Juiced Up: Talking Testosterone
Dr. Jordan Feigenbaum, Barbell Medicine
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Testosterone — What's Actually True — Dr. Jordan Feigenbaum, Barbell Medicine
The DOD just mandated testosterone testing across the force. Alex posted about it. The internet lost its mind. So Drew and Alex went and got one of the most knowledgeable people in the field — Dr. Jordan Feigenbaum of Barbell Medicine — to actually explain what's going on.
What we get into:
Are testosterone levels really dropping? The short answer is probably not in the way the internet says. The long answer involves a testing methodology problem — older immunoassay tests read artificially high compared to the more accurate mass spectrometry tests that replaced them around 2000. When you only use mass spec data across 100,000 people and 30 years, there's no decline. The real culprit, to the extent there is one, is obesity — specifically visceral adipose tissue, which BMI is terrible at detecting.
The DOD testosterone testing mandate — what it actually says, what it doesn't say, and why the Army endocrinology community is about to have a very bad time. Jordan breaks down the difference between having a low lab number and actually having testosterone deficiency, why both criteria have to be met before treatment makes sense, and why testing people without symptoms is going to generate a flood of unnecessary clinical encounters.
TRT — who actually benefits, what the evidence says, and what it doesn't. The difference between restoring someone who is genuinely deficient to a normal level versus using it as a performance enhancing drug. What happens to your natural production when you go on exogenous testosterone. Why fertility consequences are a real concern and not being talked about enough in the military context.
Lifestyle first — sleep, obesity, alcohol, and opioids are the four biggest modifiable drivers of low testosterone, in that order. Fix those before anyone puts a needle in you. Jordan's framework for the workup and when treatment actually makes sense.
The history of testosterone — it started with a French physician injecting himself with ground-up animal testicle extract in the 1800s. It ends with Drew and Alex's Fitness Aptitude Test, which Jordan correctly identifies he would lose on the five-mile run.
Mentioned in this episode:
Signal: What Your Testosterone Is Telling You About Your Health — Dr. Jordan Feigenbaum, Barbell Medicine
Travison 2007 study — the original birth cohort testosterone decline study
Barbell Medicine — barbellmedicine.com
DOD testosterone testing mandate — referenced throughout
Long and Strong — the Mops and Moes training program on TrainHeroic →
Views expressed are those of the speakers and do not represent any official organization.
