The Dr. Gabrielle Lyon Show

When you have musculoskeletal pain, the natural instinct is to try and treat it directly. But the cause of that pain often starts somewhere else in the body.

I learned that from this week's guest, Dr. JJ Thomas, who is my physical therapist and good friend. She was my patient first, and now we are each other's patients. She has practiced physical therapy for more than 25 years and has worked with the Philadelphia 76ers, the Philadelphia Eagles, and athletes from the UFC and US Olympic programs.

What you'll learn in this episode:

• Why a chronic tendon injury can come right back, even after eccentric loading or PRP
• Whether a frozen shoulder in menopause is a hormone problem, and one of the first movements Dr. Thomas checks
• Why she works lying on her stomach, and the 10-minute band routine she wrote for an eight-hour desk day
• Why sitting up taller won't fix your posture, and what poor posture tells her about your body
• Why she gives patients shoulder blade exercises for their pelvic floor
• How much a standard squat does for your posterior chain, and the position she wants you in more often
• Why she believes “overuse” injuries are often underuse injuries, and how that changes the way she treats shin splints
• Why needling a clinician's quad and adductors normalized his neck rotation
• What her blood work showed after years of hard training, and the nutrition change she calls her “game changer”

Thank you to our sponsors:

• Manukora - Get 31% off at https://www.manukora.com/drlyon

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Explore More from Dr. Gabrielle Lyon

Weekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/

Apply to become a patient: Personalized care with Dr. Lyon’s clinical team https://drgabriellelyon.com/new-patie...

Find Dr. JJ Thomas at:

• YouTube: https://www.youtube.com/@drjjthomas

• Website: https://primalphysicaltherapy.com/

• Instagram: https://www.instagram.com/drjjphysicaltherapist/

Connect with Dr. Gabrielle Lyon:

• Instagram: https://www.instagram.com/drgabriellelyon/

• TikTok: https://www.tiktok.com/@drgabriellelyon

• Facebook: http://facebook.com/doctorgabriellelyon

• X: http://x.com/drgabriellelyon

• Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/

• Weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page

Chapters

00:00 – Posture Myths & Why Sitting Up Straight Fails

02:18 – Treating Root Causes vs. Bandaging Pain

06:48 – The Hazards of Sitting & Reframing Movement as Health

13:39 – The 7 Primal Movement Patterns Every Body Needs

25:28 – Scapular Stability, Pelvic Health, and Primal Movements

39:12 – Fixing Glute Amnesia & Activating the Posterior Chain

51:57 – Why "Overuse" Injuries Are Really Underuse Problems

58:34 – Dry Needling & System-Based Movement Resets

1:13:53 – Dialing in Hormones, Protein, and Metabolic Health

If you found this episode valuable, share it with someone who would benefit from it.

Disclaimers: This episode includes paid sponsorships.

The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Will I get too bulky?" No. "Is it too late?" Also no. Here's the context: during the menopause transition, women lose lean mass, gain fat, and their muscle becomes harder to build — the same workout and the same protein meal produce less than they did at 30. For years the only conversation has been hormone therapy, yes or no, as if that were the fix. In Part 2 of her menopause series, Dr. Gabrielle Lyon looks at what the evidence actually says builds muscle back.

In this episode:

-Postmenopausal women can build muscle and strength at any age (Frontiers in Endocrinology)

- Up to 8 lbs of skeletal muscle in 12 weeks (J Nutr Health Aging RCT)

- Anabolic resistance: why the same workout and the same meal produce less after menopause

- "I was wrong": hormone therapy vs. lifting, and the conversations with Dr. Donald Layman

- HRT alone and lean mass: a 0.06 kg difference across 12 trials

- Estradiol plus training: bigger quad and fat-free mass gains, maintained at 12 months

- Lift first — the practical translation while the HRT evidence evolves

- Why protein matters more after menopause, and why 60 g spread thin isn't enough

- The RDA (0.8 g/kg) isn't enough to protect bone; ESCEO's 1–1.2 g/kg floor

- Doubling protein to 1.6 g/kg: more fat lost, more lean mass kept

- The 6-step Forever Strong menopause protocol

Sponsor

David Protein — 28 g of protein, 150 calories, zero sugar → davidprotein.com/drlyon, subscribe to save 10% on every order

