Barbell Medicine Podcast

Every week there's a new headline saying men are losing testosterone. A quarter of men now start testosterone replacement therapy without ever getting their blood tested. The supplement aisle is full of boosters that either do nothing or contain undisclosed steroids. And the lab test that gets everybody to the pharmacy? Half of low results normalize on their own. In Episode 1 of the Signal launch series, Dr. Jordan Feigenbaum and Dr. Austin Baraki (both MDs and strength coaches) walk through the three-layer problem with how testosterone gets diagnosed and treated in 2026, then take apart the "testosterone is crashing" headline with the most current data available, including a 2025 meta-analysis of more than one million men. Timestamps What you'll learn in this episode: This is Episode 1 of a four-part series built around our upcoming book, Signal. Over the next four weeks we cover what testosterone actually is, how to tell when it is genuinely low, what is really driving population-level changes, and what the evidence says you can do about it. Next Steps Signal Resources Baillargeon, J., et al. (2015). Trends in Androgen Prescribing in the United States, 2001–2011. JAMA Intern Med, 175(8), 1413–1415. — 25% no preceding lab; post-prescription monitoring gap. Rao, P.K., et al. (2017). Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States. J Urol, 197(4), 1121–1126. — Prescription volume growth. Selinger, S., & Thallapureddy, A. (2024). Cross-sectional analysis of national testosterone prescribing through prescription drug monitoring programs, 2018–2022. PLoS One, 19(8), e0309160. — Recent prescribing data, 3-4 million estimate. Vesper, H.W., et al. (2015). Serum Total Testosterone Concentrations in the US Household Population from the NHANES 2011–2012 Study Population. Clin Chem, 61(12), 1495–1504. — Population testosterone levels, NHANES data. Clemesha, C.G., et al. (2020). "Testosterone Boosting" Supplements Composition and Claims Are Not Supported by the Academic Literature. World J Men's Health, 38(1), 115–122. — 62% no published data, 10% decreased T. Tucker, J., et al. (2018). Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US FDA Warnings. JAMA Network Open, 1(6), e183337. — 12% adulterated with undisclosed steroids. Trost, L.W., & Mulhall, J.P. (2016). Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials. J Sex Med, 13(7), 1029–1046. — Half of low results normalize on repeat. Travison, T.G., et al. (2008). The Natural History of Symptomatic Androgen Deficiency in Men: Onset, Progression, and Spontaneous Remission. JCEM. MMAS data — 50%+ spontaneous normalization. Travison, T.G., et al. (2007). A Population-Level Decline in Serum Testosterone Levels in American Men. JCEM, 92(1), 196–202. — Original MMAS secular decline, 15–20% lower across cohorts. Santi, D., et al. (2025). Meta-analysis of secular trend in total testosterone levels, 1971–2024. 1,256 studies, N > 1,000,000. — 0.56%/year adjusted; LH parallel decline; mass spec subgroup no significant decline. Methods note on the ~0.56% per year figure cited in this episode: the Santi paper does not report a single percentage rate. The headline adjusted meta-regression coefficient (−0.6 nmol/L/year) is inflated by the random-effects weighting scheme and is not a biological rate. The 0.5–0.6% per year approximation comes from the pre-2000 stratified subgroup (Fig. 5, coefficient −0.1 nmol/L/year) divided by the dataset mean of 18.5 nmol/L. The post-2000 stratum runs larger (~1.1%), and the age-stratified coefficients in Table 5 cluster in the 0.4–0.9% range. The mass spectrometry subgroup (Table 3, Group 4) showed no significant trend (p = 0.845). The episode uses the conservative end of this range as the most defensible estimate of the real population-level rate after accounting for assay...

