Episode Transcript
[00:00:00] Speaker A: Welcome to On Purpose with Paul Peters. Today we're uncovering the passions, principles and divine guidance that leads to a meaningful life. You're watching now Media Television.
Welcome to On Purpose where we explore the deeper meaning behind living, leading and loving with intention. I'm your host, Paul Peters. Today's conversation is one many shy away from, but it's one we need to have. Joining us is Dr. Andrew Sun, a Harvard trained urologist and the director of the largest sexual medicine clinic in North Texas. He's a national leader in men's health, known for his compassionate whole person approach to healing. Dr. Son specializes in helping men navigate sexual, hormonal and reproductive health issues that are often kept in the dark until they begin to impact every part of life. Let's start with a powerful truth. When your body feels broken, so does your purpose. Many people will feel ashamed and their health issues, especially when it involves intimacy or bodily functions. For, for men, the shame can run deep and it often keeps them from seeking help.
Dr. Sun, welcome to the show.
[00:01:01] Speaker B: Absolutely. Thank you for having me.
[00:01:03] Speaker A: Why is it so hard, especially for men to speak up about things like sexual health or urinary problems?
[00:01:10] Speaker B: You know, I think men, I'll give you some statistics. Men die of like the top 10 causes of death. Nine of them are more common in men. They're much more likely to have most of the common medical issues out there, but they're 80% less likely to go see a doctor about it. It's cultural, it's machismo, it's whatever you want to call it. But men are just very bad at seeking health care for most conditions and then even more so for conditions that they're, you know, embarrassed about, such as sexual dysfunction, urinary dysfunction, they tend to shy away from talking about it until the problems become really bad. Unfortunately, they, they wait until it's almost too late to compete.
[00:01:48] Speaker A: Yeah. And when that happens, I'll give you a gift. You and I were talking earlier about, you know, I have to go back from my urologist and really came because of issues that I was having. And once I started going there, you know, it was kind of a little scare for me. And so what is it that gets men to actually go and do what they need to do to take care of them? Because you're going to have issues continue to pile up if they don't go and see you.
[00:02:11] Speaker B: Absolutely. Interestingly, most often it's that their wife forces them to come. So there is that reality.
But also times we, in my field of men's health, we Try to think about this problem a lot. How do we appeal to these guys to come and see us? And we realized for a variety of practical reasons that appealing to their risk aversion for heart disease or cancer works to some extent. But perhaps the most easiest way to get people to come and see us is actually when we talk about their sexual health. Because it happens to be something that most men happen to care a lot about. And so we, we use the analogy of cars a lot in our practice. You know, the human body is a lot like a car and there's this idea of like fixing it. Well, if that's the case, if that's the analogy, the penis is essentially the check engine light for the body. Because oftentimes the first signs of cardiac disease, high cholesterol, diabetes are not going to be when you have a heart attack. The first thing you're going to see is erectile dysfunction because that's, those are the most common causes of erectile dysfunction. So, so keep an eye out for that check engine light and when it comes on, it means you may have some deeper issues to address. And so hopefully they'll come and see us.
[00:03:21] Speaker A: That is fascinating. That's the first time I've ever heard that. So let me ask you a quick question. What got you into what you're currently doing as a urologist?
[00:03:30] Speaker B: Yeah, when I went into urology. Urology is a great field. We do all sorts of things. Kidney disease, bladders, male sexual health.
But in my third year when I was doing a rotation at the va, I just really, really enjoyed talking to the gu.
VA is an interesting place for a lot of reasons, but I just really enjoyed the interactions, the personability of it. And I kind of got this desire to really help these guys because a lot of them, unfortunately, you know, some for psychological reasons and some for just like socioeconomic and health reasons, just were not taking care of themselves the best. And I thought that was very tragic, especially for our veterans population. So I became really interested in specializing specifically in men's health and advocating for this, this, you know, for men, which even though it's, you know, 50% of the population in terms of healthcare, in some ways is significantly less well served.
[00:04:18] Speaker A: Gotcha. So let me ask you this, what is the leading cause of the impotence for men?
Overall?
[00:04:27] Speaker B: It's just natural aging. So there is of course some degree of erectile function that gets worse as people age. And everybody should accept that an 80 year old penis will not function as good as a 20 year old penis.
But I would Say then, you know, number two, three and four would be high blood pressure, high cholesterol, diabetes, and low testosterone.
[00:04:44] Speaker A: Wow. Okay, what do you recommend? I'm gonna use myself as a test case because, like I said, I wouldn't go to a urologist. I've had many of the issues that would prompt me to go simply because. And the driving force for most men, and just to put it right out there, is if they're not performing sexually, that's a huge hit to their sense of who they are as a man, if they're not able to please the woman they're with. And so that is a hard thing for men, is that the driving force brings men to come in to see you when they just feel like, I'm not performing, I gotta fix this, because my manhood is attached to that.
[00:05:16] Speaker B: Yes, correct, Absolutely. And I think that that's, that's. We like that fact because it is something that will motivate men who are generally, like I said before, reticent to seek healthcare, actually come in and see us is, you know, something that's probably. It's fertility. It's when they're trying to have a baby and they can't. And it's when their sexual function and performance is not where they want it to be. And the causes of both of those things can often be the same, which can be just low testosterone, metabolic syndrome, which is obesity, hypertension, high cholesterol, diabetes.
And we sort of joke, like if we, like they did with cigarettes, and they put the labels like, warning will cause cancer. If we put on like sugary sodas, you know, warning will cause erectile dysfunction. I think people would be a lot healthier for that because it would actually work.
