Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver

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 Case 00:03:44 How to Read a Liver Panel: ALT, AST, GGT, Alk Phos, Albumin Explained 00:10:50 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 More 00:19:42 Second Set of Labs — The Mystery Deepens 00:25:25 Updated Differential: What's Still on the List? 00:27:08 The Labs Normalize — A Critical Clue Appears 00:31:40 The Reveal: Exercise Was the Cause All Along 00:32:18 The Mechanism: How Exercise Elevates 'Liver' Enzymes 00:32:54 Point 1 — ALT & AST Are Not Exclusively Liver Enzymes 00:33:49 Point 2 — It's Unavoidable: 100% of Lifters Are Affected 00:36:02 Point 3 — It Takes 10–12 Days to Normalize 00:37:00 Point 4 — It's Mostly Harmless 00:38:27 56% of Physicians Miss This Diagnosis 00:38:48 Why Clinicians Overlook Exercise History 00:44:01 Point 5 — GGT as the Differentiator (And Its Limits) 00:46:42 Why Alkaline Phosphatase Also Rises Post-Workout 00:48:51 The Cost of Missing Lifestyle Context: Over- and Under-Diagnosis 00:53:29 What to Say to Your Doctor: 3 Patient Scripts 00:59:31 5 Key Takeaways 01:00:25 Final Advice from Dr. Baraki Next Steps For evidence-based resistance training programs: barbellmedicine.com/training-programs For individualized training consultation: barbellmedicine.com/coaching Explore our full library of articles on health and performance: barbellmedicine.com/resources To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: To consult with Drs. Baraki or Feigenbaum email us at support@barbellmedicine.com Barbell Medicine Vital 5 Action Plan: Resources: Case: Our Sponsors: * Check out FIGS and use my code wearfigs.com for a great deal: * Check out Factor and use my code factormeals.com/bbm50off for a great deal: * Check out Quince and use my code quince.com/bbm for a great deal: Advertising Inquiries: Privacy & Opt-Out:

You can listen to Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver online on Radio and Podcast. Open the player on this page to stream the available audio.

Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver is an episode from Barbell Medicine Podcast by Barbell Medicine.

This episode is 61:32 long.

This episode was published on Mar 9, 2026.

Yes. Use the heart button on the episode page to add it to your favorite episodes list.

Yes. This page shows related episodes from Barbell Medicine Podcast when more episodes are available from the podcast feed.