Medical Mystery: The Man Who Got Weaker When He Started Training
About this episode
The episode discusses a case of a man who became weaker after starting to train, exploring the medical implications and research behind statin use and muscle health.
A 43-year-old man starts exercising and ends up in the ER with a CK over 100x the upper limit of normal. His doctor says it’s from training. We don’t think so. In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through the full case — history, labs, diagnosis, and what actually went wrong — then break down the mechanisms behind the answer, the nocebo research, and what the brand-new 2026 guidelines mean for the 40 million Americans on a drug class you’ve definitely heard of. We also cover the STOMP trial (do statins actually impair strength gains?), the SAMSON trial (how much of statin intolerance is nocebo?), the difference between myalgia, myositis, and rhabdomyolysis, Austin’s clinical approach to a patient whose strength is declining on a statin, and the treatment escalation pathway for statin-intolerant patients including bempedoic acid, PCSK9 inhibitors, and inclisiran. Plus, where GLP-1 receptor agonists like tirzepatide fit into the cardiovascular risk picture. Timestamps 0:00 — A 43-year-old man is getting weaker, not stronger 2:09 — Taking the history: Medications, lifestyle, and red flags 12:53 — The labs come back: CK at 18,979 16:05 — Metabolic…
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