[00:05:59] Speaker A: Gotcha. Now, let me ask you this, because, for example, for myself, so if I'm having these issues and I go to the doctor because I want. Want that one issue fixed, I want to be able to please my woman. And I'm hoping you're going to give me a pill. But as you said, there's things behind that, the, the symptom per se.
How do you help lifestyle change in regards to, you may give them a pill. I don't remember the exact pills that you would get for that, but there's processes to determine what's the reason, what's the cause. Like you said, low testosterone. So if I was to walk into your office and say, I'm having this issue, how would you then, you know, diagnose me per se as to what the steps are to take to make sure that issue is done as well as preventing it from happening again. Because if there's something dietary or health related, for example, I've got heart disease. That's in my family.
[00:06:49] Speaker B: Yeah, absolutely. And I think that, you know, in the recent years, there's been a proliferation of these telehealth clinics, which basically you can like, log online and just buy some Viagra. And that's fine in terms of accessing medication, but unfortunately that does not give you the ability to truly do this deeper dive like you're talking about to figure out what's going on. So many of our patients that we see, they don't have primary care doctors. Or you ask them, when's the last time you went to your doctor? And they're like, five years ago. Well, in those cases, we sometimes almost serve as their primary care doctors to start the conversation. So I will see a guy for ED and sure, I might prescribe him some Viagra or Cialis, but I'll also do the full due diligence of checking his A1C for diabetes, his blood pressure, his cholesterol. We'll check some labs to look at his thyroid. We'll check his testosterone levels. And then if we identify things that he didn't know about, like he has really bad cholesterol, I'll refer him to a primary care doctor to help get those.
We also have a lot of overweight patients. And, you know, a lot of people now are on GLP1 agonists like Ozempic, WeGovy, Zepbound, these kinds of things. And I work very closely with some weight loss specialists because many of my patients struggle with those issues as well. It's a chicken or the egg thing. You know, is it the low T that caused the weight gain or the weight gain that causes low T? Is the answer is usually it's both.
[00:08:00] Speaker A: Sorry.
[00:08:02] Speaker B: And so we will do a lot of peer referrals to, you know, weight specialists as well, to kind of help things out from that perspective too.
[00:08:08] Speaker A: Gotcha. Can you tell a personal story? I mean, I could share you my story and had some success. So I'm very thrilled with the things that I was able to do when I saw my urologist. But do you have a personal story that you can share about somebody who's come in and maybe months later they have been able to that, with your help, address some of the things that they came in initially for?
[00:08:30] Speaker B: Oh, absolutely. I think of one guy specifically. He, in his youth was actually like a Golden Gloves boxing champion or something. He actually worked with Sylvester Stallone on the rocky wounds. But as he got older and his health deteriorated, you know, he was gaining a bunch of weight. When I first saw him, he just looked just dilapidated, like tired, you know, kind of not walking, very strong, overweight. And first, you know, he came in because he was having trouble peeing. So we fixed that up, you know, from a year urinary standpoint. And then, you know, we checked his testosterone and it was super low. And just by fixing that, by giving him testosterone now it's been probably three or four years that we've been, you know, following him and he's lost like nearly 100 pounds. He's back in the gym, he's exercising, he looks like a million bucks. And he tells me that he feels like he's 20 years younger, that he's like 50 again instead of being 70. And it's just great to see because he's done something that dramatically improves his quality of life as well as his quantity of life, which is going to be extended.
[00:09:30] Speaker A: Yeah. So when people come in and see you, like we talked about, is it primarily because of sexual dysfunction or erectile dysfunction? Like when I went to the doctor, you know, I was diagnosed, I had a, they did a biopsy and came back with a, you know, whatever that they come and they ran it and it ended up being negative. But there was a little bit of a scare and I have to go back typically and have my prostate checked annually. And so what is the recommendation you as a doctor for men? And I'm 60, so I mean, when should men start to consider going to urologist? Because it's usually going to go because they're having erectile dysfunction or they're not able to pee or they're getting up in the middle of the night. Those are fairly typical things that affected me.
Yes.
[00:10:15] Speaker B: We definitely recommend people to come as soon as they have any of those symptoms. So the first sign of ED or difficulty peeing, you know, we're not scary.
Maybe some of us are, but like, I hope, I hope I'm not scary, you know, just come and see us. That being said, there are some standard age related screening events that we do recommend, primarily screening for prostate cancer. Prostate cancer is the second most common cancer in men after skin cancer. And it is very easily detectable with a simple blood test called a PSA or prostate specific antigen. A PSA can be drawn on your normal yearly labs and we can also check it. The American Urological association recommends checking everyone's PSA starting at age 55, but potentially earlier if you have risk factors such as African American race or family history in a primary relative like your father or something like that. In those patients, we might Recommend Starting at 50.
I think we see nowadays higher incidence of cancer in younger and younger men. They moved up the colonoscopy screening from 50 to 45. And so I think it's very reasonable to start getting your PSA checked as early as age 40, maybe as a one timer just to get a baseline and just kind of go from there.
[00:11:16] Speaker A: Gotcha. Now typically kind of describe to everybody what you do in your practice in regards to. Because I never really thought about having to go to a urologist. You know, it seems to be lined up with what the obvious is, but, you know, help people understand exactly what a urologist does and the benefits of seeing them sooner than later.
[00:11:35] Speaker B: Sure. Urology is a subspecialty associated with disorders and diseases of the urinary tract and the male genitourinary tract. So for men and women, we manage physiological or structural issues of the kidneys. So kidney disease is managed by nephrology, kidney tumors or blood in the urine or things like that is managed by urology. Anything related to the bladder, that's our domain. For women, you know, pelvic organ prolapse, you know, leakage, incontinence is very common. And then for men, it's essentially you can think of us as like the gynecologist or the obgyn, but for men. So any type of male sexual reproductive fertility or genitalia issue is going to be managed by us. In addition to the prostate, which is probably our main organ that we intervene.
