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Barbell Medicine PodcastAuthor: Barbell Medicine
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Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver
Monday, 9 March, 2026
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 Differential (Yet)00:17:35 The Workup: Hepatitis Panels, Abdominal Ultrasound, and More00:19:42 Second Set of Labs — The Mystery Deepens00:25:25 Updated Differential: What's Still on the List?00:27:08 The Labs Normalize — A Critical Clue Appears00:31:40 The Reveal: Exercise Was the Cause All Along00:32:18 The Mechanism: How Exercise Elevates 'Liver' Enzymes00:32:54 Point 1 — ALT & AST Are Not Exclusively Liver Enzymes00:33:49 Point 2 — It's Unavoidable: 100% of Lifters Are Affected00:36:02 Point 3 — It Takes 10–12 Days to Normalize00:37:00 Point 4 — It's Mostly Harmless00:38:27 56% of Physicians Miss This Diagnosis00:38:48 Why Clinicians Overlook Exercise History00:44:01 Point 5 — GGT as the Differentiator (And Its Limits)00:46:42 Why Alkaline Phosphatase Also Rises Post-Workout00:48:51 The Cost of Missing Lifestyle Context: Over- and Under-Diagnosis00:53:29 What to Say to Your Doctor: 3 Patient Scripts00:59:31 5 Key Takeaways01:00:25 Final Advice from Dr. Baraki Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized 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/To consult with Drs. Baraki or Feigenbaum email us at support@barbellmedicine.com Barbell Medicine Vital 5 Action Plan: https://www.barbellmedicine.com/vital-5-action-plan/Resources:Case: https://pubmed.ncbi.nlm.nih.gov/37025214/https://pubmed.ncbi.nlm.nih.gov/29059178/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7438350/https://pubmed.ncbi.nlm.nih.gov/18557801/https://pubmed.ncbi.nlm.nih.gov/19209234/https://pubmed.ncbi.nlm.nih.gov/11476029/https://pmc.ncbi.nlm.nih.gov/articles/PMC11165564/https://pmc.ncbi.nlm.nih.gov/articles/PMC12460594/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2291230/https://pmc.ncbi.nlm.nih.gov/articles/PMC11319523/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3936967/https://pmc.ncbi.nlm.nih.gov/articles/PMC12188904/https://pmc.ncbi.nlm.nih.gov/articles/PMC7969109/https://pmc.ncbi.nlm.nih.gov/articles/PMC11498664/https://pmc.ncbi.nlm.nih.gov/articles/PMC3104191/Our Sponsors:* Check out Factor: https://factormeals.com/bbm50off* 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
