T Nation

Low Testosterone


#1

Hi everyone,
first of all I am sorry for my English.

  • male
  • age:26
  • 179cm
  • 68kg
  • endurance sportsman (road cyclist)

I was training for my 8 day mountain stage race in the Italy, so I was training really hard 25h+/week and I also went on diet to lose some fat. I lost weight from 68kg to 60kg and the troubles started. I was also in stressful relationships with my girlfriend (my hormones went crazy so I became a difficult person and my girlfriend left me).

Symptoms:

  • poor sleep (at best 11:00 p.m. - 5:00 a.m.) - melatonin doesnt help at all
  • anxiety (I cant even watch a football game)
  • I constantly feel my heart, but it's not palpating, it beats slowly (this is really annoying, I can check my pulse without heartmeter)
  • erectile dysfunction
  • no libido (like girls doesnt exist for me)
  • low heart rate during exercise
  • I am NOT tired at all, i dont need to drink coffee (i have constant energy through all day)

Almost all blood tests are in attach image but some i will write them:

HCG-Beta: 0.1 IU/L [0-5]
S-Estradiol: 25.93 ng/L [7.63-42.59]
Prolactin: 7.63 qg/L [4.1-18.4]
testicles are OK

morning temperature: 36.4°C
afternoon temperature: 36.7°C
evening temperature: 36.7°C

My two endocrinologist says that I am fine and in normal ranges, but this is not normal because i know how i felt year ago.

Can you guys help me with some advices? Can i exercise: walking, strenght training....


#2

TSH is too high, best closer to 1.0
T3 and T4 should be near mid-range or higher, both are low.
Your temperatures are a bit low. Please to repeat testing, single readings are not enough.
- have you been using iodized salt continuously for years? Sea salt does not contain iodine unless the package states that iodine has been added [iodized].

Your blood is thin. Note the two low results and hematocrit should be higher. This can sometimes be a result of a GI [gastrointestinal] bleed. Sometimes this occurs with a ulcer or food allergy/sensitivity. You can have a test that can detect small amounts of blood in your stool/poop [occult blood test]. Hematocrit is also showing some signs of iron loss via blood loss.

Your LH/FSH are a bit low and your T levels are consistent with that.

Your cortisol is high. What time of day were the labs done and how long had you been awake then? High cortisol will interfere with sleep and cause or contribute to mental agitation.

Read carefully: [you might find articles at Wikipedia in your native language]


The symptoms here are for cases that are much more severe compared to your cortisol levels.
"The excess cortisol may also affect other endocrine systems and cause, for example, insomnia, inhibited aromatase, reduced libido, impotence in men..."
"... due to hypercortisolism, which feeds back onto the hypothalamus resulting in decreased levels of GnRH release.[8]"

Your calcium and potassium levels are OK.

More labs:
ACTH https://en.wikipedia.org/wiki/Adrenocorticotropic_hormone
]FT - free testosterone
DHEA-S - DHEA sulfate

Estradiol looks OK, but with low T, that makes you somewhat estrogen dominant, SHBG may be elevated and FT depressed.

Please read these stickies:
- advice for new guys
- thyroid basics
-- note references to stress, starvation diets, adrenal fatigue

Focus on thyroid and adrenal issues. So the suggested labs above plus the occult blood test.

What has happened to your blood pressure? You thin blood would tend to lower it, but high cortisol will increase it.

Over training can stress the adrenals and also lower LH/FSH and T. So can fast weight loss.

Please read this post carefully, read the links and advice for new guys sticky, then read this page again.


#3

Maregol,

I'm going to tell you something you probably don't want to hear, but it's the voice of experience. Your problem is probably less an issue of your body and more one of your sport. Road biking is incredibly taxing and when you're training at the pro (or semi-pro) level, you genuinely do damage to your body.

Most people talk about Lance and his era as dopers in the same way they think of bodybuilders. That's not really correct. Cyclists in that era (and probably present day as well, truth be told) were bumping their testosterone tiny amounts. They were going from 250 ng/dl to 300 or something like that. On any normal scale, they'd be deficient, but they're essentially riding themselves deficient.

Your hematocrit is low because you've ridden it low. Why do you think EPO and blood doping are so powerful? A couple percent more oxygen carrying capability is massive. It just can't be overstated.

Right now, judging by your symptoms, you're over-trained. Do you have an organized team coach that does regular monitoring of your training? You've dropped a lot of weight (more than 10%, and I'm betting you weren't heavy to begin with), your blood levels are in the toilet and you're disconnected mentally. I've been there, man, and it sucks!

