The Dr. Gabrielle Lyon Show

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...

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⏰ 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.
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📱Connect with Aldrich Chan, Psy.D
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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:
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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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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
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LinkedIn: https://www.linkedin.com/in/drsusanhardwicksmith/
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Explore More from Dr. Gabrielle Lyon
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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.

You probably ate something today with high protein printed across the front of it, and there is a good chance it did almost nothing for your skeletal muscle. There is no meaningful enforcement standard for what the front of a package is allowed to promise, and the research points to a per meal threshold most of these products do not come close to touching. Here is the number, the five myths that have to come off the table first, and how to read any label in about five seconds.
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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
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Connect with Dr. Gabrielle Lyon:
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Chapters
00:00 - Introduction: what a high protein label promises
01:03 - Protein-ification and the labeling gap
04:10 - Myth 1: protein and kidney function
06:01 - Myth 2: the 0.8 gram RDA
07:04 - Nitrogen balance and the 2026 guideline change
07:45 - Where the clinical target lands above the RDA
08:43 - Myth 3: acid ash and bone density
11:01 - Myth 4: leucine and the per meal threshold
12:12 - Four product categories in your pantry
14:44 - The 25 to 30 gram complete protein rule
15:08 - Myth 5: daily total versus per meal distribution
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.