Dr. Spencer Nadolsky and Karl sit down with Dr. Susan Brian, a Yale-trained endocrinologist, certified menopause provider, and medical director of a clinic with seven endocrinologists who runs an active bone fragility fracture clinic, to answer the question that has been flooding social media since a viral abstract with two fake bones on a surgical table convinced people their skeletons are quietly dissolving.

Follow Dr. Susan here

In this episode they cover why the preclinical and mechanistic data on GLP-1 medicines actually points toward bone benefit rather than harm by improving osteoblast activity and reducing osteoclast activity, why the meta-analyses from over two decades of GLP-1 use in type 2 diabetes show reduced fracture risk rather than increased risk, what the recent Israeli retrospective cohort study actually found and why an 11% increased fragility fracture signal in older adults on GLP-1 for diabetes versus other treatments deserves attention without panic, why almost every nutritional deficiency flagged in GLP-1 patients turns out to be vitamin D deficiency that likely predated the medicine, why the degree of weight loss matters far more than the medicine itself and how the one to two pounds per week threshold and the one percent of body weight per week guideline translate into real clinical practice, what the Hansen JAMA 2024 study showed about GLP-1 alone versus GLP-1 with resistance training and why that finding is the single most important takeaway for anyone on these medicines, why Spencer has idiopathic hypercalciuria and was spilling 650 milligrams of calcium per day in his urine before anyone caught it, how romosozumab works and why it is the most powerful bone building medicine available, why Dr. Brian orders baseline bone densities on patients well before the standard screening age and why insurance almost always covers it, and why comparing GLP-1 nutritional risk to bariatric surgery nutritional risk is not even close to an apples to apples comparison.

The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Spencer Nadolsky and Karl sit down with Dr. Eryn Russo, a board-certified occupational and environmental medicine physician with nearly 20 years of experience working at Hill Air Force Base, where she deals with real toxic metal exposures every single day. She is one of less than one percent of all board-certified physicians practicing in this specialty, which makes her exactly the person you want explaining why the heavy metal detox content flooding your social media feed is not medicine. It is marketing.

In this episode they cover how a proper toxic exposure workup actually happens including detailed exposure history, industrial hygiene testing at the source, biological monitoring, and organ-specific testing that goes far beyond a urine panel mailed to your house, why the provoked urine test being sold by influencers is a complete artifact that artificially concentrates metals in your urine using the same chelation agent they then try to sell you as treatment, the real clinical presentations of lead, mercury, cadmium, arsenic, and chromium six and why none of them look like vague brain fog or fatigue, why the gold standard test for lead is blood not urine and what the actual diagnostic thresholds are for adults versus children, why amalgam fillings and the form of mercury previously used in vaccines are not the toxic forms people need to worry about, the Consumer Reports plant protein lead story and whether parents actually need to be concerned, why Dr. Russo has never once recommended chelation therapy in 20 years of treating workers who actually work with these chemicals daily, and why real chelation therapy carries serious renal and electrolyte risks that make unsupervised use genuinely dangerous.

The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Spencer Nadolsky and Karl sit down with Dr. Adam Auton, geneticist at 23andMe, to break down a brand new paper using data from over 27,000 people that identified specific genetic variants linked to how well GLP-1 medications work and how likely someone is to experience side effects. 23andMe has over 11 million people in their research database and used voluntary survey data on medication use, dosage, duration, weight loss, and side effects to match against genetic profiles at scale, making this one of the most powerful datasets anyone has brought to this question.

In this episode they cover how genome-wide association studies work and why scanning 600,000 genetic variants at once lets researchers find signals they never could have predicted in advance, why the first signal that jumped out of the data was a variant right in the GLP-1 receptor itself and why that was the moment the team knew they were on the right track, why the same variant that predicts better efficacy also predicts a higher risk of side effects and what that tells us about how the drug is being processed, why tirzepatide users showed a separate signal in the GIP receptor that modulates side effects rather than weight loss, why carrying both variants could make someone 14 times more likely to experience side effects on tirzepatide, why genetics explains roughly 10 percent of weight loss variation and what the other 90 percent looks like, why women tend to respond better than men and why diabetics tend to respond less well, what the future of this research looks like including who regains weight after stopping and whether those patterns are genetically predictable, and why heritability is a statistical measure that gets badly misunderstood even by clinicians.

The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.