T Nation

Special Case: Advice Needed


I'm glad I found this website - I hope I can get some help here...

Let me start off with some background information:

I am 22 years old and back in my high school days (4-5 years ago) I was very athletic. I played varsity football/varsity tennis. I wouldn't say I was ever ripped, but I was always nicely toned and strong for my weight. I am 6'1" and back then I weighed about 165-180...depending on which sport I was playing at the time.

During the beginning of my senior year I came down with an illness that took over 6 months to diagnose correctly. At first I had horriffic pain in my left foot (docs thought it was another broken bone...had done it before), so I was put in a cast for 3 months and came out worse, then about another 3 months later the pain/inflammation moved into my shoulders/neck/spine/tailbone and went away in my foot. It has been there to this day.

I was diagnosed with Ankylosing spondylitis, a pretty rare disease with similarities to advanced rheumatoid arthritis...and there is no cure :frowning:

The background is necessary to understand whats going on, but to get to the point:

In the first year of being diagnosed my weight dropped down to as low as 145lbs and you could see the bones, etc in my shoulders and surrounding areas. So I was put on Prednasone (sp?) for a short while to help build up some muscle and finally decided to move ahead with my chemo-therapy treatments.

My QUESTION is for the last few years I have bordered the 195-205lbs range and have been almost unable to lose weight or gain much muscle, especially in my shoulders/chest/upper back.

I have tried training for months at a time, eating good, weight lifting as I used too (regardless of pain), tons of cardio...but I am just not burning off any fat and getting no muscle. I have tried this time and time again...I know what it takes but its not working and its really starting to get to me. I have been so frustrated that I have almost looked into getting fat removed surgically...which I never want to resort to...I have also "considered" the use of steroids to help, but don't know enough about them.

I will do whatever it takes, whatever anyone could recommened, because I am just not getting anywhere. Could be the meds, the chemo, who knows...but if anyone has any ideas what-so-ever I would greatly appreciate it if you would share them.

I don't weigh that much, but I feel fat and look fat to myself, I have hardly any muscle you can see and I can't take it anymore.

Sucks going from 28-30 waist to 34-36 and having a gut vs defined abs.

As I said above, there is nothing I won't try so don't hold back, please. I still have a ton of joint pain because of my disease, but I can handle that...its the least of my worries. With the chemo its nothing like it used to be.

If you need any other information please ask, I will provide anything necessary. I know there are people here with a lot of expertise and that is why I have come here.

Sorry for the long post and thank you for your time.


On what dreamguy wrote:

what have you been eating recently
whats a usual day of food look like
how have you been training recently
are you able to do anything that puts weight on your foot?
does this affect your entire body?


Looking at your post, I am interested in knowing what type and duration of lifting you are doing and exactly what you mean by "tons of cardio". It is possible that you are putting in the required effort but just using the wrong ingredients.


For the last 2-3 weeks I have been eating mostly clean. A lot of lean meat (chicken & lean turkey)...occasionally some extra lean beef. Yogurt, fruit, meal replacement shakes here and there, reduced fat wheat thins and other similar foods for snacks. Some low fat/low sugar candies every once and a while to keep me from snapping. And no more than 1-2 sodas a week, sometimes none. At least 6-7 cups of water a day, more if I am working out.

I have recently started resistence training again, different exercises trying to get to all the muscles...free weights, machines, resistance bands...

I have also been running/jogging at least a mile a few days a week or riding my bike 3-5 miles in place of running.

I have no problem putting weigh on my foot, I have no more problems there, just in my shoulders/spine...but I can deal with it.

The disease and related pain effects my whole body yes, but its mostly focused in my shoulder/neck/spine.



I vary my lifting between free weights and machines, and if I am lifting I usually do it for about 45 minutes to an hour. I also try and keep my heart rate up and don't take long breaks so I can "esentially" burn more calories.

"tons of cardio" might have been an over statement, but I do try to run 1-2 miles a few days a week for ride my bike 3-5 miles instead. I ride on the road, but with a moutain bike, so its almost like getting twice the workout over a regular road bike.

I agree with your statement about possibly using the wrong ingredients, and thats exactly why I came here. Maybe there is something I am overlooking. Hopefully we can figure out something though because I am not getting very far =\

If you need more info, let me know...


Here are some figures from the last 6 days of my diet (approx):

Average calories eaten: 1,758

from fat: 31%
from carbs: 44%
from proteins: 20%
from alcohols: 5%

Need to cut out some more of those carbs...

**One of those days was an "off" day, but I didn't go crazy or anything.

Hope some of this info helps...

Thanks again!


That is a low calorie intake for someone your height and weight. I would be inclined to increase the calorie intake, but at the same time cut the carbs (considerably). And definitely cut out the alcohol. Try some variation of the paleo diet, or Dan John's meat, leaves and berries or something similar. Looks to me like your body is going into starvation mode and hording fat because of the low calorie intake. Also your insulin sensitivity could be out of whack. Cutting down on the carbs and cutting out alcohol will make a big difference to this.


No Dreamguy,

you are not a special case. Anyone at 200 lbs consuming only 1800 cals and around 88 grams of protein is not going to gain muscle. Neverever.

Try 300g of protein with 3000 kcals a day that is probably more like it. 6-7 meals a day, protein+carb meals around training ,yadayadaydada....


Those calories do seem low. I would also watch that cardio as you are probably eating up some much needed muscle there. Your muscles are your body's engine, you want to drive a Viper, not a Yugo.

Try out these articles to get an idea on where to take your training.

Try http://t-nation.com/readTopic.do?id=490160 (tabata), http://t-nation.com/readTopic.do?id=459809 (meltdown training), and http://t-nation.com/readTopic.do?id=459230 (bowl full of jelly)
for fat loss.

Try http://t-nation.com/readTopic.do?id=499987 (Dawg School) and
http://t-nation.com/readTopic.do?id=499987 (5 Ways to Get the Most out of Your Gym Time!
) to help design your wieght training.

Learn to use the search. All of the info you need is here somewhere. Good luck!


Try this post, http://t-nation.com/readTopic.do?id=640350 , by Vroom also. There is a ton of good info and how to find answers to your question at that post.


I know its a low calorie intake, but I am getting desperate. The thing is, I don't feel much extra hunger now that I have reduced my calories for a while.

Also, I rarely drink alcohol, but some of my friends moved back to town and I went out the other night...thats rare though.

I will be cutting the carbs back a lot. Most of them come from the whole wheat bread I eat, but I can supplement that with something else.


Wow, thats a lot of protein, but I will definately try this. It makes sense...

Note: I didn't say I was a special case, I just can't figure out what the problem is...needed some other points of view.


The title of your post says so! Special case: Need help...

I agree, Vrooms thread is probably what you are looking for and 300 grams of protein is not that much, that is only 1,5 gram per lb of bodyweight. There are people here that go for 2-3 grams per pound and more...

The answer to what your problem is: You do not eat enough healthy food.


1800 cal is O.K.....for a 100 lb. female couch potato. NOT O.K. for a 200 lb male that is lifting and biking.

Drop the cardio to bare minimum.

What's with all this low fat/no fat shit? 60% of your brain and CNS is composed of fat. Cell membranes are composed of fat. Testosterone is made from fat. All your hormones are made from fat. Cartilage and conective tissue is made from fat.

Read the articles suggested in previous posts.



I don't eat all no fat stuff, some of the snacks I eat are "reduced" fat
vs the more fatty versions...not LOW or NO fat - besides, those foods taste gross anyhow.

I will definately beef up my diet with more calories and more protein, and I will also read the atricles everyone pointed out. Hope this helps...

Thank you