Find Dr. Gabrielle Lyon at:

- Instagram: https://www.instagram.com/drgabriellelyon/

- TikTok: tiktok.com/@drgabriellelyon

- Facebook: facebook.com/doctorgabriellelyon

- X: x.com/drgabriellelyon

- Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/

- Weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page

Chapters:

00:00 Will I get too bulky? Is it too late? Both answers are no

01:09 Postmenopausal women gained up to 8 lbs of muscle in 12 weeks

02:24 Anabolic resistance: more volume, more intensity, more protein

03:34 Hormone therapy or lifting? "I was wrong"

05:16 HRT alone and lean mass: 0.06 kg across 12 trials

06:16 Estradiol amplifies training — it doesn't replace it

07:22 Lift first: what to do while the evidence evolves

10:21 Why protein matters more after menopause (and why 60 g isn't enough)

11:16 The RDA won't protect your bones: the 1–1.2 g/kg floor

12:16 Doubling protein: more fat lost, more lean mass kept

13:22 The Forever Strong protocol, step 1: train 2–3 days a week

14:15 Steps 2–3: 30–50 g protein at first and last meal, impact and loading

15:13 Steps 4–6: hormone therapy with training, body composition, blood work

16:07 You're not alone: the Menopause Challenge

Disclaimer: This podcast is for general informational purposes only and does not constitute medical advice or create a doctor–patient relationship. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not disregard or delay seeking medical advice because of something you heard here.

Most patients are told one thing before surgery: stop all supplements. Duke surgeon Dr. Rebecca Knackstedt says that blanket advice can do harm, and that what you do in the days before surgery changes how you heal.

Dr. Knackstedt is a plastic and reconstructive microsurgeon on faculty at Duke, an MD-PhD researcher and a certified functional medicine provider whose research focuses on surgical prehabilitation: preparing the body, mind, and home before surgery, the way we already do with rehab.

In today’s episode, we discuss:

• What prehab looks like for any operation

• The labs she checks

• Which supplements to keep and which to stop (omega-3s do not increase bleeding)

• Hormones after breast cancer

• Why mammograms still beat thermography

• What chemo does to metabolism

• The questions to ask your oncologist before a treatment decision

• How much protein to eat (no standard exists, and the average woman gets 60 to 70 grams a day, well short of the 100-gram floor)

• Why surgery is catabolic and muscle is your reserve

• Carbohydrate loading before the fasting cutoff and why it can reduce pain

• The five-day window that lowered complications and even mortality in head and neck cancer patients

• Why early walking replaced routine bed rest

Connect with Dr. Knackstedt

Instagram → https://www.instagram.com/surgical_recovery/

Website → https://www.clararecovery.com/

Sponsors

• Perfect Amino by BodyHealth, https://bit.ly/4wZgg6N, code LYON20 for 20% off your first order

• Timeline Mitopure → https://bit.ly/4x18cm5, for an extra 20% off

• Lola Blankets → lolablankets.com (http://lolablankets.com/), code: DRLYON for 40% off select blankets (limited time)

Find Dr. Gabrielle Lyon at:

• Instagram: https://www.instagram.com/drgabriellelyon/

• TikTok: tiktok.com/@drgabriellelyon

• Facebook: http://facebook.com/doctorgabriellelyon

• X: http://x.com/drgabriellelyon

• Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/

• Weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page

Chapters:

00:00 Prehab saves lives and money. So why isn't it standard of care?

