Evidence of the Exercise-Hypogonadal Male Condition at the 2011 Kona Ironman World Championships

Prior research has illustrated that high volumes of aerobic exercise result in a reduction in basal concentrations of testosterone in men. Those studies were mostly conducted on recreational runners and identified reduced testosterone, but not concentrations low enough to be considered pathological. Therefore, the purpose of this study was to assess the basal concentrations of testosterone and cortisol in elite triathletes, as well as the impact of a World Championship race, on the acute responses of these hormones.

A total of 22 men (age 40.6 [11.5] y, height 179 [6] cm, weight 77.0 [7.0] kg) who participated in the 2011 Ironman World Championships served as subjects. Resting blood samples were taken 2-4 d prior to provide a baseline (BL), as well as immediately, 1 d, and 2 d after the event and were later analyzed for total testosterone and cortisol concentrations.

At BL, 9 men had a normal testosterone concentration, whereas 9 men fell within a "gray zone" and 4 other men demonstrated concentrations suggestive of deficiency. Testosterone was significantly lower than BL at 1 d (95% confidence interval [CI] 0.10-0.34, P < .001, ES = 0.53) and 2 d (95% CI 0.01-0.21, P = .034, ES = 0.35) after the event. Cortisol was significantly different from BL at immediate post (95% CI 1.07-0.83, P < .001, ES = 8.0). There were significant correlations between time and age (R = .68, P = .001), as well as BL testosterone and cortisol (R = .51, P = .015).

Elite ultraendurance athletes may demonstrate not only reduced testosterone but also sometimes clinically low concentrations that could be indicative of androgen deficiency.