Episode #99: Pain and Rehab Team on Pain Medication

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-UpFor the 6-part audio series and Training Plateau Action Plan, sign-up for Barbell Medicine Plus:https://barbellmedicine.supercast.com/Key Learning PointsThe Fitness-Fatigue Model: Understand the physiological duality of every workout—while a session builds your "fitness" (potential), it also creates "fatigue" that temporarily suppresses your performance.Strength vs. Effort: Performance must be measured relative to RPE. If the weight on the bar increases but the RPE climbs disproportionately (e.g., jumping from RPE 8 to RPE 10 for a 5lb gain), your absolute strength has not actually improved.Noise vs. Signal: A one-week stall is statistical "noise." Constant program hopping in response to a single bad session destroys the cumulative stimulus (the "signal") required for actual tissue adaptation.The Root Cause Audit: Determining the "Why" behind a plateau.Lack of Fitness: The stimulus is no longer sufficient to drive a new adaptation (Needs more volume/intensity).Lack of Recovery: The fatigue is overwhelming the adaptation (Needs a deload or volume reduction).Autoregulation as a Diagnostic Tool: Using RPE not just to prescribe load, but to "interrogate" your current state of recovery and readiness.Timestamps[00:00] Intro: Introducing the Barbell Medicine Plus Exclusive Series[02:15] The Thought Experiment: 310x6 @ 8 vs. 315x6 @ 10[05:30] Deep Dive: Defining the Fitness-Fatigue Model[09:45] Interpreting the Stall: Is it a Stimulus Problem or a Recovery Problem?[14:20] The Danger of "Short-Termism": Why Panicking Destroys the Signal[18:50] Introduction to the 6-Part Audio Course & Actionable PDFPearlsThe Pivot Rule: Never change a successful program based on a single week of data. Look for a 3-week trend of stagnant or declining performance (at the same RPE) before initiating a program pivot.Peaking Mechanics: Most "peaking" protocols do not build new strength; they simply reduce fatigue to reveal the strength you've already built.The stimulus-Recovery Trap: If you feel "beat up" but the weights are moving well, you likely don't need a deload yet. If you feel "great" but the weights are stuck, you likely need a stronger stimulus.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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

6 Helmi 23min

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] Intro: The Longevity Industry’s Thermometer Error[01:42] The Neuro-Axis: Anatomy of a Maximal Squeeze[06:43] The 35-3-5 Rule: Biomechanics of Grip[09:12] Asymmetries and Clinical Red Flags[17:31] Dynapenia vs. Sarcopenia: Why the Hand Fails First[18:41] Normative Data and the PURE Study Statistics[27:16] Genetics, Lean Body Mass, and Predictive Power[31:44] Absolute vs. Relative Grip Strength (The Metabolic Signal)[37:03] Bro-Science Beatdown: Neural Jitter and Training Readiness[42:19] The Extensor Training and "Grip Maxing" Myth[45:13] Programming: Systemic Training vs. Indirect Grip Work[48:10] The Straps Debate: Are You Killing Your Gains?[52:03] Final Verdict: Hierarchy and Health PrioritiesKey Takeaways:Grip is Systemic: Handgrip strength tests the integrity of the entire system, from the motor cortex in the brain down to the tendons and bones. It is a proxy for overall muscular quality and neurological health.Predictive Power: According to the PURE study, for every 5 kg decrease in grip strength, there is a 17% increased risk of cardiovascular death and a 7% increased risk of non-cardiovascular death.The Sarcopenia Floor: Clinical "red zones" for probable sarcopenia are <27 kg for men and <16 kg for women.Relative Strength Matters: Relative grip strength (Grip Strength ÷ BMI) is a more accurate predictor of hypertension, diabetes, and dyslipidemia than absolute grip strength alone.Don't Chase the Test: Direct grip training (crushers, etc.) obscures the predictive power of the test. To improve health, focus on indirect systemic resistance training (training the whole body) rather than "gaming" the thermometer.Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo 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/1538102 https://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 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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