A 43-year-old man starts exercising and ends up in the ER with a CK over 100x the upper limit of normal. His doctor says it’s from training. We don’t think so. In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through the full case — history, labs, diagnosis, and what actually went wrong — then break down the mechanisms behind the answer, the nocebo research, and what the brand-new 2026 guidelines mean for the 40 million Americans on a drug class you’ve definitely heard of. We also cover the STOMP trial (do statins actually impair strength gains?), the SAMSON trial (how much of statin intolerance is nocebo?), the difference between myalgia, myositis, and rhabdomyolysis, Austin’s clinical approach to a patient whose strength is declining on a statin, and the treatment escalation pathway for statin-intolerant patients including bempedoic acid, PCSK9 inhibitors, and inclisiran. Plus, where GLP-1 receptor agonists like tirzepatide fit into the cardiovascular risk picture. Timestamps Five Takeaway Next Steps Resources Training Plateau Action Plan (free): https://www.barbellmedicine.com/training-plateau-action-plan/ Fish oil episode: https://open.spotify.com/episode/4kRtXZBMZWKkZPDdIKpu1S Lp(a): https://www.barbellmedicine.com/blog/lipoprotein-a-testing-and-treatment/ Guidelines Blumenthal RS, Morris PB, et al. 2026 ACC/AHA Guideline on the Management of Dyslipidemia. Circulation. 2026. DOI: 10.1161/CIR.0000000000001423 Case László A, et al. Exercise and Statin-Fibrate Combination Therapy-Caused Myopathy. BMC Research Notes. 2013;6:52. https://pubmed.ncbi.nlm.nih.gov/23388500/ LDL Targets Lee YJ, et al. (Ez-PAVE) Intensive LDL Cholesterol Targeting in Atherosclerotic Cardiovascular Disease. NEJM. 2026. PMID: 41910315 Mechanisms of Statin Myopathy Meador BM, Huey KA. Statin-Associated Myopathy and Its Exacerbation with Exercise. Muscle Nerve. 2010;42(4):469–479. https://pubmed.ncbi.nlm.nih.gov/20878737/ Safitri N, et al. Statin-Induced Rhabdomyolysis: Mechanisms, Risk Factors, Management. Drug Healthc Patient Saf. 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC8593596/ Molinarolo S, et al. Cryo-electron microscopy reveals sequential binding and activation of Ryanodine Receptors by statin triplets. Nat Commun. 2025;16(1):11508. doi:10.1038/s41467-025-66522-0 Thompson PD, et al. Lovastatin Increases Exercise-Induced Skeletal Muscle Injury. Metabolism. 1997;46(10):1206–1210 Nocebo Effect and Statin Intolerance Wood FA, et al. N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects (SAMSON). NEJM. 2020;383(22):2182–2184. https://pmc.ncbi.nlm.nih.gov/articles/PMC8453640/ Khan S, et al. Does Googling Lead to Statin Intolerance? Int J Cardiol. 2018;262:25–27. https://pubmed.ncbi.nlm.nih.gov/29706390/ Gupta A, et al. Adverse Events Associated with Unblinded, but Not with Blinded, Statin Therapy in the ASCOT-LLA. Lancet. 2017;389(10088):2473–2481. https://pubmed.ncbi.nlm.nih.gov/28476288/ Moon JC, et al. Examining the Nocebo Effect of Statins through the FDA AERS. Circ Cardiovasc Qual Outcomes. 2021;14(1):e007480. https://pubmed.ncbi.nlm.nih.gov/33161769 Statins and Exercise Outcomes Parker BA, et al. Effect of Statins on Skeletal Muscle Function (STOMP). Circulation. 2013;127(1):96–103. https://pubmed.ncbi.nlm.nih.gov/23183941/ Parker BA, Thompson PD. Effect of Statins on Skeletal Muscle: Exercise, Myopathy, and Muscle Outcomes. Exerc Sport Sci Rev. 2012;40(4):188–194. https://pmc.ncbi.nlm.nih.gov/articles/PMC3463373/ Mikus CR, et al. Simvastatin Impairs Exercise Training Adaptations. JACC. 2013;62(8):709–714. https://pubmed.ncbi.nlm.nih.gov/23583255/ Slade JM, et al. The Impact of Statin Therapy and Aerobic Exercise Training. Am Heart J Plus. 2021;10:100028. https://pmc.ncbi.nlm.nih.gov/articles/PMC8477381/ Gui Y, et al. Efficacy and Safety of Statins and Exercise Combination Therapy. Eur J Prev Cardiol. 2017;24(9):907–916. DOI: 10.1177/2047487317691874 Genetic...