Another red flag is that you say your heart rate is low during exercise. That's a classic indicator of over-training. You get on the bike and start pushing a gear expecting your heart to jump to some 'high' heart rate, but you end up 10-20 bpm too slow, no matter how hard you push yourself. You need to rest. Let me repeat that. YOU NEED TO REST!

I don't know when your stage race is, but if you continue to ride as you are, you're going to struggle to finish it, much less be a real factor. Do yourself a favor. Cut your training by ~40%. 15 hours a week maximum. Sleep 10 hours a night minimum. Eat enough to get your weight back up 1 or 2 kg. Ride mostly tempo. When your heart rate starts to respond to short, high intensity efforts, then you can put some race-type efforts back into your training.

If you need help with training programming, I can help, but mostly you need to balance your fitness vs. your recovery. You'll race much better if you go into the race slightly less fit, but much more rested. Your heart rate will respond as it should and your legs will have the snap in them that they probably haven't had in a while. This is a case of less is more and that is something most athletes do not want to hear. I can tell you that many people want to be a pro athlete, but very few are willing to do what it takes to actually be one. What you have to do right now is rest.


#4

KSman:

Yes I was in kind of a shock when i saw TSH high, because i dont have alot of symptoms of hypothyroidism. I will try to work on that with food and rest. I dont think I am iodine deficiency, here in Slovenia all salt must have ioned.

I did take occult blood test and there was no sigh of blood in stool.
Hematocrit raised from test one month a ago, when it was a very low 37. That test made me realized that something is wrong with me.

When i told my doctor that i have constantly high cortisol problem he laughed at me, because of my low weight, low hear rate, low blood pressure. In home in the evening i have blood pressure around 100/70, heart rate 39. But these are my constant numbers of all my life, probaly because of my constant endurance training.
I still think that cortisol is ruing my sleep.

I will also do some other test which you are suggesting. Thank you for that!

Fat Boy 33:

When i was healty and OK even in my nightmare didnt think that cycling can ruin sexual hormones or anything else. I didnt even read any book about those problems. I just trained! But now i see that this sport is really crazy.

We have some coach in our team but he doesnt look at our training logs (training peaks) and we train with him just one or two days per week.
I will focus now on REST, i told to myself at least one month off the bike and do some weight training in the mean time. My legs have such bad lactat respons that my tempo rides feel like VO2max intervals.

Yea in future probaly i will need some training advices because obviously I am very bad self-coach.

Is it possible to get to racing/weight shape after disaster like this?


#5

maregol,

First, You absolutely can return to racing shape after over-training. In fact, I'd say that pretty much everyone in the pro peloton has been there at some point or another. If they haven't, they will be. It's the nature of the sport. Honestly, it's the reason that I've personally moved away from it. I enjoy the hell out of riding, but when I'm just not physically equipped to be really good at racing. It sounds like you do have the physical make-up to be successful, but, like most top level athletes, you need to be patient.

Developing patience means resting and letting your body recover. You don't get stronger when you ride hard, you get stronger when you recover. If all you do is train hard and have insufficient recovery, then you will start tearing down your body (as you've seen). Dropping body weight is part of it, but the emotional and hormonal response is a more hidden effect. The high cortisol levels are just part of it.

It's January. You've got a lot of time to salvage the season. If you're willing to take time off the bike, then this is a good time to do it. At the end of the day, you're going to take time off the bike. It's just a matter of whether you do it willingly or simply because your body shuts down. Lifting weights is a good idea, but keep it simple. Don't try to burn yourself down in the gym, just do things that will help you on the bike. Posterior chain work (the back side of the body) gets completely neglected while riding. Doing these things during a break will allow you to balance your body out to some extent. Yoga is very good for cyclists. You spend so much time in the same position that you mold to the shape. By stretching and strengthening your soft tissues you will make yourself much less prone to injury.

You're taking the right path. You'll recover and become stronger for it. Just follow your body. When you can start riding well again, you will feel like riding. You will want to go ride hard. You will lose some top-end strength (Lactate threshold and up). That's OK. Once you're rested, restart with base training and then start throwing in the high intensity work. You'll gain it all back and more in 3 months. The trick is, you have to wait long enough that you really are recovered before jumping back in. Do it because you want to, not because you feel obligated.

What does your diet look like? I'm an advocate for most people to run on a moderate carbohydrate intake with more fat, but cyclists are not like most people. Cyclists need to be heavy on the carbohydrates with less fat. If you were trying to limit carb intake, that will make things much worse. As far as protein intake goes, I think essentially any athlete should be 20% protein as an absolute minimum.