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Date of last update: 10/17/2017.

Forum Name: Endocrinology Topics

Question: Marathon Runner Overtrained - Doctors cannot diagnose

 Sab713 - Sun Oct 25, 2009 12:48 pm

My husband is a marathon runner. He is 31 years old with no medical conditions and is on no medication. About six months ago he began to notice that while running his heart rate had significantly increased and he was becoming fatigued very quickly (he wears a monitor). He kept running, but slowed it down and decreased the frequency. He then took the entire month of Sept off from any activity (no running, weights or yoga) hoping to recover. He has lost weight, is irritable, depressed and says his legs are extremely fatigued while running and his heart rate still races, but only when running. Riding the bike feels fine. He has been tested for Valley Fever (we live in AZ). Negative. He has seen a cardiologist who did an EKG, Echo and a Stress Test. All came back good. He has had a chest xray which showed nothing. From what we've read, he has the symptoms of overtraining, however doctors can not find anything wrong and taking time off has not made him feel any better. Does this sound like overtraining? Are there any tests that can diagnose this? His next step is to see an Endocrinologist, but I want him asking the right questions.
 Dr.M.Aroon kamath - Mon Oct 26, 2009 3:35 am

User avatar Hi,
It could be due to overtraining.
But i am unable to give a better opinion as some information is lacking...
- was his "resting" heart rate normal?
- Were his blood counts normal (especially lymphocytes)
- any problems with erections?
- undue fatigue?
- muscle cramps?
- any suspicion of depression?
- any recent injuries?
If there is nothing remarkable in the above, then one should test his Thyroid profile as the first step.
Good luck!
 Sab713 - Tue Oct 27, 2009 3:40 pm

Thank you Dr. Kamath-
Here is more info:
- was his "resting" heart rate normal? Yes, resting Heart Rate is normal
- Were his blood counts normal (especially lymphocytes) Yes bloodwork came back normal and lymphocytes normal.
- any problems with erections? No.
- undue fatigue? Yes.
- muscle cramps? Soreness but not cramps.
- any suspicion of depression? No.
- any recent injuries? No.

His thyroid was recently tested. He did just get his 2nd chest xray and he has a small pulmonary nodule that is 8mm.
 Sab713 - Tue Oct 27, 2009 6:44 pm

Here are the answers:
- was his "resting" heart rate normal? - Resting HR was elevated, but seems to have stabilized. However, exercise HR is elevated above previous levels at similar stress levels (running pace)
- Were his blood counts normal (especially lymphocytes) - CBC was all normal. Tests were performed in Feb and July. Lymphocyte levels were 1.8 and 1.9 respectively. Differential was performed with the Feb. CBC and all tests were in the normal range.
- any problems with erections? - No
- undue fatigue? - Yes, fatigue and muscle soreness are both symptoms. Along with HR, fatigue and muscle soreness perception are elevated for similar stress levels.
- muscle cramps? - No cramps, but soreness and delayed onset muscle soreness.
- any suspicion of depression? - Maybe, but more related to frustration due to lack of diagnosis and lack of progress in resolution of symptoms.
- any recent injuries? - No classic injuries (i.e. sprains and strains)

Other symptoms:
Disturbed sleep - easily awakened and waking in the middle of the night. 1-2 bathroom trips per night. Also waking in the morning and not feeling rested.

Chest Xray did show a small (8mm) nodule in the right lung base, only visible in PA view, not visible in lateral view. Follow up chest xray (5 weeks) showed same nodule with no change in size, shape, or presentation.
 Dr.M.Aroon kamath - Sun Nov 01, 2009 8:37 pm

User avatar Hi,
Thank you for the two posts( within a space of 3 hours!) in reply to my queries. I got a little confused (typing errors do occur).

I still think it is possible that it could have been overtraining.That pulmonary nodule also may need further evaluation.

Best wishes!

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