[00:12:20] Speaker A: Great. We will be right back after this commercial. Thank you.
Right back with more stories and insights to help you discover your calling and live With Purpose. This is On Purpose with Paul Peters on NOW Media Television.
I'm Paul Peters and you're watching On Purpose with Paul Peters on NOW Media Television. Let's continue the journey towards your best life.
Welcome back to On Purpose. I hope you're enjoying the show. Don't miss a moment of On Purpose or any of your favorite NOW Media TV shows live or on demand, anytime, anywhere. Download the free Now Media TV app on Roku or iOS and enjoy instant access to our full lineup of bilingual programming in both English and Spanish. Prefer to listen on the go catch the podcast version of the show right on Now Media TV website at www.nowmedia.tv.
from business and breaking news to lifestyle, culture and everything in between, now media TV is streaming 24. Seven ready whenever you are. We're back with Dr. Andrew sun, top urologist, men's health advocate whose work is changing lives. In this segment, we're diving into the silent struggle many men face, ignoring their health until it's too late. These are the problems no one talks about because many men have conditioned to stay silent. Ignoring symptoms doesn't make them go away. And too often men wait until they're in crisis before they seek help. But it doesn't have to be that way.
Dr. Sun, we were talking and it's interesting, I call it providential because I wasn't really sure exactly in detail what you did. And it's interesting because it makes it much more personal for me. I had shared with you that I see a urologist. Fortunately, I just see him every six months to a year.
I caught it early enough because of a little bit of a scare.
And a lot of times men who go are going because of an issue that's already in a reactive phase where they have to go because they're, they're having difficulty urinating. They may be having some erectile dysfunction. And when they come to you, and I know you do the various tests and if you don't mind sharing some of those, I think it's very important. The takeaway from this is be proactive, seek a urologist as soon as possible, because once you go and you find out, for example, that you have your PSAs are high, which mine typically run high, you may actually have a positive biopsy. So stress the importance of how and why men need to go.
And for me, it's like I've got five kids and so I did not want to, I want to be around for a long time. And so I know that's a big part of what you do because, you know, I think you identified, you got into this because it was part of what you felt called to do is your purpose. And you wanted to be there for men to and be able to give them the help, medical help, to be able to make a difference and make a choice they could that would help them live longer and be around for their family. So talk about what has to happen for men to wake up and do what they need to do and how you encourage men. And I don't really know what exactly your practice does to get people in the door, but like I said, it becomes a pride issue. It becomes a shame issue where they're ashamed of and they, rather than go and deal with it, they're going to hide it. But it just gets worse if you don't do something about It.
[00:15:40] Speaker B: Yes. You know, that is probably the hardest part of my job. It's not the practice of medicine.
You know, eventually that becomes pretty easy. Actually. It's not even doing surgery anymore. It's convincing men to actually come in and just start the conversation to begin with. And obviously, over the years, we've tried many different things.
We've done health talks in the community. We do health fairs. I do some events at different churches and, you know, men's support groups and these kinds of things. But so much of it just ideally happens on a more broad and national level. And so, you know, we have been encouraged that, like, say, 30, 40 years ago, nobody would talk about erectile dysfunction. But because of Viagra and because of some of the commercials and celebrity endorsements about it, you know, erectile dysfunction is becoming a little bit more easy to talk about. And I will give some credit there to the telehealth platforms that have expanded in the last few years about, you know, dispensing Viagra and Cialis, because at the very least, they're raising awareness, you know, and this is a very common problem and one that is embarrassing, but not one that you can't treat if you find the right people, you know, to go see.
One of the more common things that we definitely manage a lot is prostate cancer screening.
That is something that many people should be having checked, you know, routinely with their primary care doctors. If the PSA is low, we're good. We don't have to care about it. When the PSA is high, it does not necessarily mean that you have cancer. It could be just in large prostate, which can mean you get up at night to pee and your stream is kind of slow and that kind of stuff. It could be infection or irritation of the prostate, but it could also be prostate cancer. And so that's where we come in and we try to deduce those three things. And like you were saying, you know, that may involve, you know, things that are maybe not so fun, like a biopsy, but there are also a variety of other tests for or through the urine or MRIs, and that kind of thing that we can also do to take a look at that. Because. Yes. I mean, if you ignore these things for too long, they can eventually become a big problem.
[00:17:34] Speaker A: Gotcha. So how much, percentage wise? I guess when somebody comes in, let's say the issue is they're having erectile dysfunction and you said you do the testosterone test first, or how do you. What would be the next steps once they come in, to evaluate what is the issue because they obviously want it corrected, but it may run deeper. Like I said, there may be other reasons going to health, health related, maybe have some hereditary issues, a diet. Can you kind of help lay out to the audience exactly when you're screening. And obviously you're trying with the goal to fix the issue. But some of those issues may be lifestyle changes and how that plays into getting the individuals who come in to make those changes.
Right.
[00:18:14] Speaker B: So when I talk to my patients about erectile dysfunction, I tell them you basically need four things to work correctly to get the erection. You need vascular blood flow, neurologic function for the nerves, hormones to be normal, testosterone. And you need the proper psychology. Right? And the psychology part, we all know that intrinsically as men, you know, unfortunately, we're all thinking about it too much. And the more you think about it, the worse it gets. There's always a performance anxiety associated there. So that, that's an important piece of it. It could be 5% of the issue, it could be 95% of the issue.
