know, Can I try this supplement? Or what do you think about this, my third cousin was on this and it worked really well. And then I go, and I unpack that with them. Let me take a look at the list of ingredients.
Dr. Judson Brandeis
So let's go, you know, I'll do routinely I'll do PubMed searches with my patients in the office and say, you know, does testosterone improve diabetes? I didn't, you know, I don't know. Oh, you know, look, there was a study in Journal of Sexual Medicine a couple months ago that showed that putting someone on testosterone actually improved diabetes.
Steve Washuta
Let's talk a little bit about prostate numbers. We mentioned that before. I am 37. So I haven't really had those numbers checked on a regular basis. I do twice a year, just because I get my labs done twice a year and myself but it's not something I'm hyper concerned with. But as I get over 40, I'm going to have to be or prostate numbers associated correlated or sort of a causational? Like mechanistic thing with high or low tea? Meaning if I have low tea, am I more likely to have prostate cancer or high tea? Or is there no correlation?
Dr. Judson Brandeis
So there's the really short answer is really there's, there's a correlation between testosterone and prostate cancer. But just because you have a normal testosterone doesn't mean you have prostate cancer, right? So your testosterone is highest when you're 20 years old, and no one gets prostate cancer when you're 20. You know, the incidence of prostate cancer is peaks as you get older, right. And at that same time, your your testosterone is declining.
Dr. Judson Brandeis
Now dihydrotestosterone, right. So testosterone converts into dihydrotestosterone, which has a higher affinity for the testosterone receptor, meaning it fits tighter into the testosterone receptor will cause male secondary sex characteristics, right? So it'll cause the prostate to grow, it'll cause you to lose hair, you know, you get all that wonderful hair on your back and your ears and your nose, etc, etc. Right? So that's all kind of Dihydrotestosterone kicking in.
Dr. Judson Brandeis
So there is definitely a relationship between prostate growth and also prostate cancer because one of the, the main treatments for metastatic prostate cancer, prostate cancer that spread outside the prostate, say into the bone is medical castration. And that was discovered in 1934, the only urologist ever to win the Nobel Prize, Dr. Huggins. So we've known that for almost 100 years, but still, it's to tease out the exact relationship is somewhat complex.
Steve Washuta
Is prostate cancer almost inevitable, if you live long enough? Is the reason why people weren't getting it, let's say 100 years ago, because they were dying of something else beforehand.
Dr. Judson Brandeis
Yeah, I mean, 100 years ago, people didn't live really much more than 4045 years, you know, in the the number one cause of death back in those days were accidents and infectious disease. Now, you know, cars are safer, and people don't die in horse accidents and those kinds of things. And, and we don't die of pneumonia and diarrhea. You know, we die of old people's diseases like cancer and heart disease and stroke and cetera, et cetera.
Dr. Judson Brandeis
So yeah, I mean, to a certain extent, that is definitely the case. And I guess, if you live to 150, you're gonna get prostate cancer. But the most, you know, prostate cancers, then the second leading cause of cancer related death in men, but only causes death and a couple percent of men. And so really, the big ones you really have to focus on are heart disease. Some of the more preventable cancers, you know, colon cancer, you know, avoiding smoking.
Dr. Judson Brandeis
And the the 21st century man really is about prevention and early intervention of diseases, right? If you have prostate cancer, go to the doctor, you know, go to your urologist or your medical oncologist. At that point, the information in the book is useful. But you should be spending your time at the doctor really the time to read the 21st century man is, before you need the doctor,
Steve Washuta
is your recommendation or let's say the general recommendation to start looking at those prostate numbers in your like mid 30s.
Dr. Judson Brandeis
Mid 30s is too young. So if you have a family history, or if you're African American, I would check your PSA at one time maybe at 41 time at 45. And then really, the general population should begin at the age of 50. Now there's a PSA is a very controversial thing. And in fact, the guy that even discovered PSA came out maybe 1015 years ago and said, You know that, you know, he regretted actually, what happened with PSA? Because a lot of people and a lot of doctors saw cancer and said, Oh, you know, we got to cure cancer, cure cancer. But a lot of prostate cancer is relatively slow growing now that the paradigm is shifting again, in my mind, right, because we have genetic tests now.
