How often does a doctor say “you need to gain weight?” We’re all used to medical professionals (and the media) focusing on weight loss and other ways to prevent diabetes and cardiovascular disease. What’s often overlooked is that a surprising number of otherwise healthy people actually suffer from being underweight, sometimes with devastating consequences.
One group of such people is those with the Female Athlete Triad, with a combination of three elements:
- Too few calories available. This can be due to not eating enough, exercising too much, or both.
- Menstrual irregularities. Menstrual periods can be irregular or absent.
- Bone loss.
This develops into osteopenia and snowballs into osteoporosis. Stress fractures are a key early warning sign. The diagnosis requires a bone density (DEXA) scan and sometimes an MRI to detect early stress fractures.
Why does it matter?
- Amenorrhea is a key part of infertility;
- Osteoporosis can lead to broken bones at any age. The older you are, the more serious the consequences of a break can be. With severe osteoporosis, even normal activities like lifting a box can lead to a fracture;
- Osteoporosis can result in compression of the spine, causing decreased height and deformities like a dowager’s hump (kyphosis);
- Depression, anxiety, and mood disturbances are often related to the hormonal imbalances caused by too much exercise and/or insufficient nutrition;
- Electrolyte imbalances and anemia can both lead to fatigue, cramping, fainting, and under-performance in sport and daily activities;
- Heart arrhythmias and low blood pressure can be life threatening in serious cases of disordered eating and malnutrition.
How does it happen?
Essentially, the Triad is caused by stress on the body. Stress can come in many forms:
- Not eating enough calories;
- Intermittent fasting;
- Cutting out carbohydrates or fat;
- Exercising too much;
- Not having enough body fat;
- Not sleeping enough;
- Taking certain drugs, dietary supplements or medications.
Ongoing stress shuts down the GnRH signal from the hypothalamus, which will stop the production of the hormones FSH and LH. Without FSH and LH, estrogen and progesterone levels will plummet. Estrogen is necessary for bone formation and preservation, so inadequate estrogen guarantees bone loss.
What can I do?
If you (or someone you know) identify with any element of the triad, go see your primary care doctor as soon as possible. The doctor can measure your body fat, order blood work, and request a DEXA scan. The two of you can check your body composition and hormonal status and devise a plan to bring you back to a healthy, bone building state. Alterations in diet, exercise, supplements, and overall lifestyle will likely be necessary. Medically supervised “self tracking” is a useful tool for keeping track of dietary intake, exercise, sleep, body pH levels, and correlating these with changes in bone density. Having a Quant Coach and Quant-friendly Doctor on your team can give you the support and guidance you need to stay on your route to recovery and health.
If you need a doctor who understands these issues, and has a team ready to help, just give us a call here at My Doctor Medical Group.