Role of Relative Malnutrition in Exercise Hypogonadal Male Condition

Kidmealem L Zekarias, Rupendra Shrestha

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective Exercise hypogonadal male condition is a well-recognized condition in women but much less understood in men. The aim of this case report is to highlight exercise-induced hypogonadotropic hypogonadism in a male who recovered with lifestyle modifications. Methods We report a case of an adolescent male who developed hypogonadotropic hypogonadism secondary to excessive exercise and malnutrition that was followed up for a year without exogenous testosterone supplementation. Informed consent was obtained from the patient for his information to be used in a manuscript submitted to a journal. Results An 18-yr-old adolescent male presented to the clinic with symptoms of fatigue and low endurance, low libido, and lack of morning erections. At the time of his presentation, he was running about 60 miles per week for school cross-country team in addition to cross training with kickboxing. Physical examination was remarkable for low body mass index of 19 kg·m -2 but was otherwise normal. Biochemical workup confirmed hypogonadotropic hypogonadism and a mild pancytopenia. Other pituitary laboratory values and MRI of the brain were unremarkable. Bone marrow biopsy performed for anemia showed features consistent with malnutrition. With a working diagnosis of exercise hypogonadal male condition, he was advised to reduce the frequency and intensity of his exercise and increase calorie intake. Cell counts and testosterone levels normalized, and his symptoms resolved without any further interventions. Conclusion Significant reversible hypogonadism can develop after intensive and prolonged exercise. One of the mechanisms of hypogonadism in endurance athletes performing intensive exercise could be relative malnutrition. Further studies to evaluate the role of nutrition and body mass index in male endurance athletes presenting with hypogonadism are needed to identify the underlying mechanism of this condition.

Original languageEnglish (US)
Pages (from-to)234-236
Number of pages3
JournalMedicine and science in sports and exercise
Volume51
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Hypogonadism
Malnutrition
Exercise
Athletes
Testosterone
Body Mass Index
Libido
Pancytopenia
Manuscripts
Informed Consent
Running
Physical Examination
Fatigue
Life Style
Anemia
Cell Count
Bone Marrow
Biopsy
Brain

Keywords

  • EXERCISE
  • HYPOGONADISM
  • HYPOGONADOTROPIC HYPOGONADISM
  • MALE ATHLETE
  • MALNUTRITION
  • TESTOSTERONE

PubMed: MeSH publication types

  • Case Reports
  • Journal Article

Cite this

Role of Relative Malnutrition in Exercise Hypogonadal Male Condition. / Zekarias, Kidmealem L; Shrestha, Rupendra.

In: Medicine and science in sports and exercise, Vol. 51, No. 2, 01.02.2019, p. 234-236.

Research output: Contribution to journalArticle

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AB - Objective Exercise hypogonadal male condition is a well-recognized condition in women but much less understood in men. The aim of this case report is to highlight exercise-induced hypogonadotropic hypogonadism in a male who recovered with lifestyle modifications. Methods We report a case of an adolescent male who developed hypogonadotropic hypogonadism secondary to excessive exercise and malnutrition that was followed up for a year without exogenous testosterone supplementation. Informed consent was obtained from the patient for his information to be used in a manuscript submitted to a journal. Results An 18-yr-old adolescent male presented to the clinic with symptoms of fatigue and low endurance, low libido, and lack of morning erections. At the time of his presentation, he was running about 60 miles per week for school cross-country team in addition to cross training with kickboxing. Physical examination was remarkable for low body mass index of 19 kg·m -2 but was otherwise normal. Biochemical workup confirmed hypogonadotropic hypogonadism and a mild pancytopenia. Other pituitary laboratory values and MRI of the brain were unremarkable. Bone marrow biopsy performed for anemia showed features consistent with malnutrition. With a working diagnosis of exercise hypogonadal male condition, he was advised to reduce the frequency and intensity of his exercise and increase calorie intake. Cell counts and testosterone levels normalized, and his symptoms resolved without any further interventions. Conclusion Significant reversible hypogonadism can develop after intensive and prolonged exercise. One of the mechanisms of hypogonadism in endurance athletes performing intensive exercise could be relative malnutrition. Further studies to evaluate the role of nutrition and body mass index in male endurance athletes presenting with hypogonadism are needed to identify the underlying mechanism of this condition.

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