But, you know, we will definitely look and screen for that, talk about it, but also look for the other three things. So blood cell issues, most commonly, you're looking at high cholesterol, you know, heart attack history, hypertension, high blood pressure. What's interesting about high blood pressure, of course, is that high blood pressure itself can cause ED and heart attacks and strokes over the long term. But acutely high blood pressure medication causes ED. And there's actually about 25 to 30% of men that will like, stop taking their high blood pressure medication because it gives them ed. If you think about it, if you have high blood pressure, your body is used to a blood pressure of like, let's say 150 over 100. And over the long run, that's not good for you. But if your penis getting a pressure of 150 and then you suddenly drop it to 120 with a medication, and there's not as much pressurized blood going into the penis, you're going to see that as erectile dysfunction. But so we have to work around that. Hormones. That's really just testosterone. Very, very common to have low testosterone. It's associated with poor sleep, with being overweight, with lack of exercise. And so that's something that we check. And then the nerve. One is there's really two categories of people that have nerve issues. One, diabetes, which affects the nerves, and it's probably the single worst disease process you can get from a sexual function standpoint. And two is the nerves could have been surgically Injured or radiated through patients who've had, say, prostate cancer and things like that.
And so those would be the most common. We try to examine all of these things. The treatments ultimately, regardless of the initial etiology, are mostly the same, which is lifestyle management, blood pressure, diabetes control, all that good stuff.
Pills like Viagra, Cialis, there are fancy compounded versions of those, there are regular versions of those. You can do what we call direct to penis therapy, which would be delivering medication directly to the organ, which usually comes in the form of an injection, which I know sounds horrible, but it's not that horrible. It's just a little horrible, but it does work. And then there's something called a surgical procedure called a penile implant, which sounds terrifying as well, but is a 45 minute surgery similar to a, a knee replacement that, you know is guaranteed to work and is actually covered by Medicare. So, you know, we definitely have options.
[00:20:48] Speaker A: So I'm glad you walked me through because these are the various steps that my urologist talked to me about. So it is a reality and I think very important for the audience that we have these conversations because men want to be able to perform. I mean, it's part of who they are. They want to please their woman. And. But very few men, including myself, link the erectile dysfunction to a poor diet, unfortunately. I feel like after you share this, like, oh my gosh, is there hope for me? Because I have high blood pressure, I have a high cholesterol, I have gout, I have sleep apnea. So all those things you mentioned, which I'm seeing the doctors about, but I think it runs deeper. I mean, and I think, you know, one of the things, the takeaway I want the audience to hear is these are things you can do something about. You know, not only with the, if you were going there for the erectile dysfunction, you're getting the, the medication or you're going the next level steps, and it's got to run deeper, it's got to be lifestyle changes. Got to make sure that you're making good decisions with your diet and health. And so speak on that because, not that I want to minimize your customers, but I want to make sure that, you know, some of these things can't necessarily be fixed by a pill or a shot. And believe me, the shot to the, to the penis is not a fun experience. And I think the last, last case, my, my urologist says you can have that surgery and install, but a lot of that can be prevented. And I think it's very important for our audience, specifically the men to recognize what can I do now? Because I may have come to the doctor for this reason, you know, urination in the night or multiple times like that, or erectile dysfunction. But, you know, walk the men through, it's like, okay, let's go back 10 years. What you could have done. You can't go back and change that, but you can make some changes today. And what does that look like? Because like I said, you know, I'm looking at, for me, because I went and saw the sleep doctor of having an aspira put into, into my chest because the, you know, a lot of men wear that, that mask and they don't link that sleep apnea to the ultimate issue that leads to erectile dysfunction. I think more men, including myself, have to really get that connection because we have some power in our choice, and I think that's very important. You're just trying to prevent these issues, but a lot of times they're already, already presented. And now what can men do proactively after they've gone to you and you said, okay, this is the situation.
And I think then the men, especially if they have something to leverage that is a family, and they don't want to, they don't want to go through these issues. But like myself, they started piling up and I had to deal with them, but I never really understood the connection with all of them. So can you kind of talk about all of those things? I just happen to be your case study here today.
[00:23:21] Speaker B: Yes, no, it's absolutely true. And one of the truisms that you learned in medical school is that, like, if, if we were truly perfect at our jobs and doing everything, ideally, we are always in the business of trying to put ourselves out of business because if everybody really could prevent all the diseases, we wouldn't have to intervene after the fact. Unfortunately, people, life, lots of other things.
Sadly to say, we're usually always going to be busy because we're going to have to treat some things. And luckily, the first thing I tell people is that no matter how bad your ED is, I can pretty much guarantee that I can treat it. There's very few things in medicine that you can guarantee, but I can guarantee somebody that I can get them an erection. I just can't guarantee them how much work it's going to take. And, you know, if they're coming to me and it's been many years and they haven't taken care of themselves, it's going to take more work. But certainly the earlier you start trying to do those preventative things, the better. And it's all just kind of the same theme, which is healthy living. Right? Obesity is the biggest epidemic that we have. It's probably the source of 99% of our problems. That's why I think that the wonderful medications that the GLP1s are very helpful and that can prevent a lot of things. Don't get diabetes. If you already have diabetes, it's not that controlling your blood sugar will completely reverse the changes, but it will prevent it from getting even more worse. And so it is definitely important.
Exercise is huge. Sleep apnea. If you really think about it like, you know, we always think of, there's like my day, there's what I do during the day and then there's sleep. But the single most important activity any of us does any day is sleep, because everything else comes from that. And if you don't sleep well, literally every other body function will not be as good, especially testosterone levels. We make testosterone during the night while we sleep. Sleep apnea and obesity are linked, but also the two most common causes of low testosterone. Low testosterone then causes poor metabolism, muscle atrophy, lack of ability to lose weight, erectile dysfunction, low energy, and, you know, all these kinds of things. So I think sleep apnea treatment is wonderful. I think weight loss treatment is, you know, a huge piece of it. And then of course, you know, diabetes management, high blood pressure management and all those things. But the good thing is that even for the guy who's 75 and you know, he's had diabetes for 50 years and you know, we're really not going to be like changing him back till he was 20, luckily I can still do a 45 minute procedure and restore his ability to have sex.