In 2022, researchers conducted the most rigorous systematic review ever performed on overtraining syndrome — looking specifically for controlled studies that documented a human transitioning from a healthy training state to an overtrained state. Zero studies met those criteria. The word "overtrained" appears in coaching certifications, wearable device dashboards, and clinical sports medicine guidelines — and in each context it means something different. That definitional chaos has consequences: it delays real diagnoses, produces nocebo effects with measurable physiological outcomes, and leads athletes to reduce training they didn't need to reduce. In this episode, Drs. Jordan Feigenbaum and Austin Baraki work through the full evidence base on overtraining syndrome — the taxonomy, the attempted studies, the six competing mechanistic theories, the biomarker failures, and what's actually happening when a lifter can't make progress. Timestamps: What we cover: Next Steps: For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To consult with Drs. Baraki or Feigenbaum email us at support@barbellmedicine.com For ad free listening and exclusive discounts, become a Barbell Medicine Plus subscriber at https://barbellmedicine.supercast.com/ Resources Taxonomy / Definitions Meeusen et al. (2013) European College of Sport Science / ACSM consensus statement on FOR, NFOR, and OTS taxonomy. Defines OTS as a diagnosis of exclusion. https://pubmed.ncbi.nlm.nih.gov/23247672/ Meeusen et al. (2006) "Often only after a period of complete rest" — the retrospective nature of distinguishing NFOR from OTS. https://pubmed.ncbi.nlm.nih.gov/23016079/ Nocebo Effects in Sport 2024 Systematic Review Nocebo effects in sport were approximately twice the magnitude of placebo effects on performance across 20 studies. https://pubmed.ncbi.nlm.nih.gov/38999724/ Stress-Recovery-Adaptation Model Original general adaptation syndrome / stress physiology work in Nature. Foundational source the SRA model was derived from — not a sports science paper. https://www.nature.com/articles/138032a0 Multi-system adaptation timescales; critique of single-wave supercompensation model. https://pubmed.ncbi.nlm.nih.gov/3057313/ Multi-system adaptation timescales; further critique of the SRA "window of opportunity" model. https://pubmed.ncbi.nlm.nih.gov/15044685/ Lack of empirical support for the supercompensation "window of opportunity" in real training scenarios. https://pubmed.ncbi.nlm.nih.gov/29189930/ Resistance Training and OTS Grandou et al. (2020) Systematic review: 22 studies on resistance training overtraining. 10 showed zero performance decline under deliberate overload. No reliable biomarker established for RT overtraining; sustained performance drop is the only consistent signal. https://pubmed.ncbi.nlm.nih.gov/31313309/ Coleman et al. (2024) 9-week supervised high-volume RT protocol (~90 sets/week). No OTS criteria met. Ceiling for resistance training-induced OTS is considerably higher than commonly implied. https://pmc.ncbi.nlm.nih.gov/articles/PMC10809978/ Zourdos et al. (2016) Case series: 3 competitive strength athletes performed daily 1RM squat for 30 consecutive days. All three improved. https://pubmed.ncbi.nlm.nih.gov/26816276/ Daily 1RM Bench Press Study 7 athletes attempted a true 1RM bench press every day for 38 days. All improved despite day-to-day fluctuation. https://www.thefreelibrary.com/Efficacy+of+Daily+One-Repetition+Maximum+Bench+Press+Training+in...-a0828317501 3 weeks of daily loading; volume arm hypertrophied. Daily frequency did not produce overtraining; volume drives hypertrophy, not frequency alone. https://pubmed.ncbi.nlm.nih.gov/27875635/ Fry et al. (1994) — Overreaching Protocol Original...

In this free preview of the March 2026 Direct Line AMA. Drs. Feigenbaum and Baraki cover: VO2 max versus cardiorespiratory fitness for longevity (are Peter Attia’s targets evidence-based? — with Goodhart’s Law and the JAMA evidence), what GLP-1 medications actually cost now via manufacturer programs ($149–449/month), and whether 7,000–10,000 daily steps actually meet the bar for cardiovascular training. Full episode for Barbell Medicine Plus subscribers at https://barbellmedicine.supercast.com/ Timestamps: 0:00 — Introduction 3:26 — VO2 Max vs. Cardiorespiratory Fitness for Longevity 14:11 — GLP-1 Costs: What you should actually be paying now 21:43 — Is Walking Enough for Cardiovascular Health? Next Steps: For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To consult with Drs. Baraki or Feigenbaum email us at support@barbellmedicine.com Resources: Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