Dr. Judson Brandeis
Right? We're not just looking at cells, but we're actually looking at the genome. We also have tools like prostate MRI, and so we're able to much better determine aggressive prostate cancer versus non aggressive prostate cancer, we're much much better able to advise patients when they should just keep an eye on prostate cancer versus when it needs to be treated aggressively. And so for a long time, I think it was right to be very, very conservative about PSA and about prostate cancer.
Dr. Judson Brandeis
But you know what we've seen since PSA got a derating from the US Preventive Task Force and since COVID, right because a lot of people weren't going to their doctors is now all of a sudden we're picking up prostate cancer at a much later stage, when it's really, really hard to do something about it. And so here again, it's important to be proactive.
Dr. Judson Brandeis
But at the same time, it's also important to be educated and the the chapter I wrote in 21st century men on prostate, both BPH and prostate cancer is super valuable, packed with really, really, really good information to help you make an informed decision about getting your PSA checked. And then if you do have prostate cancer with or if you do have an elevated PSA, what the next step is, and then if you do take the next step, and you have prostate cancer, what are the things to consider? Before you consider treatment?
Steve Washuta
Let's go into some health and fitness here. I am a patient of Dr. Brandeis, I'm 62 years old, I'm a male, I walk in, look at all my numbers, they look okay, maybe I'm on medication or two that you've prescribed, but I am 15 to 20 pounds overweight, and I want to start exercising and becoming healthier. What is sort of your process in that.
Dr. Judson Brandeis
So everyone that comes into my office gets a body composition scan, right, because it's not enough to stand on a scale. Scale doesn't tell you all that much, right? Even, you know, a body mass index doesn't tell you that much you need body composition, right, you need to know how much muscle you have in each arm, each leg in the trunk, you need to know what your basal metabolic rate is, you need to know what your percentage of body fat is. And that's where the that's where you really start.
Dr. Judson Brandeis
That's where the analytics start, of course, you checking testosterone, and I explain to men about the aging process, right? Because I explain it like you know, you're going on a long journey. And the first 60 years of your life, you're traveling through the prairies, right? It's all flat, right? And traveling is pretty easy, right? You know, slight grade when you're getting into your 40s and 50s. But not too bad, right? When you hit your 60s, all of a sudden, you're in the foothills, right and it gets gets harder, right.
Dr. Judson Brandeis
And then when you hit 80, you know you're on the mountain, each each foot you're sort of fighting for. And the thing is, when you're 59 and you're ready to head into the foothills, you've been walking through the prairie all your life, you think it's you know that that slight grade that that I'm been walking up, that's what the aging process is going to look like in the 60s. But it's not right. And the reason it's not is because first of all, your nerves don't work as well as they used to. Second of all, your mitochondria aren't kicking out ATP, like they used to third of all the DNA is getting damaged.
Dr. Judson Brandeis
Fourth of all, the Golgi apparatus in the endoplasmic reticulum aren't making protein the way that they should be making it. Second, you're we live in a world of plastics and all sorts of toxic crap. So you get chronic inflammation that chronic inflammation prevents you from absorbing protein like you should. And a lot of us don't eat as much protein as we did when we were younger, because we were building muscle that that time, the food that we're eating is packed with too much fat and too Much Bad Fat and too many carbs.
Dr. Judson Brandeis
And so there's so many things that work against us, that accelerate as we age. And you have to understand. And you know, that was really interesting, there was a study I read the other day at a tufts, they compared a 20 year old to a 50 year old was really hurt because I'm 54, right. And they looked at the gene expression in muscle after someone worked out. So a 20 year old expressed 150 genes and a 50 year old expressed 50 genes, right and a gene expression and muscle is basically building protein, protein builds muscle.
Dr. Judson Brandeis
Right? So the 20 year old, doing the same workout is expressing three times are building three times as much muscle as a 50 year old. Which means you got to work three times as hard or be three times as intelligent.
Dr. Judson Brandeis
You know, at our age, or my age anyway, and older. And so this is you know, this is the background that I work with my patients on is, you know, even though you think you are, you ain't 20 anymore. So let's now all of a sudden change your whole way of thinking about things and then the next thing we do is unpack testosterone. Right? If your testosterone 200 or 250 or 300 I don't care how many hours a day you go to the gym, you're not going to build muscle.