And fortunately, you know, we have those tools in our toolkit. But for sure we always, the foundation is always prevention.
[00:25:48] Speaker A: Yeah, thank you. We will be right back after this commercial. Thank you. Right back with more stories and insights to help you discover your calling and live with purpose. This is On Purpose with Paul Peters on NOW Media Television.
I'm Paul Peters and you're watching On Purpose with Paul Peters on NOW Media Television. Let's continue the journey towards your best life.
We're continuing our conversation with Dr. Andrew Sun. I hope this is fascinating. I myself am learning a great deal. He's a leader in treating not just the symptom, but the whole person. In this segment we're talking about chronic pain. It might not seem serious, but when discomfort becomes constant, it can cloud everything, even your sense of purpose.
Dr. Sun, we were talking about the various Symptoms that arise that really kind of are linked together. And I share with you some of the issues that I'm personally having with the sleep apnea. And a lot of times a person may have a particular issue go to, and I think it was an endocrinologist that deals with the sleep apnea.
But then other symptoms arise, and one of them being this specific thing to a urologist when you, when you have a patient come in and let's say they're coming in because of the urination or the erectile dysfunction, are these things that you also screen for, like said, are you having sleep apnea? I know you run tests for the high cholesterol and high blood. And I think it's very important for men.
One, it's hard for them to go to the doctor at all.
And I think it's important that we all get a wake up call, especially as we get older. But how can you help men, you know, whatever, wake them up to the reality that these things are indicators of something gone wrong in your body that you can fix if you make some changes. So I want you to kind of talk about that and then if you were able to tell men this is the ideal schedule, this is the ideal diet, so men can start making incremental changes in their life to be able to not only address the issues with their, with lifestyle choices, but also, I mean, there are situations with medication. So if you can kind of talk about the linkage between some things we talked about off camera, where symptoms are going to rise, but it's really indicative of one big issue.
[00:28:01] Speaker B: Yes.
And a lot of times you could have a singular issue result in many different symptoms. The classic one in my field is low testosterone, because low testosterone can generate fatigue, mental clarity loss, weight gain, low libido, erectile dysfunction, like so many different things. But those things can also have 100 different other explanations. So it is important to always kind of try to take as holistic of a picture as possible. I wish I could say that we were all, we being doctors were all great at this. Unfortunately, as most people probably have experienced, the time pressures of being a doctor these days are significant. So it's hard to have enough time per visit to be able to talk to everybody about everything. So sometimes by practical reality we are forced to kind of compartmentalize things into like talking about one or two issues, you know, per particular visit and just kind of go from there. But as much as we can, I try to link these all together because, you know, a lot of men will come in like you're saying, and they'll be like, I'm here for the ed. But then we unearth, you know, the fact that all of these things are linked behind it. And many men, as you pointed out earlier, don't have a concept of this. I can't tell you the number of people that come in. You know, they're like 55. They're like, yeah, I don't. I don't get it. You know, I have ed. I can't understand why. And I look at their medication list, and there's like 50 medications and high blood pressure, high cholesterol, diabetes medications. I'm like, well, it's because of all these things. Then they're like, yeah, but I'm taking the medication, so I'm good. I'm like, you're controlled. It doesn't mean that you haven't suffered the injury from those things already.
And so we do still have some work to do.
Ultimately, I don't have a time machine. I can't revert some of those changes, but I can certainly prevent them from getting worse.
That's a very common situation for us. And, you know, you just try to paint them the whole picture of the fact that, like, if you get them to care about their penis, then hopefully by extension, they'll care about the rest of their health, because the two things are incredibly linked. You can't divorce them from one for another.
[00:29:55] Speaker A: Yeah, it's funny. It's like men do care about their penis. I will be honest and tell you.
[00:30:01] Speaker B: Absolutely.
[00:30:02] Speaker A: Question is, will they do the hard work to make sure that it functions properly? You know, and that's the challenge because, you know, much like probably many men, I, you know, did great. And then all of a sudden, uh, oh, what's going on here?
And then I remembered.
Go ahead.
[00:30:17] Speaker B: I was thinking, you know, you're saying, like, what's the ideal I in the modern world? Like, especially with, you know, podcasts and these sort of, like, popular science things, Everybody, I find, especially in the west, are very hyper focused on, like, what's the latest and greatest, like, cool protocol or biohacking trend. You know, is it carnivore? Is it keto? Is it Atkins? Is it this or that? And the answer is, like, to some extent, those things do make sense. I mean, certainly low carb is a significant thing. But when you really step back and take a look at it and you look at the populations in the world in which they do live long, healthy, fulfilling lives, you know, those blue zones, like in Japan or in the Mediterranean, they may have slightly different diets. They're not doing carnivore, they're not doing keto. What they are doing is they're just not eating that much food. The food that they do eat is real food, not like ultra processed, whatever. They walk around a lot and like, you know, they have like good family structures and they're social and, and all this kind of stuff. And I think it's distilling it down to like, that. That's the general trend that you would see that that unifies all people across all cultures. It's just eat real food, not too much, move your body, sleep well, and then you don't have to get bogged down in the weeds of like counting your macros and that kind of thing. If you're like a performance bodybuilder or you have a specific, you know, like, competition type target in mind. I understand the importance and the relevance of, you know, accounting macros, but for most people, it's just generally these overarching themes, I think.
