Anorexia and Hypogonadism

[Douche_Nutz]

I'm looking into the relationship between anorexia nervosa and hypogonadism. I've found that anorexia can cause hypogonadism, but there is very little information on the net regarding this. Is hypogonadism permanent in this case?


I'm curious because I was anorexic at the age of 14. I went from 150 pounds to 100 pounds and it took me about two years to return to 140. Now, I am having pretty severe low test problems and am looking into the possibility that I have hypogonadism, but I don't see any of the other causes applying to me.

 

[Douche_Nutz]

Also wondering about the possibility that the anorexia was a result of hypogonadism.

 

[luke77]

I am in the same situation as you - I had anorexia which led to hypogonadism. At least i'm fairly sure it was the anorexia first and hypogonadism second. You are right, there is very little information on the link between the two, most likely because it has not been studied in depth. I have a study that detailed the case of a male anorexic who had low bone density, low wbc counts, low hemoglobin, and low test. as a result of anorexia. After he gained about 15 pounds in 2-3 months all of his irregularities returned to normal...except for the testosterone, which the doctors then supplemented with trt. The study did not follow his progress after this, so it is unknown whether his natural production returned to normal eventually or not. I'm on trt because of anorexia-induced hypogonadism and my doctor thinks that my natural production will re-start because I'm at a healthy weight now, but it hasn't yet. Do you have any other symptoms/abnormalities other than the hypogonadism?

 

[Douche_Nutz]

Luke, thanks for the thoughtful reply. Symtoms and abnormalities? I referenced some of them throughout this thread (https://thinksteroids.com/community/threads/134236766), but I'll summarize the way I feel:

Depression - which I am on medication for now (Wellbutrin XL 300mg daily)
Erectile Dysfunction - have been unable to get an erection a few times
Low Libido
Gyno - I've noticed that this developed in the past half a year, and I'm pretty confident that it has gotten worse in the last month.
Extreme Moodiness/Irritability
Loss of memory/ability to recall events/things
Lethargy
Low confidence
Difficulty gaining muscle without gaining more fat (sounds stupid, but I feel like I've had training, nutrition, and sleep all in order and still had horrible results)

I spoke with my endo's nurse tonight and was given lab results. I will also get the results faxed to me later tonight. I was to this endo after getting a blood test at a local clinic.

Luke, where are you located?... I'm asking because it seems like you may have found a real good doc, or no?

I am in the same situation as you - I had anorexia which led to hypogonadism. At least i'm fairly sure it was the anorexia first and hypogonadism second. You are right, there is very little information on the link between the two, most likely because it has not been studied in depth. I have a study that detailed the case of a male anorexic who had low bone density, low wbc counts, low hemoglobin, and low test. as a result of anorexia. After he gained about 15 pounds in 2-3 months all of his irregularities returned to normal...except for the testosterone, which the doctors then supplemented with trt. The study did not follow his progress after this, so it is unknown whether his natural production returned to normal eventually or not. I'm on trt because of anorexia-induced hypogonadism and my doctor thinks that my natural production will re-start because I'm at a healthy weight now, but it hasn't yet. Do you have any other symptoms/abnormalities other than the hypogonadism?

 

[caos]

It'a been awhile since I looked into this, but I believe that Dr. Walford's work on caloric restriction found a strong link between low calorie consumption and low T levels. You can get more info from the list-serve archives at calorierestriction.org.

 

[Cryptochid]

Partial Adrenal insificiency and anorexia

PAI is rare and presents with superimposed psychiatric symptoms of depression, confusion, and apathy. PAI is associated with fatigue, weakness, anorexia, and weight loss. These problems may present insidiously over a prolonged period. The acute presentation of PAI includes nausea, vomiting, and hypertension.
http://www.emedicine.com/pmr/topic109.htm

 

[Douche_Nutz]

PAI is rare and presents with superimposed psychiatric symptoms of depression, confusion, and apathy. PAI is associated with fatigue, weakness, anorexia, and weight loss. These problems may present insidiously over a prolonged period. The acute presentation of PAI includes nausea, vomiting, and hypertension.
http://www.emedicine.com/pmr/topic109.htm

Not sure what this is in regards to...

Anyways, I got my second set of lab results back:

Estradiol: 15 pg/mL - Range: 0-54
TSH: 1.87 uU/mL - Range: 0.40-5.50
Prolactin: 8 ng/mL - Range: 4-18
Free T4: 1.12 ng/dl - Range: 0.90-1.70
% Free Testosterone: 2.9% - Range: 2.0-4.9
Free Testosterone: 8.2 ng/dL - Range: 9-30
Total Testosterone: 284.0 ng/dL - Range: 300-1200

What are your thoughts on these results?

 

[SWALE]

I think it's the other way around, anorexia leads to hypogonadism.

HYPOtension is hallmark of adrenal insufficiency.

 

[luke77]

Luke, thanks for the thoughtful reply. Symtoms and abnormalities? I referenced some of them throughout this thread (https://thinksteroids.com/community/threads/134236766), but I'll summarize the way I feel:

Depression - which I am on medication for now (Wellbutrin XL 300mg daily)
Erectile Dysfunction - have been unable to get an erection a few times
Low Libido
Gyno - I've noticed that this developed in the past half a year, and I'm pretty confident that it has gotten worse in the last month.
Extreme Moodiness/Irritability
Loss of memory/ability to recall events/things
Lethargy
Low confidence
Difficulty gaining muscle without gaining more fat (sounds stupid, but I feel like I've had training, nutrition, and sleep all in order and still had horrible results)

I spoke with my endo's nurse tonight and was given lab results. I will also get the results faxed to me later tonight. I was to this endo after getting a blood test at a local clinic.

Luke, where are you located?... I'm asking because it seems like you may have found a real good doc, or no?

No, actually my doc is a specialist in eating disorders - he's a good doctor but doesn't know a whole lot about trt and that kind of stuff. I pretty much have tried to educate myself and I'm seeing an endocrinologist for the first time in about 2 weeks. I looked over your results and it looks to me (obviously i'm not a doc) like you would benefit from trt. What was your endocrinologist's recommendation?

 

[Douche_Nutz]

No, actually my doc is a specialist in eating disorders - he's a good doctor but doesn't know a whole lot about trt and that kind of stuff. I pretty much have tried to educate myself and I'm seeing an endocrinologist for the first time in about 2 weeks. I looked over your results and it looks to me (obviously i'm not a doc) like you would benefit from trt. What was your endocrinologist's recommendation?

I went into the endocrinologist a 10 days ago, and I had to call yesterday to get my results. I was also told at the same time that the doctor's reccomendations would be sent in the mail in 2-3 weeks from yesterday... I'm leaving for college in a week so this is BS... I'm working on getting in contact with the endo right now.

 

[m_ob]

Not sure what this is in regards to...

Anyways, I got my second set of lab results back:

Estradiol: 15 pg/mL - Range: 0-54
TSH: 1.87 uU/mL - Range: 0.40-5.50
Prolactin: 8 ng/mL - Range: 4-18
Free T4: 1.12 ng/dl - Range: 0.90-1.70
% Free Testosterone: 2.9% - Range: 2.0-4.9
Free Testosterone: 8.2 ng/dL - Range: 9-30
Total Testosterone: 284.0 ng/dL - Range: 300-1200

What are your thoughts on these results?

Damn, I know this is an old thread but sounds familar.

 

[m_ob]

Does it not?

 

[m_ob]

Not sure what this is in regards to...

Anyways, I got my second set of lab results back:

Estradiol: 15 pg/mL - Range: 0-54
TSH: 1.87 uU/mL - Range: 0.40-5.50
Prolactin: 8 ng/mL - Range: 4-18
Free T4: 1.12 ng/dl - Range: 0.90-1.70
% Free Testosterone: 2.9% - Range: 2.0-4.9
Free Testosterone: 8.2 ng/dL - Range: 9-30
Total Testosterone: 284.0 ng/dL - Range: 300-1200

What are your thoughts on these results?

Douch Nutz bloods look the same as mine, to a T and there are many others out there who fit into this category. I want to bring eating disorder-induced hypogonadism to the attention of many so that we can resolve and find treatment.

 

[m_ob]

I'd like to add in my theory that if one person is to crack the dilemma, all who have ever been effected will be spared a long, hard road.

 

[chemman]

It is interesting to me that the hypogonadism does not resolve upon normalization of weight. I now weigh more than when I was "healthy," but my T levels are still rock bottom. I do, however, seem to feel a little better as I gain more weight. I'm now 220 at 6'6", which is 20 higher than where I was, but I have lost A TON of lean mass. It's all fat going on right now.