Dr. Judson Brandeis
Testosterone is the number one growth factor by far for men. They did a really interesting study 20 years ago that was published in the New England Journal of Medicine. They took a control group they control group over three months build one pound of muscle. They took the exercise group, right sent them to the gym for three three months gave them an exercise routine.
Dr. Judson Brandeis
They built two kilograms or two pounds of muscle right then they had a high testosterone group, no gym, just testosterone, they built four pounds of muscle. Right, so twice as much muscle as the gym group. And then they had the gym and testosterone, those guys built eight pounds of muscle. Right? So it's, I say, Listen, you know, you're over 50, you're going to have to have a very reasonable if not elevated testosterone, and you're going to have to exercise and then I explain, exercise is different now than it was when you were 21st of all don't get injured. The most important thing is consistency, right, you can't do something stupid, you know, like, when I was 20, I'd go into the gym, and I'd overdo it and whatever.
Dr. Judson Brandeis
And the next day you recovered, you go back to the gym or play basketball the next day, after 50, that, that doesn't happen anymore. You can't get injured, it's really, really hard to recover. And so I have a three day cycle that I recommend to patients, cardio, a cardio B, and circuit training, right. So choose cardio a like a elliptical or running or treadmill or, okay cardio be biking or swimming or rowing, right. And then circuit training, choose multiple different body parts, find exercises, and then repeat.
Dr. Judson Brandeis
And do it quick enough so that your heart rate gets up. So you're getting cardio pretty much every day, but you don't overdo the cardio. So a lot of guys love cardio, cardio is easy, you know, you sit on one of those machines, you spin it around, you watch the news or your watch, you know, a TV show or a sporting game. But cardio is not so good for you, as you get older, you got to understand that right? Because at a certain point, it becomes a zero sum game. Right? So if you're I see these guys that come in, and their upper body is strong and their legs are weak.
Dr. Judson Brandeis
And the reason is they're overdoing their upper body. And they don't take in enough protein. Right? You've seen this all the time. Yeah. And so what their body does is say, Well, you know, you're not using your legs. So let's just take protein from the legs and use it for the body parts that you're building. Yeah. And so that's, that's the zero sum game. So that's the other part of it that I go into is nutrition. And I'm talking a lot so interrupt me if I'm Bill this
Steve Washuta
or not, I just just echo your thoughts, you know, there's a cost to everything and fitness, there's a metabolic cost, which is a positive cost, right? If I go run four miles, let's say burn 300 calories, great. But there's also a structural cost, if I'm 50 pounds overweight, and I run those four miles. Now I've potentially put undue stress on my my ligaments and tendons and my knees and my hips, right? So we have to weigh out those costs.
Steve Washuta
And as we get older, I say, I always told my younger trainers. So I mentor, we should start training our clients in their 30s. Like they're going to like they're in their 40s and 50s and 60s and get them ready for that. And what I mean by that is moving all ranges of motion, start swimming, start doing low impact exercises, start using various modalities and don't do this 80s And 90s Arnold Schwarzenegger prescription where you're just lifting heavy weights in this 10 684 repetition range, because that's not helping you into old age. And we have to make sure that injury prevention as you said, Dr. Brandeis is the most important thing, availability is your best ability.
Dr. Judson Brandeis
Yeah, I mean, if 50 you're not going to win an Olympic gold medal, you're not going to get a contract from Nike, you know, you want to be able to roll around with their grandkids and get up. You want to be able to, I had a patient that fell, you know, they, they took his dream vacation to Greece, and then fell on the cobblestone streets and broke his hip.
Dr. Judson Brandeis
Right? You don't want to do that, right? You want to be trained well enough that you can enjoy the rest of life. And so, you know, just getting back to nutrition. I'm not a nutritionist. I'm not a dietician, I know I've never had fortunately, never really had to lose weight. So I don't know that much about it. But I do know this, the simple there are three things that you have to know to lose weight, right? And it's amazing that people really don't know them.
Dr. Judson Brandeis
First of all, you have to know how much food you're taking in how many calories, right? I tell people this and don't tell me you're trying to lose weight if you're not counting calories. If you're not counting calories, it's all bets are off. Right? If you're trying to save money, and you don't know what your salary is, how are you going to try to save money? Yeah, right, then you have to know how much you're spending. Right? You have to know what your basal metabolic rate is. If you don't know what your true BMR is not like computed off the computer, but a true one because it it varies tremendously with how much muscle like I've put on three pounds of new muscle over the past six months, right and my BMR went up 4045 points. Right, and I pretty much look the same.