You can have a completely normal BMI and be on your way to cardiovascular disease, type 2 diabetes, and metabolic syndrome without triggering a single alert on a standard health screening. The fat that predicts metabolic risk most accurately isn't the fat your scale or your doctor is tracking. Dr. Jordan Feigenbaum breaks down the science of visceral fat — what it is, how it causes disease, how to measure it correctly at home for free, and what the evidence actually shows about exercise, GLP-1 medications, and testosterone. Timestamps: Next Steps Resources: Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

A fit, healthy 39-year-old was nearly sent for a liver biopsy. The cause? Was it that he went to the gym before every blood draw or because his supplement was throwing his labs off?. Dr. Jordan Feigenbaum and Dr. Austin Baraki break down the blind spot that sends thousands of healthy athletes down an expensive, potentially unnecessary diagnostic rabbit hole every year. Timestamps: 00:01:09 00:03:44 00:10:50 00:16:38 00:17:35 00:19:42 00:25:25 00:27:08 00:31:40 00:32:18 00:32:54 00:33:49 00:36:02 00:37:00 00:38:27 00:38:48 00:44:01 00:46:42 00:48:51 00:53:29 00:59:31 01:00:25 Next Steps barbellmedicine.com/training-programsbarbellmedicine.com/coachingbarbellmedicine.com/resourceshttps://www.barbellmedicine.com/vital-5-action-plan/ Resources: Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

In this special preview of the Barbell Medicine Plus Direct Line, Dr. Jordan Feigenbaum and Dr. Austin Baraki move past the fitness basics to tackle high-level technical nuances. We dive into the persistent myth of "muscle imbalances" and why your asymmetry might actually be a functional feature of your training. We also address the "meat" of the cardiovascular debate: is red meat and saturated fat consumption still risky if you are highly active and have a high-fiber diet? Finally, we explore the Dual Intervention Point Model to explain why the body defends its energy stores and how our environment has shifted the biological "set point" for body fat. Timestamps 00:0001:0303:5908:5511:5415:3619:5026:2030:26 Next Steps barbellmedicine.com/training-programsbarbellmedicine.com/coachingbarbellmedicine.com/resourceshttps://www.barbellmedicine.com/vital-5-action-plan/ Key Takeaways Asymmetry as a Feature:The Pathological vs. The Normal:Saturated Fat & The Healthy User Bias:The Lean Mass Hyper-Responder (LMHR):Body Fat Regulation: Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Most doctors, trainers, and "safety-first" influencers warn that holding your breath while lifting is a dangerous habit that could lead to a stroke or heart failure. By looking back at the 300-year history of the Valsalva maneuver—from a 1704 ear treatment to the "boogeyman" blood pressure studies of the 1980s—we dismantle the myth of the "fragile tube." Discover the science of the "pressurized suit" and why your body is actually designed to handle extreme internal pressure during heavy exertion. Key Takeaways The 'Ear Trick' Origins:The MacDougall 480/350 Study:Transmural Pressure Protection:Reflexive vs. Intentional Bracing:Vascular Safety and Stroke Risk:Pregnancy and Fetal Safety:The 'Hissing' Safety Valve: Timestamps [00:00][05:26][06:22][12:59][28:24][31:00][35:27][41:17][46:15][49:34][56:42] Next Steps barbellmedicine.com/training-programsbarbellmedicine.com/coachingbarbellmedicine.com/resourceshttps://www.barbellmedicine.com/vital-5-action-plan/ References Middle Cerebral Artery and ValsalvaValsalva During Resistance TrainingValsalva and Force ProductionWeightIAP During CoughingLifting Belt’s Effects Leg PressTraining and Heart AdaptationsPowerlifter’s HeartsValsalva Maneuver and Cerebrovascular DynamicsRT, VM, and Cerebrovascular PressuresWomen’s Pelvic FloorsPregnancy and RTAgainFetal Heart RateInjury RiskHerniaSUI Podcast Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