I really think that the potential answer is time. But what if it never resolves completely? Then you just wasted years by not going on TRT. Also low T, for me, causes serious mood disturbances. I think it's bad to allow these thought patterns to continue. Then you have low T depression and depression depression.

 

[m_ob]

It's a damn big snowball and what sucks most is we're so young. If this were to be age-related hypogonadism I would have an easier time excepting it.

 

[m_ob]

J Clin Endocrinol Metab. 2001 Jul;86(7):2982-8.

Serum leptin, gonadotropin, and testosterone concentrations in male patients with anorexia nervosa during weight gain.
Wabitsch M, Ballauff A, Holl R, Blum WF, Heinze E, Remschmidt H, Hebebrand J.

Department of Pediatrics and Institute of Biomedical Technology, University of Ulm, Ulm D-89075, Germany.

Abstract
Amenorrhea in female patients with anorexia nervosa is associated with low leptin secretion, thus suggesting a causal link. In an attempt to address the hypothesis that leptin also influences the hypothalamo-pituitary-gonadal function in males, we studied three male patients with acute anorexia nervosa longitudinally. Serum levels of leptin, LH, FSH, testosterone, and SHBG were measured on a biweekly basis during weight gain. Leptin levels at low body mass index values were below the 5th percentile. During weight gain, leptin levels reached or surpassed the 95th percentile. The temporal dynamics of body mass index and fat mass were closely related to those of leptin concentrations in serum. Leptin increments were paralleled by increments of gonadotropins, testosterone, and the free androgen index (FAI). In each of the patients, serum concentrations of leptin were positively correlated with those of testosterone (P = 0.0001, P = 0.01, P = 0.07, respectively) and FAI (P = 0.0001, P = 0.0001, P = 0.09, respectively). In addition, in the combined data set of all patients changes of leptin over time were positively correlated with changes in LH (P = 0.01), FSH (P = 0.0001), testosterone (P = 0.002), and FAI (P = 0.002). In conclusion, these data suggest that leptin might also play an important role in the regulation of the hypothalamo-pituitary-gonadal axis and fertility in underweight males as has previously been shown in underweight females.

PMID: 11443155 [PubMed - indexed for MEDLINE]Free Article

Now what I take from this is, in anorexics Leptin is low, same with serum testosterone levels suppressed due to LH deficiency from the eating disorder. What strikes me as interesting is that the testosterone level parallels the Leptin level showing a common link between the Leptin status and reproductive function in recovered and struggling anorexics..

 

[63andfighting]

I don't know, never heard of anorexia leading to hypogonadism, how old are you? You could try HCG if you are adverse to life long hormone therapy, I have not really heard fantastic reviews on this. I heard about http://bit.ly/aZwyPX , that might give you an idea what it's all about.

 

[m_ob]

I don't know, never heard of anorexia leading to hypogonadism, how old are you? You could try HCG if you are adverse to life long hormone therapy, I have not really heard fantastic reviews on this. I heard about http://bit.ly/aZwyPX , that might give you an idea what it's all about.

Sixteen, and it does cause hypogonadism.

 

[m_ob]

ABSTRACT
Besides its role in the regulation of energy balance, leptin seems
to be involved in linking energy stores to the reproductive system. A
gender-dependent difference exists in plasma leptin concentration
and leptin messenger ribonucleic acid expression in rodents and humans.
This difference does not seem to be explained simply by differences
in the amount of body fat between genders. To elucidate the
relationship of endogenous testosterone and leptin, we studied the
serum leptin concentrations in 269 elderly nondiabetic men. In addition,
to assess whether exogenously administered testosterone
could influence leptin production, we followed the serum levels of
leptin in 10 healthy men during a 12-month treatment with 200 mg
testosterone enanthate, im, weekly for contraceptive purposes. We
found that the serum leptin concentration correlated inversely (r 5
20.39; P , 0.001) with that of testosterone in elderly men. This
inverse correlation was still present when body mass index and
plasma insulin were included in the analysis. The administration of
testosterone to young men suppressed serum leptin from the pretreatment
level of 3.461.4 to 1.960.6mg/L during the therapy. After
cessation of testosterone injections, serum leptin concentration returned
back to the pretreatment level. It is concluded that testosterone
has a suppressive effect on leptin production, as reflected by
circulating levels of this hormone. (J Clin Endocrinol Metab 83: 3243–