I've been diagnosed with low testosterone since 2013 and identified with osteopenia since 2017 via DEXA scans and my most recent scan showed continued decrease in bone density. I've tried to increase my testosterone over the years with no success and even took two years off from structured endurance training while still remaining active with unstructured exercise, but have only been able to get my results just inside the normal range twice throughout the years of blood work. My weekly training volume at it's peak is 10 hours or less and I predominately compete in Olympic distance events. My BMI is 19.8 and has remained essentially constant since I was in high school, which was almost 20 years ago. I know there's a lot of content about endurance exercise reducing testosterone levels and the diagnosis of RED-S, but I haven't seen much documentation on recovery from it and case studies on how it was done. I was wondering if anyone has or knows someone that has recovered from a similar situation and how they did it as my endocrinologist is recommending testosterone therapy to slow the bone loss. I also have low thyroid levels and have been taking Liothyronine and Levothyroxine for the past four or so years. I've also had two MRIs that revealed a small tumor that was pressing on my pituitary gland, but there's mixed opinions of if that's the cause or not. Any advise, suggestions, or contacts are greatly appreciated. Thanks.
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Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
Tell us about your diet? rather than your BMI your body fat %? For me I had to increase calories especially undamaged fats (up in olive oil, avocado, animal fats, reduce vegetable oil fat). Had to eat a little more calories too, and drop some of the high fiber foods I ate (raw kale). Its easy to over do it with endurance exercise. Lifting heavy weights helps too. but only if you are getting enough sleep and rest! so i shut myself down by 3pm usually
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
Cody Beals has documented his struggles with low testosterone.
Here's the link to the article he wrote about his recovery, but his website has several other articles that detail his history with low T.
https://www.codybeals.com/...er-low-testosterone/
Here's the link to the article he wrote about his recovery, but his website has several other articles that detail his history with low T.
https://www.codybeals.com/...er-low-testosterone/
Re: Recovery from Low Testosterone? [Apollo71]
[ In reply to ]
Apollo71 wrote:
Cody Beals has documented his struggles with low testosterone. Here's the link to the article he wrote about his recovery, but his website has several other articles that detail his history with low T.
https://www.codybeals.com/...er-low-testosterone/
great article expanding my simple statement, and yes it did remind me I cut lots of soy from my diet.
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
So I used to publish my blood tests back in the day. I had T on the lower side of things and tried to work on it a bit, I did get it to raise quite a bit over time. Not all my tests are published but I have a few that I link to. Here is the 1st one. Tangentially it may been some help.
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Re: Recovery from Low Testosterone? [synthetic]
[ In reply to ]
Thanks for the response. My diet is nothing radical. I'm mostly plant based with fruits and vegetables at the core of my meals. Every meal I try to have a main protein and starch, for example brown rice and peas are typically part of my lunch (oatmeal, potatoes, and whole wheat bread are also common) and aim for 100+ grams of protein per day (I'm 130 lbs). Breakfasts are typically smoothies with plant based protein powder. I eat usually four eggs per day, beef a couple times a week and fish as well. Early on I was vegetarian with minimal dairy. I've also tried gluten free, and low(er) carbs, but now am eating more carbs the past few years with more gluten and dairy (mostly cheese) in my diet. My major sources of fat are olive oil, coconut oil, butter, and beef fat; nut butters are also a staple in my diet. I usually have a snack before my morning workouts, banana, butter, and toast for example, post workout snack of whey and some type of simple carb, and I fuel any workout over 90 minutes. As for body fat %, I've never had it officially measured, but looking at benchmark photos I'd guess somewhere between 6-10%. Finally, I also try to get one or two strength sessions in a week year around.
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
BigByte wrote:
Thanks for the response. My diet is nothing radical. I'm mostly plant based with fruits and vegetables at the core of my meals. Every meal I try to have a main protein and starch, for example brown rice and peas are typically part of my lunch (oatmeal, potatoes, and whole wheat bread are also common) and aim for 100+ grams of protein per day (I'm 130 lbs). Breakfasts are typically smoothies with plant based protein powder. I eat usually four eggs per day, beef a couple times a week and fish as well. Early on I was vegetarian with minimal dairy. I've also tried gluten free, and low(er) carbs, but now am eating more carbs the past few years with more gluten and dairy (mostly cheese) in my diet. My major sources of fat are olive oil, coconut oil, butter, and beef fat; nut butters are also a staple in my diet. I usually have a snack before my morning workouts, banana, butter, and toast for example, post workout snack of whey and some type of simple carb, and I fuel any workout over 90 minutes. As for body fat %, I've never had it officially measured, but looking at benchmark photos I'd guess somewhere between 6-10%. Finally, I also try to get one or two strength sessions in a week year around.is the calorie input matching the output then? Perhaps you need to eat more. Or sleep more? Is training polarized (80/20) ? i learned my lesson trying to hammer everyday.