30 Tammi 53min

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:00:00 - The Case of the Paralyzed Personal Trainer 03:48 - How Doctors Build a Differential for Weakness 12:08 - Interpreting Negative Labs and MRI Results 15:04 - Identifying Foot Drop and Nerve Distribution 20:53 - Understanding Nerve Conduction and EMG Studies 26:06 - The Diagnosis: Slimmers Paralysis Explained 32:56 - Are GLP-1 Medications Increasing Nerve Injury Risks? 35:01 - Rapid vs Slow Weight Loss: Muscle Mass and Performance 41:27 - The Truth About Metabolic Adaptation and Weight Regain 52:33 - New Research on Weight Regain After Stopping Medications 58:32 - Clinical Recommendations for Sustainable Weight Management Key Learning Points (SPOILER ALERT)Slimmer’s Paralysis (Dieting Palsy): Discover how rapid fat loss depletes the protective structural fat pads at the fibular head, leaving the common peroneal nerve vulnerable to compression.The "Two-Hit" Model: Understand how the combination of biological depletion (rapid weight loss) and mechanical provocation (aggressive stretching or squatting) triggers focal weakness.Speed vs. Quality for Athletes: Evidence suggests that for trainees, a slower weight loss rate of $\sim$0.7% of body weight per week is superior for maintaining lean mass compared to faster rates.Metabolic Adaptation as a Signature of Success: Why a reduction in resting metabolic rate is an unavoidable adaptive response to weight loss and not necessarily a predictor of future weight regain.Diagnosing Focal Weakness: A step-by-step look at how clinicians differentiate between lumbar spine issues and peripheral nerve entrapment using physical exams and electrodiagnostic testing.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/ https://www.bmj.com/content/392/bmj-2025-085304 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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

23 Tammi 1h 3min

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.Timestamps00:00 - Introduction: The 1992 Food Pyramid vs. the 2026 Reset03:11 - A History of Lobbying: From the McGovern Committee to the USDA09:44 - Big Food and Big Tobacco: How the American pantry was engineered17:15 - The Good: Protein floors and the official war on ultra-processed foods27:13 - The Bad: Saturated fat, beef tallow, and the dairy hall pass44:02 - The Ugly: The 25-gram fiber gap and the retreat on alcohol guidelines54:10 - Economic barriers and the Healthy Eating Index scores01:06:18 - The Barbell Medicine Dietary Guidelines: A practical frameworkNext StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Key Learning PointsEnvironment over Willpower: Weight gain is an emergent process caused by an engineered food environment that adds nearly 500 passive calories to the average American's daily intake compared to 1977.The New Protein Floor: The 2026 Reset finally acknowledges that the old 0.8g/kg RDA was a "survival dose." The new range of 1.2–1.6g/kg is a victory for skeletal muscle health, though doesn't really change intake for many (if they even read the guidelines).Incoherent Fat Logic: There is a fundamental conflict in guidelines that recommend beef tallow and butter while simultaneously advising that saturated fat stay below 10% of total calories.The Fiber Gap: By emphasizing animal proteins over legumes, the new guidelines risk widening the already massive fiber deficiency in the U.S.The 10:1 Rule: For better metabolic health, aim for a carbohydrate-to-fiber ratio of 10:1 (acceptable) or 5:1 (elite).ReferencesBarbell Medicine Guidelines Coming Soon! https://www.youtube.com/watch?v=inCEbKyWYwg (Trial of Big Food)https://pmc.ncbi.nlm.nih.gov/articles/PMC12027923/ https://www.govinfo.gov/content/pkg/CPRT-95SPRT98364O/pdf/CPRT-95SPRT98364O.pdf https://pubmed.ncbi.nlm.nih.gov/31462476/ https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001050 https://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://pmc.ncbi.nlm.nih.gov/articles/PMC6124841/ 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%20income). https://www.ers.usda.gov/data-products/food-price-outlook/summary-findings#:~:text=Beef%20and%20veal%20prices%20are,higher%20than%20in%20August%202024. https://pmc.ncbi.nlm.nih.gov/articles/PMC4733413/ https://pubmed.ncbi.nlm.nih.gov/26843151/ https://www.barbellmedicine.com/blog/how-to-eat-a-healthy-diet/https://www.barbellmedicine.com/resources/calorie-calculator/ https://www.barbellmedicine.com/resources/macronutrient-calculator/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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