Dr. Judson Brandeis
So you have to know what your BMR is. And then the other thing is and it's amazing how many people go through these Some fancy weight loss programs where they give you like little doggie bags of food every day. And they don't know that one pound of human fat is 3500 calories. Like, if anyone that's that's that's training people or teaching people to lose weight if if your client doesn't know those three simple facts, you failed, you really have, you know, that's just the basics.
Steve Washuta
Yeah, that's great information. There's a lot of people who are so dyed in the wool one team, whether it's keto, or it's, it's the opposite of keto, or it's carnivore, whatever it is, is typically as long as you stick to a diet, and you understand like you talked about, there's calories in calories out the law of thermodynamics, right, the energy and energy out we need to take into this account, you can be on the path to losing weight. I'll also add in there, I think people will underestimate two things.
Steve Washuta
Number one, sleep and stress when my clients struggle, a lot of times, you know, they're not sleeping or they're super stressed in other areas, which causes certain things. Again, I'm not a registered dietician, I don't write out diets. But as somebody who has to help them in the weight loss journey, as a personal trainer, I have to, I have to ask those questions.
Steve Washuta
And then the other one is that people lie to themselves and they don't actually write down all the things. They go, Yeah, this is what I ate Monday through Friday. But on Saturday, I had six whiskies and from four slices of pizza, I'm like, Okay, well, you didn't write that down. Like you can't, like Saturday matters, too.
Dr. Judson Brandeis
So we want to so that brings me to alcohol, right? And, you know, I used to drink I don't drink anymore. I never had a drinking problem. But I know three things about alcohol. Really, actually four things. So the first thing really is, it's totally ingrained in American society.
Dr. Judson Brandeis
Right. When you're young, you drink beer, you go to the game, you drink beer, then you get older, you drink wine, you know, it's like, you're, you're classy, and everyone thinks, oh, red wine, you know, you extend your life. Look at the fringe people in the Blue Zones and all that crap. And then, you know, as you get older, you know, it's cool to drink whiskey or scotch or whatever. Okay. So that's fact number one. Fact number two is, Alcohol is a depressant.
Dr. Judson Brandeis
Right? That's the class of drug alcohol is a drug. And drug is the drug of class. It's in is depressant, right? it depresses your mood, it depresses your energy, seven calories per gram, as well. Yeah, well, I'll get there. Okay. Third thing is it dis inhibits you. Right? Most of the stupid things that humans do are done under the influence of alcohol. I was having this discussion with it with one of my patients. And he just looked at me and tears started running down his face. And then I looked at his face, and he had this giant scar.
Dr. Judson Brandeis
All across the face. He was African American, uh, you know, it wasn't fully obvious until, you know, tears started trickling over it and I could see, I was like, yeah, man, you know, I mean, driving while drunk, spousal abuse, you know, stupid financial decisions, hooking up with the wrong girl, whatever, or hooking up with the wrong guy. The stupidest decisions we make are made under the influence of alcohol. And I, I'd love to debate anyone on that. Okay. And then the last thing, like you said, is it's empty calories. It's calories. But not only is it calories, it's empty calories, you can take a bottle of vodka, light it on, on on fire, throw it at a tank in Ukraine, and blow something up, right? It's just pure energy with no nutritional value. And I had a patient who was trying to convince to lose 25 pounds, and he was drinking two glasses of wine every night.
Dr. Judson Brandeis
And I said, let's do some math. Right? And so said, let's figure out how many calories are in a glass of wine. So when on the internet, how many calories are glass of wine? 140 calories? Okay? Take that, multiply it times two. So that's 280. Multiply that times 365 And divided by 3500. And guess what? That's 28 pounds. So I said, Listen, if you stop drinking two glasses of wine every night for the rest of the year, first of all, you have a lot more money in your pocket. Second of all, you'll have lost 28 pounds if you don't replace that with anything. And he just looked at me like, like, you know, I just split the atom or something like that. But it's it's simple math.
