Uploaded May 2026 | Updated September 2026, 1 week ago
Less than a quarter of testosterone prescriptions in the US are written after the patient gets a single lab. Half of patients who start TRT never get a follow-up level checked. The wellness-clinic playbook is engineered to skip the workup, because the workup is what would catch the cases where TRT isn't actually the answer.
Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through how a real testosterone workup gets done: morning sample, fasted, not during illness or after a run of bad sleep; total testosterone first, then on the repeat draw, add LH, FSH, and SHBG to localize the problem and check the binding protein. From Episode 2 of our Signal book launch series.
Pre-order our book, Signal: barbellmedicine.com/signal
Watch the full episode on the channel: youtube.com/watch?v=Gz9utAEx9-w&feature=youtu.be
Chapters:
00:00 The cold-open finding: 3 of 32
01:30 What the EMAS study actually tested (3,000+ men, 8 centers)
03:00 Why the other 29 symptoms didn't survive the analysis
04:15 The wellness-clinic funnel mismatch
05:30 The guideline standard: symptoms + biochemical evidence
06:30 The 10-symptom-checklist patient (Austin's approach)
07:45 Premature closure: a cognitive bias that costs people
Resources & links
Signal — Feigenbaum & Baraki (Barbell Medicine, 2026): coming soon
Episode 1 (Is the Testosterone Crisis Real?): youtube.com/watch?v=dm5FxIw-I7Y&feature=youtu.be
Training Plateau Action Plan (free): barbellmedicine.com/training-plateau-action-plan
Barbell Medicine programs and consultations: barbellmedicine.com
To support us and get ad free listening, plus special product discounts, and exclusive content, go to supercast.barbellmedicine.com
pubmed.ncbi.nlm.nih.gov/20554979
pubmed.ncbi.nlm.nih.gov/29562364
pubmed.ncbi.nlm.nih.gov/18308002
pubmed.ncbi.nlm.nih.gov/16670164
pubmed.ncbi.nlm.nih.gov/19112025
pubmed.ncbi.nlm.nih.gov/18838208
pubmed.ncbi.nlm.nih.gov/27210182
pubmed.ncbi.nlm.nih.gov/10523012
pubmed.ncbi.nlm.nih.gov/33739153
pubmed.ncbi.nlm.nih.gov/40066943
pubmed.ncbi.nlm.nih.gov/26075486
Less than a quarter of testosterone prescriptions in the US are written after the patient gets a single lab. Half of patients who start TRT never get a follow-up level checked. The wellness-clinic playbook is engineered to skip the workup, because the workup is what would catch the cases where TRT isn't actually the answer.
Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through how a real testosterone workup gets done: morning sample, fasted, not during illness or after a run of bad sleep; total testosterone first, then on the repeat draw, add LH, FSH, and SHBG to localize the problem and check the binding protein. From Episode 2 of our Signal book launch series.
Pre-order our book, Signal: barbellmedicine.com/signal
Watch the full episode on the channel: youtube.com/watch?v=Gz9utAEx9-w&feature=youtu.be
Chapters:
00:00 The cold-open finding: 3 of 32
01:30 What the EMAS study actually tested (3,000+ men, 8 centers)
03:00 Why the other 29 symptoms didn't survive the analysis
04:15 The wellness-clinic funnel mismatch
05:30 The guideline standard: symptoms + biochemical evidence
06:30 The 10-symptom-checklist patient (Austin's approach)
07:45 Premature closure: a cognitive bias that costs people
Resources & links
Signal — Feigenbaum & Baraki (Barbell Medicine, 2026): coming soon
Episode 1 (Is the Testosterone Crisis Real?): youtube.com/watch?v=dm5FxIw-I7Y&feature=youtu.be
Training Plateau Action Plan (free): barbellmedicine.com/training-plateau-action-plan
Barbell Medicine programs and consultations: barbellmedicine.com
To support us and get ad free listening, plus special product discounts, and exclusive content, go to supercast.barbellmedicine.com
pubmed.ncbi.nlm.nih.gov/20554979
pubmed.ncbi.nlm.nih.gov/29562364
pubmed.ncbi.nlm.nih.gov/18308002
pubmed.ncbi.nlm.nih.gov/16670164
pubmed.ncbi.nlm.nih.gov/19112025
pubmed.ncbi.nlm.nih.gov/18838208
pubmed.ncbi.nlm.nih.gov/27210182
pubmed.ncbi.nlm.nih.gov/10523012
pubmed.ncbi.nlm.nih.gov/33739153
pubmed.ncbi.nlm.nih.gov/40066943
pubmed.ncbi.nlm.nih.gov/26075486