16 Tammi 1h 16min

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 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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

13 Tammi 2min

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 StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Timestamps00:00 - The San Francisco Lawsuit vs. Big Food01:46 - Legal Shift: Personal Choice vs. Public Nuisance08:02 - Probabilistic Automaticity: Why Environment Wins13:40 - The 500-Calorie Shift: The Rise of Energy Toxicity16:11 - The Tobacco Playbook & The Bliss Point22:33 - The Potato Continuum & The Food Matrix28:09 - Yale Food Addiction Scale (YFAS) Data33:48 - The BMJ Umbrella Review on UPF Risks52:35 - Practical Strategy: Playing Offense at HomeKey Points The Public Nuisance Shift: Why legal strategy is moving away from "individual choice" toward holding corporations accountable for creating a toxic health environment.Probabilistic Automaticity: Human willpower hasn't decreased since the 1970s; instead, the probability of making a "bad" choice has been engineered to increase through environmental cues.The Bliss Point: How food scientists precisely calibrate salt, sugar, and fat to create a transient "nirvana" that mutes the brain's satiety signals.The Potato Continuum: A framework for understanding how processing transforms a simple, satiating food into an energy-dense, hyper-palatable "drug."Food Addiction Data: Why 14% of adults meeting the Yale Food Addiction Scale criteria suggests a systemic design flaw in our food supply, not a character flaw in the consumer.The Tobacco Playbook: The historical link between cigarette manufacturers buying food companies and the subsequent optimization of addictive "mouthfeel" and delivery systems.Clinical PearlsMaster Your Micro-Environment: Spend your "willpower budget" only once—at the grocery store. If hyper-palatable foods aren't in your pantry, they cannot exploit your fatigue at 9 p.m.Prioritize the Food Matrix: Aim for foods high in protein and fiber that have "built-in stoplights," rather than ultra-processed items where the matrix has been dismantled.Distraction-Free Feeding: Eliminate "subconscious eating" by removing screens during meals, allowing your brain to accurately register hormonal satiety signals like leptin and ghrelin.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-defined https://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/2006-22447-006 Maimati 2018 Stephen 2020 Machado 2019 Young 2002Zlatevska 2014 https://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/fulltext https://pubmed.ncbi.nlm.nih.gov/38418082/ https://www.fao.org/3/ca5644en/ca5644en.pdfhttps://www.mdpi.com/2674-0311/3/3/25 Powell 2013 Bhutani 2018 Fernandez 2021Our 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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