Steve Washuta
You know, they've also done these studies where you basically can't get into REM sleep, when you've had too much to drink, right? So then you're not sleeping well. You're not sleeping well. Your body's tired when your body's tired. energies are energy and calories are synonymous right nutrition world so your body thinks, oh, I need some dense foods because I'm tired. So then you wake up. And that's why when you're hungover people go I need like a bacon egg and cheese on a bagel. It's like okay, because your body thinks you're tired because you never hit Run sleep and and there's just sort of a snowball effect of negative things.
Dr. Judson Brandeis
Yeah, absolutely. Or, you know, when I was in college, and we'd go out drinking. Taco maker was the only thing that was open at one o'clock in the morn. mean? Yeah. So you know you, not only you drinking extra alcohol, but then all of a sudden you're hitting the taco truck at two o'clock in the morning. And the other thing is, you know, I'm not an expert at sleep either. But Dr. Mike Murphy from Stanford is an expert in sleep.
Dr. Judson Brandeis
And his chapter is fantastic in the 21st century, man. But that's when you do your psychological repair, your emotional repair, you know, that's what dreaming is all about. And that's where you do your physical repair. Right? So if you're injured, or, you know, that's the other thing that that's why I do this three day cycle. Right? I play basketball with my son for 30 minutes. And then, you know, on Saturday, and then the next day, he's like, Dad, that was so fun. Let's do it again. And I can barely get out of bed, right? And so, at after the age of 50, you need two or three days to recover. Right?
Dr. Judson Brandeis
Because when you're working out, most people don't really know this or don't, it never really occurred to them, that when you're working out, you're not building muscle, you're tearing muscle down. Yeah. And if you don't give that muscle a chance to recover and rebuild, and adapt, then you won't build muscle, you'll just keep tearing it down carrying a diary. Every time it goes to rebuild, you're carrying it down.
Dr. Judson Brandeis
And so that's why I think I've one of the reasons I've been so successful with my patients over 60 building muscles, because I give them a program and I don't tell them what to do. You know, I'm not a personal trainer, you guys know, ton more about this kind of stuff that I do. I just know how to create guidelines. Like for example, I don't give anyone a diet, I say high protein, low carbs, high micronutrients, high fiber, healthy fats, and I give them a handout, you know, a nice color handout with all those things.
Dr. Judson Brandeis
And it's up to you to eat what you want to eat, you want to meet you want to eat, not meat, vegan, Paleo, keto, whatever. That's, that's not my thing. You know, someone came up to me the other day, and they're like, is buffalo meat better than beef? I have no idea. Right? I'm the last guy you want to ask?
Steve Washuta
Yeah, well, you know, just to add to what we were talking about before, I think a big portion of that is sort of this macro concept that you keep hitting on is that we can't train the same or eat the same or do the same things in our 50s and 60s, as we did in our 20s. And in your 20s. You don't need to rest as much, the body recovers quicker.
Steve Washuta
Rest is still important, but you don't need to rest as much. And it's different when you're in your 50s and 60s. And we need to have that sort of ingrained into our head that we're not training like we were in our 20s and 30s anymore. This is a whole new game. And we have to implement both the food and the exercise choices and the rest choices and all of these other things. Like it's a totally different sport for lack of a better term.
Dr. Judson Brandeis
Yeah. Now there are two supplements that I recommend in people over 51 is one that I produced called affirm, which is a nitric oxide booster. Right? So nitric oxide, when I was at UCLA, my professors won the Nobel Prize for discovering how nitric oxide works and the importance in improving circulation. And it's really a, it's there. There's 1000s and 1000s of articles written on the benefits of nitric oxide. And what nitric oxide does, is it's released from nerves onto blood vessels and helps blood vessels open so it improves circulation.
Dr. Judson Brandeis
It naturally decreases blood pressure. You know, my blood pressure this year at my primary care doctor's office was 10 points lower than it usually is because I take four affirm tablets a day, right so my circulatory system is naturally more open, more pliable. My heart doesn't have to work as hard. Okay, and it improves circulation to the brain. A lot of elite endurance athletes boost nitric oxide.
Dr. Judson Brandeis
Before and during and after workouts. It improves circulation to the penis, which is why, you know, I'm a sexual medicine expert. It's essential it works synergistically with PDE five inhibitors like Viagra and Cialis. It's excellent even for COVID. You know, they were using inhaled nitric oxide to treat COVID patients early on with great success because COVID is a vasculitis which destroys the endothelial of blood vessels.
