I’ve read the stickies and have done quite a bit of reading before finding this site. I’ve been diagnosed with Secondary Hypogonadism. I’ve gone from PC to Urologist to Endocrinologist. For different reasons, they’ve all given me advice I feel is inaccurate and not in my best interest. I found a Urologist who has a history of prescribing hCG. He’s in my insurance network and I’ve been given a referral to visit with him. I’ll be making an appointment on Monday. He is a professor and has authored studies on TRT, so I’m hoping he is open to more progressive therapies.
I have summarized all of my labs into an excel spreadsheet which I’ll paste below. I’ve also put together a word doc medical summary outlining my objectives and history. I’ll paste sections of that doc below, too.
I would really appreciate some input from some of the more knowledgeable guys here on the site. Specifically, I’m looking for input as to what some possible causes could be and feedback on my own self-diagnosis of over-training.
I recently stopped competing as a road cyclist. I was on a caloric deficit, raw-vegan diet while at the same time pushing an intense training load (~20-25hrs/wk or 200-400 miles/wk). Couple that with poor sleep and massive increase in life stress and I think I shut my endocrine system down.
There is a well-know condition in women called amenorrhea where over-training leads to hormone problems. There is a very small body of literature regarding the effects of over-training in men. I have not been able to find any protocols as to how to fix it.
I stopped training and abandoned the diet almost 6 months ago with no improvement. It doesn’t seem like my body is healing itself. Or, maybe, I was always low and this just put me over the edge… Not sure.
Does anyone know if KSman’s restart protocol has been successful with endocrine problems that resulted from over-training?
If some of you would be so kind, I would appreciate you looking through my “case” and giving feedback.
Age: Early 30s
Weight: 205 Lbs.
Body and facial hair description:
Athletic, muscular build, ~13% body fat. Male pattern balding with slow-growing facial hair. Facial hair growth rate has slowed and rate of balding increase recently. I’ve also noticed that my body-hair has thinned out severely in the last few years. I used to have “furry” arms and legs. The hair was course and dark, now I have a faint, sparse, lightly colored hair covering my arms and legs.
Do not ache or hurt but are smaller than they used to be. Physical exam by urologist performed April of 2017 was normal.
Apathy, irritability, low motivation, general pointlessness to everything – I am suffering from all of them.
I have always been an energetic person. Recently, I can barely muster the energy to get out of the recliner. I constantly feel run-down and physically/psychologically tired. No amount of sleep or coffee seems to help.
Extremely low Libido. I do not experience morning erections. When I do (very rarely), it is alarming – it happens so infrequently.
I tend to get cold easily. This is very strange as I have always been “warm-blooded”. My skin is dry/scaly and nails seem to be more brittle than they used to be. Hair is thinning at an alarming rate. Body hair in addition to the top of my head.
I’ve read recently that Iodine and selenium are key factors in Thyroid function. I eat next to no salt, bread and seafood. I suspect I might be low on iodine. I am starting to track body temp, but I would like to get input on this.
I eat a “clean” diet. Little to no processed foods including bread and pasta. I primarily eat whole foods someone from the 1700s would recognize as food. I consume very little iodized salt or sea food. I am a former competitive cyclist. I steadily decreased my weight from 220lbs in 2013 to 187lbs this last spring. I was <10% body fat and trying to lose more weight. For nearly two years I was a raw-vegan, consuming a net choleric deficit with macro rations near 80-90% carbs, 5-10% protein and <5% fat. I kept my caloric intake at a 500 calorie deficit per day. Despite maintaining the same deficit, I stopped losing weight and actually started to put some on toward the end of the spring.
I abandoned the raw-vegan diet and stopped counting calories late march 2017. Since then I’ve put on 20lbs. Not all of it has been fat, but a lot of it is and I’m disproportionately carrying it in my chest and belly.
For the last three years I increased my training from 10 hrs per week to an average of 20-25 hrs per week (200-400 miles). Despite increasing training volume and intensity, I started getting weaker and weaker toward the end of the spring of 2017. This, coupled with crippling depression and non-existent libido, is why I sought out medical intervention. Training harder should not lead to getting weaker. Something was wrong.