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
Do you have low total testosterone, free testosterone, or both? If your thyroid is underactive you might be producing less SHBG which binds to testosterone. If SHBG is lowered your body could produce less total testosterone while maintaining healthy free testosterone levels. As long as your free testosterone levels are good, total testosterone might not be such an issue. Especially true if you are asymptomatic, which you seem to be other than osteopenia which may or may not be caused by low testosterone.
That said is there a reason you don't like the idea of testosterone replacement therapy? A lot of athletes jump at the chance to do it, and you can read plenty of positive stories about it online.
For the osteopenia low testosterone certainly can play a role but worth considering other things too. How much calcium and vitamin d are you getting per day? How much weight bearing exercise are you doing per week? (Cycling and swimming don't count).
That said is there a reason you don't like the idea of testosterone replacement therapy? A lot of athletes jump at the chance to do it, and you can read plenty of positive stories about it online.
For the osteopenia low testosterone certainly can play a role but worth considering other things too. How much calcium and vitamin d are you getting per day? How much weight bearing exercise are you doing per week? (Cycling and swimming don't count).
Re: Recovery from Low Testosterone? [James2020]
[ In reply to ]
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
How old are you? The older your are/get the more unlikely it will be that you van recover your levels naturally. Can you post bloodwork?
Re: Recovery from Low Testosterone? [trail]
[ In reply to ]
trail wrote:
James2020 wrote:
That said is there a reason you don't like the idea of testosterone replacement therapy?
Are you just trolling for fun?
If someone is deficient in a micronutrient it wouldn't be controversial to suggest supplementing it. OP is already taking Liothyronine and Levothyroxine which are hormones (just like testosterone), to bump up thyroid hormones to an acceptable level. Why is taking a therapeutic dose of testosterone prescribed by a medical doctor to put levels into the normal range any different?
If you are talking about the legality of competing, I think you will find wada grant TUE's for testosterone replacement therapy. So would be completely above board. Although, if it comes down to it, health is much more important than competing.
Re: Recovery from Low Testosterone? [James2020]
[ In reply to ]
James2020 wrote:
trail wrote:
James2020 wrote:
That said is there a reason you don't like the idea of testosterone replacement therapy?
Are you just trolling for fun?
If someone is deficient in a micronutrient it wouldn't be controversial to suggest supplementing it. OP is already taking Liothyronine and Levothyroxine which are hormones (just like testosterone), to bump up thyroid hormones to an acceptable level. Why is taking a therapeutic dose of testosterone prescribed by a medical doctor to put levels into the normal range any different?
If you are talking about the legality of competing, I think you will find wada grant TUE's for testosterone replacement therapy. So would be completely above board. Although, if it comes down to it, health is much more important than competing.
100% agree with you. Health is way more important than racing. I started replacement therapy a year ago after feeling like shit for years. Walked away from racing because of it and have never been happier. People can say what they want about my choice but low testosterone is not healthy.
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
Define Low T, are you in the 200s?
Washed up footy player turned Triathlete.
Washed up footy player turned Triathlete.
Re: Recovery from Low Testosterone? [TheStroBro]
[ In reply to ]
TheStroBro wrote:
Define Low T, are you in the 200s?Need his free T too. I'm not sure total T is enough as due to thyroid he may have lower levels of SHBG, which obviously has an importent role in this all. Other than osteopenia, which could be due to low testosterone but not necessarily from what we know so far, he doesn't seem to suffer from any of the common low T side effects. So it could be his low total T is sufficient to produce healthy levels of free t due to lack of SHBG.
Re: Recovery from Low Testosterone? [James2020]
[ In reply to ]
James2020 wrote:
trail wrote:
James2020 wrote:
That said is there a reason you don't like the idea of testosterone replacement therapy?
Are you just trolling for fun?
If someone is deficient in a micronutrient it wouldn't be controversial to suggest supplementing it. OP is already taking Liothyronine and Levothyroxine which are hormones (just like testosterone), to bump up thyroid hormones to an acceptable level. Why is taking a therapeutic dose of testosterone prescribed by a medical doctor to put levels into the normal range any different?
If you are talking about the legality of competing, I think you will find wada grant TUE's for testosterone replacement therapy. So would be completely above board. Although, if it comes down to it, health is much more important than competing.
I thought it was nearly impossible to get a TUE for testosterone. Has something changed?