Dr. Judson Brandeis
So nitric oxide boosters, especially after the age of 50, have a massive number of benefits and really zero side effects. The other thing that I put people on when they're trying to build muscle and they're exercising is creatine, right? Creatine monohydrate, the cheapest creatine out there is all you need. You only need 2345 grams if you're younger, two or three grams if you're if you're older, right and what that does is it helps restore ATP. So ATP is adenosine triphosphate it holds the phosphates in orbit using energy.
Dr. Judson Brandeis
When you're burning energy that mitochondria make ATP when you're burning energy, it releases says a phosphate, that energy that it used to hold the phosphate gets used by your body, right? And then, but now you have an ADP and a phosphate kind of floating out there, and creatine is what grabs onto the phosphate and puts it back on the ADP to make ATP because your body recycles everything.
Dr. Judson Brandeis
And so, you know, there's like a million, not a million, but you know, 1000s of articles on creatine, there's very little negative side effects from that. And if you're trying to build muscle, and you're trying to maintain energy, and guess what uses 20 to 50% of energy at any given time in your body, your brain, right, so not only to help workouts, but it's been shown to improve brain function.
Steve Washuta
Yeah, and creatine is very cheap. Like you said, it's been well studied, there hasn't been a lot of negative side effects. In addition, when you're building muscle, a lot of times you do have to sort of work out in those higher weight lower rep ranges. And when you do that you are using that phosphate system, right. So it's not like running a marathon where we're sort of an anaerobic, this is where this kind of four to 12 second push, where we need that extra rep in that heavyweight, that's where we're using that system.
Steve Washuta
That's why it's important to have that creatine because that extra rep matters when when we're building muscle and sort of pushing our muscles past that line of what they're supposed to do. So we tear them down. And then we rest like Dr. Brandeis says, and we eat properly, and we build them back up.
Dr. Judson Brandeis
Yeah, you know, the one other sort of secret weapon that I have is this thing called emsculpt. I don't know if you've ever tried emsculpt before, but it's it's like remember rocky to where he fought Dolph Lundgren. Drago,
Steve Washuta
I think that's Rocky IV but yeah,
Dr. Judson Brandeis
maybe it's Rocky V.
Steve Washuta
Yeah, you're and he's hooked up to the draft?
Dr. Judson Brandeis
Yeah, so like Rocky is, you know, in the in the woods with the carrying rocks and carrying logs and running through the snow. And Drago is like, hooked up to all these monitors and stuff like that. So this is straight out of rocky four. Yeah, right. So it uses high intensity focused electromagnetic waves. So it creates an electrical field. So think of it like a like a 10s unit, right? So a 10s unit uses direct current. So direct current, if you remember from your like, your high school physics class is kind of like a racetrack.
Dr. Judson Brandeis
And it takes the path of least resistance. So you can't really build muscle that well with the 10s unit. Because it doesn't go deep into the muscle and it goes through the skin where it creates heat. And so what these folks at BTL did is they created a machine that uses electromagnetic fields to, to contract muscle.
Dr. Judson Brandeis
Wow. And so, you know, you watch the Oscars last night, anyone with a six pack abs was using emsculpt. Right, a lot of professional athletes now are starting to use emsculpt, I have a bunch of 40 Niners that come to the the office, I talked to the head trainer for the Philadelphia Eagles a couple of months ago. This is really a remarkable technology. And in my, in my experience, and I'm doing some studies on my office to prove this. It builds muscle 10 to 15 times faster than you can build it in the gym.
Steve Washuta
And are you doing any work whatsoever? Or much like
Dr. Judson Brandeis
you're just you're just lying down?
Steve Washuta
Just lying down? Yeah,
Dr. Judson Brandeis
I mean, if you go to my YouTube channel, which is Brandeis MD, I have a bunch of videos of myself doing emsculpt, I have a 25 minute video that explains really the science behind it, I have a video with some of the 40 Niners using it. And you know, these guys are remarkable, in remarkable physical condition, and they're not using emsculpt to get into physical condition.
Dr. Judson Brandeis
But you know, if you're six foot two with 120 pounds of muscle, and you're competing against guys that are six foot two with 120 pounds of muscle, you know, every last little bit helps, you know, to to win Super Bowls and stuff like that, you know, you're looking for that, that tiny little bit of extra help.
