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Episodes from Barbell Medicine Podcast
Menopause, Part 1: What It Actually Is and the 24-Year WHI Correction
In 1889 a French physiologist injected himself with guinea pig and dog testicle extract and published a claim of self-rejuvenation in The Lancet. That announcement kicked off a 200-year medicalization of menopause that ran through leeches and bromides, Premarin, the 2002 Women's Health Initiative, and the contemporary menopause-content space. In Episode 1 of our three-part menopause series, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through what menopause actually is at the hormonal level, which midlife symptoms are menopause-driven and which are not, the KNDy neuron mechanism behind hot flashes (and the new medication that blocks it), and the 24-year f...
Is Creatine Causing Your Shin Pain? + Splitting Training, Endometriosis for Lifters | Direct Line · May 2026
This is the free preview of the May 2026 Direct Line, our monthly AMA for Barbell Medicine Plus subscribers. Three reader questions answered in full.We open with a mid-30s woman with bilateral shin pain and exertional foot numbness who started creatine a month ago and is asking whether the supplement is the cause. We walk through the compartment syndrome literature, the 2025 case report being passed around online and misinterpreted, what creatine actually does to total body water (and what it doesn’t), the four compartment pressure studies that exist, the Waterman 2013 demographic data on who actually ge...
What’s Actually Driving Your Testosterone Down? | Signal Ep 3
Most cases of low testosterone in modern men are not a problem with the testes. The number is downstream of body composition, sleep, and energy availability. The wellness-clinic algorithm walks past every one of them.Jordan and Austin walk through what actually drives men’s testosterone down, the mechanisms behind it, and the modifiable levers that bring it back up. MOSH, the leptin and Kisspeptin pathway, the aromatase loop, the sleep apnea picture most clinics never ask about, the GLP-1 and weight-loss data on testosterone recovery, the low energy availability case th...
Progressive Loading Part 3: Why the Novice / Intermediate / Advanced Framework Doesn't Work, and What to Do Instead
Three weeks of stalled squats. The conventional answer is to switch programs because you've crossed into intermediate territory. The data says something else. In Part 3 of the Progressive Loading series, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through why the standard novice / intermediate / advanced framework runs into trouble in real training, what the four adaptive systems are actually doing across a training career, and why most of what gets called a stall is impatience with the noise floor at your current strength level.This is Part 3 of the Progressive Loading series. Part 1 covered why loading should...
Is Your Testosterone Actually Low? Why Higher Testosterone Doesn't Do What You Think | Signal Ep 2
Out of 32 symptoms commonly attributed to low testosterone, only 3 actually correlate with it. All three are sexual. The other 29 — fatigue, brain fog, low mood, weight you can't lose, feeling not quite like yourself — are real, but they are produced by something else, and the wellness-clinic funnel runs on getting that wrong. Episode 2 of our Signal book launch series. Dr. Jordan Feigenbaum and Dr. Austin Baraki cover how testosterone actually works, what the number on your lab report is really measuring, and what a real evaluation of low T looks like.Pre-o...
Direct Line April 2026: Stopping Ozempic and Lifting With Osteopenia
Stop a GLP-1 and about two thirds of the weight loss comes back within a year. Three randomized withdrawal trials (SURMOUNT-4, STEP 1 extension, STEP 4) and a new BMJ 2026 systematic review of 37 RCTs and nearly 10,000 adults all land on the same signal. The cardiometabolic benefits, blood pressure, fasting glucose, lipids, drift back in parallel with the weight. The framing that actually fits the data: GLP-1s behave like a statin. There is a cumulative benefit during exposure, but this does not extend indefinitely,This month's Direct Line covers two subscriber questions. The first asks what the new BMJ...
Is the Testosterone Crisis Real? The Numbers Behind the Headlines | Signal Ep 1
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...
Medical Mystery: The Man Who Got Weaker When He Started Training
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 i...
Overtraining Syndrome: Causes, Diagnosis, and What's Actually Going On
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...
Episode #391: VO2 Max vs. Cardiorespiratory Fitness, GLP-1 Costs, and the 10,000-Step Myth | Direct Line March 2026 (Free)
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 — Introduction3:26 — VO2 Max vs. Cardiorespiratory Fitness for Longevity14:11 — GLP-1 Costs: What you should actually be paying now...
Episode #390: Why Your Waist Matters More Than Your Weight — The Science of Visceral Fat
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:00:00:00 Cold Open: The Vi...
Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver
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 Introducing the Case00:03:44 How to Read a Liver Panel: ALT, AST, GGT, Alk Phos, Albumin Explained00:10:50 What Is GGT and Why Does It Matter Clinically?00:16:38 Why Exercise, Protein, and Creatine Aren't on the Differen...