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Re: Recovery from Low Testosterone? [s.gentz]
[ In reply to ]
I have results going back further, but here's the last few years (the units and ranges have changed some with the lab over time):
Date Test units Result Range Low Range High 12/14/2018 Free T pg/mL 18 47 244 4/19/2019 Free T pg/mL 23.5 47 244 12/31/2019 Free T ng/dL 8.19 5 21 11/5/2020 Free T ng/dL 11.08 5 21 5/14/2021 Free T ng/dL 8.65 5 21
Date Test units Result Range Low Range High 12/14/2018 T ng/dL 128 300 1080 4/19/2019 T ng/dL 149 300 1080 12/31/2019 T ng/dL 190.5 264 916 11/5/2020 T ng/dL 265.1 264 916 5/14/2021 T ng/dL 176.6 264 916
Date Test units Result Range Low Range High 12/31/2019 Cortisol ug/dL 15.85 4.3 22.4 11/5/2020 Cortisol ug/dL 15.9 4.3 22.4
Date Test units Result Range Low Range High 12/21/2018 LH mIU/mL 0.9 1.19 9.3 12/31/2019 LH mIU/mL 1.19 1.2 10.6 11/5/2020 LH mIU/mL 1.91 1.2 10.6 5/14/2021 LH mIU/mL 0.787 1.2 10.6
Date Test units Result Range Low Range High 12/21/2018 FSH mIU/mL 1.3 0.7 10.8 12/31/2019 FSH mIU/mL 0.8 0.7 10.8 11/5/2020 FSH mIU/mL 1.1 0.7 10.8 5/14/2021 FSH mIU/mL 1 0.7 10.8
Date Test units Result Range Low Range High 12/14/2018 Free T pg/mL 18 47 244 4/19/2019 Free T pg/mL 23.5 47 244 12/31/2019 Free T ng/dL 8.19 5 21 11/5/2020 Free T ng/dL 11.08 5 21 5/14/2021 Free T ng/dL 8.65 5 21
Date Test units Result Range Low Range High 12/14/2018 T ng/dL 128 300 1080 4/19/2019 T ng/dL 149 300 1080 12/31/2019 T ng/dL 190.5 264 916 11/5/2020 T ng/dL 265.1 264 916 5/14/2021 T ng/dL 176.6 264 916
Date Test units Result Range Low Range High 12/31/2019 Cortisol ug/dL 15.85 4.3 22.4 11/5/2020 Cortisol ug/dL 15.9 4.3 22.4
Date Test units Result Range Low Range High 12/21/2018 LH mIU/mL 0.9 1.19 9.3 12/31/2019 LH mIU/mL 1.19 1.2 10.6 11/5/2020 LH mIU/mL 1.91 1.2 10.6 5/14/2021 LH mIU/mL 0.787 1.2 10.6
Date Test units Result Range Low Range High 12/21/2018 FSH mIU/mL 1.3 0.7 10.8 12/31/2019 FSH mIU/mL 0.8 0.7 10.8 11/5/2020 FSH mIU/mL 1.1 0.7 10.8 5/14/2021 FSH mIU/mL 1 0.7 10.8
Re: Recovery from Low Testosterone? [BigByte]
[ In reply to ]
BigByte wrote:
I have results going back further, but here's the last few years (the units and ranges have changed some with the lab over time): Date Test units Result Range Low Range High 12/14/2018 Free T pg/mL 18 47 244 4/19/2019 Free T pg/mL 23.5 47 244 12/31/2019 Free T ng/dL 8.19 5 21 11/5/2020 Free T ng/dL 11.08 5 21 5/14/2021 Free T ng/dL 8.65 5 21
Date Test units Result Range Low Range High 12/14/2018 T ng/dL 128 300 1080 4/19/2019 T ng/dL 149 300 1080 12/31/2019 T ng/dL 190.5 264 916 11/5/2020 T ng/dL 265.1 264 916 5/14/2021 T ng/dL 176.6 264 916
Date Test units Result Range Low Range High 12/31/2019 Cortisol ug/dL 15.85 4.3 22.4 11/5/2020 Cortisol ug/dL 15.9 4.3 22.4
Date Test units Result Range Low Range High 12/21/2018 LH mIU/mL 0.9 1.19 9.3 12/31/2019 LH mIU/mL 1.19 1.2 10.6 11/5/2020 LH mIU/mL 1.91 1.2 10.6 5/14/2021 LH mIU/mL 0.787 1.2 10.6
Date Test units Result Range Low Range High 12/21/2018 FSH mIU/mL 1.3 0.7 10.8 12/31/2019 FSH mIU/mL 0.8 0.7 10.8 11/5/2020 FSH mIU/mL 1.1 0.7 10.8 5/14/2021 FSH mIU/mL 1 0.7 10.8
How old are you? What were you doing different in 2020 up until November? Less training because of covid? Your test levels got barely back in range but still suck and then tanked again in you may bloods. How do you feel? This is prob not the correct forum to discuss HRT without getting crucified but i would listen to your endo and at least try the cream for a bit to see how you feel after 5 or 6 months. I was very hesitant because of racing but IMO you need to do what is best for you/your health. PM me if you want to discuss further. I'm not an expert in bloodwork and what it means but I know people who are that I could have look at it if your interested.