Steve Washuta
Sure. You know, I'd love to wrap this up with how your book wraps up talking about relationships. We already talked about that a little bit. But if there's anything else you want to say whether it is the four temperaments, or why it's so important to understand the relationships because I do feel like there might be this is just me playing devil's advocate, but sort of a philosophical side that says, Well, why would I want to go on testosterone?
Steve Washuta
Or why would I want to try to be different than what I am isn't like evolution, like purposely making me become less aggressive and less sexual, desirable, and shouldn't I just sort of go into old age that way, but talk about why you believe that's maybe not the case and why understanding relationships will will get you to still avoid that. But also being physically capable to do what you want to do day to day.
Dr. Judson Brandeis
Yeah, so you know, first of all, evolution has made it so that we would get eaten by tigers at the age of 35. So you know, We live a whole lot longer than we used to. And there's something called lifespan and there's something called healthspan. So lifespan is how long you live healthspan is how long you live well how long you're healthy for.
Dr. Judson Brandeis
And so, really what I'm focused on with my patients is, what is their best health span? How can I help them live? Well, like good happy lives into old age, and then, you know, relationships. You could be, you know, in great shape, you know, have all the money in the world. eating right, and working out and whatever. But if you come home and your wife's pissed off at you, you're not going to have a good day, and you're not gonna have a good night.
Dr. Judson Brandeis
So there's amazing chapters written by Brett Beaver, who's a family family therapist on different types of therapy, reasons to go into therapy. How to listen better. There's a great chapter written by a divorce attorney on how to avoid divorce. There's chapters on depression, anxiety, there's a great chapter on work life balance, written by Robert Bonfiglio, who's the president of the California Psychological Association, there's chapters on vitality.
Dr. Judson Brandeis
So, you know, even if you have the physical plant all together, and even if you're a smart guy, you still have to master the EQ the emotional aspect and a relationship aspect of life if you want to be truly happy. And, you know, it's something, there's something in the book. I mean, there's not just one thing, and there's tons of things in the book that every man struggles with, you know, the book isn't meant to be read cover to cover, I would suggest that you read the 21st century man, read the introduction, read the first chapter, go through the table of contents and find things that interests you that are relevant to you that pique your interest.
Dr. Judson Brandeis
And then the last bit of the book is a chapter on inspiration written by Bart Bryan Ben Miller, who's the national news correspondent chapter on gratitude Written by Bernie Churchill, who is my favorite surgical professor, and a chapter on leaving a legacy written by my business advisor, Larry via naughty so you know, inspiration, gratitude, and legacy should all be things that we have at the end of life.
Steve Washuta
Yeah, that's a great point to that there's probably something going on in that book that is relevant now. But what I will say is, there's going to be something relevant later to, it's a book you can go back to, right, because as we age, and as our relationships change, and as our bodies change, those things are going to be inevitably coming up, whether it's you having a prostate issue, whether it's you having sleep issues, whatever that is, and it's a good book to say,
Steve Washuta
Okay, I remember this was a chapter in here, let me go back and see what the experts said to make sure that this is all want. Well, awesome, let's let everyone know, where can we find this book and find more about you, your website? And what's the easiest way to get the book?
Dr. Judson Brandeis
Sure. So if you go to the 21st century, man, all written out in letters 21st century man.com. That's where the book is, you can read the bios for the authors, you can read some sample chapters, you can download, the things that you need to know to make the most of your doctor's visit. We have an e book, we have a hardcover book, we're very soon going to be having an audio book.
Dr. Judson Brandeis
And and then if you're interested in me just go to Brandeis MD, b, r a n d i s md.com, brand as md.com and learn about all the things we do at Brandeis MD, and then my supplement company is affirmed science, a FF IRM science.com. And then I post almost all of my I do a lot of physician teaching and a lot of patient lecturing. And so I post all that stuff on my YouTube channel, which is Brandeis. And
Steve Washuta
I will put all the links in the description. My guest today has been Dr. Brandeis. Thanks for joining The Trulyfit Podcast.
Dr. Judson Brandeis
Thank you so much. It's really been a pleasure.
Steve Washuta
Thanks for joining us on The Trulyfit podcast. Please subscribe rate and review on your listening platform. And feel free to email us we'd love to hear from social@trulyfit.app.Thanks again.