[00:31:49] Speaker A: Well, let's talk about this because it's interesting and I shared with you my issue with gout. It happens to be in my left ankle. Had an injury when I was in high school, so it was really prevalent there, which affects my ability to walk. And so when people see me walk, it's everything okay. And I'll say, what's my gout? Well, there's much more, deeper issues. And I think for me, it's like I may start having pain in my knees. And so let's talk about, from a urologist perspective, some of the issues related to chronic pain and maybe inflammation. Because a lot of men, including myself, didn't fully understand how that played out because I'm like, I'm dealing with the gout issue with this medicine and whatever the doctor tells me to do. But it's, you know, in some cases it feels like it's getting worse because of the inflammation. And so what can men do to help alleviate the chronic pain, pain, more specifically with inflammation? And what is inflammation?
[00:32:38] Speaker B: Yes, indeed. And gout is something that we deal with a lot because gout is usually uric acid excess, either from, you know, acid metabolism or excess protein intake. It also causes kidney stones.
One of the most common things that we see as urologists, uric acid, kidney stones.
Uric acid stones, which eventually can precipitate calcium oxalate type stones. Inflammation is a big buzzword these days for sure. Just like the buzzword toxins, which I, as a sort of regular doctor, I never really understood what that Meant, but certainly inflammation leads to a lot of other problems. And chronic inflammation and chronic pain has a significant effect in raising things like cortisol levels, which can, you know, over time have negative changes to your body composition. In addition, chronic stress, chronic inflammation in the body can suppress testosterone levels, which is again the sort of key male hormone, but also important in women as well, you know. And so whether it's a single site inflammation like in your ankle or in your prostate or something like that, or just sort of a chronic inflammatory state in the body, that heightened degree of inflammation, you know, may, and I say may because it's not definitively proven yet, may lead to a downstream higher risk of certain diseases, metabolic syndrome, cancer even, and lots of things. So, you know, people talk about like the sort of low inflammatory diet or low inflammatory habits. Well, certainly, you know, smoking is high inflammation, sitting around all day is not good for you. And so I think in general it gets back to the same lifestyle things. And reduction of inflammation probably also reduces your risk for some of these other downstream.
[00:34:13] Speaker A: What can men do to reduce the chronic pain? I mean, once they come to you and they get the official diagnosis and you may give them a pill, I'm assuming you also give them some recommendations on dietary and other types of things. But what can men do to begin making some of those changes that. Because they can't go against the natural progression of aging. But I think they can begin to reduce the effects of aging or some poor lifestyle choices. So what would you recommend to the audience on what they can do now? And I want to also touch base and I'm asking two questions here for me, because I'm actually taking a pill to address the uric acid. Why would there be a buildup of uric acid? So if you could address what men can do now to help slow that process down. And then the other question in regards to uric acid, how you get the, the overflow, I guess, or abundance of something that's ultimately going to lead to inflammation.
[00:35:10] Speaker B: Yes.
So I'll start with the uric acid part. You know, uric acid is a breakdown byproduct of protein, animal protein. We in Texas here we have sort of the worst overall situation for kidney stones because we have heat, so dehydration. We have a lot of steak, we have a lot of salt, and we have a lot of oxalate is found in tea. So if you're like a somewhat overweight Texan who drinks a lot of sweet tea, eats a lot of salty steak and doesn't drink enough water, like, that's a kidney stone nightmare right there.
And unfortunately, the same things can also cause gout. Now, some people have a more of an intrinsic kind of uric acid purine metabolism issue, where it's not so much that they're just like huffing steaks all day, but they just happen to make more uric acid, which can deposit usually into joints. Like, big toe is the classic one. The ph of the urine affects, certainly for us in the kidney stone world. So when you have very acidic ph, you know, it's going to. It's definitely going to make an effect on the prevalence of forming kidney stones there. In terms of things that people can do to address, you know, I think there's. There's never too late of a time to start trying to eat healthier and exercise and sleep better. I would say the first thing to work on is sleep, because if you don't sleep well and you don't have the energy, you know, it's gonna be very difficult to do anything else after that. Once you can optimize that piece of it, then we can start talking about, you know, diet. Bodies are, you know, most people come in, they're talking about weight loss, and I was like, yeah, I'm gonna get in the gym. And I'm like, bodies are made in the kitchen, not in the gym. Right. The gym helps. The gym is necessary. The gym is like 15 to 20%, but 80% of it is in the kitchen. You could go to the gym for an hour and walk on the treadmill, and that's great. And get your 10,000 steps and one chocolate chip cookie, and it's all gone. You know, so we just have to kind of reorient ourselves around, like, what are the. The bigger priority issues there and kind of proceed accordingly.
[00:37:00] Speaker A: Gotcha. We have a little bit more time in this segment, so it's interesting. I'd asked or wanted you to talk about what can men do in regards to changing their habits? So, for example, sleep is a very, very important part to get good sleep, because that's, for me, that's where the body naturally heals. And you said, I think it produces testosterone during that time frame. But you also mentioned a big proponent. A big component of it is the diet, what you eat. And so, you know, what are certain things? I'm a big meat lover. I love steak. I love those types of things. But it almost sounds like it's okay in moderation. And also it sounds like you need to be drinking a lot of water. So can you explain just in about 20 seconds. Or we can continue this into the next segment. Why diet so important?
[00:37:48] Speaker B: Yeah, I mean, you know, foundationally. I remember learning in elementary school, right. Like you are what you eat. And that is so true on so many levels.