01:05 Meet Dr. Rebecca Knackstedt: Duke microsurgeon and functional medicine provider

05:35 The patient who changed everything, and why good surgery isn't enough

08:34 What prehab is, and the exercises to do before any surgery

12:14 Hormones after breast cancer, rising rates in young women, and real risk factors

18:42 Chemo, metabolic syndrome and why body composition matters

23:13 The end of bed rest, and the labs that matter before surgery

27:04 Mammograms vs. thermography, and absolute vs. relative risk

34:12 Protein before surgery: 2 g/kg, track 3 days, never under 100 g

38:43 Supplements to take, and why "stop all supplements" is wrong

44:40 Preparing the mind: anxiety, sleep, anesthesia depression, expectations

51:21 Red light, saunas, hyperbaric oxygen, wound vacs, scars and pain control

1:04:59 Surgery is catabolic: muscle as your glucose reserve

1:07:34 Carb loading, the 5-day window, probiotics and the surgery go-bag

1:14:15 Why prehab isn't standard of care yet, and why she's hopeful

Disclaimer: This podcast is for general informational purposes only and does not constitute medical advice or create a doctor–patient relationship. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not disregard or delay seeking medical advice because of something you heard here.

Menopause is changing your body, but the part nobody talks about isn't hot flashes. It's muscle. Women lose lean mass fastest in perimenopause, the loss probably starts closer to 35, and no pill, patch or injection fixes it.

In this solocast, Dr. Gabrielle Lyon explains what estrogen, testosterone and FSH actually do to your metabolism, why a 50-year-old body can still build muscle, and the training and protein protocol to start now.

Join the Menopause Challenge →

https://drgabriellelyon.com/menopause-challenge/

[Use Code 25OFF through Sept 27]

Thank you to our sponsors:

- Rula, therapy covered by insurance → rula.com/drlyon

Find Dr. Gabrielle Lyon at:

- Instagram: https://www.instagram.com/drgabriellelyon/

- TikTok: @drgabriellelyon

- Facebook: facebook.com/doctorgabriellelyon

- YouTube: youtube.com/@DrGabrielleLyon

- X (Twitter): x.com/drgabriellelyon

- Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/

- Join my weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page

- Pre-order my new book - https://www.amazon.com/exec/obidos/ASIN/1668085623

Chapters:

00:00 Menopause is changing your body — but it doesn't have to change your life

00:59 The suitcase story: today is about muscle, not hot flashes

01:47 Hormone therapy, yes or no? Why that's the wrong first question

03:36 What menopause is, when it arrives, and 40% of your life after it

04:37 When lean mass really starts to fall — and why testing misses it

06:46 Testosterone vs. estrogen: no two women go through it the same way

08:40 Anabolic resistance: why the muscle-building switch gets sticky

10:31 Estrogen, joints and injury risk (Dr. Jocelyn Wittstein)

13:27 Less muscle, nowhere to put carbs: the lean prediabetic patient

14:19 Falls, fractures, heart disease, and muscle as an early bone signal

16:14 Visceral fat, energy expenditure, fat oxidation and FSH

18:02 Test your blood — and pull the levers you control

19:00 The starting protocol: 2–3 days a week and the movements to keep

20:30 Menopause changes your body, not your life — the Menopause Challenge

Mentioned

- Dr. Jocelyn Wittstein on estrogen, joints and injury risk → https://youtu.be/ILyzNTjZTGI

- Juliet & Dr. Kelly Starrett on floor sitting and mobility → https://youtu.be/QOjzh-711Q0

- SWAN (Study of Women's Health Across the Nation)

- The Lancet Diabetes & Endocrinology review on lean mass and chronic disease

- ESCEO guidance on muscle and bone

Disclaimers: This episode includes paid sponsorships. The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Your testosterone number matters at every age, but most men never learn what theirs should be. Mayo Clinic urologist Dr. Tobias Kohler explains why ~500 is the target, why 1,000 is already running hot, what 2,000+ does to the heart, and why a randomized trial found lifting without steroids beat steroids without lifting. Plus: the blood test that catches heart risk your cholesterol panel misses.

Dr. Kohler returns for his second appearance (his first, on erections, testosterone and muscle mass, is one of the most-watched episodes in the show's history). This time: why men's longevity is roughly 50 years behind women's; the Princeton IV consensus he co-chaired, which treats ED as one of the strongest predictors of a future heart attack and points young men toward a coronary calcium scan; the 0–12 ceramide blood test that changes with your behavior; how to get a testosterone baseline that actually means something; what redlining to 2,000–3,000 does to the heart, the set point and the skin; Peyronie's disease, Viagra vs. Cialis, the pills-to-implant ladder, sexual rehab after prostate surgery, and a patient who got stronger with zero testosterone.