The longevity industry is now worth over $100 billion per year. From DNA methylation clocks to multi-cancer blood tests and GLP-1 medications, the promises are bold. But what actually predicts lifespan? In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki break down the science behind biological clocks, the real story on GLP-1–related muscle loss, and introduce the Barbell Medicine “Vital Five” — a clinically grounded framework for health and longevity. Key Points: The Three Generations of Biological Clocks:Descriptive vs. Prescriptive Metrics:GLP-1s and Sarcopenia Reality:Weight-Independent Benefits of Incretins:The Limitations of Early Detection:The Barbell Medicine Vital Five:Neurodegenerative Research Outlook: Next Steps barbellmedicine.com/training-programsbarbellmedicine.com/coachingbarbellmedicine.com/resources Timestamps: 00:0001:0608:1816:1630:3954:391:07:231:34:241:49:191:58:15 References: Biological Clockhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8853656/https://pmc.ncbi.nlm.nih.gov/articles/PMC12038942/https://pmc.ncbi.nlm.nih.gov/articles/PMC11424583/https://pmc.ncbi.nlm.nih.gov/articles/PMC6366976/Cancer Screeninghttps://ascopubs.org/doi/10.1200/JCO.2019.37.15_suppl.5574https://www.thelancet.com/article/S1470-2045(23)00277-2/fulltexthttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01700-2/fulltexthttps://www.nhs-galleri.org/Exercisehttps://bjsm.bmj.com/content/56/13/755https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2807854https://pubmed.ncbi.nlm.nih.gov/35442242/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915309/?mc_cid=87bfcaaa3a&mc_eid=8786146256https://pmc.ncbi.nlm.nih.gov/articles/PMC9012529/https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428https://pubmed.ncbi.nlm.nih.gov/35228201/https://pubmed.ncbi.nlm.nih.gov/35662329/https://academic.oup.com/biomedgerontology/article/77/4/781/6354429https://www.sciencedirect.com/science/article/abs/pii/S0025619625001004https://pmc.ncbi.nlm.nih.gov/articles/PMC12131147/https://pubmed.ncbi.nlm.nih.gov/18595904/https://pubmed.ncbi.nlm.nih.gov/12242311/Proteinhttps://pubmed.ncbi.nlm.nih.gov/40418846/https://pmc.ncbi.nlm.nih.gov/articles/PMC7250948/https://pubmed.ncbi.nlm.nih.gov/39110456/https://pubmed.ncbi.nlm.nih.gov/24606898/https://www.bmj.com/content/370/bmj.m2412GLP-1https://www.cell.com/cell-metabolism/abstract/S1550-4131(26)00008-2https://www.nejm.org/doi/full/10.1056/NEJMoa2307563https://www.nejm.org/doi/abs/10.1056/NEJMoa2403347https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/fulltexthttps://link.springer.com/article/10.1007/s11154-025-09991-4https://pmc.ncbi.nlm.nih.gov/articles/PMC12338914/HRThttps://pubmed.ncbi.nlm.nih.gov/25754617/https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(25)00211-6/abstracthttps://www.nejm.org/doi/full/10.1056/NEJMoa2215025https://pmc.ncbi.nlm.nih.gov/articles/PMC4527564/https://www.mdpi.com/1422-0067/25/22/12221Body Roundness Index (BRI) Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Lifting more weight doesn't always mean you've gotten stronger. In this foundational session, Dr. Jordan Feigenbaum and Dr. Austin Baraki introduce the Fitness-Fatigue Model to explain why "stalled" progress is often just a temporary masking of strength by accumulated fatigue. By learning to differentiate between a lack of fitness adaptation and a lack of recovery, you can avoid the "panic pivot" and maintain the long-term signal necessary for elite-level gains. Supercast Sign-Up For the 6-part audio series and Training Plateau Action Plan, sign-up for Barbell Medicine Plus: https://barbellmedicine.supercast.com/ Key Learning Points The Fitness-Fatigue Model:Strength vs. Effort:Noise vs. Signal:The Root Cause Audit:Lack of Fitness:Lack of Recovery:Autoregulation as a Diagnostic Tool: Timestamps [00:00][02:15][05:30][09:45][14:20][18:50] Pearls The Pivot Rule:Peaking Mechanics:The stimulus-Recovery Trap: Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Can a simple one-second squeeze predict your risk of cardiovascular disease, cognitive decline, and all-cause mortality? Dr. Jordan Feigenbaum and Dr. Austin Baraki explore why grip strength has become the go-to metric for the longevity industry and why most people are interpreting the data incorrectly. Timestamps: [00:00][01:42][06:43][09:12][17:31][18:41][27:16][31:44][37:03][42:19][45:13][48:10][52:03] Key Takeaways: Grip is Systemic:motor cortexmuscular qualityPredictive Power:PURE study5 kg decrease17% increased risk7% increased riskThe Sarcopenia Floor:<27 kg for men<16 kg for womenRelative Strength Matters:Relative grip strengthhypertension, diabetes, and dyslipidemiaDon't Chase the Test:indirect systemic resistance training Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized medical and training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/ RESOURCES: https://europepmc.org/article/med/1538102https://pubmed.ncbi.nlm.nih.gov/12188074/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC6322506/https://pmc.ncbi.nlm.nih.gov/articles/PMC10777545/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC6322506/#/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113637#/https://pubmed.ncbi.nlm.nih.gov/31499496/#/https://pubmed.ncbi.nlm.nih.gov/25982160/#/https://www.sciencedirect.com/science/article/pii/S2095254620300752?via%3Dihub#/https://pubmed.ncbi.nlm.nih.gov/27701433/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC5517526/#/https://pubmed.ncbi.nlm.nih.gov/18271028/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC7344191/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC7244054/#/https://www.sciencedirect.com/science/article/abs/pii/S1388245710003561#/https://pubmed.ncbi.nlm.nih.gov/25653226/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC6306785/#/https://pubmed.ncbi.nlm.nih.gov/27619723/#/ Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Dr. Feigenbaum and Dr. Baraki walk through the clinical workup of a 24 year old male presented with persistent weakness in his foot following weight loss of 22 pounds in two weeks. What could've possibly caused this? The discussion pivots to the science of how fast one should lose weight. While athletes should prioritize slow loss to preserve performance and lean mass, the data for individuals with obesity suggests that the speed of loss may be less critical than protein intake and resistance training. Timestamps: Key Learning Points (SPOILER ALERT) Slimmer’s Paralysis (Dieting Palsy):The "Two-Hit" Model:Speed vs. Quality for Athletes:Metabolic Adaptation as a Signature of Success:Diagnosing Focal Weakness: Resources: Case: https://pubmed.ncbi.nlm.nih.gov/39809480/ https://pubmed.ncbi.nlm.nih.gov/29503139/https://pmc.ncbi.nlm.nih.gov/articles/PMC12157737/https://pmc.ncbi.nlm.nih.gov/articles/PMC11273815/https://pubmed.ncbi.nlm.nih.gov/32576318/https://pubmed.ncbi.nlm.nih.gov/20443094/https://pubmed.ncbi.nlm.nih.gov/24372837/https://pubmed.ncbi.nlm.nih.gov/25459211/ Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki dissect the federal government’s 2026 Food Pyramid Reset and its radical shift in nutrition policy. They explore the history of industry lobbying that shaped previous guidelines and evaluate whether the new emphasis on protein and animal fats aligns with current clinical evidence. Finally, the doctors provide the framework for the Barbell Medicine Dietary Guidelines, offering a practical, evidence-based framework for managing the modern food environment. Timestamps Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized medical and training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/ Key Learning Points Environment over Willpower:The New Protein Floor:Incoherent Fat Logic:The Fiber Gap:The 10:1 Rule: References Barbell Medicine Guidelines Coming Soon! https://pmc.ncbi.nlm.nih.gov/articles/PMC12027923/https://www.govinfo.gov/content/pkg/CPRT-95SPRT98364O/pdf/CPRT-95SPRT98364O.pdfhttps://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001050https://pubmed.ncbi.nlm.nih.gov/6841553/https://pubmed.ncbi.nlm.nih.gov/7068846/https://pubmed.ncbi.nlm.nih.gov/6841553/https://pubmed.ncbi.nlm.nih.gov/7068846/https://pmc.ncbi.nlm.nih.gov/articles/PMC10552423/https://pubmed.ncbi.nlm.nih.gov/26980437/https://pubmed.ncbi.nlm.nih.gov/26843151/https://pmc.ncbi.nlm.nih.gov/articles/PMC10552423/https://pubmed.ncbi.nlm.nih.gov/26980437/https://pubmed.ncbi.nlm.nih.gov/28889851/https://www.ers.usda.gov/data-products/chart-gallery/chart-detail?chartId=58372#:~:text=As%20their%20incomes%20rise%2C%20U.S.,of%20after%2Dtax%20incomehttps://www.ers.usda.gov/data-products/food-price-outlook/summary-findings#:~:text=Beef%20and%20veal%20prices%20are,higher%20than%20in%20August%202024https://pmc.ncbi.nlm.nih.gov/articles/PMC4733413/https://pubmed.ncbi.nlm.nih.gov/26843151/ Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Fiber is the most underutilized tool in human nutrition. While the internet is currently buzzing about the new food pyramid and debating processed foods versus beef tallow, most people are missing the actual structural levers that dictate health and performance. Today, we are launching the Barbell Medicine Fiber Action Plan to bridge the gap between clinical science and your next trip to the grocery store. If you are a Barbell Medicine Plus subscriber, you can binge the entire 4-part audio series and download the full Action Plan right now in the Plus feed. If you are not a subscriber, head to the link below to sign up for early access to the Action Plan and exclusive content. Join Barbell Medicine Plus: https://barbellmedicine.supercast.com/ In this series, we move beyond the simple soluble versus insoluble labels and discuss how fiber can lower cholesterol, manage blood sugar, and regulate satiety. Nutrition should not be a social media shouting match; it should be a deliberate strategy for your health. Stop guessing, get the guide, and let us get to work. Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