Whether it's the macro breakdown or just, you know, different compositions of things is incredibly important. Different types of foods can decrease or increase inflammation. Carbohydrates usually make you very tired. You know, we always in the sort of longevity and lifestyle space recommend you know, a higher percentage intake of protein along with like weight training. Most of us are very heavy proponents of resistance weight training or high intensity interval training versus low intensity steady state like long distance walking. That being said, if you can only manage to do long distance walking, that's still better than doing nothing. And so we would always recommend going with that as well.
Yeah, I just try not to focus too much on individual dietary things because I think that people go down rabbit holes of like these kind of optimization things. But I guess one, you know, key point that I do stress to everybody is like the first thing you should try to remove is liquid calories. Liquid calories are the most useless form of calories. They don't make you feel full and you have to keep doing it. So sugary sodas, any, any sugar in any drink. Basically like okay, protein shakes, that's, you're getting protein there but like otherwise we should just be drinking water and, and like with all things, you know, meat I like, I enjoy good steak too and I don't eat it every day. Right. And I'm probably not going to eat like a, like a £1 steak by myself completely. But actually that maybe I will but you know, occasionally. Right. It's always going to be everything's fine in moderation and don't go crazy on any level. I'm not a big fan of like the carnivore diets. You know, things like that are just a little too extreme, I think. Okay.
[00:39:25] Speaker A: Operation. We're going to continue this into the next segment. We'll be right back after this commercial. Right back with more stories and insights to help you discover your calling and live with purpose. This is all On Purpose with Paul Peters on NOW Media Television.
I'm Paul Peters and you're watching On Purpose with Paul Peters on NOW Media Television. Let's continue the journey towards your best life.
Welcome back to On Purpose. Loving what you're watching. Don't miss a moment of On Purpose or any of your favorite NOW Media TV shows. Live or on demand, anytime, anywhere. Download the free Now Media TV app on Roku or iOS and enjoy instant access to our full lineup of bilingual programming in both English and Spanish. Prefer to listen on the Go catch the podcast version of the show right on the Now Media TV website at www.nowmedia.tv. from business and breaking news to lifestyle culture and everything in between, now media TV is streaming 24. 7 ready whenever you are.
So we're back here with Dr. Sun. We're finishing up in the last segment, and Dr. Sun is a renowned urologist, but we're talking more deeply about the decisions that individuals make, specifically men. They come into your office primarily for erectile dysfunction or urology issues, and then you run the gamut. But it really is allowing to pull back the curtain per se and look at somebody's life and look at the lifestyle choices they're making, look at their diet, look at different things like that. So in this last segment, if you could help prepare men who are now awakened to the reality of something's going wrong in my body and it's an area that I'm very, very important to me, that is how do I perform in bed? And and the goal is one, they're going to continue to perform well in bed or they're going to not have these medical issues. What recommendations can you give as a doctor who's seen hundreds and thousands of patients and been able to see and walk through many of them to, you know, would be a better life, healing and, you know, talk about what you would tell me. And I've shared some of my personal health issues on what I can do because I'm starting to make some changes because, you know, I'm going to be getting, you know, into a relationship and going to be moving on and different great things. And I've got kids, but I'm 60 and I want to be able to live for 25 years. So in the last remaining minutes, we have talk about what you would recommend and we've talked about a few of those. But if you were to summarize and leave the last bit of words to amend to advise them, what would it be?
[00:41:47] Speaker B: Sure. I would say that A, it's never too late to get started. And I think a lot of people are like, well, you know, maybe all the damage is done and there's no point anymore to like trying these hard things, but it's never too late to get started. It is hard work, but the hard work will pay off in so many ways that you can't even imagine. Right. It's not just about longevity or the number of years that you live. It's about the quality of those years and how much you can enjoy them. The three fundamental actions that all of us do are eat, move and sleep. And those three things, if you can fix those, you can probably live a very healthy and fulfilling lifestyle. So you have to eat, you know, reasonably well. Like, doesn't mean you can't have, you know, an enjoyment thing here or there or a cheat day or whatever you want to call it. But you just have to eat, you know, normally good.
You have to move your body. It doesn't mean you have to do, you know, three hours of exercise every day, five days a week, but just get up off the couch and start moving around a little bit. And then you have to sleep. And if the sleep is a problem, then we have to see a specialist to help you sleep. Because if you don't sleep, your body doesn't know what to do, and it's basically in a chronic state of inflammation and being tired. If you can fix those three things, we can make things happier for your life. And then, of course, we have tools to help on the margins on the more specific things. So if it's erectile dysfunction per se, fortunately, we have a variety of medications and different things, including up to surgery for testosterone. I always hearken back to how critical of a hormone testosterone is for everyone. And, you know, I always have this thing because it's not something that people usually get checked at their pcp. It's not just part of that standard screening, but I wish it would be because I think testosterone is such a vital component to. To metabolism and life. It's not just about bodybuilding. It's not about cheating at sports. It's not about, you know, steroids and baseball or whatever. It's a critical hormone for metabolism, for brain function, for just general overall health. And if you have low testosterone, you may be working really hard at all of those other things, but they may not be giving you the benefits that you could achieve if you had normal levels of testosterone. And there are many, many ways to increase testosterone, from just working out and losing weight and all that stuff to medications. Testosterone is easy, it's cheap, it's commonly available. There are side effects. It is something that you need to be prescribed by and done under supervision of a medical professional.
But there are many potential benefits and many different ways of doing testosterone. It's not just injections. There are testosterone pills now that you can take that have been on the market since 2019. So lots of different things to optimize there.
And Then the last piece of it is that, you know, there is a significant connection between the mind and the body. Right. If you have confidence and belief that you're going in the right direction and that you can achieve these things, that will help. And if you're mentally defeatist, I guess you could say about it, then it is going to make it more difficult. And so, you know, part of my job is, is a little bit, you know, nutrition coach. It's a little bit men's health urologist. It's a little bit endocrinologist. It's a little bit like psychiatrist, you know, cheerleader. It's a lot of these things at once because, you know, only when you bring all of these together do you really see the dramatic results to people's life. But when you do, it's a magical thing to watch.