8 Tammi 1h 2min

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] Introduction to the Case: The Fit Soldier’s Failure[01:07] Welcome and Mystery Case Framework[02:05] Patient History: The River and the GI Symptoms[03:53] Building the Differential: Infection vs. Dehydration[08:20] Initial Workup and the Hypercalcemia Discovery[14:14] The Medical Student’s Reveal: Supplement Reconciliation[18:05] Final Diagnosis: Severe Hypervitaminosis D[22:20] Metastatic Calcification and Permanent Vascular Damage[25:23] The Mechanism of Jaw Pain: Bone Resorption[28:34] Science Review: Debunking the Pilz (2011) Study[32:27] Fat-Soluble vs. Water-Soluble Risks[43:06] The Free Vitamin D Hypothesis[48:06] Updated 2024 Endocrine Society Guidelines[55:16] Final Thoughts: Vitamin D and the Endurance PopulationNext StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo 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: Meta-analyses confirm that Vitamin D supplementation has no significant effect on testosterone levels in men who are not clinically deficient.The Fat-Soluble Risk: Unlike water-soluble vitamins, Vitamin D is stored in adipose tissue, meaning toxicity can persist for months or years after cessation.Metastatic Calcification: Severe Vitamin D toxicity causes calcium phosphate to deposit in arterial walls, potentially turning flexible vessels into rigid pipes.2024 Endocrine Guideline Shift: Updated medical standards now recommend against routine Vitamin D screening and universal high-target levels for healthy adults.The Natural Blind Spot: Patients often fail to categorize supplements as "medication," leading to dangerous diagnostic delays when clinicians do not ask specifically about over-the-counter products.The Mechanism of Bone Pain: Toxic Vitamin D levels can drive aggressive bone resorption, effectively "stealing" calcium from the skeleton and causing severe pain.Clinical Pearls Screening Protocol: Avoid routine Vitamin D blood testing for healthy, asymptomatic adults under 75 unless a specific condition like malabsorption or osteoporosis is present.Dosing Guidelines: For the general population, stick to the daily recommended intake (600–800 IU) rather than using high-dose bolus therapy or chasing a serum level of 30 ng/mL.Medication Reconciliation: Always disclose all "natural," "herbal," or "gym-based" supplements to your medical provider, as these can interact with other medications or cause direct toxicity.Timestamps[00:00] Introduction to the Case: The Fit Soldier’s Failure[01:07] Welcome and Mystery Case Framework[02:05] Patient History: The River and the GI Symptoms[03:53] Building the Differential: Infection vs. Dehydration[08:20] Initial Workup and the Hypercalcemia Discovery[14:14] The Medical Student’s Reveal: Supplement Reconciliation[18:05] Final Diagnosis: Severe Hypervitaminosis D[22:20] Metastatic Calcification and Permanent Vascular Damage[25:23] The Mechanism of Jaw Pain: Bone Resorption[28:34] Science Review: Debunking the Pilz (2011) Study[32:27] Fat-Soluble vs. Water-Soluble Risks[43:06] The Free Vitamin D Hypothesis[48:06] Updated 2024 Endocrine Society Guidelines[55:16] Final Thoughts: Vitamin D and the Endurance PopulationReferenceshttps://pmc.ncbi.nlm.nih.gov/articles/PMC9478588/ https://link.springer.com/article/10.1007/s12020-020-02482-3 https://pubmed.ncbi.nlm.nih.gov/32446600/ https://pubmed.ncbi.nlm.nih.gov/21154195/ https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false https://academic.oup.com/edrv/article/45/5/625/7659127 https://academic.oup.com/milmed/article/189/1-2/e417/7218964  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/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

1 Tammi 57min

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 StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Key PointsThe FDA Category 2 Crackdown: Federal regulators restricted many peptides because of the risk of immunogenicity where the body creates antibodies that attack its own proteins.BPC-157 Has Zero Human Data: Despite being marketed for tendon repair, there is not a single published human randomized controlled trial for this molecule.The MK-677 Prediabetes Tax: While it increases lean mass, human trials show zero improvement in strength or power while frequently causing insulin resistance.Retatrutide as the Weight Loss Godzilla: This triple agonist is achieving nearly 29 percent weight loss in trials by increasing energy expenditure through thermogenesis.Sourcing and Safety Realities: A study of 44 research chemicals found that only 18 actually contained the labeled compound, with many containing heavy metals.The 40-Amino-Acid Rule: The legal distinction between a peptide and a protein is based on size, which dictates how the FDA regulates these substances and how your body absorbs them. Timestamps00:03 Intro: The CJC-1295 Heart Attack Case05:39 Defining a Peptide: The 40-Amino-Acid Bright Line15:14 GH Secretagogues: CJC-1295 and Ipamorelin23:51 MK-677: The Oral Hunger Mimetic and Prediabetes Risk32:56 BPC-157 and the Lack of Human Data38:12 Immunogenicity: Why the FDA Banned BPC-15749:46 Retatrutide: The Triple Agonist Weight Loss Godzilla01:11:24 Summary: Peptides vs. Anabolic Steroids01:16:12 The Sourcing Spectrum: Pharmaceutical vs. Research ChemicalsClinical PearlsUse load management and progressive resistance training as the primary intervention for tendon and muscle injuries rather than unproven peptides.If choosing to use metabolic modulators, monitor fasting blood glucose and insulin sensitivity to avoid drug-induced prediabetes or metabolic dysfunction.Avoid the research chemical gray market entirely due to the high prevalence of under-dosing, contamination, and incorrect active ingredients found in third-party testing.Resourceshttps://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 1993 He 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 Quince: https://quince.com/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

26 Joulu 20251h 21min