I stopped training in late March 2017. Since then I’ve seen/felt little to no improvement.
I suffered from insomnia throughout childhood. It got worse when I got heavier in my mid 20s and I believe the stimulants exacerbated the condition. I took a number of different sleep-aids for nearly 20 years. I stopped taking them in 2013 and haven’t since.
I have always struggled to get 7-8 hours of sleep on a regular basis. Normally I would get 5 or 6 hours. However, in the fall of 2016 my life stress led to greatly diminished sleep. I was back to getting ~5, maybe 6 hours of sleep.
I have not been tested for sleep-apnea, but my wife thinks I should.
• I don’t have any known exposure to noxious chemicals.
• I have never used hair loss drugs.
• Frequent urination at night.
• Dizzy/faint when standing abruptly.
• Swelling in extremities.
• Skin on the backs of my hands is thin and “crinkly” looking.
• Things that have stopped since I’ve gained weight/stopped training: numbness in fingers, extreme calf cramps at night.
• Had sever gum disease. Treated and overcome early 2017. Unknown duration. I suspect several years.
• I am not on any Rx drugs. Supplements are as follows:
o B-12: 1,000 mcg daily
o D3: 10,000 IU daily
o Calcium: 1,000 mcg daily
o Magnesium: 400 mg daily
o Zink: 15 mg daily
o Omega 3: 1900 mg daily
o B complex daily multivitamin
o Vitamin E: 1,000 IU daily
o Iron (ferrous sulfate): 65 mg daily
Unrelated medical conditions:
As a child, I suffered from severe asthma. I was frequently prescribed prednisone and/or amoxicillin. Puberty reduced my asthma to the point where I only experience symptoms when I get very ill. Asthma has not been an issue in adulthood.
At the same time I started getting weaker and fatter (spring 2017) despite increased training volume and continued caloric deficit, I was also experiencing repetitive knee injuries. I’ve had knee surgeries in the past but it’s been years since my last surgery without injury since. After I stopped training I went and got x-rays done. Turns out I have severe osteoarthritis in both knees. The doctor said “if you were 30 years older, I would tell you to have both your knees replaced.”
In the fall of 2016 my life became extremely stressful.
Work: I hated my job to start with, but recent changes in the company made the situation very stressful.
Personal: Me not wanting to have sex made for a stressful home life.
Nearly 6 months ago I stopped training, abandoned my quest to lose weight, and quit my job.
For the last six months I’ve eaten a healthy, balanced diet, lived a relatively stress free life (including training stress), and gotten 8 hours of sleep come hell or high-water. But I don’t feel any better.
- I need to increase my libido.
- Any therapy needs to maintain any endogenous sperm production.
- I have a feeling my training/diet/sleep/stress over-load destroyed my endocrine system. Or if nothing else, tipped it over the edge. If possible, I would like to “jump-start” my endocrine system and get it back to a functional state without ongoing exogenous intervention.
Questions for doc:
• What are your thoughts on hCG, Estradiol (e2), SERMs, Aromatase Inhibitors and testosterone cypionate dosage/frequency?
• What kind of temporary protocol would you put me on to “jump-start” my natural hormone production? Is this even possible?
• Have you seen any patients whose natural hormone production rebounded from levels like mine?
• Do you have any experience with or knowledge of Overtraining Syndrome or Amenorrhea?
• I am also including a summary of all blood-work to date. Based on that, what additional blood-work would you run and why?
• I’ve read that Nolvadex (SERM similar to Clomid but without as many negative side effects) could possibly be a better alternative to hCG for maintaining fertility do to its preservative effects to LH AND FSH. What are your thoughts on this?
Additional Labs I’d Like to Run:
PSA, E2 (estradiol: LabCorp serum E2 test or Quest Sensitive 4021x. PLEASE DO NOT USE Quest ULTRASENTIVE!), fT3, DHEA-S, Cortisol 4 (sample saliva), Pregnenolone,