The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition

Abstract

Men exhibiting EHMC do appear to present with symptoms associated with androgen deficiency. For the most part, these symptoms are limited to those reported on the AMS questionnaire, although there are also some cases of clinically low BMD. It is possible that inadequate energy intake is contributing to this condition.

Low energy availability in male athletes: A systematic review of incidence, associations, and effects

“…It was reported that LEA induced through dietary restrictions resulted in significant decreases in leptin and insulin, but no changes in IGF‐1, ghrelin, testosterone, or free T 3 in recreationally active participants. Contrary to these results, evidence from cross‐sectional studies by Heikura et al and Hooper et al suggests significantly lower testosterone levels are associated with LEA (21 kcal/kg LBM/d) in both middle‐ and long‐distance runners and racewalkers. Additionally, McMurray et al reported elevations in human growth hormone (HGH) and significant decreases in IGF‐1 in wrestlers under conditions of LEA (<30 kcal/kg LBM/d).…”

“…Table summarizes the methods of assessing energy availability used across the cross‐sectional studies. Energy intake was measured via food frequency questionnaire or 3‐ to 7‐day food diaries using household measures or weighed records . One study measured energy intake 3 days per month .…”

“…One study measured energy intake 3 days per month . Exercise energy expenditure was assessed by training logs, heart rate monitoring, or through use of the SenseWear Armband . Four out of seven studies (57%) derived resting metabolic rate (RMR) from predictive equations, two studies (29%) measured RMR using a ventilated canopy hood system, and one study did not report any measurement of RMR .…”

“…An assortment of EI measures has been used including food frequency questionnaires, weighed food records, and food diaries were implemented across each study, making dietary intake difficult to evaluate comparatively. Energy intake via conventional methods has been shown to exhibit large discrepancies for a number of reasons; for instance, food frequency questionnaires and nutrient databases often fail to provide adequate information regarding sports nutrition supplements and ergogenic aids.…”

“…Exercise energy expenditure (EEE), adjusted for resting metabolic rate (RMR), is however required. Four of the studies (57%) included in this review recorded EEE by means of training logs and estimated the calories expended based on metabolic equivalents (METs) . A MET is defined as approximately 3.5 mL 02/kg/min for a 70 kg individual .…”