About Dr. Tobias Kohler

Tobias S. Kohler, MD, MPH, is Professor of Urology at Mayo Clinic, a fellowship-trained andrologist with 25+ years of clinical and surgical experience and 250+ peer-reviewed publications. He co-chaired the Princeton IV Consensus Guidelines on ED and cardiovascular disease, co-founded the EROS penile implant registry, and co-edited Contemporary Treatment of Erectile Dysfunction (2nd ed.).

🙌 Thank you to our sponsors:

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📺 Watch the “Dr. Gabrielle Lyon Show” every Tuesday at 9AM EST:

YouTube: https://bit.ly/4boCFC3

Spotify: https://bit.ly/4cWTbLG

📱 Connect with Dr. Gabrielle Lyon:

Instagram: https://bit.ly/4uk9adc

TikTok: https://bit.ly/3OFK3kJ

X.com: https://bit.ly/4l3YlaX

Facebook: https://bit.ly/3MBrJso

LinkedIn: https://bit.ly/3N1nrdL

Website: https://bit.ly/3NdV2kT

Books: https://bit.ly/4r6ugZK

Newsletter: https://bit.ly/402QCAj

⏰Chapters

00:00 Men are dying earlier than women the penis is the check-engine light

03:26 Boys stop seeing doctors for 20 years the case for an Office of Men's Health

10:57 Princeton IV: ED predicts heart attacks, calcium scans, and Cialis

12:44 The ceramide blood test your cholesterol panel can't replace

20:37 Cardiac risk calculators, statins, and what your LDL should be

25:38 GLP-1s, fertility, and "what's the risk of doing nothing?"

29:05 Testosterone: the ~500 target, why 1,000 runs hot, what 2,000+ does to the heart

31:44 Check your testosterone at 25 and why steroids won't make you a pro

36:57 Tolerance and the new set point redlined men can't escape

38:13 The 1980s trial: lifting without steroids beat steroids without lifting

42:06 Steroid cocktails, arrhythmias, irreversible side effects, and the sarcopenia trade-off

53:04 Peyronie's disease and Viagra vs. Cialis

57:32 Penile implants: the knee-replacement analogy and the pills-to-surgery ladder

1:02:27 Sexual rehab after prostatectomy and the questions to ask before cancer treatment

1:07:55 Closing: be proactive and the patient who got stronger with zero testosterone

Disclaimer: This podcast is for general informational purposes only and does not constitute medical advice or create a doctor–patient relationship. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not disregard or delay seeking medical advice because of something you heard here.

Your testosterone number matters at every age, but most men never learn what theirs should be. Mayo Clinic urologist Dr. Tobias Kohler explains why ~500 is the target, why 1,000 is already running hot, what 2,000+ does to the heart, and why a randomized trial found lifting without steroids beat steroids without lifting. Plus: the blood test that catches heart risk your cholesterol panel misses.

Dr. Kohler returns for his second appearance (his first, on erections, testosterone and muscle mass, is one of the most-watched episodes in the show's history). This time: why men's longevity is roughly 50 years behind women's; the Princeton IV consensus he co-chaired, which treats ED as one of the strongest predictors of a future heart attack and points young men toward a coronary calcium scan; the 0–12 ceramide blood test that changes with your behavior; how to get a testosterone baseline that actually means something; what redlining to 2,000–3,000 does to the heart, the set point and the skin; Peyronie's disease, Viagra vs. Cialis, the pills-to-implant ladder, sexual rehab after prostate surgery, and a patient who got stronger with zero testosterone.

In this episode:

- Why ED is a blood-flow problem "until proven otherwise," and who needs a calcium score

- The ceramide test: what it measures and the score that sends you to a cardiologist

- Statins, LDL goals and testosterone

- Baseline T at 25, the ~500 target, why 1,000 runs hot

- The 1980s trial: exercise vs. high-dose testosterone vs. both

- Tolerance, the new set point, and the irreversible side effects

- Trading obesity for sarcopenia in the GLP-1 era

- Peyronie's disease: not cancer, not an STD

- Pills, shots and implants; what 90–95% satisfaction means

- Penile rehab after prostatectomy

About Dr. Tobias Kohler

Tobias S. Kohler, MD, MPH, is Professor of Urology at Mayo Clinic, a fellowship-trained andrologist with 25+ years of clinical and surgical experience and 250+ peer-reviewed publications. He co-chaired the Princeton IV Consensus Guidelines on ED and cardiovascular disease, co-founded the EROS penile implant registry, and co-edited Contemporary Treatment of Erectile Dysfunction (2nd ed.).

