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Int J Sports Med 2012; 33(02): 154-156
DOI: 10.1055/s-0031-1285927
Clinical Sciences
© Georg Thieme Verlag KG Stuttgart · New York

Hypogonadism and Anemia in an Athlete

U. Korsten-Reck
1   Department of Rehabilitative and Preventive Sports Medicine, University Medical Center, University of Freiburg, Germany
,
J. Seufert
2   Department of Internal Medicine II, University Hospital of Freiburg, Germany
,
H.-H. Dickhuth
3   Department of Preventive and Rehabilitative Sports Medicine, Germany
,
Y. O. Schumacher
4   Sports Medicine Section, University Hospital, Freiburg, Germany
,
D. König
1   Department of Rehabilitative and Preventive Sports Medicine, University Medical Center, University of Freiburg, Germany
› Author Affiliations
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Publication History



accepted after revision 22 July 2011

Publication Date:
17 November 2011 (online)

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Abstract

We report the case of a highly trained endurance athlete (22-year-old) who developed anemia (Hb 9.5 mg/dl) over a period of 6 months. Iron deficient or haemolytic anemia, as well as chronic loss of blood, were excluded. Further, laboratory analyses revealed that this athlete exhibited very low levels of testosterone due to a partial hypo­gonadotropic hypogonadism. Following test­o­sterone supplementation, red blood cell indices improved. Although hypogonadotropic hypogonadism is well known to be associated with reduced hematopoesis, it rarely causes anemia in athletes. This should be considered as a possible cause for anemia. Extreme training, unbalanced nutrition or the combination of both, have been shown to be causally involved in the development of secondary hypogonadotropic hypo­gonadism.

Key words

endurance-trained - athlete - anemia - hypogonadism
 

  • References

  • 1 Chahal HS, Drake WM. The endocrine system and ageing. J Pathol 2007; 211: 173-180
    CrossrefPubMedGoogle Scholar
  • 2 Dandona P, Dhindsa S, Chaudhuri A, Bhatia V, Topiwala S, Mohanty P. Hypogonadotrophic hypogonadism in type 2 diabetes, obesity and the metabolic syndrome. Curr Mol Med 2008; 8: 816-828
    CrossrefPubMedGoogle Scholar
  • 3 Dunzinger M, Esterbauer B, Lintner C. Guidelines for hypogonadotropic hypogonadism. Urologyn 2008; 15: 19-20
    PubMedGoogle Scholar
  • 4 Ferrucci L, Maggio M, Bandinelli S, Basaria S, Lauretani F, Ble A, Valenti G, Ershler WB, Guralnik JM, Longo DL. Low testosterone levels and the risk of anemia in older men and women. Arch Intern Med 2006; 166: 1380-1388
    CrossrefPubMedGoogle Scholar
  • 5 Hackney AC. Endurance training and testosterone levels. Sports Med 1989; 8: 117-127
    CrossrefPubMedGoogle Scholar
  • 6 Hackney AC. Endurance exercise training and reproductive endocrine dysfunction in men: alterations in the hypothalamic-pituitary-testicular axis. Curr Pharm Des 2001; 7: 261-273
    CrossrefPubMedGoogle Scholar
  • 7 Hackney AC. Effects of endurance exercise on the reproductive system of men: the “exercise-hypogonadal male condition”. J Endocrinol Invest 2008; 31: 932-938
    PubMedGoogle Scholar
  • 8 Harriss DJ, Atkinson G. Update – Ethical Standards in Sport and Exercise Science Research. Int J Sports Med 2011; 32: 819-821
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Ochsenkühn R. Idiopathischer hypogonadotroper Hypogonadismus und Kallmann-Syndrom. In: Nawroth PP. ZRed. Klinische Endokrinologie und Stoffwechsel. Berlin, Heidelberg, New York: Springerverlag; 2000: 259-263
    Google Scholar
  • 10 Pallais JC, Caudill M, Pitteloud N, Seminara S, Crowley JW. Hypogonadotropic Hypogonadism Overview. In: Pagon RA, Bird TC, Dolan CR, Stephens K. eds. Gene Reviews. Seattle (WA): University of Washington, Seattle; 2007: 1993-2007
    Google Scholar
  • 11 Risser W, Lee E, Poindexter H, West M, Pivarnik J, Risser J, Hickson J. Iron deficiency in female athletes its prevalence and impact on performance. Med Sci Sports Exerc 1988; 20: 116-121
    CrossrefPubMedGoogle Scholar
  • 12 Rowland TW. Iron deficiency in the young athlete. Pediatr Clin North Am 1990; 37: 1153-1163
    PubMedGoogle Scholar
  • 13 Sawka MN, Convertino VA, Eichner ER, Schnieder SM, Young AJ. Blood volume: importance and adaptations to exercise training, environmental stresses, and trauma/sickness. Med Sci Sports Exerc 2000; 32: 332-348
    CrossrefPubMedGoogle Scholar
  • 14 Schubert M, Jockenhovel F. Late-onset hypogonadism in the aging male (LOH): definition, diagnostic and clinical aspects. J Endocrinol Invest 2005; 28: 23-27
    PubMedGoogle Scholar
  • 15 Schumacher YO, Schmid A, Grathwohl D, Bultermann D, Berg A. Hematological indices and iron status in athletes of various sports and performances. Med Sci Sports Exerc 2002; 34: 869-875
    CrossrefPubMedGoogle Scholar
  • 16 Shaskey DJ, Green GA. Sports haematology. Sports Med 2000; 29: 27-38
    CrossrefPubMedGoogle Scholar
  • 17 Venderley AM, Campbell WW. Vegetarian diets: nutritional considerations for athletes. Sports Med 2006; 36: 293-305
    CrossrefPubMedGoogle Scholar
  • 18 Yeap BB, Beilin J, Shi Z, Knuiman MW, Olynyk JK, Bruce DG, Milward EA. Serum testosterone levels correlate with haemoglobin in middle-aged and older men. Intern Med J 2009; 39: 532-538
    CrossrefPubMedGoogle Scholar
  • 19 Yin A, Swerdloff R. Treating hypogonadism in younger males. Expert Opin Pharmacother 2010; 11: 1529-1540
    CrossrefPubMedGoogle Scholar
  • 20 Zitzmann M. Therapy of male hypogonadism. Internist (Berl) 2008; 49: 559-566
    CrossrefPubMedGoogle Scholar