[00:44:53] Speaker A: Yeah. So what would be. Is there a range for men in regards to the testosterone? Because if they go. And how often would they need to check that?
[00:45:01] Speaker B: You know, the official cutoff from the American urological association is 300. So less than 300 is low. Above 300 is normal. I don't love official cutoffs. You have to make them. But does that mean that 299 is, like, suddenly bad and 301 is perfectly normal? No. And obviously it also means that 301 is not the same as 999. Right. I wish everybody could have checked the testosterone at age 18 just to get a baseline. Every person individually has a variation in their testosterone levels from. From person A to person B. You know, some people are going to have. They're used to higher levels, some people are used to lower levels. So without that knowledge, it's a little bit hard to predict. But, you know, low is less than 300. Most people should probably naturally exist in the 4 to 600 range. If everything's going okay, really young athletic guys are probably 7, 8, 900. But you can also, you know, artificially manipulate those numbers to optimal ranges, and you probably start to see normalization of metabolic syndrome and some of those really deleterious things at about 500 or so. But you really start to see performance from an athletic standpoint from a muscle growth perspective into the higher, like, 8, 900,000 type range. @ the same time, as a true medical professional, like, I'm not trying to crank people up into, like, 1500. That's not the goal of this.
There are people who do that, and they can seek their ways of doing that, but the goal is to make people healthy. And so for that, you're Trying to get people into that. Four to, let's say, 800 range.
[00:46:27] Speaker A: Gotcha. Now, you mentioned three components. I'm going to leave the audience really understanding this eating, which is very important. And so typically would it be if you were going to average it out. Greens, meats, dairy products, those types of things, breads. I mean, what would be your equivalent serving? Because if somebody's heavy on the sugars or the sweets, you know, that's going to. That's going to break down a lot of various issues related to. Related to the body.
[00:46:52] Speaker B: Yes. I forget the name of the author now, but a few years ago he came out with a statement that's like, you know, eat real food, not too much, mostly vegetables like that. That's really all you have to remember.
And I think the. As everybody now knows, the food pyramid is probably like, inverse of what it actually should be. Right. It's not like 8 to 12 servings of grains. We eat far too much like, you know, wheat, basically. I think, you know, in the US we have, like, a monocrop of one version of wheat, which may be why many Americans suffer from GI distress from wheat products. That does not seem to occur. When you go and travel in Europe and eat European bread, it's just like a very different thing.
But essentially it's mostly vegetables and some proteins and some carbohydrates, not a lot of refined sugars, not a lot of processed foods, and just overall, not too much pure bread.
[00:47:40] Speaker A: Gotcha.
[00:47:41] Speaker B: Our volume of intake is probably our worst problem.
[00:47:44] Speaker A: Gotcha. And typically, what do you recommend? Cause for me, I like to lift weights. But you say movement, exercise.
Does it matter? Cardiovascular versus lifting or just some kind of movement that will help?
[00:47:57] Speaker B: Yeah, both.
But I definitely think everyone should do some resistance training or weightlifting, because more commonly you have people that, like, only do cardio and they do like, I'll just like, walk on a treadmill for like an hour. You know, you want to get your heart rate up, right? That's good for your cardiac health. You can get your heart rate up through lifting. You can get your heart rate out through sprinting, through running, through jogging. I think, you know, like, with everything, it's a mix, right? You do a little bit of cardio, a little bit of strength training. You can do them on different days, but everybody should do strength training. And I think that's even more important to stress to women because a lot of women sort of have an aversion to doing strength training either because they think suddenly they're going to look like a, like, A shredded, you know, muscle maniac. And when I talk to, like, women about it, I'm like, I wish it worked that well. Like, if it worked that well, men would be doing it all the time. But it clearly is not so easy to just become shredded like that. So weight training is very, very good postural training. So especially as people get older.
Peter Attia, who's a famous sort of longevity doctor, talks about the, like Octogenarian Olympics, which is like things that you want to be able to do at age 80.
Squat, lift a kid, you know, pull like, you know, a little bit. They're basically normal lifestyle things. And unfortunately we see so many 80 year olds who can't do those things. But the training to get to that point is basically just a little bit of moderate resistance training, some cardiac training, keeping your bones intact, preventing yourself from being injured. That's very important. As we get older, we never stretch enough. We never warm up enough, we never cool down enough so that, you know, you basically don't stretch when you're like a teenager. And then at some point in your 30s and 40s, because you didn't stretch, you get some kind of injury and suddenly you realize the importance of stretching.
[00:49:40] Speaker A: Yeah. Before we wrap up, Dr. Sun, where can our viewers follow your work or reach out to you? Online, website? Social media?
[00:49:46] Speaker B: Yeah, yeah, absolutely. So my practice is called Urology Partners of North Texas. The practice website is upnt.com my office is in Arlington. I also have a personal website where people can look at more detail on the men's health issues that I treat. And that's www.AndrewsonMD.com.
and so I have a lot of wealth of information on there, as well as some videos and some podcasts and in terms of stuff that people can check out. But certainly if you're in North Texas or in anywhere in Texas, we offer telemedicine appointments, in person appointments, and you can find us there, right?
[00:50:21] Speaker A: Dr. Sun, thank you. It's been a true honor. Thank you for keeping it real. Leave on this note, eat, move, sleep, all of those three. Keep it simple. Thank you, Dr. Sun.
[00:50:30] Speaker B: You got it. Thank you.
[00:50:31] Speaker A: Bye.
