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HEALTH CONCERN? BioHealth Health Concerns

Advice for a Challenged Triathlete

Contributing Author: Rubin, Josh O.T.

Josh RubinJoshua Rubin graduated from American International College with a B.S. in Occupational Therapy. After working with the geriatric population for many years, he decided to take his career to the next level. By incorporating corrective exercise, nutrition and lifestyle coaching with his rehabilitation background, he began working with individuals of all ages within the personal training industry. This is where he found his love for holistic coaching, and as a result of developing San Diego’s EastWest Healing & Performance in 2002, he is one of Southern California’s top Personal Trainer, Nutrition and Lifestyle Coach, and Rehabilitation Specialist.

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I am a personal trainer who is a 45-year-old pre-menopausal woman. I do cardio five times a week and strength train almost every day. I am training for my first triathlon in September. At the gym where I work, we have a New Leaf metabolic analyzer. I know my RMR and my V02 max. I train in all my zones every week. Often times, I run in the morning and bike at night, or swim and run, etc. My RMR is 2,300 calories and I write down everything I eat. I try to eat 2,700 a day. I am trying to lose 20 lbs. I weigh 159 and want to be 140. I am 24% body fat (with an Omron). Help!!! What more can I do? Am I eating too much? Not enough? I am on hormone replacement therapy for testosterone, progesterone, and DHEA. I have a thyroid condition and take cytomel and levoxyl. All of my hormones are in normal ranges.

This is a great example of how there can be more than one piece to the healing puzzle. You are learning, as is most of society, that just exercising and eating right sometimes does not cut it. Not to downplay these activities, because they are important, but you can see that there is more to the healing puzzle. There are many questions within your question, so I will do my best to answer them in sections.

PHYSICAL STRESS: When it comes to being a triathlete, overtraining and being in some sort of adrenal fatigue comes with the territory. Overtraining can actually decrease secretory IgA (sIgA) in the gut, which is our first line of defense against foreign invaders. Without sIgA, the strength of our immune system decreases, creating an environment for bacteria, parasites, and fungus, stress on the adrenal glands, hormonal imbalances, and so forth.

During triathlon training, the main goal should be adaptation to your many stressors. This might entail certain types of parasympathetic exercises, eating high quality organic foods, drinking plenty of water, eliminating most lighter colored Gatorade type drinks and replacing them with electrolyte capsules, getting regular soft tissue work, and working with a professional such as Chris Maund for proper training. Doing these things will allow you to train effectively, have homeostasis within and create homeostasis with-out!

HORMONES: At the same time, you need to get out of the mindset that doing more results in weight loss. This is not the case, and you are a prime example. When you overtrain or can’t adapt to the many stressors in your life, your adrenal glands become overworked. You can end up in one of three stages of adrenal fatigue, with Stage 2 or 3 being very common in triathletes. When our bodies are stressed, our adrenal glands overproduce hormones (typically cortisol) to reduce inflammation and to help us handle our stressors. The adrenal glands get these signals from the pituitary. When the adrenals are forced to overproduce cortisol, a process called pregnenolone steal happens. This is a process where pregnenolone (precursor) is stolen from the production of DHEA, testosterone, estrogen, and progesterone to overproduce cortisol. It is how most women develop what is called estrogen dominance (not enough progesterone to counteract the unwanted effects of estrogen), based on my clinical experience and testing.

The problem with being estrogen dominant is that estrogen inhibits T4 to T3 conversion, overloads the liver, inhibits osteoclasts, increases water retention, and is produced and stored in fat cells (these are all symptoms when progesterone is not there to oppose estrogen). The more estrogen dominant you are, the more the body converts hormonal precursors (cholesterol and pregnenolone) to cortisol than to progesterone. This leads to estrogen dominance, which results in excess weight around the midsection and a gluteal cleft area (according to Charles Poliquin, this is where a lot of estrogen receptors are found). Estrogen is stored and produced in fat cells. The more estrogen you have in your body, or the more estrogen dominant you are, the harder it is to lose body fat. Moreover, cortisol is a fat-storing hormone. When your cortisol level increases, so does your insulin level, another fat storing hormone.

My recommendation—and that is all that it is—is to treat your hormonal issues from the precursors down, not from the end products up. My experience has shown me that treatment with DHEA and testosterone, with low precursors, typically will not do the trick. You might feel good when on DHEA and testosterone, but once off them, you will be right back to where you started. Progesterone is fine, but you need to add pregnenolone into the mix, which is its precursor (as well as fats!). You most likely have low testosterone and DHEA levels because of pregnenolone steal. I typically recommend bioidentical progesterone, secondary to the creams stored in plastic bottles (which contain a lot of Xenoestrogens and synthetic solvents, and you can actually measure how much cream is being absorbed into the body).

As for the thyroid issue, many schools of thought believe that this is actually a byproduct of an adrenal issue. You have the HPA (hypothalamus-pituitary-adrenal) and the HPT (hypothalamus-pituitary-thyroid) axis. In simplistic terms, the thyroid is the master gland of metabolism and, with stress and estrogen dominance, it actually slows down to protect the body. Treating it head on gives little results, in my experience. Instead, what I have seen work better to facilitate the thyroid function is using holistic nutrition and lifestyle principles and aggressively balancing adrenal and progesterone levels.

Now with all of this, here is a list of things that you can do:

  1. Follow holistic nutrition and lifestyle principles (eating organic foods, eliminating plastics, sleeping well, drinking lots of water, getting the right types and amount of exercise, and so forth).
  2. Read the book How to Eat, Move and Be Healthy by Paul Chek.
  3. Read the book The Metabolic Typing Diet by Bill Wolcott.
  4. Find a provider who can help you balance your hormones with bioidenticals head on, instead of backwards.
  5. Contact Chris Maund, a professional endurance athlete, skilled endurance athlete practitioner, and certified in endurance training.

Remember, our bodies are three-dimensional representations of what is going on inside. So, you must get healthy to lose weight, not lose weight to get healthy.

Good luck!

Joshua Rubin