For decades, the health and fitness industry has blamed rising obesity rates on a lack of individual willpower and "poor choices." However, a landmark lawsuit in San Francisco argues that the modern food environment is a public nuisance engineered by food giants using a literal tobacco playbook. By manipulating "Bliss Points" and dismantling the natural food matrix, these companies have created an environment where healthy choices are the path of highest resistance. Understanding the shift from personal responsibility to environmental accountability is the first step in reclaiming your health. Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized medical and training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/ Timestamps Key Points The Public Nuisance Shift:Probabilistic Automaticity:The Bliss Point:The Potato Continuum:Food Addiction Data:The Tobacco Playbook: Clinical Pearls Master Your Micro-Environment:Prioritize the Food Matrix:Distraction-Free Feeding: References: https://sfcityattorney.org/san-francisco-city-attorney-chiu-sues-largest-manufacturers-of-ultra-processed-foods/https://www.lawforhoas.com/civil-code-section-3479-nuisance-definedhttps://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/https://pmc.ncbi.nlm.nih.gov/articles/PMC3667220/https://pubmed.ncbi.nlm.nih.gov/22551473/https://linkinghub.elsevier.com/retrieve/pii/S0195666325000819https://psycnet.apa.org/record/2006-22447-006Maimati 2018 Stephen 2020Machado 2019Young 2002Zlatevska 2014https://pubmed.ncbi.nlm.nih.gov/37250387/https://pmc.ncbi.nlm.nih.gov/articles/PMC6550161/https://pubmed.ncbi.nlm.nih.gov/30040431/https://pubmed.ncbi.nlm.nih.gov/31105044/https://pubmed.ncbi.nlm.nih.gov/37813420/https://ajcn.nutrition.org/article/S0002-9165(22)00584-6/fulltexthttps://pubmed.ncbi.nlm.nih.gov/38418082/https://www.fao.org/3/ca5644en/ca5644en.pdfhttps://www.mdpi.com/2674-0311/3/3/25Powell 2013Bhutani 2018Fernandez 2021 Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

A 23-year-old soldier presents with hypertensive urgency and acute kidney injury. He thought he was doing everything right for his health—so what caused his system to fail? Dr. Feigenbaum and Dr. Baraki break down the clinical evidence and the surprising lab results. Timestamps [00:00][01:07][02:05][03:53][08:20][14:14][18:05][22:20][25:23][28:34][32:27][43:06][48:06][55:16] Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized medical and training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/ Key Learning Points The Testosterone Fallacy:The Fat-Soluble Risk:Metastatic Calcification:2024 Endocrine Guideline Shift:The Natural Blind Spot:The Mechanism of Bone Pain: Clinical Pearls Screening Protocol:Dosing Guidelines:Medication Reconciliation: Timestamps [00:00][01:07][02:05][03:53][08:20][14:14][18:05][22:20][25:23][28:34][32:27][43:06][48:06][55:16] References https://pmc.ncbi.nlm.nih.gov/articles/PMC9478588/https://link.springer.com/article/10.1007/s12020-020-02482-3https://pubmed.ncbi.nlm.nih.gov/32446600/https://pubmed.ncbi.nlm.nih.gov/21154195/https://academic.oup.com/jcem/article/109/8/1907/7685305?login=falsehttps://academic.oup.com/edrv/article/45/5/625/7659127https://academic.oup.com/milmed/article/189/1-2/e417/7218964 Our Sponsors: * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Biohackers and longevity clinics claim peptides are a side-effect-free sniper rifle for fat loss and injury recovery, but the reality is often buried in failed clinical trials and regulatory bans. Many popular compounds like BPC-157 have never undergone a single randomized controlled trial in humans, despite their reputation for Wolverine-like healing. This episode dismantles the hype surrounding the gray market, exposing the significant risks of immunogenicity and heavy metal contamination. Learn why modern load management and evidence-based medicine beat a research chemical bought with Bitcoin every time. Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized medical and training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/ Key Points Timestamps Clinical Pearls Resources https://pubmed.ncbi.nlm.nih.gov/16352683/https://pubmed.ncbi.nlm.nih.gov/18347346/https://pmc.ncbi.nlm.nih.gov/articles/PMC2657499/https://pubmed.ncbi.nlm.nih.gov/9849822/https://pubmed.ncbi.nlm.nih.gov/10496658/https://pubmed.ncbi.nlm.nih.gov/21298258/https://pubmed.ncbi.nlm.nih.gov/18981485/https://pubmed.ncbi.nlm.nih.gov/9467542/https://pubmed.ncbi.nlm.nih.gov/18981485/https://pubmed.ncbi.nlm.nih.gov/20554713/https://pubmed.ncbi.nlm.nih.gov/39813152/Duzel 2007Strinic 2017Sikiric 1993He 2022https://pmc.ncbi.nlm.nih.gov/articles/PMC2289708/https://pubmed.ncbi.nlm.nih.gov/10469335/https://pubmed.ncbi.nlm.nih.gov/23050815/https://pubmed.ncbi.nlm.nih.gov/20536454/https://pubmed.ncbi.nlm.nih.gov/29986520/https://pmc.ncbi.nlm.nih.gov/articles/PMC4508379/https://pubmed.ncbi.nlm.nih.gov/41090431/https://pubmed.ncbi.nlm.nih.gov/38858523/https://pubmed.ncbi.nlm.nih.gov/20445536/https://pmc.ncbi.nlm.nih.gov/articles/PMC3136748/#R41https://pubmed.ncbi.nlm.nih.gov/25738459/https://pubmed.ncbi.nlm.nih.gov/33473109/https://pmc.ncbi.nlm.nih.gov/articles/PMC5826726/https://pubmed.ncbi.nlm.nih.gov/31599840/https://pubmed.ncbi.nlm.nih.gov/18206919/https://pmc.ncbi.nlm.nih.gov/articles/PMC5820696/ Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM * Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com * Check out Washington Red Raspberries: https://redrazz.org Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Experiencing a pins-and-needles sensation on a run or fearing the straight bar deadlift shouldn't be your fitness journey's bingo card. Many trainees abandon effective habits due to false narratives regarding physiological signals or myths regarding back safety. We break down the clinical reality of exercise-induced sensations, the ethics of modern metabolic medicine, and why your choice of imlpement is more about preference than peril. Resources and Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized medical and training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/ Topics The Hemodynamic Itch:Exercise-Induced Anaphylaxis:Medical Paternalism:The Seatbelt Analogy:The EMG Trap:Biomechanical Distribution: Clinical Pearls Identify Red Flags:Prioritize Habituation:Shared Decision-Making: Timestamps 00:0000:4304:1906:2207:2410:5715:3218:1221:3124:54 Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM * Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com * Check out Washington Red Raspberries: https://redrazz.org Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Welcome to the Barbell Medicine Cholesterol Action Plan. Cardiovascular disease is the #1 killer globally. We just released a massive 6-part audio series and written guide to fix that. The full series is available INSTANTLY for Barbell Medicine Plus subscribers. If you're not a subscriber, start here: https://barbellmedicine.supercast.com/ Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM * Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com * Check out Washington Red Raspberries: https://redrazz.org Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

The wellness industry wants you to believe that menopause renders you fragile, fasting creates "cortisol belly," and birth control is silently destroying your skeletal health. These claims aren't just scientifically inaccurate; they act as "nocebo" barriers that scare women away from effective training and healthcare. We brought in the heavy artillery—Dr. Lauren Colenso-Semple, Dr. Loraine Baraki, and Dr. Spencer Nadolsky—to dissect the physiology behind these viral fears. Discover why your body remains resilient through hormonal transitions and why lifestyle or GLP-1s is a false dichotomy, Key Learning Points The Menopause "Cliff" Myth: Cortisol Fear-mongering: IUDs & Bone Density: The "Masking" Fallacy: Birth Control & Performance:free GLP-1 Agonists (Ozempic/Mounjaro): Get More Value: Exclusive Content and Resources Want to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days. Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level. For media, support, or general questions, please contact us at support@barbellmedicine.com Clinical Pearls & Takeaways Programming for Menopause: Protein Simplified: Medical Decisions: Timestamps References Journal of the International Society of Sports NutritionActa diabetologica Our Sponsors: * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor: https://factormeals.com/bbm50off * Check out Quince: https://quince.com/BBM * Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com * Check out Washington Red Raspberries: https://redrazz.org Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy