Stanford neuroscientist Andrew Huberman broke down the physical markers of performance-enhancing use during an appearance on the “2 Bears, 1 Cave” podcast with Tom Segura and Bert Kreischer‘s stand-in seat. The conversation turned to fitness culture after the hosts brought up the controversy surrounding influencer Liver King, prompting Huberman to lay out exactly what he looks for.
“There’s some telltale signs, okay, and you know, when people have a huge physique and they’re hypervascular, sure, there’s some possibility of a genetic () there,” Huberman said, before walking through the specific markers.
The first sign involves facial changes tied to fluid retention.
“One thing that you’ll notice is when people go on TRT, they’ll, these creases get deeper from some of the edema, the tissue retention that comes from the increase in estrogen associated,” he explained. “You look at the creases between the nose and the cheeks, how deep those creases are, so almost like the cheeks are trying to crawl up on the nose.”
The second involves the shoulders and traps.
“There’s a lot of androgen receptor in the deltoids and traps,” Huberman noted, making disproportionate development in those areas a common indicator.
The third is a visible vein along the side of the head.
“There’s the left side vein, or it’s a major artery, when somebody’s talking and they’re not having just finished some physical exercise, and they’ve got this left side vein kind of bulging out of the side. That’s the elevation in blood pressure,” he said, adding that this shows up “in almost everybody that’s on high levels of TRT or full-blown kind of s****** use.”
The fourth marker is skin tone.
“There’s the ruddiness of the skin, people get a little bit red because of the increased blood flow,” Huberman said, noting that many users pair this with vasodilators like C***** or V***** before photo shoots “to kind of get more pump into the muscles.”
Overly lean, vein-heavy physiques were the fifth flag, tied to estrogen blockers used to counteract the conversion of testosterone to estrogen. Huberman warned this comes with a cost:
“If your estrogen is pushed too low, as a male or female, your libido crashes. So a lot of the bodybuilders that look like they’re wrapped in Saran wrap, ask them how they’re feeling. It’s not, you know, often not great, behind their libido.”
Huberman also pushed back on the idea that PED use is rare among elite physiques, pointing to Hollywood and professional sports. He referenced performance-enhancing allowances in some leagues, saying players have told him:
“if you had an injury, you can take up to 200 milligrams of testosterone a week.”
His larger point was about honesty: the health risk comes not from admitting use, but from concealing it while marketing an unattainable, unexplained physique to the public.