Dr. Kohler's first episode → https://youtu.be/__xtrUa3Dck

Clip: Why Every Man Should Prioritize Muscle Mass → https://youtu.be/PgBntuDnzTQ

Chapters:

00:00 Men are dying earlier — the penis is the check-engine light

02:01 Men's longevity is "50 years behind"

03:26 Boys stop seeing doctors — the Office of Men's Health

09:09 Princeton IV: ED predicts heart attacks; calcium scans; Cialis

10:46 The ceramide blood test your cholesterol panel can't replace

15:19 Ceramides, muscle, and knowing if your exercise works

20:51 Statins, testosterone, and your LDL goal

24:01 GLP-1s and "what's the risk of doing nothing?"

25:32 Testosterone: ~500 target, 1,000 too hot, 2,000+ and the heart

28:49 Check your T at 25 — but only if you feel good

29:19 Why steroids won't make you a pro athlete

31:52 Tolerance and the set point redlined men can't escape

35:18 The trial: lifting without steroids beat steroids without lifting

38:58 Steroid cocktails, arrhythmias, WrestleMania mortality

42:42 Irreversible side effects

45:45 Obesity to sarcopenia in the GLP-1 generation

47:51 Peyronie's disease explained

50:53 Viagra vs. Cialis

52:20 Penile implants: the knee-replacement analogy

54:17 Pills, injections, surgery: how long each works

57:15 Sexual rehab after prostatectomy

1:01:08 Fertility and the questions to ask before cancer treatment

1:03:20 The patient who got stronger with zero testosterone

Find Dr. Gabrielle Lyon at:

- Instagram: https://www.instagram.com/drgabriellelyon/

- TikTok: @drgabriellelyon

- Facebook: facebook.com/doctorgabriellelyon

- X: x.com/drgabriellelyon

- Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/

- Weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page

- Pre-order my new book – https://www.amazon.com/exec/obidos/ASIN/1668085623

Disclaimer: This podcast is for general informational purposes only and does not constitute medical advice or create a doctor–patient relationship. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not disregard or delay seeking medical advice because of something you heard here.

You say "steroids" and picture a baseball scandal, a jacked guy, a bad spray tan. But cortisol is a steroid. Estrogen is a steroid. The cream you put on poison ivy is a steroid. The word covering all of them is also covering testosterone therapy for women, and that collision is quietly costing women muscle and bone they don't have to lose.

In this solo episode, prompted by a magazine interview on steroid use in women, Dr. Gabrielle Lyon breaks down what these molecules actually are, what they do inside a cell, and why the line between medicine and misuse has nothing to do with the word "steroid."

Study and References:

The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men (Bhasin et al., NEJM 1996) - https://pubmed.ncbi.nlm.nih.gov/8637535/

Testosterone Enhances Estradiol's Effects on Postmenopausal Bone Density and Sexuality (Davis et al., 1995) - https://pubmed.ncbi.nlm.nih.gov/7616872/

Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019) - https://pubmed.ncbi.nlm.nih.gov/31498...

ISSWSH Clinical Practice Guideline for the Use of Systemic Testosterone for HSDD in Women (2021) - https://pubmed.ncbi.nlm.nih.gov/33814...

The Global Epidemiology of Anabolic-Androgenic Steroid Use: A Meta-Analysis (Sagoe et al., 2014) - https://pubmed.ncbi.nlm.nih.gov/24582...

What Is the Prevalence of Anabolic-Androgenic Steroid Use Among Women? A Systematic Review (Piatkowski et al., Addiction, 2024) - https://onlinelibrary.wiley.com/doi/1... "

The Compounds for Females Are Really Commonly Faked!": Women's Challenges in Anabolic Steroid Acquisition (Piatkowski et al., Drug and Alcohol Review, 2024) - https://onlinelibrary.wiley.com/doi/1...