Re: Recovery from Low Testosterone? [Thomas Gerlach]
[ In reply to ]
Thomas Gerlach wrote:
I thought it was nearly impossible to get a TUE for testosterone. Has something changed?
That was my understanding as well
My Blog - http://leegoocrap.blogspot.com
Re: Recovery from Low Testosterone? [Thomas Gerlach]
[ In reply to ]
The TUE system isn't transparent so none of us have a clue how hard/easy it is to get one for Testosterone.
Washed up footy player turned Triathlete.
Washed up footy player turned Triathlete.
Re: Recovery from Low Testosterone? [Morelock]
[ In reply to ]
Morelock wrote:
Thomas Gerlach wrote:
I thought it was nearly impossible to get a TUE for testosterone. Has something changed?
That was my understanding as well
The RCTUE may have changed things for some. Not openly advertised (by USADA or similar), but my understanding is that it's more permissive of testosterone use. The "increased flexibility" mentioned in this article may be a veiled admission of T allowance.
Re: Recovery from Low Testosterone? [James2020]
[ In reply to ]
Quote:
Why is taking a therapeutic dose of testosterone prescribed by a medical doctor to put levels into the normal range any different?Oh that's easy. Because those thyroid hormones are not prohibited substances according to WADA and testosterone is.
James2020 wrote:
I think you will find wada grant TUE's for testosterone replacement therapy.
RCTUEs maybe, not TUEs. I'm OK with "TRT" if people either stop racing in events that have an anti-doping policy or get an RCTUE and adhere to the conditions of the RCTUE.
Re: Recovery from Low Testosterone? [trail]
[ In reply to ]
interesting, thanks for the links
In my own experience - pretty much same as TG... had very low T (especially free) when I had my blood tested... doctor pretty much said if you're going to do endurance sports it's most likely going to be low.
As soon as I moved to a more balanced (lifting, less overall load) lifestyle, it went back to "normal"
My Blog - http://leegoocrap.blogspot.com
In my own experience - pretty much same as TG... had very low T (especially free) when I had my blood tested... doctor pretty much said if you're going to do endurance sports it's most likely going to be low.
As soon as I moved to a more balanced (lifting, less overall load) lifestyle, it went back to "normal"
My Blog - http://leegoocrap.blogspot.com
Re: Recovery from Low Testosterone? [Morelock]
[ In reply to ]
Morelock wrote:
In my own experience - pretty much same as TG... had very low T (especially free) when I had my blood tested... doctor pretty much said if you're going to do endurance sports it's most likely going to be low.
As soon as I moved to a more balanced (lifting, less overall load) lifestyle, it went back to "normal"
Same here. I've improved my diet, cut out 99% of alcohol (have maybe 1 beer on special occasions like Memorial Day), (running and ducking), started doing CrossFit a few times per week, and cut down the number of Saturday hero group rides that I do (group rides that are essentially full-up 3-hour road races).
Re: Recovery from Low Testosterone? [s.gentz]
[ In reply to ]
I'm in my mid 30's. Prior to my November results I had been almost completely sedentary for over a month. I didn't feel much different then than any other time. I was skeptically optimistic since that was the best results I'd had in 8 years even though it wasn't great.
BigByte wrote:
I'm in my mid 30's. Prior to my November results I had been almost completely sedentary for over a month. I didn't feel much different then than any other time. I was skeptically optimistic since that was the best results I'd had in 8 years even though it wasn't great.I feel for ya. I'm 43 and my symptoms started in my early 30's. Coincidentally that was the time when I started getting serious about long distance triathlon and ultra running. Lotta time spent training and prob not properly recovering. I think this is the case with a lot of triathletes. Some can manage the load and some cannot. These days i'm happy to weight train 6 days a weeks and ride my bikes. Haven't run since October of last year. Good luck getting you situation squared away. Unless your a FOP racer i would consider treating your condition like you are your thyroid. Highly unlikely your symptoms will subside naturally.