jazzytherunner wrote:
Anouther thing I see now that you told me, is the likelihood of Relative-Energy Deficiency Syndrome(RED-S). Low bone density and recurrent stress reactions are huge red flags for this issue. In relevance to getting leaner believe it or not, low energy availability can cause unfavorable metabolic and/or endocrine changes that make getting lean much more difficult. In fact, many athetes with RED-S find that they gain weight easily. I would check your caloric intake to see if you are in energy balance. Also what blood tests did your doctor do?
Thanks, I seriously considered RED-S but have pretty much ruled it out based on the following (‘+’ refuting, ‘-‘ confirming, ‘*’ inconclusive):
+ Weight hasn’t fluctuated much from long-term ranges, and has slightly increased (3-5 pounds) since I started running and weight training, almost certainly predominantly posterior chain muscle mass increase;
+ Currently have nearly 15% body fat, which is not low for men, and it doesn’t seem to have shrunk at all going by abs and waist size stasis;
+ Eating by hunger to satiety has served me well for a long time and I would find myself eating more on running days;
+ My nutritionist hasn’t concluded that I’m on a troubling calorie deficit though she did agree my calorie intake based on hunger was lower relative to guidelines (but am still back-and-forth’ing with her);
+ No perceivable feeling of fatigue that I could attribute to caloric-deficit-induced BMR reduction;
+ Hormones including testosterone, thyroid, FSH, LH etc. are normal;
+ Am a hobbyjogger running for love of running for a little over a year, not an athlete, so there was no pressure to reach any body or performance targets;
+ No eating or body image issues ever to my knowledge, just a casual desire to have defined abs.
- Developed stress fractures last fall on both feet that seems difficult to attribute to recklessly high mileage as I gradually increased it to just ~30 mpw over several months, and am pretty sure the first stress fracture happened when I was doing just under 20 mpw.
* Vitamin D level is 29.4, which is “insufficient” (but not considered “deficient”) and, by some studies, can increase stress fracture risk (though doc doesn’t think so) but is not attributable to caloric deficit, plus I started taking isolated D supplements to increase it in Dec;
* DXA showed osteopenia in femur (-1 to -2.5) and nearly osteoporosis in spine (-2.1 to -2.5), but it’s unclear that this has anything to do with running or caloric deficit (as opposed to being innate) as I don’t have any past DXA info;
The last bullet above being the most likely explanation is my current hypothesis. My secondary sports doc in another town prescribed bone density increasing medication but I’m waiting for my primary sports doc to review the various recent tests and get his opinion on that medication.