Explore More from Dr. Gabrielle Lyon:

• Premium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.com
• Weekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/
• Apply to become a patient: Personalized care with Dr. Lyon's clinical team https://drgabriellelyon.com/new-patie...

📱 Connect with Dr. Gabrielle Lyon:

Instagram: https://bit.ly/4uk9adc

TikTok: https://bit.ly/3OFK3kJ

X.com: https://bit.ly/4l3YlaX

Facebook: https://bit.ly/3MBrJso

LinkedIn: https://bit.ly/3N1nrdL

Website: https://bit.ly/3NdV2kT

Books: https://bit.ly/4r6ugZK

Newsletter: https://bit.ly/402QCAj

📺 Watch the “Dr. Gabrielle Lyon Show” every Tuesday at 9AM EST:

YouTube: https://bit.ly/4boCFC3

Spotify: https://bit.ly/4cWTbLG

⏰ Chapters:

00:00 - Beginning

01:25 - Introduction: The Sister Who Says "Oh My Gosh, You're Taking Steroids" Why Medicine Needs a Shared Vocabulary

03:43 - What a Steroid Actually Is: Four Rings of Carbon

04:49 - Anabolic vs. Androgenic: Same Receptor, Different Effects

06:16 - A Brief History: From Wasting Disease to the Weight Room

08:59 - Restoring vs. Exceeding: Why the Range Is the Whole Game

11:38 - The Davis Trial: Testosterone, Bone Density, and Lean Mass

13:38 - Oral Compounds, the Liver, and Why Conversion Matters

14:20 - What Gets Sold Isn't What's Labeled: The Australian Drug-Checking Data

15:31 - The 1.6% vs. 4% Myth: Reading the Prevalence Data Correctly

18:33 - Why GLP-1s Are Pushing Women Toward Androgens

20:26 - Permanent Effects: Voice Changes and What the Literature Shows

21:33 - The Four Questions to Ask Before Any Androgen Conversation

24:25 - Closing: Entering the Sarcopenia Era

‼️ Disclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Most people assume becoming a parent is an emotional change, but a measurable part of it is hormonal, and it happens in fathers too. I sat down with Aldrich Chan, Psy.D., to talk about what changes in the brain, why the split we draw between mind and body does not hold up, and what decides whether stress reads as manageable or overwhelming when the hormones are identical either way.

Want ad-free episodes? Subscribe to Forever Strong Insider: https://bit.ly/4u5VSRe

Get Aldrich Chan’s books here:

https://www.drchancnc.com/books

📱Connect with Aldrich Chan, Psy.D

Website: https://www.drchancnc.com/

YouTube: www.youtube.com/@draldrichan

Instagram: https://www.instagram.com/draldrichan

Facebook: https://www.facebook.com/draldrichan

LinkedIn: https://www.linkedin.com/in/draldrichan/

🙌Thank you to our sponsors:

One Skin - Get 15% off at https://bit.ly/4hlfso9

Timeline - up to 20% off when you subscribe and save at https://bit.ly/4xkRIFw

David Bars - Subscribe and save 10% on every order’ at https://bit.ly/3SGC7Cd

📺Watch the “Dr. Gabrielle Lyon Show” every Tuesday at 9AM EST:

YouTube: https://bit.ly/4boCFC3

Spotify: https://bit.ly/4cWTbLG

📱Connect with Dr. Gabrielle Lyon:

Instagram: https://bit.ly/4uk9adc

TikTok: https://bit.ly/3OFK3kJ

X.com: https://bit.ly/4l3YlaX

Facebook: https://bit.ly/3MBrJso

LinkedIn: https://bit.ly/3N1nrdL

Website: https://bit.ly/3NdV2kT

Books: https://bit.ly/4r6ugZK

Newsletter: https://bit.ly/402QCAj

⏰Timestamps:

00:00 - Introduction: what a neuropsychologist measures

03:25 - Mild cognitive impairment and proactive interference

04:52 - The SAD theory: separation, alienation, discord

06:30 - The default mode network and 46.9% mind wandering

08:56 - Reframing ADHD as an evolutionary advantage

18:21 - Evolutionary mismatch and hunter-gatherer comparisons

21:03 - Neuroplasticity, epigenetics, and the 24-hour timeline

24:29 - Mind-body dualism and the gut-brain connection

31:31 - What fatherhood does to the brain and testosterone

36:47 - Choice overload and the four-bit working memory limit

39:54 - Temporal discounting and building immediate feedback

43:23 - Vital signals and how to identify a core value

49:49 - Intuition, somatic markers, and the vmPFC

55:00 - The 20-watt brain versus a 10-gigawatt supercomputer

01:02:58 - Only 35% of the brain is built at birth

01:06:13 - Creativity, nothingness, and the fear of uncertainty

01:16:31 - Process, flow states, and the jazz pianist studies

01:22:53 - Mirror neurons, group selection, and the rat experiments

01:34:20 - Eustress and the line between moderate and major stress

01:44:39 - Alloparenting and what the Hadza numbers show

‼️Disclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

This episode includes paid sponsorships.

You might think bone density is something you build slowly over a lifetime, but nearly all of your peak bone mass is set before age 18, in a four-year window most parents never see coming. In this solo episode I break down what happens to a child's skeleton during that window, what GLP-1 medications do inside a body that's still growing, and the protocol I'd want every parent to follow. Muscle and bone are not what a body has they're what a body was built to become.

In this solo episode, Dr. Gabrielle Lyon breaks down the science of bone health in children, adolescent GLP-1 use, and muscle building in kids:

• Why the four years around age 12 in girls and 14 in boys account for close to 40% of the total bone mineral a person will carry for life
• Why a hip fracture in a healthy 29-year-old is almost always a story about a childhood building phase that never happened, often tied to a history of restriction like anorexia
• What semaglutide and other GLP-1 medications do inside a still growing skeleton, and why no long term bone density data exists for adolescents on these drugs
• Why a JAMA Network Open trial found the group combining liraglutide with resistance training lost the most weight with bone mineral density statistically unchanged, while the drug alone caused bone loss
• The complete protocol for parents: track strength and function over the scale, muscle strengthening and bone loading exercise three days a week each, protein at breakfast, and a screen time floor instead of a ceiling

Muscle and bone are not what a body has; they are what a body was built to become, and childhood is the only window that bone accrual and muscle development happen. Understanding pediatric bone health, sarcopenia in children, and the real research on GLP-1s and adolescents is the difference between guessing with your child's skeleton and protecting it on purpose.

Study and References:

• Sarcopenic Obesity in Children - https://pubmed.ncbi.nlm.nih.gov/41995008/
• Sedentary Behaviors in Today's Youth (AHA) - https://www.ahajournals.org/doi/10.1161/CIR.0000000000000591
• Semaglutide and Body Composition (STEP 1) - https://pmc.ncbi.nlm.nih.gov/articles/PMC8089287/
• Peak Bone Mass Position Statement (NOF) - https://pubmed.ncbi.nlm.nih.gov/26856587/
• Bone Health After Exercise vs GLP-1 Treatment - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820308
• Resistance Training in Kids: An Umbrella Review - https://pubmed.ncbi.nlm.nih.gov/32757164/

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• TikTok: https://www.tiktok.com/@drgabriellelyon
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Chapters

00:00 - Introduction

00:44 - The 29-Year-Old Who Fractured Her Hip

01:20 - Muscle and Bone Are Childhood Assets

03:01 - The Question I Keep Getting From Patients

03:39 - The 30-Year Lifting Debate Is Over

04:23 - Sarcopenic Obesity: More Muscle, Less Strength

07:01 - What a Mouse Model Reveals About Muscle Potential

08:24 - Screens: What the Data Shows

10:00 - Food, Sleep, and the Screen-Weight Loop

12:38 - GLP-1s in Teens: The STEP TEENS Trial

13:52 - The Muscle Framing Mistake Everyone Makes

16:49 - The Four-Year Window Bone Gets Built

18:02 - The Trial That Proves Exercise Protects Bone

20:29 - Prescribing Into an Unstudied Window

20:46 - Why Lifting Doesn't Stunt Growth

21:49 - Kids Get Stronger Without Building Muscle

22:29 - The Protocol: What to Do Starting Today

If you found this episode valuable, share it with someone who would benefit from it.

Disclaimers: This episode includes paid sponsorships.

The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

You have probably been told that testosterone is a male hormone. Women produce more of it than estrogen, and for many of us it is the first hormone to go, sometimes reading zero five years before menopause while periods are still regular. Dr. Susan Hardwick-Smith and I get into what that costs you in muscle and bone, why there are thirty-one approved testosterone products for men and none for women, and what the number on your own lab report is measuring.

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Create Her: Aging into the Healthiest Version of Yourself by Susan Hardwick-Smith MD https://www.amazon.com/Create-Her-Healthiest-Version-Yourself/dp/1637636644/ref=sr_1_3?s=books&sr=1-3

Dr. Gabrielle Lyon with Amy Pearlman Podcast

https://bit.ly/3TcVgvB

Connect with Dr. Susan Hardwick-Smith

Website: drsusan.com

YouTube: https://www.youtube.com/@drsusan

Instagram: https://www.instagram.com/drsusanofficial

TikTok: https://www.tiktok.com/@drsusanofficial

Facebook: https://www.facebook.com/drsusanofficial/

LinkedIn: https://www.linkedin.com/in/drsusanhardwicksmith/

Thank you to our sponsors:

• Timeline - up to 20% off when you subscribe and save at https://bit.ly/4x18cm5
• BodyHealth - Use the code LYON20 to get 20% off your first order https://bit.ly/4wZgg6N
• Branch Basics - Get 15% off the Premium Starter Kit at https://bit.ly/4i6iOfK with the code DRLYON.

Explore More from Dr. Gabrielle Lyon

• Premium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.com
• Weekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/
• Apply to become a patient: Personalized care with Dr. Lyon’s clinical team https://drgabriellelyon.com/new-patient-inquiry/

Connect with Dr. Gabrielle Lyon:

• Instagram: https://www.instagram.com/drgabriellelyon/
• TikTok: https://www.tiktok.com/@drgabriellelyon
• X (Twitter): https://x.com/drgabriellelyon
• Facebook: https://www.facebook.com/doctorgabriellelyon

Timestamps:

00:00 - Introduction: testosterone in women

03:00 - Eighteen years in OB-GYN and the practice she left

04:57 - Thirty years in medicine, zero training on testosterone

06:40 - 31 FDA-approved products for men, zero for women

07:35 - Why women produce more testosterone than estrogen

09:20 - What the ovaries stop making at menopause

10:18 - Testosterone reading zero five years early

11:41 - Low testosterone symptoms in women

13:22 - Intrinsa, the 2004 patch the FDA turned down

19:04 - Off-label prescribing and what FDA approval means

21:35 - Cognition, breast cancer, muscle and bone

25:33 - Osteoarthritis and the anti-inflammatory theory

26:31 - Dosing fears: hair loss, acne, voice changes

28:16 - Why gels are dosed ten times higher

32:14 - The 2019 international consensus

34:00 - Dividing a 50 mg tube by ten

38:18 - The Baylor study: pellet versus gel at six weeks

40:13 - Safety data from fifty years of transgender care

45:03 - Eight years of high dosing and what it cost

46:16 - Lab reference ranges versus optimal ranges

48:28 - ELISA versus LC-MS, and what the study found

51:07 - Why free testosterone is calculated, not measured

57:58 - Tachyphylaxis and chasing the number

1:01:39 - Pellets, BioTE and where the reputation came from

1:06:33 - Delivery methods, cypionate and enanthate

1:11:47 - Whether anything raises testosterone naturally

1:13:03 - DHEA at 100 mg and what it moved

1:17:07 - Drugs that lower testosterone in women

1:20:55 - Closing thoughts on dosing and access

If you found this episode valuable, share it with someone who would benefit from it.

Disclaimers: This episode includes paid sponsorships.

The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.